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The Underlying Dynamics of Psychopathy with Focus on Early Childhood and Adolescence

November 14th, 2013 by Maximilian M. Bolejko | Posted in Disorders and Pathologies | No Comments » | 330 views | Send article | Print this Article |


Abstract

Integrated in this review are most of the social aspects from past environmental research to more current trends from within the field of neuropsychology, personality, clinical and forensic psychology, biology and psychiatry in order to create a holistic understanding of the underlying dynamics of psychopathy. In despite of its ethical weight, focus was put on childhood and adolescence, even though these areas still remain as relatively uncharted territory because of the notion that children can change. Although it is especially difficult to measure personality traits in children, research seem to be suggesting that several traits connected to psychopathy can be recognized even from one to three years of age. Several case studies, including attempts to disentangle the confusion of DSM-IV classifications and the wide array of diagnostic tools for the condition will also be presented.

The Underlying Dynamics of Psychopathy with Focus on Early Childhood and Adolescence

Acts of violence and deceit are generally appalling to most people, even more so when such acts are of a deliberate nature. Furthermore, most of the conduct connected with psychopathy, often goes unnoticed in our society (Babiak & Hare, 2006). It is only recently that scientists have begun to properly understand the importance of further research on a condition, with a following psychological make-up, that is clearly different to that of the general population (Cleckley, 1941; Hare, 1993). The issue of psychopathy can be traced back to the first large-scale civilized societies, such as the ancient Roman Empire. Possibly the most well-known example would be the conniving nature of Emperor Nero and his alleged attempt of burning down the capital of Rome (Collins, 2010). Today, most of the layman’s intuitive understanding of the condition is mostly contrived out of cinematic or literary fiction, such as the portrayal of cannibalistic psychiatrist Hannibal Lecter (Harris, 1989). More contemporary examples include such real-life serial killers as Ted Bundy or Jeffrey Dahmer. Most people would not hesitate in drawing a parallel between psychopathy and criminal behaviour, yet a large majority of psychopaths are neither violent nor are they incarcerated.

It has been suggested that about one percent of the world’s population are psychopathic, often occupying the space of such areas as politics or the corporate environment (Souza, Moll, Ignacio, & Hare, 2008). It is seemingly not uncommon for psychopaths to choose highly influential positions, often hiding between a veneer of trustworthiness, even in such fields as the mental health care system or the scholarly environment. Even so, the condition seems largely overlooked by the mental health mainstream. Moreover, there is notably even less support for the study of psychopathy in children, in spite of the growing base of research pointing towards a condition that seems rather stable over time and which by many is believed to be operating from birth (Blonigen, Carlson, Krueger, & Patrick, 2003). Furthermore, the mentioned foreboding attitude might well persist because of the universal notion that children can change and are justifiably so, not yet fully developed until they have reached adult age. Such an assumption could also be warranted by the known slow development of different brain regions during childhood and adolescence. However, in support of putting more focus on research with the young is the fact that most treatment programs on adult psychopaths, as talk or group therapy, have been found largely ineffective. In fact, such techniques appear only to enhance the psychopath’s proficiency in manipulating others (Caldwell, 2011). Another factor that makes psychopathy difficult to treat, or even to recognize in the first place, lies in the fact that psychopaths have been found capable of misleading even the finest of mental health professionals. In addition, many aspiring psychiatrists and psychologists of today are continually being misinformed about the true nature of the condition, often left with the impression that Antisocial Personality Disorder (ASPD) and psychopathy are the same, which they are arguably not (Cooke, 1998). At odds with the theoretical framework of ASPD, is the fact that psychopaths have often been found to appear far less hostile as one would like to believe. Moreover, labels such as secondary and primary psychopathy which have been used in past literature only seem to confuse the matter further (Kirkman, 2002).

