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Authors: Paul Babiak,Robert D. Hare

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Evidence of this sort does not mean that the pathways to
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adult psychopathy are fixed and immutable, but it does indicate that the social environment will have a tough time in overcoming what nature has provided. As noted in
Without Conscience
, the elements needed for the development of psychopathy—such as a profound inability to experience empathy and the complete range of emotions, including fear—are provided in part by nature and possibly by some unknown biological influences on the developing fetus and neonate. As a result, the capacity for developing internal controls and conscience and for making emotional

“connections” with others is greatly reduced.

To use a simple analogy, the potter is instrumental in molding pottery from clay (nurture), but the characteristics of the pottery also depend on the sort of clay available (nature).

The most reliable, valid, and widely used instrument for the assessment of psychopathy is the Hare Psychopathy Checklist–Revised (PCL-R). The PCL-R is a clinical rating scale, not a self-report test.

The person who is being evaluated does not answer questions, as is the case with other psychological tests. Rather, a qualified psychologist or psychiatrist familiar with the evaluation procedure completes the assessment based on an in-depth interview and a review of information contained in the person’s records. Then, for each trait or characteristic, the psychologist or psychiatrist must make a judgment as to whether or not each applies to the person being assessed. For each trait, several criteria and tests must be applied. A technical manual contains extensive definitions and behavioral examples for each of the twenty psychopathic characteristics.

If the rater judges that a person clearly has a given trait, then 2

points are added to the total score; if a trait applies only partially or sometimes, then only 1 point is added to the total. And if a trait just doesn’t apply to the person, nothing is added to the total. Because there are twenty traits on the PCL-R, someone can receive a total score from 0 (meaning no psychopathy) to a high of 40 (a perfect match to the prototypical psychopath).

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The availability of the PCL-R and the shorter PCL: Screenings Version (PCL: SV, discussed on pages 26–28) has allowed people to conduct extensive research on all aspects of psychopathy, including its neurological bases. As noted earlier, a particular area of interest has been the manner in which psychopaths process emotional material, including emotional words and pictures. The results of several brain scan experiments (using functional magnetic resonance imaging, or f MRI) indicate that psychopaths do not show the same patterns of brain responses to verbal and visual emotional material as do nonpsychopathic individuals. Whereas normal people showed a different brain response to emotional words and pictures than to neutral material, psychopaths responded the same to each type of material.

Psychopaths processed what should be emotional material as if it were neutral in content.

Sometimes answering one question raises others. Why don’t psychopaths respond the way others do? Are their brains wired differently? Is their obvious emotional poverty the result of their upbringing? It will take several more years of research to answer some of these questions, but significant improvements in the sophistication of laboratory equipment is helping us move toward a deeper understanding of the psychopath. Many researchers will continue their work well into the twenty-first century.

Since the initial studies on the PCL-R, a large number of researchers have used the instrument to assess criminal psychopaths in many countries and settings. The items have withstood the test of time and scientific scrutiny. Although the PCL-R was developed with offender populations, it also has been used with other groups, including psychiatric patients and the general population. For the latter, however, a more suitable instrument is a derivative of the PCL-R, the Psychopathy Checklist: Screening Version (PCL: SV ), developed by Hare and his colleagues. The items in the PCL: SV are listed below, and are scored in the same way as the PCL-R is scored. Total scores on the twelve-item PCL: SV can range from 0 to 24.

We can break down the psychopath’s personality into a model made up of four key factors or domains. The interpersonal domain de-Who
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scribes how psychopaths present themselves to others, the affective domain includes what they feel or don’t feel emotionally, the lifestyle domain describes how they live in society, and the antisocial domain describes their propensity for antisocial behaviors. Note that scoring each item requires professional qualifications, adherence to the scoring instructions in the PCL: SV Manual, and access to extensive interview and collateral information. More extensive descriptions are provided in the book Without Conscience.

Domains and Traits of the Psychopath

[ f r o m t h e P C L : S V ]

Interpersonal

Affective

The person is:

The person:

• Superficial

• Lacks remorse

• Grandiose

• Lacks empathy

• Deceitful

• Doesn’t accept

responsibility

Lifestyle

Antisocial

The person:

The person has a history of:

• Is impulsive

• Poor behavioral controls

• Lacks goals

• Adolescent antisocial

• Is irresponsible

behavior

• Adult antisocial behavior

What is a high enough PCL-R score to warrant a diagnosis of psychopathy? Most people in the general population would score less than 5 on the PCL-R, whereas the average score for male and female criminals is about 22 and 19, respectively. A cut score of 30 typically is used to identify psychopaths, although some investigators and clinicians use
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a score of 25 or above for research purposes. About 15 percent of male offenders and about 10 percent of female offenders obtain a score of at least 30.

The PCL: SV has fewer items than the PCL-R, but scores on these two instruments have the same theoretical and practical meaning. Most people in the general population would score less than 3

on the PCL: SV, while the average score for criminals is around 13.

A cut score of 18 is typically used for a diagnosis of psychopathy.

Whatever cut score is used, individuals who meet or exceed the score clearly are different from those with lower scores. Whether this difference is in kind or in degree is yet to be firmly established, although the most recent scientific evidence is that the latter is the more likely.

Am I a Psychopath?

A list of psychopathic features frequently evokes concern or a superficial flash of insight. “My God, John is impulsive and irresponsible.

Maybe he’s a psychopath!” Or, “I’m a risk taker and I sleep around a lot. Holy shit, I’m a psychopath!” Perhaps so, but only if a lot more of the relevant characteristics are present.

