A Little Clarification on Psychopathy

HARE, R. (2006). Psychopathy: A Clinical and Forensic Overview Psychiatric Clinics of North America, 29 (3), 709-724 DOI: 10.1016/j.psc.2006.04.007

Guay, J., Ruscio, J., Knight, R., & Hare, R. (2007). A taxometric analysis of the latent structure of psychopathy: Evidence for dimensionality. Journal of Abnormal Psychology, 116 (4), 701-716 DOI: 10.1037/0021-843X.116.4.701

So there's some confusion about the differences between the diagnoses of psychopathy and Antisocial Personality Disorder (APD). Well, to make matters worse, the Diagnostic and Statistical Manual of Mental Disorders (DSM) goes and equates the two. Dr. Geiselman has said in his lectures that the difference, in his experience, is that psychopathy is characterized by delusions, hallucinations, and other sensory phenomena. Okay, for the test you're going to want to go with this definition; however, I tend to prefer the definition offered by one of the primary researchers on psychopathy, Robert Hare. Did I ever mention how much great forensic research comes out of Canada? Hare's based in the University of British Columbia, and he developed the Psychopathy Checklist thirty years ago, which has become the instrument to assess psychopathy.

As summed up in a recent overview (Hare 2006), psychopathy can be subdivided into four main factors:

1. interpersonal (glibness, narcissism, conning behaviors, etc.)
2. affective (lack of remorse, shallow affect, etc.)
3. lifestyle (need for stimulation, parasitism, impulsivity, etc.)
4. antisocial (criminal versatility, poor control, etc.)

Notice there's no mention of hallucinations or disordered thinking among these factors. So how does this compare with APD? According to the DSM, they're synonymous. However, taking a real look at them, APD is diagnosed entirely by manifest behaviors, while psychopathy is an attempt to define a personality type by the underlying cognitive and relational patterns. As Lykken (quoted in Hare 2006) puts it: "Identifying someone as ‘having’ APD is about as nonspecific and scientifically unhelpful as diagnosing a sick patient as having a fever or an infectious or a neurological disorder." APD is the symptom; psychopathy is the disease. There's significant overlap in diagnoses of APD and psychopathy, but there are also significant numbers of people who fail to meet both definitions.

There have been numerous attempts to put psychopaths into a taxon, a group used for classification - either you're psychopathic or you're not. However, these attempts have consistently failed to find evidence supportive of a taxonomic system. Hare (2007), in a large and diverse sample, again tried to perform a taxometric analysis, but could only find evidence for dimensionality. What does this mean? Well, there are several reasons why a legitimate taxon could be covered up in an analysis, but if psychopathy is truly dimensional, it means that there are no clear, defining lines between those with psychopathy and those without. It may just be a scale on which a given person is either high, moderate, or low.

Article #6 - Blanchard et al. and Measuring Pedophilia

Blanchard, R., Kuban, M., Blak, T., Cantor, J., Klassen, P., & Dickey, R. (2006). Phallometric Comparison of Pedophilic Interest in Nonadmitting Sexual Offenders Against Stepdaughters, Biological Daughters, Other Biologically Related Girls, and Unrelated Girls Sexual Abuse: A Journal of Research and Treatment, 18 (1), 1-14 DOI: 10.1007/s11194-006-9000-9

So now we're delving into the mind of the pedophile. It's a disturbing, uncomfortable place to be, but it can also be quite fascinating and revealing of human nature in general. To me, at least, it's much more interesting to study the fixated, or "classical," pedophile, versus the opportunistic molester. They are generally much more deliberate and provide much more elaborate reasons for their behavior, which can be traced to the fact that they have a genuine attraction to children. While the opportunistic offender generally operates under a mixture of drugs, rage, and hormones, the fixated offender often truly appears to believe that they are doing something that should be okay, if only society loosened up.

Of course, there are differences among fixated pedophiles, as well. The paper for this week provides a good look at not only what these differences are, but also the techniques used to study this kind of behavior. The researchers got their subject pool from community and legal referrals for "illegal or disturbing sexual behavior" (except for the controls, who were referred by physicians), and they were grouped by their relation to the victim: biological fathers, stepfathers, nonpaternal incest, unrelated molesters, offenders against women, and the control group, who had no illegal activities but reported sexual complaints.

In order to gauge the degree of pedophilic orientation in each of these groups, the researchers employed a phallometric device - basically, a pressure gauge that fits over the penis. The subjects then heard descriptions of sexual acts with various subjects, male and female, ranging from prepubescents to adults, accompanied by slides. To get the "pedophilia factor approximation score" the results for the adult descriptions were subtracted from those of the prepubescent and pubescent descriptions.

As you can see in Fig. 1, there was a clear trend between relation to victim and pedophilic score. As the authors broke it down, the less of a social relation a perpetrator had to his victim, the more his pedophilic orientation. It appears that the more effort a person exerts to get to a victim, the more pedophilic he is likely to be. Interestingly, the biological fathers and stepfathers scored equivalently, while nonpaternal but related perpetrators scored on par with unrelated molesters. However, if you'll remember from class, stepfathers are more likely to offend than biological fathers (i.e. the percentage of stepfathers who are molesters is higher than the percentage of biological fathers who are molesters), which Dr. Geiselman attributed to some planning or manipulations by stepfathers who only marry for access to children. This would imply that stepfathers should display more of a pedophilic orientation, driving them to go through this effort to get what they want. But the results show that the ones who are more pedophilic are already related to the victim by chance!

There appears to be a complicated interaction between pre-existing motivation and access to victims that determines whether a person will offend or not. So are stepfathers scheming to get their hands on little kids, or are they slightly abnormal guys who just happen to end up in situations where their weaknesses are laid bare? Is there something special about raising an unrelated child that makes a stepfather more likely to offend? Many mammals rely on pheromone signaling to differentiate related and unrelated potential mates, i.e. those who are safe and those who might lead to genetic defects. It could be that similar systems operate in humans, and when a stepfather who would otherwise not display and pedophilic tendencies comes into regular, close contact with a young, unrelated child, this pheromonal system doesn't send the inhibitory signals that it would if the child were related.