History of Psychopathy Research

The term psychopathy was first described by French psychiatrist Philippe Pinel in the early 17th century as insanity without delirium (Patrick, 2006). The name was wrought about by Pinel’s observation of individuals with seemingly superb mental health, without any noticeable psychopathology, yet with all the indicators of an utter lack of remorse. During the early 1940s, Cleckley (1941) further elaborated upon the deceptive nature of the psychopath, capable of ”concealing behind a perfect mimicry of normal human emotion, fine intelligence and social responsibility, while deep inside being grossly disabled, irresponsible and devoid of empathy“ (Cleckley, 1941, p. 188). Previous research has in short described psychopathy in possessing the following factors of little to no attachment, under arousal, and minimal anxiety followed by a minimal likelihood of developing depression (Meloy & Gacono, 1998). The first proper measurement tool of psychopathy was created by one of the leading experts in the field, who, together with colleagues, developed the Psychopathy Checklist (PCL-Revised; Hare, 1991). The checklist has been revised for more precise application, and is now largely accepted as a valid and reliable tool of measurement in most of the world’s clinical and forensic practises. As for the testing procedure, it consists of a carefully scored interview, combined with records of the individuals’ environment and personal history. Exemplifying the kind of information that one would come to learn during an interview procedure would usually be a portrayed socially correct response by the psychopath, as opposed to the actual inner cognitive pattern of thought. As Hare (2006) states, ”a psychopath may express remorse for rape or murder, only to later clarify with the statement: I felt the same as if I would squash a bug“ (Hare, 2006, p. 710). In fact, scholars have oftentimes been amazed at how normal psychopaths seem to be. Typically engaging with a skilled use of both tone and mimicry, they often come across as relatively likeable individuals (Cleckley, 1941; Hicklin & Widiger, 2005). It would therefore not be difficult to imagine that one could unsuspectingly be drawn to them, which is seemingly precisely what they crave. As mentioned by Kirkman (2002), the most notable sign, if one were to analyze the psychopath up-close, would be the apparent mismatch in-between words and the facial display of affect. Kirkman flowingly states that if one were to look close enough, one would begin to see a disconnect with what the individual is saying and what he/she actually feels. Experts theorize that this may well be because of the fact that psychopaths seem to lack a normal fear response and also the fear of being punished (Glenn, Raine, & Laufer, 2011). Studies specifically focused on aggression with the following mappings of brain functions have also been one of the main focal areas of interest in research on psychopathy (Blair & Mitchell, 2005; Cooke, 1998). However, more research is yet to be made on children and adolescents in regards to psychopathy, since the number of studies on the matter have so far been limited. Nonetheless, those that do exist present some rather compelling findings, which often show to be congruent with other theories related to psychopathy within other fields of psychology. In recent years, studies on psychopathy have also largely shifted from the view that it is the result of bad parenting and supposedly caused by the environment, to more biologically rooted explanations. Whatever the case, it is certainly not merely biological, nor is it purely environmental, but a combination of both (Blonigen, Hicks, Krueger, Patrick, & Iacono, 2006). As suggested, the evidence within the field of neuropsychology seems to be that genetic factors might be acting as a more general influence on behaviour, preceding a certain variation of environmental conditions which might influence the manifestation of psychopathy traits over time. Peculiarly enough, females are rarely found to be psychopathic. This may well be one of the factors pointing towards a condition that is clustered together with other co-morbid traits, which are more pertinent to males. Social thinkers as Lash (1991) emphasized upon the modern western values such as ambition, drive, victory and hierarchy which tend to increase the prevalence of narcissism in a given population. Narcissism, in its more extreme forms, is also one of the co-morbid traits of the anti-social individual. Its malignant form is also mostly found amongst males (Bushman, Baumeister, & Dijk, 2003). In other words, different environmental factors could very well instil a heightened sense of narcissism in males, more so than in females. Stemming from evolutional theory, it has also been suggested that narcissistic individuals are often seen as more attractive partners, exuberating more confidence and supposedly represent better genetic material at first glance (Alvarez & Jaffe, 1994). As for the damage caused, the toll on society in terms of the mental health of families who have been in contact with psychopathic individuals is rather vast. Furthermore, the costs which these individuals cause each year have been estimated being up to 400 billion dollars in the U.S. alone with up to three-and-a half trillion dollars worldwide (Babiak, Neumann, & Hare, 2010). These figures mainly stem from fraud in the banking and financial sector, but may also include trial and imprisonment, poverty and property damage, limb replacement or the loss of life.

