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In 1887  Kraepelin, a German psychiatrist, identified
the ‘morally insane’ as suffering congenital defects in their ability to
restrain the reckless gratification of immediate egotistical desires (p.281). He
reffered to psychopathic states as one of several forms of degeneration, along
with such syndromes and obsessions, impulsive insanity, and sexual perversions.
In 1904 Kraepelin identified four types of personality who had features akin to
what we speak of today as antisocial personalities.

In 1909, Karl Birnbaum, writing in Germany at the time
of Kraepelin’s later edition, was the first to suggest that the term
‘sociopathic’ might be the most apt designation for the majority of these
cases.

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The origin of the current description of Psychopathy
can be traced back to the work of Cleckley(American psychiatrist). In his book,
The Mask of Sanity by Hervey, Cleckley, delineated sixteen criteria for the
diagnosis of psychopathy (Cleckley,1941).

Reconceptualizing Cleckley’s description of
psychopathy, Hare (1980) developed the Psychopathy Checklist (PCL), reviewed in
1991 and named Psychopathy Checklist-Rivised (PCL-R), for the classification of
adult psychopathy.

The
Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the
American Psychiatric Association included several concepts of psychopathy /
sociopathy / antisocial personality in early editions but, starting in 1980,
attributed a diagnosis on antisocial personality disorder that was based on one
of the criteria already employed by Cleckley but modified differently and,
moreover, more specifically related to criminology. The taxonomy (ICD) of the
World Health Organization currently includes a similar diagnosis. Both the ICD
and the DSM establish that psychopathy and sociopathy are synonymous with the
same diagnosis (Cameron, 1987).

In 1980,
Hare developed the Psychopathy Checklist based on the assumptions made by
Cleckley and subsequently revised. The development of the Psychopathy Checklist
(Hare, 1980, p.249) and of the III edition of the Diagnostic and Statistical
Manual of Mental Disorder (DSM-III, 1980) represented the starting point for
the establishment of a thriving research network on the theoretical and
empirical construct of psychopathy.

Historically
summarizing the most used terms to indicate psychopathy are: non-scrupulous man
(Theophrastus, 3rd century BC), mania without delirium – manie sans délire
(Pinel, 1801) or sociopathy (Birnbaum, 1909).

In light of
these different studies, theories and definitions on psychopathy, similarities
are found that converge on defining more or less universal aspects that
characterize the psychopath: psychopathy consists of a deficit for different
areas, such as interpersonal relationships, emotions, and behaviours.

Hare (2003)
described psychopaths as ‘social predators’. Hare and other criminologists
wrote about the phenomenon as ‘the use of a particular charisma, manipulation,
intimidation, sexual relations and violence’ in order to control other people
and pursue their own interests:

‘Missing consciousness
and empathy, they do what they want and as they like, violating social norms
and social expectations without guilt or remorse, what is missing, in other
words, is the true quality that makes a human able being to distinguish himself
from an  animal’ (Hare , 1999, p.182).

Following
Hare (2006), many psychopaths are apparently able of striking the attention of
others because they can perfectly mimic the most common human emotions, and can
wander, in disguise, in a variety of environments, including corporations or
other similar associations (p. 48).

Regarding empathy,
psychopathy prevents understanding the emotional states of other people, except
in the purely intellectual sense of expression.

Psychopaths
do not perceive their emotions like normal people. Even if they are not
completely impassive, their emotions are so low that some doctors have
described them as simple ‘proto-emotions’ or ‘primitive responses to immediate
needs’ (Hare, 1999, p.196).

Psychopaths
do not feel the need to establish a romantic relationship and are not able to
form emotional bonds with people. Although a psychopath can sometimes perceive
a person’s charm or be infatuated with him / her, he cannot reciprocate his
feelings, but only pretend and enjoy sexual encounters, even if they are
superficial and impersonal (Hare et al., 2006 , p.39).

The
researchers obtained brain scans on psychopaths while exposing them to
emotionally charged speeches like rape, murder and love. In a normal person,
these words cause success in the limbic system, which governs emotions.
Psychopaths did not show these  activities but reacted in a totally
indifferent way (for example ‘tree / love’, ‘chair / rape’, ‘spoon / murder’),
however, they showed reactivity in the cerebral areas associated with language
processing, suggesting that their response was more cognitive than emotional
(Hare, et al., 2006, p.41).

Another
aspect concerns plagiarism and manipulation: psychopaths are incorrigible and
recidivist liars. Often they can get what they want or to impress people, and
they do it with such skill that the investigators, even those with considerable
experience behind them, are sometimes misled (Cleckley, 1976).

