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Psychopathy Assessment

Additional Psychology Flashcards




What is a forensic evaluation?
Any evaluation that is conducted specifically for use in a legal forum to assist the decision-maker about the case at hand.
What are some examples of counter transference?
-Fear of assault or harm
-Therapeutic nihilism - the immediate conclusion that person is not treatable
-Hatred and the wish to destroy
-Denial and collusion
-Illusory treatment relationship
-Misattribution of psychological health-psychologist’s/psychiatrist’s hope of therapeutic miracle - emanating from therapist positive projections.
-Helplessness and guilt - passive expression of anger in response to being devalued and rejected
Who coined the term "psychopath" and what were some of the ideas the individual had regarding the disorder?
-Phillipe Pinel (1801/1962)
-Advocated for appropriate, moral treatment (not bloodletting or cold baths)
-Impulsive, able to comprehend their acts, no psychosis, reasoning abilities not impaired – affective condition
-Morally neutral
-Suffered from manie san delire (insanity w/o delirium)
Who coined the term "moral insanity" and what were some of this individual's beliefs?
-J.C. Prichard (1835, British Physician)
-Disagreed with moral neutrality
-“deplorable defect in personality that constituted social castigation” (p.5).
-No volitional control/defense should be legal in nature
What were Kraft-Ebbings views on psychopathy?
-Less sympathetic than B. Rush
-Impervious to treatment (if done, must in asylum)
-Severe condemnation
-“without prospect of success… these savages… must be kept in asylums for their own good [good] and [for] the safety of society”
Who began the modern conception of psychopathy and what were some short comings of his research?
-Hervey Cleckley
-Mostly based on the Caucasian, middle class patients residing in psychiatric hospital
-Normal socializing experience were ineffectual with psychopath
-Criminal history was not the focus as many never became involved in the criminal justice system
What were some of the features of Cleckley's psychopath (16 total)?
-Superficial charm and good intelligence
-Pathological egocentricity and incapacity for love
-Untruthfulness and insincerity
-Lack of remorse or shame
-General poverty in major affective reactions
-Unresponsiveness in interpersonal relations
-Sex life impersonal, trivial and poorly integrated
-Failure to follow any life plan
-Inadequately motivated antisocial behavior
-Poor judgment and failure to learn from experience
-Absence of delusions and other signs of irrational thinking
-Suicide very rare
-Absence of nervousness
-Specific loss of insight
-Fantastic and uninviting behavior
Describe the DSM evolution of psychopathy and psychopathy related disorders
-DSM (1952): Sociopathic Personality Disturbance; Focus was on internal processes rather than behavior which eventually gave way during later iterations
-DSM-II (1968): Focused more on antisocial behavioral elements; Still contained elements of personality traits of psychopaths
-DSM-III (1980) and DSM-III-R (1987): ASPD; Emphasized behavior – greater reliability; Included Conduct Disorder before age fifteen; Polythetic model of diagnosis
-DSM IV-TR: Antisocial Behavior since age 15, repeated criminal acts, deceitfulness,
impulsivity, recklessness, irresponsibility,etc.; Current age at least 18; Conduct disorder before the age of 15, as indicated by clinically significant impairment in social, academic or occupational functioning resulting from three or more of the following:
Occurrence of AB not exclusively during the course of Schizophrenia or manic episodes.
What is a polythetic category?
Having many, but not all properties in common.
What are the differences between ASPD and psychopathy?
-Psychopathy is defined in terms of personality traits and behaviors whereas APD is based largely on a social deviance model defined predominately in terms of antisocial and criminal behaviors.
-Psychopathy can be understood as a disorder composed of selected features of all Cluster B syndromes.
-Psychopathy is more predictive of APD than APD is of psychopathy
-Inmate populations: base rate for APD is 75% and base rate for psychopathy is about 25%