Classification and Assessment

The Diagnostic and Statistical Manual of Mental Disorders (4th Edition) includes ASPD as a diagnosis associated with criminal and anti-social behaviour, previously known as Sociopathic Personality Disorder (DSM-IV; American Psychology Association, 2000). Symptoms are thought to be long lasting, emerging in childhood or adolescence, persisting into adulthood and usually decreasing in middle life. Research has also revealed that individuals prior to the age of 15, who show delinquent behavioural signs, may later develop ASPD and/or psychopathy (Hare, 2006).

The diagnosis of Conduct Disorder (CD) is the American standard for diagnosis of defiant behaviour in adolescence. The criteria involved in CD include such factors as deceitfulness, theft, bullying, vandalism and/or a violation against the law. Other markers include such behaviours as cruelty to animals, fire setting and bed-wetting, known as the McDonald Triad (McDonald, Donnellan, & Navarrete, 2011). However, the most common correlation between CD and psychopathy are callous-unemotional traits (CU) which have been found present in male adolescent populations (Essau, Sasagawa, & Frick, 2006). Based on the current body of research, CD is thought to be three to four times as likely to occur amongst boys as in girls. On the contrary, the factor of impulsivity has been found in both genders by the assessment of early life behaviour records. However, research by Loeber and Hay (1997) emphasized upon the other components of the family structure and environment, such as low socioeconomic status (SES). Specific studies on aggression have also shown that it certainly appears to be connected to genetic heritability across child populations as well (Huber, Bannasch, & Brennan, 2011). In general, there is rather good evidence for the stability of psychopathy traits persisting into adulthood and well beyond. For the purpose of clarification, the term sociopath usually assumes that the condition is largely environmental, while the term psychopath refers more to the idea of psychopathy having a mainly biological cause (Hare, 2003). Psychopathy, as identified by Hare (1980), seems to be the most accurate and comprehensive framework up to present date. The development of the standard measurement tool for psychopathy, the PCL-R (Hare, 1991), is now used by professionals all over the world. The checklist includes a twenty-item scale, much similar to the Child Psychopathy Scale by Lynam (1998). The tool most similar to the PCL-R, applied to youths between the age of 12 to 18 is the PCL: YV (PCL: Youth Version; Forth, Kosson, & Hare, 2004). As for the diagnostic criteria of the DSM-IV, ASPD is mostly comprised out of socially deviant behaviour, while psychopathy focuses less on observed behaviour and more on individual character (Hare, 2006; Ridenour, 1996). Furthermore, it is not uncommon for psychopathy to be seen as a subset of ASPD, yet many researchers believe it to be a separate condition altogether, criticizing the diagnosis criteria of ASPD for not being empirically validated enough. It has also been criticized for leaving out affective and interpersonal personality factors (Hart & Hare, 1996). Additionally, it has been argued that the PCL-R is by far better able to predict future criminality and recidivism, as opposed to the screening tools used to diagnose ASPD. A difference in the processing of linguistic and emotional information has also been found to separate the two conditions, as well as measurements regarding the mentioned lack of conscience and empathy. Moreover, most researchers would agree on a divide between ASPD and psychopathy, in that the latter seems to have a largely genetic component (Harris, Skilling, & Rice, 2001; Rutter, Giller, & Hagell, 1998). Furthermore, only about one third of those diagnosed with ASPD meet the criteria for psychopathy (Hart & Hare, 1996). It is also as important to note that a vast majority of individuals with the tendency to engage in antisocial behaviour do in fact possess an ability to feel remorse for their actions, while psychopaths do not. ”APD is often associated with low socio-economic status. Psychopathy seems less likely to be associated with social disadvantage or adversity.” (Rutter et al., 1998, p. 110). In addition, some of the personality characteristics more typical of the psychopath, such as impulsiveness and a lack of empathy are ascribed to ASPD in the DSM-IV, which makes it even more confusing for clinicians to use. The psychiatric diagnosis of ASPD also concentrates more on the displayed antisocial behaviour itself, and not so much upon the aspect of actual emotional impairment. Yet unfortunately, Hare’s checklist (1991) has not been included in the DSM-IV since it was believed to be far too durative and also unsafe to implement because of the fear connected with clinicians not using it properly (Binkley, Schmitt, Smith, & Newman, 2001). To further elaborate on the divide between ASPD, populations of CD and psychopathy, focus will be put on the case-study of two boys, in which only one is showing accurate signs of psychopathy.

