A Woman’s Guide to Identifying Psychopaths, Part 1
Diagnostic Criteria, Associated Personality Disorders, & Brain Attributes

Alex DeLarge in A Clockwork Orange is a psychopath with antisocial personality disorder.

2,902 words

Part 1 of 8 (Part 2 here)

Greg Johnson asked me to write a brief guide to help women spot psychopaths. He made this request after reading something I wrote on how murderer Brian Laundrie displayed several behaviors common among psychopaths. I can’t be brief on the subject, though, because psychopathy is associated with many behaviors and traits. Everyone should read this, because knowledge of it will not only benefit groups of people but individuals as they go through life as well.

Introduction

Psychopathy is a collection of behaviors that often go together. Everyone has exhibited at least one of them, so we all have a little of it in us.

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It’s tempting to exaggerate psychopathy-linked behaviors in one’s enemies. It’s not a healthy thing to do, because other people’s immorality doesn’t make us virtuous, and we may let ourselves slide into errant ways if we neglect to reflect on our actions because we’re too busy judging others. To quote Cicero, “It is the peculiar quality of a fool to perceive the faults of others and forget his own.” As we’ll see, it’s also a trait of psychopaths.

This series may be a useful guide in avoiding psychopaths, but it’s no guarantee you won’t have to deal with them. Sometimes it’s impossible to avoid them. What’s more, real life is more complicated than what can be written about. The only fail-safe method of dealing with them is finding a source of inner strength to endure the difficulties to which they often subject you. Regardless, avoiding them is still worth trying.

I will divide my analysis into short points, because rather than spin a narrative I’d rather just provide the facts. This way, people can skim through and find topics easily. This may not be as entertaining, but it’s more efficient in conveying information. Sometimes I use actual or fictional examples of psychopathic behavior because it’s easier to think about this information in terms of people than in terms of abstract concepts. It’s also more instructive, because we deal with real people and not simply their abstract attributes.

Diagnostic Criteria

Psychopathy is not a black-and-white issue. It’s a spectrum. Psychologists diagnose people who score in the top 1% of this spectrum as psychopaths. They sometimes refer to people ranging between the 85th and 99th percentiles as subclinically psychopathic.

Psychologists use the Hare Psychopathy Checklist-Revised to test for psychopathy. It contains 20 traits, each of which is scored on a three-point scale ranging from 0-2. If the item does not apply at all, the score is 0; if it’s a partial match, it’s 1; and if it’s a good match, 2. Adding up all the points gives the person’s overall score. A score of 30 is the cutoff for psychopathy in the United States, and a score of 25 is the cutoff in the United Kingdom.

To put this in perspective, 1% of individuals score 30 or higher and thus are considered psychopaths. Ted Bundy, a serial killer who admitted to murdering 30 women, scored a 39/40. The average prisoner in the US scores 22/40, and in the UK, 17/20. The average law-abiding person scores 5/40. I wish I could provide further information as to the score of each percentile, but I couldn’t find any texts on the topic.

The difference between someone scoring 29 and 30 is probably insignificant, but this doesn’t mean the score doesn’t tell us something, because the difference between the average score of 5 and the cutoff of 30 usually describes a marked difference in character. Simply because the scale is a continuum doesn’t mean it can’t tell us something. Similarly, ethnicity is a continuum, but it doesn’t mean it isn’t real. Genetically, racial groups are distinct, but many groups, such as Asheknazi Jews, are intermediate or debatable as to whether they are white or Middle Eastern. This doesn’t mean race is a useless concept.

Before taking this assessment, it’s important to understand what each point means, because psychologists have their own unique ways of defining them. Please consult slides 17 through 36 on this website before scoring yourself. Failing to do so will probably result in too high a score.