A potential
psychopath tries to deceive more often than it seems (body language, trust,
etc.). In fact, psychopathic stories are often full of inconsistencies and
contradictions. The first reason for this is the often improvised nature of
their consciousness. If they are caught or faced with unforeseen questions,
they simply rework their narrative to adapt to the new reality without stopping
to reflect on things. The second reason is that psychopaths seem to have
difficulty properly integrating the language and emotional components of their
thoughts, and this does not make it possible to notice the contradictions in
their speech. Hervey Cleckley (1976), a pioneering researcher of psychopathy,
called this anomaly as ‘semantic aphasia’.

Some researchers
at the University of Sydney claim that psychopathy is pure impulsivity. It is
not possible to measure the risk of being surprised, discovered or affected as
a result of one’s behaviour (Dadds et al., 2006, p.280).

The
psychopath lives day by day, changing his plans frequently and generally has no
realistic long-term goals. Psychopaths often claim to have ambitious goals in
life, but they cannot appreciate the consistency, skill or discipline necessary
to achieve them (Hare, 1999, p.196). In the workplace, on the contrary, they
are known for irregular frequency, frequent absences, embezzlement, and
unreliability. They are financially irresponsible, often living above their
means, incurring in debts and defaults on loans. They often neglect their
children, often have unprotected sex, they make children and then abandon them and
transmit sexually transmitted diseases (Harris et al., 2006, p.184).

The recurrence
rate of psychopaths is twice the number of common offenders with peaks three
times higher for the most violent crimes (Hare, 1999).

Smith and
Newman (1990), scholars of the University of Wisconsin note that psychopaths
have a low tolerance for boredom and an excessive need for excitement and
stimulation. They often break the rules, commit crimes, and risk their lives to
try cheap thrills: they are more likely to take drugs than normal people.

Psychopaths
also abuse their self-esteem. Their egocentrism is comparable to that found in
the narcissistic personality disorder and, in fact, it is sometimes difficult
to distinguish the two conditions from each other (Hare, et al., 2006). They
believe they are at the center of the universe and see themselves as superior
beings, often appear to be opinionated, bullies and arrogant. A psychopath
always thinks he is the smartest person in the world and has no respect for the
divergent opinions of others.

It has been
demonstrated that there is a correlation between psychopathy and IQ:

Hare and
Neumann (2008) state that there is only a weak association between psychopathy
and IQ but that ‘there is no obvious reason why the theoretical disorder
described by Cleckley or other clinicians should be linked to intelligence;
some psychopaths are lucid, others less so. Even if a psychopath were to
possess a great intelligence or IQ, he would rarely prove this’ (p.893).

Genetic
factors can generally influence the development of psychopathy, while
environmental factors influence specific traits that predominate.

In 2005, a
study of twins found that children with antisocial behaviour can be classified
into two groups: those with high “insensitive-emotional” attitude
were conditioned by hereditary and non-environmental factors, while those who
were classified minimum quantity of those attitudes were conditioned by both
hereditary and environmental factors (Viding, et al., 2005, p.593).

‘The
amygdala is crucial for the stimulation-reinforcement in learning and
responding to emotional expressions, e.g. the fear that, like reinforcements,
is an important factor in stimulating and reinforcing learning. Furthermore,
the amygdala is involved in the formation of both the stimulus of punishment
and reward. Individuals with insufficiency in learning stimuli and responses to
expressions of panic and pain, suffer from psychopathy syndrome ‘(Blair, 2008,
p.2557).

Recent
studies have refuted theories on how to determine the biological relationship
between the brain and psychopathy. One of these suggests that psychopathy is
associated both with the amygdala, which is associated with emotional reactions
and emotional learning, and with the prefrontal cortex, associated with impulse
control, decision-making, learning and emotional-behavioural adaptation (Weber
et al., 2008, p.8).

Criminal
endocrinology

High levels
of testosterone combined with low levels of serotonin can increase violent
aggression. Some researches suggests that testosterone alone does not cause
aggression, but increases the dominance of violent behaviour. Low serotonin is
associated with impulsive or highly negative reactions and, when combined with
testosterone, may result in aggression following frustration.

In 2010 a
British study found that a great value of the 2D: 4D ratio, indication of a
high estrogens value, indicate a positive correlation of psychopathy in
females, and a positive correlation of insensitivity (sub-scale psychopathy) in
males (Blanchard et al., 2010, p.23)

The
psychopathic tendency can sometimes be recognized in childhood or during
adolescence. Not all the subjects diagnosed during childhood turn out to be
psychopathic as adults, or even to all the sufferers of other disorders.
Therefore, psychopathy is not normally diagnosed in children or adolescents,
and some jurisdictions explicitly prohibit this diagnosis for children with personality
disorders or similar. This is because a diagnosis ‘cannot detect any emotional,
cognitive or other personality traits such as egocentrism and lack of remorse,
empathy, guilt that are so important in the diagnosis of psychopathy’ (Hare,
1999, p.186).

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