Case Study: John and Bill

The following case study is originally extracted from ”The Psychopath: Emotion and the Brain“ (Blair & Mitchell, 2005). John and Bill are both 11 years old. They both present with anti-social behaviour of varying degree. John was born into a middle-class family with two college graduate working parents. Bill was born into a working-class background with both parents in jail, with his sister being the only one to care for him. The presentation of antisocial behaviour for John began at an early age, which led to the enrolment in a school especially suited for children with emotional and behavioural problems. The first behaviours displayed by John are comparable to the McDonald Triad (McDonald, Donnellan, & Navarrete, 2011). These include such acts as fire-setting and a cruelty towards animals. Other behaviours recorded were roaming the streets late at night, frequent running away from home, and breaking an entry with the subsequent costly damage of property. John also displays frequent violent behaviour towards his peers, parents and teachers. In one instance he threw a knife at his mother, which was retrieved from a collection of stashed knives in his bedroom. John also displays early traits of narcissism in having an inflated sense of both his level of intelligence and abilities in general. At school, John does not have any genuine friends and often conjures people into believing that he is simply misunderstood. Bill presents with similar behaviour in school, but is more verbally oppositional and less violent than John in general. The types of behaviours that Bill presents also include rudeness, a refusal to complete assignments, and instances of theft. However, the main distinction between John and Bill is that Bill usually apologizes for his actions, and also seems to be genuinely remorseful for them. He also displays love towards his sister whenever she is around and enjoys playing sports with his classmates. Bill is not very emotionally stable, but is more self-destructive towards himself rather than presenting with any form of directed aggression towards others.

Even though the behaviours of these two boys vary in their degree of severity, both cases were diagnosed with CD. As argued by research, individuals that meet the criteria of CD are arguably not a homogeneous population (Frick et al., 2003). It is rather clear that John, even though having lived in an environment were rather fine possibilities were available, presents with behaviour which is seemingly more genetically rooted and might thereof be connected with the future development of his psychopathy. On the contrary, even though Bill, who has experienced of what could be considered as some of the more harmful environmental conditions, he is not psychopathic because of an ability to express genuine remorse for his actions. He also seems to be in possession of a conscience, which John does not. In past research, such differences have formerly been attributed to such factors as child abuse, parental separation, family history of mental illness, brain damage, social influence, and social isolation (Hart & Fegley, 1995). However, current research seems to suggest otherwise with an ongoing debate about the genetic predispositions and its intertwined relationship with the environment (Greene, Nystrom, Engell, Darley, & Cohen, 2004).

