The psychopathic spectrum


The psychopathic spectrum

Paola Giannetakis, University of North Dakota


In the XIX century, Philippe Pinel (1745-1826), considered the founder of modern psychiatry, and Emil Kraepelin (1856-1926) that echoed the thoughts of Pinel, use, for the first time, the term of “psychopathic personality “.

Today psychopathy is considered a personality disorder characterized by emotional deregulation, highly manipulative behavior, lack of empathy and deviant behavior.

Psychopathy is a type of personality showing emotional detachment and often-antisocial behaviors. The most important characteristics are: lack of remorse, lack of empathy, shallow affect, egocentrism, deceitfulness, impulsivity, and irresponsibility (Cleckley, 1982). Recent research concentrated on the criminal psychopath as a type of psychopathy positively associated with criminal behavior.



In the historical background of psychopathy, as its origins date from the early years of the nineteenth century, different clinical characteristics have been substantially redefined.

Psychopathy has a long tradition of clinical research and in recent decades its validity was supported by a growing development in the field. Although descriptions of psychopaths are found throughout the ages, psychopathy has been extensively described in the twentieth century (Hare) and has started to become a clinical concept only in the late eighteenth and early nineteenth century.

Before then, any discussion of psychopathy as a disorder of patients, had been denied because of mental disorder was seen only as characterized by disorders of the mind or intellect as such. During the nineteenth century, however, psychiatrists began to include it in their descriptions, in addition to mental health problems, including problems concerning the regulation of affections and feelings.

These definitions, combined with the new view that, the anti-social actions could be committed not only by individuals motivated by dark forces, but also by individuals with some kind of disturbance, allowed the establishment of the construct of psychopathy as a real clinical condition.

In the recent years psychopathy has become a psychological stereotype used increasingly in literature and movies.

The stereotype of the psychopath has interested the collective imagination, one of the first figures in the field of psychiatry, who described a pattern of conduct which would later be labeled as psychopathic, was Philippe Pinel, with its description of “Mania without delirium”(Pinel, 1809, cited in Millon, Simonsen, Birket, Smith, 1998). He was one of the first to recognize the possible presence of a free cruel behavior that did not necessarily accompanied by a lack of reason.


The concept developed by Pinel (1809) was further discussed by Kraepelin, who for the first time used the ”psychopathic personality” definition as ”a constitutional and degenerative disorder that produces significant deficiencies in emotional expression “ (Kraepelin, 1904). The characteristics are very similar to those described by Cleckley (1976) In his famous work “The Mask of Sanity” and resumed later by Hare in the construction of the PCL (Hare, 1980) and in the PCL-R in 1991. Several authors tried to identify specific behavioral patterns and personality traits related to the psychopath, attempting further classifications.


“Unstable lifestyle, egocentrism and poor judgment” according to Partridge (1930) were the main characteristics of psychopathy, he also believed that psychopathy and antisocial behavior were two overlapping constructs and suggested the term “sociopath personality” to define and characterize psychopathic individuals.

In the 30’s, Henderson argued that in psychopaths, there is a separation of the emotional and the moral systems, which are in deficit. He suggested that psychopathy had a strong biological base, and those psychological and sociological factors had little influence. In fact, he thought that: “The inadequacy or deviation or failure in adapting to social life is a real illness for which we do not have a specific explanation “(Henderson, 1947).

Henderson distinguished three subtypes: predominantly aggressive, mainly passive, and mainly creative.


Also Karpman, was concerned about the lack of specificity with the diagnosis of psychopathy, in his analysis he said that, in addition to expressing anti-social lifestyles, psychopaths were characterized by a strong need for immediate gratification, lack of anxiety, guilt or remorse for their actions, grandiose sense of self, cruel actions, impulsive and irresponsible behavior. Karpman also described those psychopaths as emotionally immature and superficial. According to this author, psychopaths do not experience the “deep and complex social emotions vehicle as the others”; consequently, they are unable to learn to control their behavior (Partridge, 1930).

Karpman also distinguished two types of psychopathy; of which the first type was considered the true psychopath, characterized by constitutional lack of guilt, insensitivity to others’ feelings and disposition to aggression.