Think of psychopathy as a multidimensional continuum, much like blood pressure, which can range from dangerously low to dangerously high. We might refer to individuals with really low or high systolic and diastolic blood pressure as hypotensive and hypertensive, respectively. In between these two extremes there is a range of pressures, some considered normal and others reflecting varying degrees of concern, but not yet pathological.

Similarly, the number and severity (density) of psychopathic features ranges from near zero, perhaps sliding into sainthood, to abnormally high, rising into big trouble. We refer to those at the upper end as psychopaths; they have an extremely heavy dose of the interpersonal, affective, lifestyle, and antisocial features that define psychopathy (see pages 26–27).

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Most people fall in between these extremes, but primarily toward the lower end. Those in the midrange have a significant number of psychopathic features but they are not psychopaths in the strict sense of the term. Their behavior would depend on the particular mix of features they have. Certainly, many will not be model citizens or very nice people, but others may variously be described as hard-driving, fun-loving, entitled, aggressively ambitious, seriously pragmatic, or difficult.

ACT I, Scene II

OFF AND RUNNING

Dave’s first day on the job created much excitement as he was shown around the department and introduced to the staff. There was a buzz about the new person who had been hired away from a larger player in the industry, and who would help them regain some of the lost ground resulting from the problematic new product introduction cycles. Everyone came out to greet Dave, and all who met him immediately liked him. He had personality and good looks, not to mention his strong technical background in the company’s major research area, and he projected rock-solid confidence.

After introducing Dave around to most of the department, Frank took him to his new office. “Oh,” muttered Dave, a bit disappointed in what he saw. “I thought it would be a little closer to the action,” he paused, “and a tad bigger.”

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“Well, we’re growing very rapidly and office space is at a pre-mium,” offered Frank, wondering why he was feeling apologetic,

“but you’ll be moving around soon enough as we occasionally shuffle staff around. In fact, it’s quite the joke here.”

Dave wasn’t amused, but as he turned to face Frank, he threw on a smile and said, “That’s great! So, I better settle in and start being productive!”

Frank returned to his office and continued with his schedule of meetings, report writing, and phone calls. He would pick up Dave around 1:30 and take him to lunch in the company cafeteria—

actually a high-quality restaurant offering free food to employees.

And perhaps, if he could, he would take him over to the executive wing and introduce him to Jack Garrideb, founder and CEO, if he were in and available.

The morning went quickly and Frank immersed himself in his work. Marge, his secretary, startled him when she came to the door about 1:15. “Frank, Victoria from Mr. Garrideb’s office called; he’d like you to come over right now,” she said, adding before his next question, “she didn’t say what it was about.” Frank picked up his project book and calendar, and grabbed his suit jacket from behind the door, putting it on as he moved out of his office and down the hall. He decided to look in on Dave as he passed his office to tell him that their lunch might be postponed a bit. Dave wasn’t in his office, so Frank continued, his thoughts returning to what projects he had outstanding and what the CEO might need of him on such short notice.

Arriving at the executive suite, which was at the other end of the complex, Frank went to Victoria’s desk. “Hi, Vicki, so am I in trouble again?” he joked.

“You know you’re never in trouble when it comes to Mr. Garrideb. You’re still his favorite,” she joked back. Vicki and Frank had started with Garrideb Technologies on the same day, and they had been friends since. The company culture was friendly, relaxed, and informal, but the executive wing was always daunting because of the
Off and Running

33

big-company aura everyone thought they had to project to visitors or potential clients.

Jack Garrideb saw Frank standing at Vicki’s desk through his open door and waved him to come in. Frank saw that Jack had someone sitting in his office, but couldn’t see much of him in the plush leather chair. “Hey, Frank, I’ve just been talking to one of yours,”

said Jack as Dave got up and turned around. “Another good choice!

Things in R&D are going to really start rocking if your new associate has anything to do with it!”

Frank was somewhat startled to see Dave in the CEO’s office.

“Well, Jack, we have to keep up with the marketing guys who keep promising customers products that don’t exist yet.” He smiled as they shook hands.

“Good luck to you, Dave; you’re now working for the best person in the business,” said Jack, as Frank and Dave took their leave.

“Nice guy,” said Dave as they headed down the hall toward the cafeteria.

Frank’s thoughts were already back on the project report he had been writing when Victoria’s call interrupted him. “You’re lucky that he was in today; he travels too much.”

3

What You See May Not

Be What You See

Ellyn picked up her small daughter and headed out to work. She locked the apartment door, walked down several flights of stairs, and got out onto the street. The bus dropped her and her daughter off at the brightly lit main square where the evening crowds of tourists and vacationers walked and talked. Her night job depended on these people, and she was looking forward to a good night.

A crowd had formed at the corner of Main and First, blocking her way. Winding through the crowd she saw that a game of three-card monte was in progress. Tourists are warned to avoid this swindle, but there is always someone in the crowd who is sucked in. The game works like this: the dealer has three cards faceup on a small table; one is a king, queen, or jack, and the other two are number cards. He (or sometimes she) flips them over, facedown, moves them around quickly on the tabletop and then stops. The dealer, using a nonstop
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and entertaining patter, invites crowd members to bet on which one of the cards is the face card. If there are no takers, he displays the cards and starts again. Eventually, some onlooker decides that his or her eye is quicker than the dealer’s hands and places a bet. No one but the dealer ever wins this game.

BOOK: Snakes in Suits: When Psychopaths Go to Work
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