Is psychopathy a disease?

Psychopathy has always aroused fascination. This is why characters with their own traits have starred in many works of fiction, some of which have won many awards.

These are individuals who have been portrayed as evil beings, capable of the most disturbing acts and shrouded in a halo of mystery. But does this stereotype correspond to the reality of the problem?

In this article, we will reflect on the question and answer a very often asked question: Is psychopathy a disease?

    To do this, it is essential to first go down to where he lives, define it and draw a line that differentiates psychopaths from others.

    What is psychopathy: ten essential traits

    Below we present the most common features of this phenomenon, through which we can answer the question posed: Is psychopathy a disease?

    The points that will be discussed describe the ways of thinking, feeling and acting of these people; although they do not always happen in all cases.

    1. Difficulty learning from the past

    People with psychopathy find it difficult to learn from facts they have experienced in the past and that they have caused them harm. For this reason, although they have been sanctioned for having adopted a behavior which infringes the rights of others, the sanction imposed on them has no deterrent effect on them. Thus, they tend to maintain their conduct despite the efforts of judges to impose severe penalties for their crimes.

    This trait has often been the subject of controversy, as it calls into question one of the fundamental pillars of the justice system: the reintegration of people who commit illegal acts. This is an argument often used to advocate the use of harsher measures for offenders who commit particularly sad acts.

    2. Low liability

    People with psychopathy tend to have a weak sense of responsibilityThus, they may be unable to maintain their work or studies for the time needed to progress. To this further contributes a certain need for stimulation and a substantial ease with boredom.

    This trait also, in turn, tends to blame others for any setbacks and vicissitudes they may endure (which undermines the emotional state of those around them).

    3. Utilitarian view of relationships

    One of the most basic characteristics of psychopathy is the pragmatic view of social relations, Which implies that they are seen as a way to meet their needs. Therefore, they may strive to maintain a bond as long as it brings them personal benefit, losing their interest as it progresses to a point where some reciprocity is required or the deliberate imbalance they aspire to is called into question.

    This fact is reinforced by the particular profile of these people in terms of empathy. Concretely, there is a deficit of emotional empathy (ability to feel identified in the pain of others and to have compassion), but a total preservation of their cognitive dimensions (ability to infer the inner states of others and to anticipate their behaviour). They can therefore use this knowledge for their own benefit (manipulation, lying, etc.).

    4. Impulse control issues

    People with psychopathy they present a remarkable difficulty in controlling impulsesIn other words, to inhibit behaviors that may have harmful implications (for them or for others). This inability (as well as the intolerance of frustration) makes it difficult to manage emotions in situations where a goal they deem important is prevented, facilitating the emergence of violent or dangerous acts.

    The most common risk behaviors among these subjects are: risky sexual encounters, substance use, extreme sensation seeking or fighting. This is one of the reasons that co-morbid mental disorders can occur, especially drug addiction.

    5. Shallow charm

    People with psychopathy can be attractive at short distances and in contacts that do not involve depth, Such as the exchanges that take place in the academic or professional framework They are individuals often described as charming, attentive and polite; thus, when they incur a wrongdoing, the social environment is often surprised, even upset.

    This social mask is often used to be the one that increases the likelihood of interacting with others profitably. However, if relationships reach a greater degree of depth, they are difficult to maintain. This fact would explain why those who are closest to them emphasize a number of traits that differ, if not diametrically opposed, to those used by people, the relationship with the psychopath is simply superficial.

    6. Antisocial behavior

    Antisocial behavior is very common among psychopaths. This includes acts which cause harm to third parties in the economic, mental, physical or moral fields; and it can boil down to fights, thefts, destruction, abuse, harassment, scams, threats or other expressions of interpersonal violence. However, there is a high percentage of these people who never incur them, so they are fully integrated into society.

    DSM5 manual includes antisocial personality disorder as the closest diagnosis to psychopathy (Based primarily on the commission of crimes from an early age), but does not have specific criteria for the latter. This form of classification is the subject of much criticism, because not all psychopaths commit criminal acts in their life.

