Murderous Minds (9 page)

“We will always need some way of making intelligent decisions about people,” psychologist and former president of the American Psychological Association Diane F. Halpern told a reporter for
Monitor on Psychology
in 2003. “We’re not all the same; we have different skills and abilities. What’s wrong is thinking of intelligence as a fixed, innate ability, instead of something that develops in a context.”
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The study of psychopathy today presents problems just as challenging. While criminal psychopaths often share a remarkably similar constellation of traits, some appear to have more characteristics described in some categories or factors of the PCL–R than others. Non-criminal psychopaths may have their own distinguishing profile of psychological traits.

A few researchers are developing new theories of psychopathy and now the field of psychopathy research has its own Triarchic model developed by Christopher Patrick, of Florida State University, and his colleagues.
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Early in his career, Patrick had done research on pain and lie detection and got interested in psychopathy, a subject he thought “was kind of cool”

when he was a graduate student. He said he was “lucky enough to be at

the University of British Columbia, where Bob Hare, the top expert in the world, was studying the topic with a number of students. I really benefited a lot from that.”
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Patrick’s theoretical model attempts to reorganize, or make better sense of, various descriptions of psychopathy that emphasize different core features of the disorder. Psychopathy, according to this model, includes three distinct components: disinhibition, boldness, and meanness. Disinhibition covers a person’s inability to control their impulses. Pierre, an intelligent college student and a patient of Hervey Cleckley, for example, forged signatures on checks for small amounts of money he did not need. He could have walked a short way to other businesses where he would have been unfamiliar to his victim. Instead, he cashed one forged check in a nearby tavern owned by his girlfriend’s father, making it easy to identify him. His teachers, parents, and authorities were baffled by his behavior. “I just don’t know why I did it,” he first told Cleckley. Later he said he was “impelled by desire for money.” On another day Pierre explained that “It seems there was some sort of an impulse I can’t account for.” A couple of days later he said “I just didn’t think [about] what I was doing.”
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Boldness covers the traits of “social dominance, emotional resiliency, and venturesomeness.” And “meanness” refers to aggressive behavior used to obtain benefits without concern for anyone else. For the term “anyone else,” in many cases you might substitute the word “victims.” The Triarchic model of psychopathy is an effort to reconcile different views of psychopathy. It has already been credited with advancing the assessment of the condition and providing insights into its nature. Future research will reveal whether it can succeed in further clarifying the concept while providing practical guidelines for psychologists and psychiatrists to use in the clinic.

Whether the Triarchic or another model someday provides the best insight and description of the phenomenon of psychopathy, researchers like Adrian Raine acknowledge that there is a counterpoint to the criticism of the suggestion that the PCL–R is not the “Gold Standard” of psychopathy testing, that it is just one way of testing and examining a complex condition: “My perspective is: it’s not 24-karat gold, but it’s 18-karat gold. And for better or worse, we still have the ‘800-pound gorilla’ to contend with.”

Near the end of the discussion he led on the question of the dominance

of the PCL–R psychopathy measure, Raine saw Robert Hare raise his hand. He turned the floor over to the researcher who had pioneered much of the scientific study of psychopathy in the second half of the 20th century, and who had developed (depending on your viewpoint) the Gold Standard and/ or the 800-pound gorilla of psychopathy research.

“The question sounds interesting,” Hare said in a soft Canadian accent. “‘Has the PCL–R strangled research?’ Hardly. As a matter of fact, I would argue that the PCL–R has fomented research in psychopathy with different forms, different approaches, and different instruments. In fact, if you look at the program for this particular meeting, more than half of the presentations have nothing to do with the PCL–R; they have to do with other measuring tools. So I think the question is a mock question, and it is also a red herring.”

Hare went on to mention the problems of using self-report inventories when measuring psychopathy. Their use has serious implications for scientific research, potential new treatments, and, perhaps one day, sentencing. He acknowledged that many of them have very good predictive power, but posed the question: “What is going to happen to the self-report inventories when an offender knows that how he or she fills out the inventory is going to have a direct impact upon what is going to happen to him or her in subsequent hearings? In all of the research we do [in the laboratory], the responses are anonymous, but that is not how it works in the real world.”

Next, Hare addressed the criticism that everything relates back to the cluster of psychopathic traits examined in the PCL–R under the heading Antisocial Behavior, Factor 4. “That is simply not true,” Hare asserted. He explained that results depend on how the data is analyzed, whether various correlations are simplified and what the outcome measure is.

The PCL–R is criticized by Skeem and others because they claim it overemphasizes criminality in the construct of psychopathy. “Technically it does,” Hare said later, “there are some items that involve criminality, but if you take the screening version—the 12-item version—there’s no criminality at all and it is highly correlated with the PCL–R. Whenever anyone criticizes the PCL–R for criminal behavior, they ignore the fact
that we have a parallel instrument that has no criminality in it, and yet does exactly the same thing.”