Social, Environmental and Biological Factors

One of the more recent large-scale studies made on children was a twenty-five year old longitudinal study, which presented as a predictive examination on developing psychopathy later in life (Glenn, Raine, Veneables, & Mednick, 2007). The study indicated that antisocial traits could be detected as early as in three years of age. Originally started in 1972, with the duration of one year, 1795 children from the Island of Mauritius were enrolled in the research project which compared the children’s traits in relation to the different facets of psychopathy including behavioural inhibition, stimulation seeking, and fearfulness/reactivity. Responsiveness to aversive noise was also monitored by the use of skin conductivity (SC). The questionnaire used, was a modified extensive version of the PCL-R, the Self Report Psychopathy Scale (SRP-II). The scale is a 60-item-version of the PCL-R, which was successfully applied to the follow-up assessment 25 years later on 335 individuals, who were by then adults. The results indicated that higher psychopathy scores were marked with significant behavioural differences from the ages of three to four years of age. Children with higher scores were significantly more inclined to seek out stimulation, were more sociable, and also tended to be less behaviourally inhibited than their peers. Interestingly enough, these children had in fact developed psychopathy in accordance with the psychopathy checklist. The group of children with higher SRP-II scores were also found to respond significantly less strongly to negative auditory stimuli, perceivability of pain in others which was also marked by the refusal to obey authority models. These findings are consistent with past literature, where children with CD have been described as more difficult in child rearing situations (Tackett, Krueger, Sawyer, & Graetz, 2003). Furthermore, one could correlate the previously mentioned findings with the development of narcissistic traits of the malignant form, such as a self-inflated grandiose sense of entitlement, pathological lying and fallacious moral reasoning. Some would even argue that one cannot have psychopathy without high levels of narcissism (Campbell & Miller, 2012). The case of malignant narcissism or Narcissistic Personality Disorder (APA, 2000) is believed to be the cause of a coping strategy implemented by the child under negative environmental circumstances. Narcissism in this form, if left unattended to, becomes almost impossible to treat in adulthood because of the rigid schemes that have been implemented and intertwined with the child’s personality. This concept is often explained as a phenomenon of the child creating an outer shell were the true self becomes locked in a sort of prison, or a ”hall of mirrors“ (Wink, 1991, p. 502). The coping strategy of NPD is seen as a way for children to hide from outside hurts, which first occurred during the child’s formative years. Furthermore, the decreased fearlessness hypotheses was tested and elaborated upon in a study demonstrating that children who were more prone to feeling remorse after doing something wrong, were subsequently more concerned with the consequences of their behaviour (Fowels & Kochanska, 2000). This would in term theoretically deter such individuals from the path of future antisocial behaviour. A decrease in recovery time of the psychological reaction to negative stimuli amongst antisocial samples has also been found. This factor could very well be correlated to the recordings of the generally short lived emotions expressed amongst adult psychopathy populations, which is presented in the PCL-R as the trait of shallow affect (Hare, 2003). Previous studies on the fearlessness response were first explained by Lykken (1957), as regards to the response modulation purposive of explaining driven goal-directed activity. Such behaviour, paired with the component of impaired affect seems to lead to the outward presentation of antisocial behaviour. The inhibition mechanism deficit hypotheses proposed by Blair (1995), seem equally relevant, which points towards the critical role of the amygdale. Blair also found a link between the inhibition mechanism and decreased autonomic arousal in psychopathic samples. Such factors would most likely lead to a failure to inhibit ongoing actions or behaviours of those with a psychopathic personality. Furthermore, studies on children and adolescents who displayed psychopathy deficits on experimental tasks assessing impulse-control and empathy (Blair, 1999), were similar to deficits seen in psychopathic adults (Hare & Newman, 2009). A comparable concept, as regards to the impaired processing of sad and fearful faces in children and adolescent samples was also tested and confirmed (Binkley et al., 2001). Furthermore, a twin study on deviant behaviour was found to be connected with reduced emotional capacity and callousness (callous-unemotional traits) strongly suggested to be inherited in children with psychopathic tendencies (Frick, 1998). The conceptualization brought forth a model which presented with positive correlations between CU-traits, temperament style and low behavioural inhibition. Furthermore, studies on children and adolescents (Forth & Burke, 1998) indicated that several family background variables, such as parental rejection, inconsistent discipline, and abuse are believed to be associated with the development of antisocial behavior later on. However, such literature also points towards the fact that it is not the most crucial key in the development of psychopathy. As previously mentioned, it has been suggested that most children with conduct disorder, particularly those with a history of repeated violent behavior, exhibit