Psychopaths Among Us: Retired University of British Columbia professor of psychology Robert Hare is a world’s expert on psychopathy and developer of a gold standard rating scale for its recognition, and he’s in anguish.
“The PCL-R has slipped the confines of academe, and is being used and misused in ways that Hare never intended. In some of the places where it could do some good — such as the prison in the TV documentary I was yelling at — the idea of psychopathy goes unacknowledged, usually because it’s politically incorrect to declare someone to be beyond rehabilitation. At the opposite extreme, there are cases in which Hare’s work has been overloaded with political baggage of another sort, such as in the United States, where a high PCL-R score is used to support death-penalty arguments, and in England, where a debate is underway about whether some individuals with personality disorders (such as psychopaths) should be detained even if they haven’t committed a crime.”
Hare believes that a large number of people — perhaps 1:100 of the population — who are not violent criminals are nevertheless ‘subclinical psychopaths’ among us. [link courtesy of David Brake]
Recall my grumblings below about the DSM system of diagnosis (with regard to another controversial diagnosis, PTSD). Here‘s an article by Hare about the confusion between the sophisticated concept of the psychopath and the closest official DSM diagnosis, antisocial personality disorder.
The problems with DSM-III and its 1987 revision (DSM-III-R) were widely discussed in the clinical and research literature (Widiger and Corbitt). Much of the debate concerned the absence of personality traits in the diagnosis of ASPD, an omission that allowed antisocial individuals with completely different personalities, attitudes and motivations to share the same diagnosis. At the same time, there was mounting evidence that the criteria for ASPD defined a disorder that was more artifactual than “real”.
And this is more information, if you’re interested, on the concepts.
People like serial killers who cannot contain their urges to kill repeatedly for no apparent reason are assumed to suffer from some mental illness. However, they may be more cruel than crazy, choosing not to control their urges, knowing right from wrong, knowing exactly what they’re doing. In such cases, they fall into one of three types that are usually considered aggravating circumstances in addition to their legal guilt — antisocial personality disorder (APD), sociopath, or psychopath — that are neither insane nor psychotic. APD is the most common type, afflicting about 4% of the general population. The American Psychiatric Association estimates that 3% of all males in our society are sociopaths. Psychopaths are rare, found in perhaps 1% of the population.
