Free The Wisdom of Psychopaths by Kevin Dutton Page B

dimensions in the spectral psychopath nebula nested mercurially within it (see figure 2.6 ).

    Figure 2.6. A four-factor model of the PCL-R (from Hare, 2003)
    Psychopathy, in other words, is a composite disorder consisting of multiple interrelated components that range discretely and independently along a number of different spectra: interpersonal, emotional, lifestyle, and antisocial—a witches’ brew of personality leftovers.
    But which of these spectra are most important? Is someone who scores high on the antisocial elements of the checklist, for example, and lower, say, on the interpersonal dimension, more or less of a psychopath than someone whose profile is the complete opposite?
    Questions like these surface quite regularly in the battle for the psychopath psyche, in the empirical and diagnostic combat zones of clinical definition. Take, for instance, DSM’s listing of Antisocial Personality Disorder (ASPD), an area of particular strategic importance in the epidemiological conflicts. The official line, as set out by the American Psychiatric Association, is that ASPD and psychopathy are, in fact, synonymous. ASPD is defined as “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.” The individual must be age eighteen or over, show evidence of conduct disorder 8 before the age of fifteen, and present with at least three of the following criteria:
    1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest
    2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
    3. Impulsivity, or failure to plan ahead
    4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults
    5. Reckless disregard for safety of self or others
    6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
    7. Lack of remorse, as indicated by being indifferent to, or rationalizing, having hurt, mistreated, or stolen from another.
    But is this really the same thing as psychopathy? Many theorists argue not—and that although there is certainly overlap between the two, the fundamental difference lies in insidious vagaries of emphasis: in the manifest imbalance between the welter of behavioral items of “socially deviant” criteria that characterize ASPD and the core affective impairment, the shadowy emotional twilight, redolent of the psychopath.
    The ramifications, statistical or otherwise, are not without consequence.In prison populations ASPD is the psychiatric equivalent of the common cold, with as many as 80 to 85 percent of incarcerated criminals, according to Robert Hare, meeting the requirements for the disorder. Contrast this with just a 20 percent hit rate for psychopaths.In addition, this 20 percent minority punches well above its weight. Around 50 percent of the most serious crimes on record—crimes such as murder and serial rape, for instance—are committed by psychopaths, and continue to be committed by psychopaths.
    Studies comparing the recidivism rates among psychopathic and non-psychopathic prisoners reveal that the former are up to three times more likely to reoffend than the latter within a period of just one year. If we factor violence into the equation, the curve gets even steeper. The psychopath emerges as anything up to five times more likely to beat, rape, kill, or mutilate his way back behind bars. More accurate is to say that the relationship between ASPD and psychopathyis asymmetrical. For every four people diagnosed with ASPD, you may also have a psychopath on your hands. But every individual presenting with psychopathy will also, by default, be presenting with ASPD.
Killer Difference
    To demonstrate a little more clearly, perhaps, the difference between the two syndromes,