neuropsychological deficits (Mofitt & Henry, 1991). A link between reduced levels of arousal with lower levels of plasma-cortisol has also been found (Mitchell et al., 2006). Research also found that antisocial tendencies (prior to the age of 13 to 14) were positively associated with later ages, from 16 to 17 years of age (Larsson, Tuvblad, Rijsdijk, Andershed, & Grann, 2007). The traits tested were affective, impulsive and interpersonal traits. Another fact that casts doubt on the social and environmental theories is the fact that about 25 percent of interactions amongst toddlers in daycare settings involve some form of physical aggression (Thompson, 2000). The majority of children between the ages of one to three are generally found to be the most aggressive during this time-period. As toddlers grow up, they usually learn to inhibit their physical aggression, with verbal and more indirect measures of aggression are displayed in later elementary years (Loeber & Hay, 1997). Worth mentioning is also the fact that no other age group exhibit the display of aggression 25 percent of the time, be it criminal or any other form of violence. This fact appears therefore to further confirm that normal levels of behavioural inhibition are crucial in the development of empathy in children. Findings which elaborate on the more environmental approach, in terms of parenting seem however still important. One of the more recent studies emphasizing on this factor is Kochanska’s study on the mother-child relation in regards the development of a normally functioning conscience (Kochanska, Forman, Aksan, & Dunbar, 2005). The study was conducted on infants as early as in the 9, 14 and 20 months of life and included the measures of responsiveness and positive mother-child affect (MRO) across a variety of naturalistic interactions between mothers and their children. The parental techniques recorded were commitment and compliance of the mother to the child’s wants and needs, enjoyment of the child’s interaction with the mother and the need for a maternal use of a power assertion in response to the child’s behaviour. The results indicated that there seem to be several rather distinct pathways in conscience development. The importance of joy expressed in child-mother interactions were found to be one of the factors which could possibly decrease the risk of CD in the child’s future (Criss, Shaw, & Ingoldsby, 2003). This finding can be conjoined with the large body of research indicating that the development of pro-social behaviour and self-regulation is related to positive emotions early in life (Carlson, Charlin, & Miller, 1988; Cialdini, Kenrick, & Baumann, 1982). Maccoby (1983) also emphasized upon the role of positive affect in socialization and that of a positive affective bond which ”engenders attention to the parent and a readiness to become interested in, and cooperative with, an enterprise suggested by the parent“ (Maccoby, 1983, p. 363). Other research implies that children who experience more positive emotions, which result in positive moods, seek to maintain such states by engaging in behaviour consistent with parental rules (Emde, 1991). Positive mood has also been found to increase the capacity in dealing with temptations that can have possible negative outcomes for the individual’s future (Eisenberg & Fabes, 1992). Nonetheless, MRO may also foster high self-esteem and may at the same time also lead to a possible increase of guilt within the child if behaviour were to fall short of what would be normally expected. The responsiveness of mothers with displayed positive affect towards the child does however promote a cooperative attitude. This is in term seemingly related to a sense of obligation which makes the child engage in committed compliance towards other individuals. A recent study conducted found that physically abused children were inclined to show less committed compliance than children without such prior family conditions (Koenig, Cicchetti, & Rogosch, 2000). As also derived from the research, was the fact that mothers who had failed to form warm and responsive relationships, developed a more confrontational strategy in dealing with the difficult child, which has been hypothesised to lead to an undermining of the workings in conscience development (Grusec & Goodnow, 1994). However, studies on children with conduct disorder have shown that the style parents use to socialize their children have less impact on the development of conduct problems in those with CU traits (Rutter et al., 1998). This suggests that genetic and neurodevelopmental factors seemingly play a larger role in children who are notably callous. On the other hand, such findings as presented by Kochanska’s MRO study have only been studied with mothers and their children, and not with fathers. Another study revealed that a randomly chosen sample of children during a period of four years, with measures in third, fourth, sixth and seventh grade, had significant predictability in the stability of ASPD traits over time (Frick et al., 2003). The sample consisted out of boys from the ages of eight to 16 and was assessed by the child behaviour checklist as well as a separate assessment of callousness and markers of low empathy. Moreover, it is equally important to note that SES and quality of parenting were significant in predicting the stability of the measured antisocial traits over time. An additional review of 10 studies in the same report exemplified upon antisocial youth with CU traits being less sensitive to cues of possible punishment, often leading to verbal deficits and aggressive situations with peers. Consistent with research on adult psychopathy, these adolescents were also found to exhibit more thrill-seeking behaviours.