Here are the 20 points on the Hare Psychopathy Checklist-Revised:

1. Glibness/superficial charm
2. Grandiose sense of self-worth
3. Need for stimulation/proneness to boredom
4. Pathological lying
5. Conning/manipulative
6. Lack of remorse or guilt
7. Shallow affect
8. Callous/lack of empathy
9. Parasitic lifestyle
10. Poor behavioral controls
11. Promiscuous sexual behavior
12. Early behavior problems
13. Lack of realistic long-term goals
14. Impulsivity
15. Irresponsibility
16. Failure to accept responsibility for own actions (blame others, bad luck, etc.)
17. Many short-term marital relationships
18. Juvenile delinquency
19. Revocation of conditional release
20. Criminal versatility

I consider a score anywhere from 0-10 to be non-psychopathic. A score of 11-19 is mildly psychopathic. A score of 20-29 is subclinically psychopathic, and a score of 30 or more warrants a diagnosis of psychopathy. I can’t find any scale that grades things similarly, so let me know in the comments if you know of one.

In my opinion, some points on the checklist are worse than others. Taken together, points 1-3, 7, and 13-16 don’t necessarily harm others. I call these victimless sins. They should be weighted lower. Points 9-12 harm others and society but not acutely. I call these chronic sins. Behaviors 4-6, 8, 17-20 are the worst. I call these acute sins. They should be weighted more heavily.

Combining these traits on the checklist in certain ways can make them more harmful. For example, combining 3, 6, and 8 leads to a combination of thrill-seeking and a disregard for putting others at risk. This might manifest itself in the individual speeding through a residential area and potentially hitting a pedestrian. However, if the individual has only point 3 — a need for stimulation and a proneness to boredom — but not the other two, he may restrict his thrill-seeking to activities that don’t put others at risk. For example, he may try daredevil stunts in a skatepark.

Figure 1. Psychologists divide traits on the checklist into two subcategories of factor 1 and factor 2 psychopathy. They further subdivide the factors into facets. There’s a lot more toleration for facet 1 and to a lesser extent facet 2 in high-status jobs than facets 3 or 4. Source: Four-Facet Psychopathy Checklist-Revised Item Structure

Gordon Gekko from the movie Wall Street is a factor 1 psychopath. He is allegedly a composite of several Jews, including Asher Edelman, Michael Milken, and Louis Stone (born Silverstein).

Psychologists identify two varieties of psychopathy. The first is factor 1, also known as primary psychopathy or interpersonal-affective psychopathy. It’s associated with superficial charm, a grandiose sense of self-worth, pathological lying, being manipulative, lacking remorse, being unemotional and callous, lacking empathy, and failing to take responsibility for one’s actions. One study found callousness and unemotionality to be about 60% heritable, meaning it may increase or decrease in the population due to individuals bearing associated gene variants breeding more or less. One study shows that it must be mostly genetic in origin, since the person’s upbringing had little impact on it. However, another source claims that harsh, negative parenting can lead to callous-unemotional traits, which can in turn lead to psychopathy. These traits are associated with factor 1 psychopathy. These psychopaths prefer careers as CEOs, supervisors, supply chain managers, finance workers, government employees, salesmen, journalists, law enforcement officers, lawyers, clergy, chefs, and surgeons. They like jobs that give them short-term control over other people’s lives. The character Gordon Gekko from the film Wall Street is an example of a factor 1 psychopath.

Factor 2 psychopathy, also known as secondary psychopathy or sociopathy, is associated with sensation seeking, lack of realistic long-term goals, impulsivity, irresponsibility, mood swings, struggles to control anger, criminality, poverty, and a disregard for authority. The impulsive and antisocial aspects are 45% heritable in men, but upbringing plays a role, too. An individual who grows up in an abusive environment is at a greater risk for developing factor 2 psychopathy. Often, the individual exhibits behavioral dysregulation as child in the sense that their emotions are absent, noticeably faked, or abnormal, and their family members and peers ridicule them for it, inducing them to flex their unstable emotions even more as a defense mechanism. Their reaction to ridicule over emotional dysregulation is to make it scary so nobody bothers them. Instead of the child receiving the nurturing understanding he needs for his emotional shortcomings, he receives only opprobrium and throws it back onto the world. To prevent a child from becoming a factor 2 psychopath, a Tulane study instructs caregivers to offer “responsive, empathetic caregiving — especially when children are in distress.” Alex, the protagonist from A Clockwork Orange, is a factor 2 psychopath.

Pure forms of factors 1 and 2 psychopathy exist only in the abstract. Psychopaths necessarily have a combination of the two in order to score a 30 on the exam because the highest score is otherwise a 20, but they usually skew more toward one or the other. Individuals high in subclinical psychopathy do as well. Normal people might have more traits from factor 1 or factor 2 as well despite having few overall.