-Most psychopaths are APD but most APD are not psychopaths
What is psychopathy?
Personality constellation of character traits, specifically affective, interpersonal and behavioral in nature, central to which are profound lack of guilt and a callous disregard for the feelings, rights and welfare of others.
Describe some findings of research on psychopathy
-Begin criminal career earlier, commit more types of offenses and offend at a higher rate than non-psychopaths.
-Burnout not as present.
-While incarcerated, engage in more disruptive behaviors than non-psychopaths.
-Engage in instrumental violence (predatory) versus expressive violence (affective) -- motivated by vengeance, retribution, sadism, money.
-Combination of psychopathy and sexual deviance is associated with higher recidivism among sex offenders.
-Demonstrate less motivation, effort and improvement in treatment.
Describe a few characteristics of the PCL-R
-Norms based on incarcerated offenders
-Data is obtained by:
review of case history, including collateral resources (required)--valid assessment requires collateral information
interview and/or observation (recommended)
-Each item is scored on a three point scale
2- item applies
1- item applies to certain extent
0- item does not apply
-range of scores 0-40
-diagnostic cut-off = 30 (3.25)
Factor 1 items of the PCL-R are called ______/_______. What does this include?
(1) glibness/superficial charm
(2) grandiose sense of self-worth
(4) pathological lying
(5) conning and manipulative
(6) lack of remorse or guilt
(7) shallow affect
(8) callous/lack of empathy
(16) failure to accept responsibility for own actions
Factor 2 items of the PCL-R are called ______ _______ _____. What does this include?
-Socially deviant behaviors
(3) need for stimulation/proneness to boredom
(9) parasitic lifestyle
(10) poor behavioral controls
(12) early behavioral problems
(13) lack of realistic long-term goals
(14) impulsivity
(15) irresponsibility
(18) juvenile delinquency
(19) revocation of conditional release
(20) criminal versatility
Which PCL-R items do not load on factor 1 or two?
(11) promiscuous sexual behavior
(17) many short-term marital relationships
In Cooke and Michie's revised model of psychopathy (2003), which three PCL-R factors were included?
-Arrogant and Deceitful Interpersonal Style
(1) Glibness/superficial charm and (2) grandiose sense of self worth
(4) Pathological lying and (5) conning manipulative
-Deficient Affective Experience
(7) Shallow affect and (8) callous lack of empathy
(6) Lack of remorse or guilt and (16) failure to accept responsibility
-Impulsive and Irresponsible Behavioral Style
(3) Need for stimulation/proneness to boredom, (14) impulsivity and (15) irresponsibility
(9) Parasitic lifestyle and lack of (13) realistic long term goals
In Cooke and Michie's revised model of psychopathy (2003), which PCL-R factors were excluded?
(20) criminal versatility – no loading
(19) revocation of conditional release – Factor 2
(18) Juvenile delinquency – Factor 2
(17) Many short-term marital relationships – no loading
(12) Early behavioral problems – Factor 2
(11) Promiscuous sexual behavior – no lading
(10) Poor behavioral controls – Factor 2
What are some shortcomings of psychopathy research on the brain?
-Studies have discrepant findings
-Structural and functional differences
-Definition of psychopathy differs
-Tests use and diagnoses
-Small sample size
-Replication or cross-validation difficult as methods are not identical
What are some characteristics of the autonomic nervous system?
-AKA Visceral nervous system
-Part of the peripheral nervous system
-acts as a control system, maintaining homeostasis in the body
-maintenance activities are primarily performed without conscious control or sensation.
What does the sympathetic and parasympathetic nervous system do?
-Sympathetic Nervous System activates the body for an emergency
-Parasympathetic Nervous System counterbalances the sympathetic system to
return to baseline arousal state
What are some general findings of fMRI studies on psychopathy?
(BOLD) blood oxygen level dependent
-Decreased activation for emotional v. neutral stimuli
-Decreased activation for fearful stimuli
-Decreased activation for moral decision tasks
-Decreased activation for aversive stimuli