The Integrative Neurobiological Perspective

Neuroscience in connection with psychology is one of the fields that have indicated a strong link between psychopathy and genetics. In the research literature, there is a wide base of data reporting a reduction in grey matter amongst antisocial individuals, including amygdale volume loss (Weber, Habel, Amuts, & Schneider, 2008). Other abnormalities include an exaggerated structural asymmetry in the hippocampus. This particular region has been demonstrated to be involved in fear conditioning (LeDoux, 1996). Lesions of the hippocampus are also known to result in affect dysfunction, poor contextual fear conditioning, and impair associative learning leading to insensitivity to cues of predicting negative consequences. Such malfunctions in the brain, usually lead to a failure to categorize one’s experiences as either good or bad. Another study identified the errors of psychopaths’ decision-making processes regarding gambling in relation to the response modulation deficit hypothesis (Newman, 1998). The experiment was arranged with a set of cards, with separately ascribed values. The game was constructed in a way that first made the players win, after a subsequent preceding of 50 cards played the odds worsened. It was consequently found that most people ceased playing as the odds turned against them, while psychopathic individuals kept on playing until the deck was exhausted, losing most of their winnings which they had previously gained. The point of the experiment was to show that psychopaths are poor at directing their attention away from initial goals which become rigidly employed without the expected change in strategy. Levels of serotonin (5-HT) have also been found to be low in populations with ASPD in general (Moeller, Barratt, Dougherty, Schmitz, & Swann, 2001) as well as lower resting heart rates (Raine & Dunkin, 1990). Records on known psychopathic serial-killers report, almost without exception, that such individuals usually suffer one or more head traumas to their frontal region during childhood (Winerman, 2004). This specific area seem also to be involved in the decision-making processes of risk assessment, while also managing such processes responsible for reward and punishment. Furthermore, the apparent dysfunction in the amygdale presumably results in the alleged lack of empathy. Aggleton and Mishkin (1986) called the amygdale a sensory gateway to emotions. This is the region of the brain which was initially linked to the emergence of psychopathy, since lesions and dysfunctions of the amygdale generally tends to impair classical conditioning and stimulus–reinforcement instrumental learning (Mitchell et al., 2006), and therefore also impairing moral reasoning. According to research, aggression and other environmental variables (e.g. poor parenting or abuse) have little impact on antisocial behaviour in samples of children with typical psychopathic emotional dysfunction (Blair, 2010). However, social environmental variables (e.g. antisocial culture, abuse and/or unemployment) are likely to have significant influence on the behaviour of children with emotional dysfunction with the specific genetic predispositions for developing psychopathy. Another more recent study, showed deficiency in psychopaths’ detection of language meaning by the use of EEG methodology (Kiehl, Hare, Liddle, & McDonald, 1999). Not only did psychopaths have problems with understanding metaphors involving concepts such as love or trust, but often responded negatively to such content because of the inability to understand the true meaning behind it. Psychopaths also had difficulties in differentiating between emotionally suggestive words as opposed to neutral ones. In general, most non-psychopathic individuals seem to be more acute at responding emotionally to such words as blood or death, rather than more neutral words such as house or tree. In psychopaths this is seemingly not the case. EEG readings were in fact shown to be consistent throughout all of the words presented, with unusually shaped brainwaves suggesting a completely different processing-strategy of the brain (Kiehl, 2006). As we can see there are numerous theories and findings related to the neurological basis of antisocial behaviour and psychopathy. It is however important to note that there is no single conclusion alone that can be drawn from the mentioned brain abnormalities as psychopathic individuals often differ as regards to the presentation of these. We can, however, state with some certainty that brain neurology seem to play a large part in the development of the condition.