Today the term “psychopath” is used both in psychological and legal settings, although is not included in the Diagnostic and Statistical Manual of Mental Disorder IV-TR.


In psychological terms, there is a four types classifications in use; narcissistic variant, borderline variant, sadistic variant, and antisocial variant. These types are defined basically on the types of inter-relations of the subject, on the patterns of crime, and on the institutional behaviors. According to this classification, the antisocial variant is the more adherent to the Cleckley description. Recent researches put in evidence that can be three behavioral dimension related to the psychopathy; 1) arrogant and deceitful interpersonal style, 2) impulsiveness and irresponsible behavior3) deficient affective experience.



Cleckley defined the behavioral characteristics of the psychopaths; he provided ten core characteristics of the psychopaths;


Selfishness (or egocentricity)

Inability to love

Frequent deceitfulness or lying

Lack of guilt

Callousness or lack of empathy

Low anxiety

Poor judgment and failure to learn from experience

Superficial charm

Failure to follow any life plan

Cycles of unreliability

(Cleckley cited in Bartol and Bartol, 2008).


Criminal Psychopaths ad Successful Psychopaths



Psychiatrists and experts use the term of antisocial personality disorder to define the criminal psychopaths (DSM IV-TR). The Antisocial personality disorder refers to “ a pervasive pattern of disregard for, and violation of, rights of others that begins in childhood and continues into adulthood (APA, 1994 cited in Bartol and Bartol, 2008).

There is a big limitation in this definition; studies have demonstrated that this definition does not extensively identify the psychopathic personality, because only some of the characteristics are identified

Currently the orthodox medical establishment recognizes only the criminal psychopaths, under the definition of ” Antisocial Personality Disorder “. However, there is not a term for the categorization of “successful psychopaths”, which still remain medically unidentified. When the media and medical literature use the term “Psychopath” or “sociopath” refer only to the “small “ minority of criminal psychopathic. (Arieti, 1969).


As discussed, it is clear that psychopathy is a spectrum and not a unique disorder defined by unique shared characteristics, psychopathy has two major possible outcomes, one is a deviant behavior extremely evident, the other is not engaging in violent acts still remaining psychopathic. Actually is common to distinguish between criminal psychopaths and non-criminal psychopaths.


The most discussed aspect is whether the delinquency, or criminal attitude is one of the main characteristics of the psychopathy. This kind of research has developed as a consequence of the higher rates of psychopaths between criminals and inmates.

Although such rates are high, Modern research, has demonstrated that many criminals are not psychopaths and not all psychopaths are criminals (Bartol and Bartol, 2008).


Eysenck (1998) believed that although criminals and psychopaths are both characterized by antisocial behavior, delinquency might not be the outcome in the psychopathic personality (Eysenck, 1998).

In addition, the prevalence of crime in the psychopathic subject may decrease with increasing age but this does not corresponds to an attenuation of the personality traits that remain, however, unchanged over time and resistant to any kind of corrective action making it easier to susceptibility to recidivism and violence (Hare, 1999; Dolan and Doyle, 2000; Harris, Rice, Cormier, 1991).


Criminal psychopaths are only those who demonstrate a persistent antisocial behavior, individuals who demonstrate to be; dominant, manipulative, impulsive with high-risk risk antisocial lifestyle who obtains the thrill from sexual gratification and targets diverse victims over time (Porter et al., 200. Cited in Bartol and Bartol, 2008), the psychopath, because of peculiar emotional characteristics, is qualitatively different from other criminals in his behavior. It has a criminal unique career compared to the frequency of criminal behavior, different motivation and also differencies with respect to the type of crimes committed.

In general, criminal psychopaths are those who seriously violate the laws and social norms, while successful psychopaths use them.


The criminal psychopaths thus, manifest a violent behavior, verbal and physical aggression; according to Hare (1996) they are responsible for a large amount of the violent crimes committed in every society. Psychopaths are involved in serious crimes, murders, torture, rape and sexual abuses, child molestation, child murders, child sexual abuse; they also reoffend faster and more then non-psychopaths. Several studies demonstrated that 65% of psychopaths reoffended within three years of their release, (Quincey, Rice, Harris, 1995, cited in Bartol and Bartol, 2008).