This issue is so contentious that it almost came to legal blows when Jennifer Skeem of the University of California, Irvine and David Cooke of the Glasgow Caledonian University wrote an opinion piece in 2010 for the journal
Psychological Assessment
. This controversial article criticized what they saw as confusion between the measurement of psychopathic traits using the PCL–R and the very nature or construct of psychopathy. They accused Hare of overemphasizing criminal behavior in the analysis of psychopathic behavior. They concluded: “Failure to distinguish between personality pathology and criminal behavior can only serve to confuse the field.”
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Although the paper had been approved for publication in 2007, Hare obtained a copy before it was published. He felt the opinion piece misquoted his publications and misrepresented his views by using fabrications and straw man arguments. Hare persuaded the senior editor of
Psychological Assessment
to request that the authors reconsider portions of their manuscript that he claimed misquoted and misrepresented his published statements. Skeem and Cooke made some changes, but they were insufficient in Hare’s view. Having exhausted his options for getting the corrections he sought, Hare threatened to sue for defamation if the corrections were not made. “The main issue here is that these authors misrepresented my views by distorting things I said,” he told a
New York Times
reporter in 2010. “I have been doing this work for 40 years and never seen anything like it.”
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Skeem told the reporter: “When we first wrote the paper, we saw it simply as a call to the field to recognize we were going down a path where we were equating an abstract concept with a checklist, and it was preventing us from looking at the concept more closely.”

Publication of the paper was delayed by three years, although it circulated widely among psychologists in the field. It was finally published in June 2010 with changes by the authors. It was accompanied by a response by Hare and a response to his response by Skeem and Cooke. The paper leaves no doubt about how the authors feel about Hare’s body of work relating to the PCL–R and his influence on the field. It makes the point that a test of psychopathy should not be confused with the construct of psychopathy.

Many fellow researchers felt that Hare, for his part, was mistaken to

threaten a lawsuit, no matter how personal an attack he perceived it to be and no matter how misrepresented he felt his work to be. As unpleasant and at times nasty these controversies can be, many believed the battle should have been fought in the journals and not in the courtroom.

Hare, however, has documented several examples where his published statements were changed in the original version of the article by Skeem and Cooke. These misquotes were eventually corrected but only, Hare maintains, after he threatened legal action.
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As he summed up his response to Adrian Raine’s question, “Does the psychopathy checklist have too much of a stranglehold on research in psychopathy?” Hare told the audience that:

The development of new measures is a terrific idea. It’s how science progresses. And if the PCL–R is proven to be inferior to other measures, that’s fine. So far, he noted, “it has been shown to be different, as opposed to inferior.” He continued on to say that it makes sense for researchers to look at psychopathy from different perspectives while trying to focus in on the same construct. (He later described Patrick’s Triarchic model of psychopathy as brilliant but difficult for many people to follow because of the complex detail behind its formulation.)

“On the other hand, I do worry that new tests are being developed so frequently that I think we are in danger of maybe going back to where we were 25 or 30 years ago when we were all talking about the same construct, but were actually measuring many different things or constructs.”

The Sociopath Next Door to the Psychopath

In addition to the dangers of measuring many different things or constructs when trying to understand psychopathy, something the Triarchic model hopes to avoid, people are still struggling with imprecise terminology. Today many people, including many mental health professionals, equate psychopaths with sociopaths. The American Psychiatric Association, and many psychiatrists like Frank Ochberg and psychologists like Martha Stout, the author of
The Sociopath Next Door
, consider a sociopath and a psychopath to be, if not exactly, then practically the same thing. For most clinicians, the differences don’t matter in their work. Frequently, the two
terms also are used interchangeably by many members of the public. The problem with this viewpoint is that some people have assigned different meanings to the word sociopath that, in their minds, distinguish it from psychopath.

There are a couple of reasons the label sociopath gained a foothold firm enough to create confusion in the field of abnormal psychology which is still struggling for agreed upon definitions. In the early part of the 20th century, the word psychopath described not only individuals who lacked a conscience but included others who had additional mental or personality disorders such as weak-mindedness and depression. The term sociopath became popular starting in the 1930s in part because it conveys the impression that the antisocial symptoms can be traced to social influences rather than to biological ones. In the past, social influences in criminal behavior were considered more important than biological influences. Today, the most popular explanation is that both influences contribute to criminal behavior and, very likely, to the development of psychopathic behavior.

As already noted, some people differentiate between sociopaths and psychopaths as if well–understood and well–documented nuances separate the terms. The inclusion of “socio” in the term sociopath may still appeal to people who believe that the origin of the pathology can be traced more to the influences of society than to biology. For them, a sociopath is created but a psychopath is born. Also, use of the word sociopath would be one way to avoid the confusion between psychotic and psychopathic. Sadly, there is no general agreement that the label sociopath reflects these distinctions, and academic researchers favor the term psychopath.

The definition of terms, the popular philosopher and history explainer Will Durant wrote, “is difficult, and ruthlessly tests the mind; but once done it is half of any task.”
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Psychologists do not appear to have reached the halfway point in their task of reaching a reasonable understanding of psychopathy, but there are at least plenty of terms from which they have to choose.

The Word of “The Bible”

The word “sociopath” has multiple definitions and yet is still a byword in popular culture. One of the reasons it persists despite its vagueness is
because the American Psychiatric Association (APA) used the diagnosis
Sociopathic
Personality Disturbance between 1952 and 1968. As a result,
sociopath
has lingered ever since as a synonym for someone who has antisocial personality disorder or is a psychopath.

Today, the APA uses the diagnosis Antisocial Personality Disorder in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-5. This is the encyclopedia-like guide most clinicians and insurance companies use to diagnose and classify mental and personality disorders. It is frequently referred to as “The Bible” of psychiatry because it plays such a central role in the field. Consequently, with so little still understood about the nature and causes of mental disorders, it has been a focus of controversy since it was first published in 1952. But, if someone has a mental disorder, that person can almost certainly find its symptoms listed neatly somewhere in the 947 pages of the DSM-5.