Structural areas of the brain are underactive/smaller
-Frontal/prefontal cortex
-Temporal-subcortical structures (Amygdala/hippocampal areas)
How are EEG findings on psychopathy?
Inconsistent, although there is a possible deficit on cognitive information processing tasks
Describe the myelination process in infants
1-Fat layer in which the sheathing of the brain allows nerve cells to communicate with each other
2-Very rapid from newborn until one year old
3-Process goes well, then the response of baby runs well
4-Continues until baby is five years old
5-Fastest process is in the first year of baby’s life
List and describe the four stages of development according to Piaget
1. Sensorimotor Stage
Birth through ages 18-24 months
focus on what they see, what is in front of them, what they do, physical interactions with immediate environment, object permanence

2. Preoperational
Toddlerhood (18-24 months) through early childhood (age 7) think about things symbolically, language use becomes more mature, develop memory and imagination

3. Concrete operational
Ages 7 to 12 logical, concrete reasoning, less egocentric and they are increasingly aware of external events, reversible mental actions, simple problem solving

4. Formal operational
Adolescence through adulthood.
who reach this fourth stage of intellectual development are able to logically use symbols related to abstract concepts, multiple complex systems simultaneously
Describe what is known about the etiology of psychopathy
-Bottom line… we do not have a full understanding of the etiology of psychopathy
-Majority of theories point to a congenital pathway
-This has significant implications for treatment
-There appear to be differences between instrument and reactive violence
-Attachment, empathy and remorse
Describe Mahler's separation/individuation process
1. Normal Symbiotic Phase:
First signs of conscious awareness at four to six weeks until about five months of age
Infant is now aware of its mother, but no sense of self
Infant and mother are as one

2. Separation-Individuation Phase:
Breaks out of its “autistic shell” and begins to connect with its environment and with the people in it.
Development of limits and to the differentiation in the infant’s mind between the infant and the mother.
Individuation refers to the development of the infant's ego, sense of identity, and cognitive abilities. Three sub-phases - occur in the following order, but which often overlap in time:

3. Separation-Individuation Phase:
Breaks out of its “autistic shell” and begins to connect with its environment and with the people in it.
Development of limits and to the differentiation in the infant’s mind between the infant and the mother.
Individuation refers to the development of the infant's ego, sense of identity, and cognitive abilities.

Three sub-phases - occur in the following order, but which often overlap in time:
1. Hatching (5 to 9 months):
The infant becomes aware of the differentiation between itself and its mother
Becomes increasingly aware of its surroundings and interested in them, using its mother as a point of reference or orientation.
2. Practicing (9 to 16 months):
Can now get about on its own, first crawling and then walking freely.
Begins to explore actively and becomes more independent of its mother.
Sill experiences itself as one with its mother.
3. Rapprochement (15 months and beyond):
Becomes close to his mother, but begins to differentiate itself from his mother. Physical mobility demonstrates psychic separateness from his mother.
May become tentative at this point, wanting his mother to be in sight so that, through eye contact and action, he can explore his world.
Mahler described three phases of rapproachment. What were they?
Motivated by a desire to share discoveries with his mother.

Torn between staying connected with his mother and venturing out from his mother and becoming more independent and adventurous.

Resolves crisis according to the dictates of his own newly forming individuality, use of language, and to his interaction with the temperament of his mother.
Describe some early environmental factors associated with psychopathy
-Mother is primary object of internalization - failure
-Trust vs. Mistrust (Erikson, 1950) and “holding environment” (Winnicott, 1962) is weakened as result of absence of consistent, predictable and predominately nurturing experiences
-Father’s role in regard to mother’s behavior
-Internalization fails
-Psychopathic process crystallizes around the end of the separation-individuation process
-Child incorporates “hard” objects
--Painful experiences
-Anticipation (early) of soothing experiences and subsequent expectation that environment is distrusting/not available leads to:
--Anticipation of malevolence
--Unconscious disavowal for need for soothing
--Narcissistic shell
What are some features of Moffit's Life Course Persistent Pathway?
-Neuropsychological deficits interact cumulatively with their criminogenic environments
-Difficult temperament as infants
-Early onset
-Attention deficit problems
-More likely to be male
-Commit a wide range of criminal offenses
-More violent behavior
-Poor prosocial skills and interpersonal relatedness
-Rejected and avoided by peers
-Parents, teachers and caretakers become frustrated and may avoid them
-Continue antisocial behavior and acts through adulthood
In their review of psychopathy literature, what did Reidy et al find (models)?
-Low arousal model:
--Abnormal low levels of autonomic nervous system
--Stimulus hunger, seeking high risk activities
--Compensates for boredom

-Response modulation model:
--Develop a mindset of seeking out specific goals
--Oblivious to extraneous stimuli such as punishment
--Don’t learn from mistakes in the face of reward and punishment

-Fearlessness Model
--High fear threshold
--Don’t anticipate or perceive the impact of punishment