Criminal psychopaths are those who for their starkly evident behavior are identified and stigmatized as such, by medical institutions or by the legal system. Better known as serial killers, swindlers, mobsters, tyrants, madmen, rapists and serious offenders, they are only a small percentage of the real phenomenon of psychopathy and represent only about 1% (Hare, 1998) of the total population.


Cleckley (1976) conceptualization of the disorder included the idea that “successful psychopaths” individuals exist, they are affected by the pathology but still able to function adaptively in the community and try not to break the law.

This group of individuals can be considered as successful psychopaths, those who apparently conform to social ideals and successfully use their personality traits in the field they work, such as corporations, management and other. Some of them use conformity to appear normal, others more ambitious become symbols of success using the charm and intellect to quickly climb corporate, political, academic, religious, military and social organizations. Between 20% and 50% of the population is included in this category.

This dichotomy evidences the difficulty to diagnose psychopathy, as all the instruments at disposition have been validated on a prisoner’s ad criminal’s population and therefore cannot be representative of the entire psychopathic population.



Some believe that early signs can be evident at age of three, the same authors consider, lying, stealing, bullying, cruelty to animals, as warning signs,

It has been discussed if psychopathy is detectable in juveniles, a major concern rise on such investigation, primarily because psychopathy is considered some how incurable and give such stigma to children and young individuals may compromise their entre life. The PCL- Youth Version, the Childhood Psychopathy scale, the Psychopathy screen device, have been used for research purpose and researches underline how such preventive assessment can be a useful tool to prevent future delinquency.

What has to be considered is that psychopathy as all others personality disorders, are difficult to be diagnosed during the developmental stages, the extremely varying nature, that characterize the juveniles, is an important limit. Such manifestations could be related to the turmoil of the adolescence and be interpreted and signs of an antisocial conduct or of an unstable personality.


In this perspective it may be that specific characteristics, such as impulsiveness, may be present in juveniles, but may be not related to psychopathy. (Fersch, 2006)

Given the large number of researches that try to assess the presence of psychopathic signs in young subjects, and the tentative to identify risk factors as to intervene and prevent future crime, a major concern should take into consideration, that such signs are not clearly demonstrating the presence of a personality disorder such as the psychopathy, and that only longitudinal researches can identify reliable results.


Psychopathy is measured using instruments based on the definition of the Cleckley study (1941) The Psychopathy Checklist identifies several area; emotional, behavioral, and social to identify psychopathic characteristics.

The studies on psychopathy evidence that this personality is complex and multidimensional (Bartol and Bartol, 2008).


In the United States, there are facilities in which psychopaths can be sent, but there are not specialized centers to treat this kind of disorders. The major concern is that in the large number of researches, the data demonstrate that such patients do respond n a very limited way to any kind of therapeutically approach.

As being a personality pattern very stable, it becomes even harder to identify a psychological method to modify such patterns. The treatments did have a very low rate of success, probably because of the methods; the most used approach is the risk management. The psychologists are intervening to discuss which is the risk that specific patients or inmates could reoffend.


Related to the risk management, psychologists do try to work on the improvement of the offender’s self-regulation, monitoring on the high risks situation, that may be in the community. As of toady, the recidivism rates remain high in the psychopathic criminals. Primarily because of their specific characteristics, of being deceptive, non compliant and violent, such individuals are very difficult to be treated. (Fersch, 2006) Future research should focus, on the validation of instruments to use in the entire psychopathic population, including those subjects who do not violate the laws. Interesting attempts have been made toward the study of successful psychopaths as of corporation and white collars who do clearly show psychopathic traits in their organizations both as individuals and as companies (Fersch, 2006).














American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders , Elsevier .

Bartol C.R., Bartol A.M. (2008). Forensic Psychology , Sage .

Hare, R. D., Harpur, T. J., Hakstian, A. R., Forth, A. E., Hart, S. D., & Newman, J. P. (1990). The revised Psychopathy Checklist: Reliability and factor structure. Psychological Assessment, 2, 338 –341.

Fersch E.L. (2006) .Thinking About Psychopaths and Psychopathy .Iuniverse.


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