Associated Personality Disorders

Psychopathy is strongly associated with antisocial personality disorder, but it’s not the same thing. Antisocial personality disorder describes behavior that is impulsive, irresponsible, and often criminal. One need not be a psychopath to exhibit it, but there is a lot of overlap. Specifically, a third of individuals who have antisocial personality disorder are psychopaths, while most but not all psychopaths have antisocial personality disorder. Probably a higher proportion of factor 2 psychopaths have it than factor 1 psychopaths. We’re comparing overlaps of sets of behaviors, and this overlap undoubtedly occurs on subclinical as well as clinical levels.

Men are more likely to foist bad treatment they receive as children back onto the world by being antisocial or psychopathic, whereas women are more likely to direct the mistreatment inward in the form of anxiety and self-loathing. The plot of A Clockwork Orange involves the attempt of a dystopian state to turn the protagonist’s antisocial tendencies into something which only harms himself. After incarcerating him for murder, the state forces him to watch films depicting sex and violence while strapping him to a chair and forcing his eyelids to stay open with metal hooks so that he can’t look away. They then give him drugs that make him feel nauseous as he sees the films, which in turn causes him to develop a Pavlovian reaction in association with sex and violence. Following the procedure, whenever he encounters such things in real life, he becomes paralyzed with nausea. It becomes so bad that he wants to commit suicide, and eventually actually attempts to do this by jumping out of a window. The public becomes outraged that the government would develop such a procedure, so the state reverses his conditioning, “curing” him so that he can return to his old antisocial self. A politician then seeks to use him as a poster boy to demonstrate the government’s humaneness to the public in an upcoming election.

Psychopathy correlates with several personality disorders:

• The antisocial facet (facet 4 in figure 1) positively correlates with borderline personality disorder (impulsivity, self-mutilation, and manipulation).
• The interpersonal facet (facet 1 in figure 1) negatively correlates with borderline personality disorder (impulsivity, self-mutilation, and manipulation).
• The interpersonal and antisocial (facets 1 and 4 in figure 1) correlate positively with paranoia (suspicion, hypersensitivity).
• The interpersonal and antisocial (facets 1 and 4 in figure 1) correlate positively with the following cluster B personality disorders: narcissism (excessive self-admiration, egocentricity, and grandiosity); antisociality (aggression, rule-breaking, abuse); and the histrionic (attention-seeking, flamboyant, provocative).

Mental disorders listed in the chart are not the only ones associated with psychopathy. Attention deficit hyperactivity disorder (ADHD) correlates with some attributes of factor 2 psychopathy, including “blame externalization, rebellious nonconformity, and carefree nonplanfulness,” but negatively with “stress immunity and coldheartedness” as typical of factor 1 psychopathy. Along with factor 2 psychopathy, ADHD negatively correlates with wealth.

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Autism also negatively correlates with wealth. Some people might confuse autism with psychopathy because psychopathy, like autism, involves a lack of empathy, but it stems from a different problem. Autistic people fail to empathize with others because they struggle with the theory of mind, or to imagine what it’s like to be somebody else. If they could, they would — but they can’t do so very effectively. Psychopaths, on the other hand, can see things from another person’s perspective, but they don’t do it automatically. Whenever they do, it’s therefore more of a conscious effort. When they decide they don’t like someone, they stop making the effort and become as cold as ice.

Before ending the discussion of associated mental disorders, it’s necessary to clarify the meaning of two terms:

• The term “psychotic” has nothing to do with psychopathy. If someone is psychotic, then they have at least one of the five types of psychoses, which include delusions, hallucinations, disorganized thought, disorganized behavior, or negative symptoms. These have nothing to do with psychopathy.
• The term “psychopathology” may seem like it describes psychopathy, but it doesn’t. It is the study of all mental disorders. It’s the pathology of psychoses and not the study of psychopathy.

Brain Attributes

A diagnosis of psychopathy relates to more than subjective evaluations of behavior. Observable differences in brain structure and function accompany the condition.