-Integrated emotion system model:
--Dysfunction of amygdala
--Empathy does not develop
Describe the cognitive model of psychopathy
-Hostile attribution bias
--Interpret, perceive or attribute ambiguous or neutral situations as hostile, threatening or aggressive.
--Define social problems in hostile manners
--Generate few alternatives
-Aggression is method to manage situation and solve conflicts
-Hostility and/or confrontation is the most direct manner of management
Name and describe the two types of violence
1. Hostile, reactive or expressive
-Occurs in response to anger-inducing situation.
-Goal is to make a victim suffer.
2. Instrumental
-Competition or the desire for some object or a person that is possessed by another person.
-Goal is to obtain something of value.
Name some interview strategies with regards to interviewing a psychopathic individual
-Familiarize self with psychopathy construct and strategize in advance
-Safe environment
-Bonding or appealing to guilt not an option
-Simplify goals
-Don’t expect anxiety or embarrassment and be prepared to be devalued
-You are constantly being monitored
-Decide in advance how to handle manipulation or deceit
-Carefully consider coercive tactics
-Review insecurities with colleagues and supervisors
-If threatened, consult
-Maintain calm and immunize self from flattery
What are the two factors in Hare's PCL-R?
1. Affective and interpersonal components - primary
2. Behavioral (lifestyle) functioning
Can you use the PCL-R to assess psychopathic traits in people under 18?
No, although you can use the PCL-YV
The PCL-R is composed of two factors, which are broken down into 4 facets (2 facets per factor). Name the 4 facets
Facet 1: Interpersonal
Facet 2: Affective
Facet 3: Lifestyle
Facet 4: Antisocial
What are the limitations of the PCL-R?
-Did not utilize random stratified samples resulting in uneven, possibly biased data.
-Lack of ethnic and cultural considerations.
-Only two ratings were used to score items in a small portion of the sample (i.e. only 2 female samples).
-A significant portion of the data was interpreted from file only reviews.
-Differences in the age, gender and race of the raters were not considered .
In general, the predictive abilities of the PCL-R with regards to recidivism, treatment outcome, and violent behavior are _______.
Is it possible that persons with psychopathic character traits unable to control themselves?

Is it possible that they simply can’t control themselves?
-Psychopaths take risks where they attempt to minimize potential harm to them whereas maximize benefit
-Psychotic individuals engage in conduct that places their welfare at risk
-Psychopathic individuals use some reasoning to guide their conduct in ways that is cognizant of reality in self-serving manners.
The base rates of conduct disorder range from ___% to ___%. With regard to convicted juvenile populations, it's ___% to ___%.

How might a language deficit affect a person's antisocial behavior?
-Inhibitory mechanisms preventing antisocial behavior
-Some models propose indirect relationship between verbal deficits and antisocial behavior
--Left cerebral hemisphere damage may make it difficult for the person to SAY what they want, so they just do it
What are some psychosocial factors that can affect psychopathy?
-Childhood fighting
-Hyperactivity, withdrawn, aggressive
-Abuse, physical and psychological
-Harsh parenting
-Early antisocial influences – key factor
--Drug availability
--Criminogenic attitudes
How common is violence and aggression in development? Are adolescents committing crimes evenly?
-Very common
-Rates of criminal activity during adolescence are so high that it is statistically normative.
-A small portion of juveniles are responsible for a majority of violent offenses
How does early onset of violence/criminality affect a person's outcome?
-Fifty percent of youth continued violent behavior into adulthood when the onset was prior to 11 years of age.
-Serious persistent delinquency begins early in childhood.
-Thirty percent of youth continued violent behavior into adulthood when the onset was between 11 – 13 years of age.
-An estimated 10% of youth continued violent behavior into adulthood when the onset was during adolescence.
Does psychological maturity have anything to do with age?
No, nor with physical maturity or the seriousness of a crime
Does a person's current offense predict their recidivism rates?
In 2002 Myers found that juvenile sexual offenders had what features?
-Impaired capacity to feel guilt
-Neuropsychological impairments
-Serious school problems
-Child abuse
-Family dysfunction
-History of interpersonal violence
-Prior arrests
-Sadistic fantasy
-Psychopathy personality traits
-Personality disorder – schizoid or schizotypal
What are the key differences between a successful and unsuccessful psychopath?
-Increased heart rate stress reactivity and enhanced executive functioning
-Higher number of arrests but few convictions
-Did not have asymmetry in the hippocampus and reduced gray matter in the prefrontal cortex and amygdala
-Greater indirect/relational types of aggression, which is more difficult to detect and allows the psychopath to better manipulate and sabotage coworkers.
In "Psychopathy and Brain Function," the authors learned that although psychopaths have less volume in certain brain areas, they actually have increased ______. How useful do the authors believe expert testimony is on psychopathy in court settings?
Activity; Modest at best. Even if the expert were to prove decreased emotional processing, that's not an excuse for murder
In "Amygdala dysfunction attenuates frustration-induced aggression," students with high psychopathic scores tended to use ____ rather than ____ aggression. Those areas that moderated _____ _____ and were responsible for long-term planning showed ___ volume for the unsuccessful group.
Instrumental; reactive

Impulse control; less
In "Brain abnormalities in antisocial individuals," the authors found the brain areas that most separated the antisocial groups the...
What do these areas do?
Prefrontal cortex, superior temporal cortex, amygdala–hippocampal complex, and anterior cingulate cortex.