Discussion

Researchers have by now pinpointed the main causes of psychopathy. These include such factors as biological brain differences linked to low behavioral inhibition, increased impulsivity and other trademarks of psychopathy such as a lack of conscience and empathy. Most researchers seem also to be in a general agreement of the fact that genes seem to account for about 50 percent of the variability amongst individuals exhibiting antisocial traits, while environmental factors appear to account for the other 50 percent (Hare, 2006). The traits of CU and impulsivity have found to especially increase the possibility of developing psychopathy. Neurological aspects in contemporary research on psychopathy seem to be the current trend in current research (Aggleton & Mishkin, 1986; Blair, 2003; Hare, 1993; LaPierre, Braun, & Hodgins, 1995). Other factors such as mood disorders, substance abuse and narcissism have also found to be positively correlated with the condition (Meloy, 1988), as well as such inherited factors as level of aggression and individual heart rates. As previously mentioned, it has also been suggested that most children with conduct disorder, particularly those with a history of repeated violent behavior, exhibit neuropsychological deficits (Mofitt & Henry, 1991). Culture, peer and family conditions, including poor socialization has also been suggested to contribute to the condition. Moreover, peer influence has actually been suggested to be more important than parental guidance (Clark, 1990; Kerr & Stattin, 2000). This factor would certainly be congruent with the mentioned findings on CU as regards to the lessened responsiveness to parent directives. However, there is clear evidence showing that some individuals raised in excellent homes and communities still grow up to become so called con-artist or display ruthless behaviour in corporate environments. Many brain areas and neural pathways have also been proven to develop through a continuous interaction with the environment (Shore, 1997). In other words, one could go back and forth between environmental and biological causes. The main point is that there is a whole variety of environmental factors which might enhance the presentation of psychopathy. The condition must also be seen as a continuum where clusters of traits are combined together forming different types of psychopathic individuals. Furthermore, it indeed appears that we can in fact detect signs of psychopathy in children. On more ethical terms, such findings have to be carefully considered in protecting both participants and the implications used from such studies by mental healthcare practitioners. The debate on the issue is focused on the common notion that children can change and that, while theoretically some traits are stable over time, it is often believed that one can grow out of deviant behaviour following adult life (Edens, Skeem, Cruise, & Cauffman, 2001). Conversely, there is a general understanding that in order to intervene with any serious condition, it is probably best to do so early on. Since psychopathy has comorbidities with malignant narcissism, the individual will most likely refuse to accept the fact that his/her behaviour is undesirable to the rest of society. Cognitive-Behavioural Therapy (CBT) has been found to be the most effective in reinforcing behaviour which is incompatible with psychopathic conduct (Teasdale, 1977). Other forms of treatment may include the use of pharmaceutics drugs to control for co-morbid factors such as mood disturbances or decreased levels of dopamine. However, most treatment programs have been found largely ineffective over time with no guarantee that treatment will be successful. Nevertheless, the option of teaching out parental skills to deal with psychopathic youth has been found effective in reducing such antisocial behaviour as aggression and impulsive conduct (McDonald et al., 2011). As one could imagine, the treatment of psychopathy is as complex as the disorder itself.

 

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