4 ms·

"Psychopath" absolutely has a clinical meaning. While not formally defined in the DSM, it can be diagnosed via the "PCL-R" test [1] administered by a psychiatri

"Psychopath" absolutely has a clinical meaning. While not formally defined in the DSM, it can be diagnosed via the "PCL-R" test [1] administered by a psychiatrist or other qualified clinician. The test has a 40 year history of use in penology. More recently, a lot of interesting research is being done now on the physical basis of psychopathy, using various non-invasive means [2]. [1] https://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist https://en.wikipedia.org/wiki/Hare_Psychopathy_Checklist [2] http://www.newyorker.com/reporting/2008/11/10/081110fa_fact_seabrook?printable=true&currentPage=all http://www.newyorker.com/reporting/2008/11/10/081110fa_fact_...

j_baker 13y ago
The thing is that the literature isn't clear on there being a single agreed-upon definition of psychopathy. The PCL-R test certainly has been successful in a criminal setting. In fact, that's its chief disadvantage: it's too focused on the criminality aspect of it. There are certainly other points of view.
- dbbolton 13y ago
  Hare's definition is rather widely agreed-upon. I doubt there are many mental illnesses that do have a single agreed-upon definition.
- theorique 13y ago
  Good point. The PCL-R is definitely not part of routine psychological / psychiatric practice - your average clinician would certainly not administer that test, for example. It is most commonly used in the penal system, not in mainstream mental health treatment.
maaku 13y ago
Worth noting that the PCL-R test was not designed for clinical use, and its author explicitly discourages such use (among other things, once you start using it widespread, it stops being effective as a measurement tool, and some parts of the test are reflective of history not current condition).
- nzp 13y ago
  There are other test which measure psychopathic tendencies, although they don't necessarily label "psychopathy" as that which they measure, for example some are "amorality" questionnaires (where amorality is roughly defined as a profound lack of regard for other people's feelings and well being etc.). Some are quite successful in discriminating various types of prison populations (that is, it doesn't just say "this person is severely lacking empathy", but it shows there are various types of psychopathic/anti-social trait clusters, and this reflects on real life behavioral history of individuals). I'm speaking from a strictly academic research background with this and a lot of time has passed since I looked into it so I'm not sure if the tests I'm talking about got any clinical use among non-prison population. However, a lot of this can be gleaned from good general purpose personality questionnaires.
lutusp 13y ago
>"Psychopath" absolutely has a clinical meaning. While not formally defined in the DSM ... Would that be the same DSM that's being abandoned by those who know it best? Consider this position taken by the sitting director of NIMH: http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml http://www.nimh.nih.gov/about/director/2013/transforming-dia... Quote: "While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity." Given the present widespread changes in the field of mental health, it might be better to find a more reliable source for views on this topic -- if they exist. As to psychopathy, the linked article says it all -- a researcher finds out he's a dangerous person by reading a brain scan, with no other supporting evidence and copious contraindications.
- nzp 13y ago
  > As to psychopathy, the linked article says it all -- a researcher finds out he's a dangerous person by reading a brain scan, with no other supporting evidence and copious contraindications. Pretty much no, that's not what the article says at all. He didn't find he's dangerous, he found out his brain is lacking in capacity for "empathy, morality and self-control" (which is what he self-observed in the first place). These traits are central to psychopaths, but that does not mean a person with such traits is necessarily violent or actually doing anything overtly anti-social. And that's what the article actually says and tries to explain. A brain scan which shows dysfunction in ventromedial frontal cortex does not mean you're looking at a brain of an anti-social maniac, it's somewhat more nuanced. EDIT: I forgot to mention a very relevant finding: it has been shown that intelligence has a non linear and interesting interaction with psychopathic personality traits. Basically, very high level intelligence can and does act like a defensive factor, extremely intelligent people with such traits are able to compensate the lack of empathy, self-control etc. (the relation is not so simple with lover levels of intelligence, as I said it's not linear). I wish I could give you some reference, but ATM I don't have anything in English at hand, sorry.
  - lutusp 13y ago
deleted 13y ago
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j_baker 13y ago

The thing is that the literature isn't clear on there being a single agreed-upon definition of psychopathy. The PCL-R test certainly has been successful in a criminal setting. In fact, that's its chief disadvantage: it's too focused on the criminality aspect of it. There are certainly other points of view.

dbbolton 13y ago
Hare's definition is rather widely agreed-upon. I doubt there are many mental illnesses that do have a single agreed-upon definition.
theorique 13y ago
Good point. The PCL-R is definitely not part of routine psychological / psychiatric practice - your average clinician would certainly not administer that test, for example. It is most commonly used in the penal system, not in mainstream mental health treatment.

maaku 13y ago

Worth noting that the PCL-R test was not designed for clinical use, and its author explicitly discourages such use (among other things, once you start using it widespread, it stops being effective as a measurement tool, and some parts of the test are reflective of history not current condition).

nzp 13y ago
There are other test which measure psychopathic tendencies, although they don't necessarily label "psychopathy" as that which they measure, for example some are "amorality" questionnaires (where amorality is roughly defined as a profound lack of regard for other people's feelings and well being etc.). Some are quite successful in discriminating various types of prison populations (that is, it doesn't just say "this person is severely lacking empathy", but it shows there are various types of psychopathic/anti-social trait clusters, and this reflects on real life behavioral history of individuals). I'm speaking from a strictly academic research background with this and a lot of time has passed since I looked into it so I'm not sure if the tests I'm talking about got any clinical use among non-prison population. However, a lot of this can be gleaned from good general purpose personality questionnaires.

lutusp 13y ago

>"Psychopath" absolutely has a clinical meaning. While not formally defined in the DSM ... Would that be the same DSM that's being abandoned by those who know it best? Consider this position taken by the sitting director of NIMH: http://www.nimh.nih.gov/about/director/2013/transforming-diagnosis.shtml http://www.nimh.nih.gov/about/director/2013/transforming-dia... Quote: "While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity." Given the present widespread changes in the field of mental health, it might be better to find a more reliable source for views on this topic -- if they exist. As to psychopathy, the linked article says it all -- a researcher finds out he's a dangerous person by reading a brain scan, with no other supporting evidence and copious contraindications.

nzp 13y ago
> As to psychopathy, the linked article says it all -- a researcher finds out he's a dangerous person by reading a brain scan, with no other supporting evidence and copious contraindications. Pretty much no, that's not what the article says at all. He didn't find he's dangerous, he found out his brain is lacking in capacity for "empathy, morality and self-control" (which is what he self-observed in the first place). These traits are central to psychopaths, but that does not mean a person with such traits is necessarily violent or actually doing anything overtly anti-social. And that's what the article actually says and tries to explain. A brain scan which shows dysfunction in ventromedial frontal cortex does not mean you're looking at a brain of an anti-social maniac, it's somewhat more nuanced. EDIT: I forgot to mention a very relevant finding: it has been shown that intelligence has a non linear and interesting interaction with psychopathic personality traits. Basically, very high level intelligence can and does act like a defensive factor, extremely intelligent people with such traits are able to compensate the lack of empathy, self-control etc. (the relation is not so simple with lover levels of intelligence, as I said it's not linear). I wish I could give you some reference, but ATM I don't have anything in English at hand, sorry.
- lutusp 13y ago

deleted 13y ago

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