Contribute to impulsivity, poor planning, irresponsibility, lack of regard for rules, and moral impairments.
In "Brain abnormalities in antisocial individuals," what did the authors have to say about using brain imaging in court?
These images are often for experimental purposes and lack the empirical foundation requisite for probative evidence. Further, the images themselves can only be properly interpreted by individuals with extensive training, and a jury should not make a decision based on a hasty explanation from an attorney. The images arguably are just as prejudicial as crime scene photographs of a violently murdered victim.
Did Murrie, Boccaccini, Johnson, & Janke, (2007) find that a PCL-R rater was biased towards the legal party that retained him or her?
In their 2010 article, Skeem & Cooke contend that criminality is or is not a central feature of psychopathy?
Is not, however the two are associated
Commenting on Skeem and Cooke's article, Hare & Neumann state that criminality is or is not a component of the PCL-R? What is their justification for this?
Is not; It is antisociality, not criminality, that is a theoretical construct of psychopathy and that a series of "problematic" and not criminal behaviors form part of the key elements of the disorder.
What did Lindberg (2012) find about psychopathy in adolescents?
-Studies have indicated intrauterine factors such as not enough omega 3 fatty acids and decreased heart rate and abnormal EEGs in children with psychopathic traits, as well as decreased volume in several key brain areas (namely the amygdala)
-Family structure and histories are also factors that impact the probability of developing psychopathic traits.
-Children with these features tend to commit more crimes and more violent/sadistic ones, as well as having more behavioral problems in general. These characteristics appear to be relatively stable throughout the child's life
Logan & Weizmann-Henelius (2012) found what with regards to women and psychopathy?
-The rates at which the disorder occurs among male and female populations differ, with women having lower rates unless the sample is drawn from high-security forensic populations
-Women and men display aggression in different ways (men in a more physical sense and women in the relational sense)
- Women tend to be more manipulative, emotionally unstable, and with a more unstable self-concept.
Viljoen, MacDougall, Gagnon, & Douglas (2010) article on psychopathy in juvenile proceedings revealed what?
-The PCL-R was used to demonstrate the low probability that the youth would reoffend, as opposed to adults where the opposite is true
-The ultimate legal decision appeared to have been unaffected by the presence of lack of psychopathy evidence.
Kreis, Cooke, Michie, Hoff, & Logan (2012)'s article discussing the Comprehensive Assessment of Psychopathic Personality (CAPP)revealed what?
-Utilized dynamic, not just static charactearistics
-Measures personality traits rather than behaviors for better specificity
-Arranged along a prototypical range rather than using a categorical approach
-Both sensitive and specific to psychopathy with good content validity overall
-More comprehensive than PCL-R
In Hawes & Boccaccini (2012) article on psychopathy and the risk of sexual recidivism, what did the authors discover regarding PCL-R predicitive capabilities?
How is this capability affected by high sexual deviance scores? Is the PCL-R better at predicting general or sexual recidivism?
-If you control for factors 1 and 3, the capability goes up
-When combined with sexual deviance a person's risk of reoffending goes up
In Murrie, Boccaccini, Caperton, & Rufino's (2012) study on the PCL-R's ability to predict sexual recidivism IN THE FIELD, what was discovered?
That the PCL-R is better at predicting violent recidivism and that field predictions were less accurate than research ones
In Babiak and Hare's article on corporate psychopathy, how were psychopathic traits seen in the business world? Give a few examples.
Was this association seen in all areas of business?
-As assets. The psychopathic person was seen as ambitious, had good communication skills, and were innovative thinkers. Having unrealistic goals was interpreted as having "vision"
-No, they were seen as poor team players and managers
How does psychopathy related to economical, war, and organized crimes?
-Economical: the personality of white collar offenders sounds quite similar to a description of a typical psychopath

-War: complete lack of empathy and remorse allows psychopath to commit the acts, while an ability to manipulate people and twist information could allow the criminal to garner public sympathy
-Organized: manipulative abilities will prove worthwhile in leadership positions as a means to get subordinates to follow them. When in contact with society at large, the psychopath’s superficial charm would be useful to create public sympathy for his or her group, and a lack of empathy is especially helpful should corporal punishment be administered to deviant gang members.
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