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See Inside December 2007/January 2008

What "Psychopath" Means

It is not quite what you may think

VIOLENT psychopath” (21,700). “Psychopathic serial killer” (14,700). “Psychopathic murderer” (12,500). “Deranged psychopath” (1,050). We have all heard these phrases before, and the number of Google hits following them in parentheses attests to their currency in popular culture. Yet as we will soon discover, each phrase embodies a widespread misconception regarding psychopathic personality, often called psychopathy (pronounced “sigh-COP-athee”) or sociopathy. Indeed, few disorders are as misunderstood as is psychopathic personality. In this column, we will do our best to set the record straight and dispel popular myths about this condition.

Charming but Callous
First described systematically by Medical College of Georgia psychiatrist Hervey M. Cleckley in 1941, psychopathy consists of a specific set of personality traits and behaviors. Superficially charming, psychopaths tend to make a good first impression on others and often strike observers as remarkably normal. Yet they are self-centered, dishonest and undependable, and at times they engage in irresponsible behavior for no apparent reason other than the sheer fun of it. Largely devoid of guilt, empathy and love, they have casual and callous interpersonal and romantic relationships. Psychopaths routinely offer excuses for their reckless and often outrageous actions, placing blame on others instead. They rarely learn from their mistakes or benefit from negative feedback, and they have difficulty inhibiting their impulses.

Not surprisingly, psychopaths are overrepresented in prisons; studies indicate that about 25 percent of inmates meet diagnostic criteria for psychopathy. Nevertheless, research also suggests that a sizable number of psychopaths may be walking among us in everyday life. Some investigators have even speculated that “successful psychopaths”—those who attain prominent positions in society—may be overrepresented in certain occupations, such as politics, business and entertainment. Yet the scientific evidence for this intriguing conjecture is preliminary.

Most psychopaths are male, although the reasons for this sex difference are unknown. Psychopathy seems to be present in both Western and non-Western cultures, including those that have had minimal exposure to media portrayals of the condition. In a 1976 study anthropologist Jane M. Murphy, then at Harvard University, found that an isolated group of Yupik-speaking Inuits near the Bering Strait had a term (kunlangeta) they used to describe “a man who … repeatedly lies and cheats and steals things and … takes sexual advantage of many women—someone who does not pay attention to reprimands and who is always being brought to the elders for punishment.” When Murphy asked an Inuit what the group would typically do with a kunlangeta, he replied, “Somebody would have pushed him off the ice when nobody else was looking.”

The best-established measure of psychopathy, the Psychopathy Checklist-Revised (PCL-R), developed by University of British Columbia psychologist Robert D. Hare, requires a standardized interview with subjects and an examination of their file records, such as their criminal and educational histories. Analyses of the PCL-R reveal that it comprises at least three overlapping, but separable, constellations of traits: interpersonal deficits (such as grandiosity, arrogance and deceitfulness), affective deficits (lack of guilt and empathy, for instance), and impulsive and criminal behaviors (including sexual promiscuity and stealing).

Three Myths
Despite substantial research over the past several decades, popular misperceptions surrounding psychopathy persist. Here we will consider three of them.

1. All psychopaths are violent. Research by psychologists such as Randall T. Salekin, now at the University of Alabama, indicates that psychopathy is a risk factor for future physical and sexual violence. Moreover, at least some serial killers—for example, Ted Bundy, John Wayne Gacy and Dennis Rader, the infamous “BTK” (Bind, Torture, Kill) murderer—have manifested numerous psychopathic traits, including superficial charm and a profound absence of guilt and empathy.

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