• According to one study, psychopaths “have reduced connections between the ventromedial prefrontal cortex and the amygdala.” The ventromedial prefrontal cortex is responsible for sentiments such as empathy and guilt, while the amygdala “mediates fear and anxiety.” Thus, their brains don’t make them fearful or apprehensive when doing bad things based on remembering punishments they received from doing such things before. This may play a role in why psychopathic prisoners are more likely to end up back in jail and why many don’t seem to learn from their mistakes.
• The amygdala, which handles fear, is smaller in psychopaths than in neurotypicals. This may relate to why factor 2 psychopaths exhibit more fearless dominance and courage. There’s less of an amygdala holding them back. The same kids who clown around in class are often good at sports. Nothing is holding them back.

• 

  James Fallon’s brain has a low activity profile often associated with psychopathy.

• According to one study, psychopaths have “reduced activity in an area towards the center of the brain called the orbital cortex, thought to play a role in regulating our emotions and impulses.” This may make them more impulsive.
• Psychopaths have less cerebral gray matter volume and thickness in their prefrontal cortex, which is “important in monitoring behavior, estimating consequences [of actions] and incorporating emotional learning into [their] future decision-making process.” Moreover, the “more severe the level of psychopathy, the greater this deficiency seems to be.”
• One study showed factor 2 psychopathy correlated with lower brain activity when judging oneself relative to others — specifically, in the bilateral posterior cingulate cortex and right temporoparietal junction. This part of the brain is also related to memory, suggesting they may not scrutinize their actions as much as others.
• Research suggests factor 1 psychopaths may have lower oxytocin levels. Oxytocin is a neurotransmitter produced in the hypothalamus involved with recognizing people, trusting people, falling in love, and parent-infant bonding. The reason psychopaths grow bored of their partners may be partly due to deficiencies in oxytocin.
• Psychopaths have “a 10% larger striatum than non-psychopaths,” a brain feature which “researchers say may account for a higher likelihood of impulsive behaviors and increased need for stimulation” — i.e., thrill-seeking. The striatum also produces dopamine, the chemical that activates the reward system in the brain.
• People with higher scores for impulsive and antisocial traits, both associated with factor 2 psychopathy, had greater dopamine responses to amphetamine. In fact, their dopamine was up to four times higher than normal people’s. The research team didn’t use full-blown psychopaths because they often have a history of substance abuse. There’s a reason the TV series about a schoolteacher who started a meth lab is called Breaking Bad.
• A study found that people high in psychopathic traits get more dopamine in the nucleus accumbens when anticipating monetary rewards. To quote 50 Cent, they want to “get rich or die tryin’.”
• The MAOA-L genotype makes someone more likely to be a psychopath. According to one source, people with this trait “produce less of the protein that breaks down signaling chemicals, which in turn causes them to build up. An excess of these chemicals, scientists believe, leads to impulsive behavior (such as hypersexuality), sleep disorders, mood swings, and violent tendencies.”
• The orbitofrontal cortex activates more in psychopaths than in normal people when they see an opponent being punished. This may play a role in their higher proclivity towards sadism and stronger taste for vengeance.
• One expert claims factor 1 psychopaths are born having gene variants coding for brain structures that make them prone to becoming psychopathic, while factor 2 psychopaths don’t have the structures but still develop a psychopathic activity profile. Thus, the latter seem like normal humans gone wrong, whereas the former are a sort of parallel brain phenotype coexisting with normal humans.

Putting it all together, psychopaths have reduced aversion to doing bad things and a stronger desire to do exciting things which may be bad.

Just because an individual’s brain scan shows a psychopathic pattern doesn’t mean he is a psychopath. For example, the brain scan of psychologist James Fallon resembles that of a psychopath in the sense that it showed low resting activity on a brain scan. Fallon jokes that his peers report he is a bit testy and not someone to mess with. He admits to being vengeful and exhibiting charm, but he’s not a psychopath. He attributes this to having loving parents. He has, however, stated that there are several murderers in his family tree, yet also many religious people. This could be because some genotypes, including MAOA, make people more environmentally sensitive, and his family has them.

What’s clear is that psychopathy correlates with certain brain features. Heredity, and to some extent upbringing, determine their presence. Psychopathy is therefore a sociobiological concern which transcends race, much like IQ.

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