The essence of psychopathy is characterized as a personality disorder that affects the normal cognition and the prospective features of the brain. This abnormality has been shown to produce: lack of empathy (including guilt), shallow affect, consistent manipulation of others in addition to premeditated violent antisocial behaviour (Brook, Brieman, & Kosson, 2013; Ly et al. , 2012; Viding, McCrory, & Seara-Cardoso, 2014). Psychopaths are unpredictable; their inability to anticipate or comprehend the consequences of their actions can be frightening while albeit simultaneously fascinating.
The mechanisms that govern regular individuals are evidently deficient and/or absent in psychopaths. Consequently, the issue of psychopathy has been an area of heavy controversy. One of the largest controversies in psychopathy is that of children. Researchers and experts in the field are across the board when it comes to how we should handle children that demonstrate extraordinarily high levels on the callous-unemotional (CU) affect trait. Discrimination issues need to be addressed when attending to children with high levels of psychopathic tendencies.
One of the largest issues is how to monitor the children that score high in CU affect without grouping them or classifying them as “psychotic” (in effect, outcasting them from their peers). If monitoring can be established, then there should be a method or series of methods that can be utilized to help children to prevent potential harm to others in the future. Furthermore, to provide a neurological basis, children should be assessed neurologically for psychopathic behaviours (brain areas associated with adult psychopathy).
However, with no defined diagnosis in the DSM-V, this becomes difficult since typical traits in an adult psychopath include grandiose narcissism and impulsivity, both which are natural traits found in children. To control this, baselining both narcissism and impulsivity for children should be considered to help with the assessment of psychopathic tendencies in children. Assessing brain activity in psychopaths is an approach that several researchers and experts have started to favour as psychopathy research moves toward what constitutes the traits.
There is a dichotomy in the research between global and specific impairment in the production of the psychopathic tendencies. Further, there is a divide in the psychological and physiological aspects of psychopaths that are different from regular individuals. The dichotomy may be due to cortical thinning of specific as well as global areas in the brain as shown by (Ly et al. , 2012). Currently, the best approach we have to measure psychopathic tendencies is the Psychopathic Checklist – Revised (PCL-R).
The PCL-R (an assessment used historically in law to determine if someone was a psychopath) is good for defining an individual who may be psychopathic and has evidence to back it up (Walters, 2012). However, an issue with the checklist is that it does not account for rehabilitation if that person is incarcerated due to results based on one’s history (which cannot be changed for the most part). The fact that if a person experiences a traumatic event, it will reflect on the PCL-R for their entire life should be abolished for the rehabilitation.
Instead, a dynamic approach may be better suited. Subsequently, the PCL-R is not intended as a diagnostic tool as it still overlaps with other conditions aligning with constituents of autism and other disorders. In psychopathy, there is a controversial area that consists of the concept of child psychopaths and how to monitor them without specifically discriminating them as a “psychopath”. Naturally, children have the tendency to be overactive and can demonstrate behaviours that would be considered psychopathic, if they were adults (Pardini & Loeber, 2007).
Normally, these actions would be treated as childlike behaviour typical of a child. However, in some cases, extreme demeanor outside of the normal range of behaviours for children over a period (~6 months) can cause complexities. This is where it becomes tough to decide with what actions are required to proceed. In the words of (Viding et al. , 2014), it is unacceptable to label children as psychopaths, however, scoring high in CU traits provide adequate reasoning to monitor those children.
Moreover, this is postulated because a high score in CU traits in children has been shown to have a high correlation of translating into psychopathic adults (Viding et al. , 2014). This is important to address because of their ability to potentially cause emotional and/or psychological harm to others as they age into adulthood. Measures, such as regular monitoring, where children (and their peers) are made unaware of their significantly higher levels in the CU trait are important when preventing future harm in psychopathic prone children.
Monitoring should include a way to further assess children’s psychopathic tendencies longitudinally. In a study by (McDonald, Dodson, Rosenfield, & Jouriles, 2011), children who demonstrated extraordinarily high levels on the CU trait were assessed and then participated in a program that used parent intervention to reduce CU levels. The parent intervention in this study was essentially teaching parents learning strategies to extinguish poor or unwanted behaviour in the child. The results from the (McDonald et al. 2011) study provided evidence toward the reduction of the CU trait through punishment of undesirable behaviour and reinforcement of positive behaviours (McDonald et al. , 2011). Implications from this research include being able to reduce the likelihood of psychopathic tendencies to mature to adulthood, where they often cause the most problems. However, children are still difficult to assess for psychopathy outside of the CU trait.
