Psychopath

Hollywood fueled popular perceptions of psychopathy with film representations of deranged serial killers such as Dr. Hannibal Lecter, played by Anthony Hopkins in Silence of the Lambs, and unhinged jilted lovers such as Glenn Close's portrayal of Alex Forrest in Fatal Attraction. Off screen, the real-life characteristics of psychopaths can be equally mesmerizing, and include the ease with which the psychopath victimizes others without any remorse or empathy. This frightening characteristic was on display in high-profile crime cases of serial murderers such as Ted Bundy, who confessed to killing 28 women before being executed, and Dennis Rader, the “BTK Killer” from Wichita, Kansas.

The core characteristics of the psychopath are antisocial behavior coupled with the inability to connect with other human beings on an emotional level. For some, the allure of the psychopath is that it is inconceivable that people who appear so “normal”—or as one psychiatrist wrote, wear a “mask of sanity”—feel no guilt or remorse for their antisocial behavior.

Definitions of psychopathy ranged from “insanity without delirium” and “moral insanity” in the 18th century—both indicating moral deficiencies without subsequent deficiencies in intellectual functioning—to the mid-20th-century clinical profile of the psychopath, which contained 16 characteristics, among them egocentricity, lack of remorse, antisocial behavior, absence of delusions and other signs of irrational thinking, and untruthfulness. A more recent contributor defined psychopathy as consisting of characteristics along two dimensions: emotional/interpersonal and social deviance. Along with social deviance characteristics such as impulsivity, poor behavioral controls, need for excitement, and antisocial behavior are also the characteristics that address emotional and interpersonal areas. Among those are glibness and superficial charm, egocentrism and grandiosity, lack of remorse and empathy, deceitfulness, and shallow emotions.

While sometimes used synonymously, psychopathy may be distinguished from antisocial personality disorder (ASPD) as defined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders IV-R. Criteria for ASPD emphasize behavioral characteristics such as disregard for the law, deceitfulness, impulsivity, aggressiveness, [Page 731]irresponsibility, and lack of remorse. Unlike the concept of psychopathy, the ASPD does not include additional emotional deficits such as shallow emotions, superficiality, and grandiosity. Though there is much overlap among antisocial personality, psychopathy, and criminality, not all criminals are psychopaths. Research reveals that psychopathic offenders are more likely to be aggressive and violent than non-psychopathic offenders and also more likely to recidi-vate. The prevalence of psychopathy is estimated at 15 to 25 percent among incarcerated federal offenders.

The most well-known diagnostic tool for psychopathy, is the Psychopathy Checklist (PCL), first developed in 1980 and later revised. The PCL-R is a tool to aid clinicians and researchers in identifying psychopaths and is widely recognized as a reliable predictor for violent behavior. Other instruments used for risk assessment that feature a measure of psychopathy include the Historical, Clinical, and Risk Management Scale and the Violence Risk Appraisal Guide.