    7. Strong aggressiveness

    People with psychopathy can exhibit very aggressive behaviors, in the broadest sense of the term. These are not only limited to their physical dimension, but can also adopt a secretive and insidious expression (hostility), especially when they see their goals hampered. This aggression is perceived by the person receiving it as excessive and includes sudden outbursts of seemingly uncontrollable anger.

    8. Inability to feel guilty

    Psychopaths find it hard to feel remorse for their actions. Guilt is a feeling that arises when we do something that is detrimental to others, and which is accentuated by voluntarily attributing to ourselves or the perception that possible alternatives for action have not been exhausted. It is a painful and unpleasant experience for most of the population, and it reduces the likelihood that in the future we will choose to repeat the behavior that motivated it.

    Guilt therefore allows us to learn from past mistakes and is linked to empathy. This is one of the main reasons psychopaths are insensitive to punishment because they perceive it as an injustice that deserves rebellion. It is a way of dealing with information in which responsibility is excluded from the equation by which one tries to explain reality.

    Numerous experimental studies indicate that people with psychopathy exhibit poor electrodermal responsiveness to scenes of violence. This means that when exposed to images in front of which a majority of people report an aversive emotion (mutilation, aggression, abuse, etc.), they feel indifferent.

    9. Self-centeredness

    Self-centeredness implies a special emphasis on the importance that the person attaches to himself, contrary to what he attributes to the rest of the individuals around him. This way of thinking usually results in a preference for relationships in which a dynamic of obvious hierarchical inequality can be established. The psychopath would be located at the top of this pyramid, favoring an asymmetry in the rights and duties attributed to all parties.

    Self-centeredness can be accompanied by emotional immaturity, a tendency to devalue others, an exaggeration of self-esteem and recourse to blackmail or extortion. This is why it ends up triggering conflicts within the family, which further degrade coexistence.

    10. Possibility of adaptation

    Many people with psychopathy occupy high positions in the social hierarchy, including political and managerial positions. (Detection of a higher prevalence in these populations). In these contexts, they may develop socially acceptable, asymmetrical relationships with subordinates or with people in their charge. This adaptability occurs in less impulsive psychopaths with a higher planning capacity.

    Psychopaths easily adapt to the demands of the future. This fact is due to an almost exclusive orientation towards immediacy, so that what happens later is relegated to a second (or third) order of importance. As a result of this way of facing reality, these are people with low anxiety levels.

    Is psychopathy a disease?

    As stated above, current diagnostic manuals (DSM-5) do not include the figure of psychopathy in their proposalsTherefore, a diagnosis for this cannot be clearly established. The approaches to the phenomenon (such as antisocial disorder) are insufficient, because they focus all their clinical description on purely behavioral aspects which do not capture the complexity of the phenomenon in question (in particular at the cognitive and experiential level).

    The truth is, most people sometimes react impulsively or act indifferently in situations where they shouldn’t (by social norms). It is also very common to seek stimulation to escape boredom or monotony. Thus, the characteristics of psychopathy describe behaviors that occur (in general) in the whole population, further qualified by the fact that, if they do, they extend absolutely to the whole of daily experience (they are not a one-time exception).

    Many studies are currently focusing their efforts on studying the amygdala, prefrontal cortex, and limbic region as structures that could explain the particular affective and behavioral pattern of psychopathy. Advances in neuroimaging technologies will make it possible to forge greater knowledge on this question and to determine a root cause, finally clarifying whether we are confronted with a pathology or a particular way of being and feeling.

    Bibliographical references:

    • Anderson, NE and Kiehl, KA (2014). Psychopathy: developmental perspectives and their implications for treatment. Restorative Neurology and Neuroscience, 32 (1), 103-117.
    • Gao, Y. and Raine, A. (2010). Psychopaths who succeed and fail: a neurobiological model. Behavioral Sciences and Law, 28, 194-210.

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