This is because the features of psychopathy that are used to determine psychopathic tendencies in adults, such as grandiose narcissism and impulsivity, are natural traits of children (Viding et al. 2014). To control for this to better assess child psychopathy, a baseline measure should be taken of narcissism and impulsivity traits in regular children (lower levels of psychopathic tendencies or CU affect). Controlling for these natural traits in children would produce a better understanding of when there are extreme narcissistic and impulsive traits, increasing our ability to benefit them as well as society. Better assessment of psychopathy is another area that is under much debate. There are several divides in the research and treatment of psychopathy that are still controversial.
First, there is a dichotomy in theoretical prospective of how psychopathy manifests (Brook et al. , 2013). There is the General Emotional Deficit (GED) perspective which focuses on the reduction of the global capacity for emotion and the processing of highly charged emotions on a spectrum. Moreover, there is also the Specific Emotion Deficit (SED) perspective which revolves around specific abnormalities with a select set of emotions that psychopaths demonstrate in addition to decreased regional brain activity (Brook et al. 2013). In their research, they reviewed the current literature and compared the differences between psychopathic and non-psychopathic participants.
What they found was that there was no significant finding that made either perspective (GED or SED) more plausible than the other. Both perspectives had evidence to support their respective hypotheses which resulted in inconsistent findings with which perspective was more representative of psychopathy assessment (Brook et al. 2013). Furthermore, Brook et al. (2013) proposed that instead of defining psychopathy between two different perspectives, to instead focus on moderators of emotion processing between psychopathic and non-psychopathic participants. Ly et al. (2012) constituted an initiation of these perspectives by assessing accelerated cortical thinning in psychopaths that would first produce specific deficits and eventually give rise to global deficits.
Their reasoning behind this was the lack of neurological evidence behind psychopathy. They observed neurological scans of psychopathic against non-psychopathic brains and found significant cortical thinning in the former. Consequently, they further want to explain the neurobiological basis of the abnormalities in psychopathy. Ly et al. (2012) found that the left insula and right anterior temporal cortices in addition to the right inferior frontal gyrus had significantly reduced functional synaptic activity.
This reduction in cortical activity was the essence for their assumption of the accelerated cortical thinning in psychopathic brains. Essentially, psychopathy has a particular cortical thinning pattern and decreased functional connectivity resulting in typical psychopathic tendencies (Ly et al. , 2012). While the neurological basis behind psychopathy is one of interest, there is still not enough information behind primarily using it to potentially diagnose a psychopath.
While there is currently no DSM-V entry for psychopathic diagnoses, there is currently the PCL-R which is currently the best method for assessing psychopathic tendencies in adults (Hare, 2016). While this tool has been shown to up to 80% effective in determining repeat offenders of incarcerated individuals, it does not properly assess for the rehabilitation of incarcerated psychopaths (Hare, 2016). Consequently, it used to both convict psychopathic criminals and to assess whether they are fit to be released back into society.
If a criminal is labelled as a psychopath they can either be held in prison or in a mental institution where they are kept until proper intervention and treatment can reduce outbursts (Dimond, 1999). The lack of a dynamic assessment for incarcerated psychopathic individuals is a strong area of controversy that could be addressed. Either, the PCL-R should be removed from reassessing incarcerated psychopaths or more resources should be dedicated to an approach that could accurately determine if an individual’s behaviour has improved.
The fact that the PCL-R relies so heavily on an individual’s history (that cannot be changed) can forever scar their chance to be returned to society. While the current strategy is to reassess with the PCL-R to determine psychopathy with a qualified professional, there is still a problem with incarcerated psychopaths. First, using this tool introduces psychopathy as a spectrum (based on its 40-point scale) which produces an ethical question of where the line is drawn.
Consequently, if psychopaths are habituated for an elongated time, secluded from society, to a prison/institution then is it facilitating or merely accustoming them to their institution’s mindset (i. e. unlike that of everyday society with non-psychopathic/non-criminal external social and physical influences). The inability to properly measure a trait inhibits the ability to manage it which is lacking in the PCL-R as a diagnostic tool. The fact that is can confuse other neuropsychiatric disorder such as autism is also a shortcoming of this tool.