Is psychopathy a disease?

Can it be considered as such?

Psychopathy has always generated fascination.. That is why characters with psychopathic traits have been the protagonists of many works of fiction, some of them widely praised.

These are individuals who have been portrayed as perverse beings, capable of the most disturbing acts and shrouded in a halo of mystery. But does this stereotype fit the reality of the problem?

In this article we will reflect on the question and answer a frequently asked question: is psychopathy a disease?

• Recommended article: "Psychopathy: what goes on in the mind of the psychopath?"

To do so, it is elementary to first descend where this dwells, to define it and draw a line that differentiates psychopaths from the rest of the people.

What is psychopathy: ten essential traits

Below we present the most common features of this phenomenon, through which we will be able to answer the question posed: Is psychopathy a disease?

The points to be addressed describe ways of thinking, feeling and acting of these people, although they are not always present in all cases.

1. Difficulty in learning from the past

People with psychopathy have many difficulties to learn from the events they have experienced in the past and that supposed for them some damage. For this reason, although they are penalized for carrying out a behavior that transgresses the rights of others, the punishment imposed on them does not have any deterrent effect on them. Thus, they tend to continue their behavior despite the efforts of judges to impose severe penalties for their crimes.

This feature has often been the subject of controversy, as it calls into question one of the basic pillars of the judicial system: the reintegration of persons who commit illegal acts. It is an argument often used to defend the use of harsher measures for those offenders who commit particularly lethal acts.

2. Low responsibility

People with psychopathy often have a low sense of responsibility and may be incapable of taking responsibility for their actions.They may be unable to maintain their work or studies long enough to progress. This also contributes to a certain need for stimulation and a substantial facility for boredom.

This trait also has, as a counterpart, the tendency to blame others for all the setbacks and vicissitudes they may experience (which undermines the emotional state of those around them).

3. Utilitarian view of relationships

One of the most elementary characteristics of psychopathy is the pragmatic view of social relationships. pragmatic view of social relationships, which implies that they are perceived as a means to satisfy their needs.This implies that they are perceived as a means to satisfy their needs. Therefore, they may strive to maintain a bond as long as it brings them some personal benefit, losing interest when this progresses to a point where some reciprocity is required or the deliberate imbalance to which they aspire is questioned.

This fact is enhanced by the particular profile of these people in terms of empathy. Specifically, there is a deficit in emotional empathy (ability to feel identified in the Pain of others and to have compassion), but a total preservation of its cognitive dimensions (ability to infer the internal states of others and to foresee their behavior). They can, therefore, make use of this knowledge in their own interest (manipulation, lying, etc.).

4. Impulse control problems

People with psychopathy present a notable difficulty in impulse control, i.e., in inhibiting behaviorthat is, to inhibit behavior that may have adverse implications (for themselves or for others). This inability (together with intolerance to frustration) makes it difficult to manage emotions in situations in which a goal they deem important is impeded, facilitating the eruption of violent or dangerous acts.

The most frequent risk behaviors in these subjects would be: risky sexual encounters, substance abuse, search for extreme sensations or fights. This is one of the reasons why comorbid mental disorders may appear, especially drug dependence.

5. Superficial charm

People with psychopathy may be attractive in short distances and in contacts that do not involve depth, such as exchanges that occur in an academic or work context.such as exchanges that take place in the academic or work context. They are individuals who are often described as charming, helpful and polite; so when they incur in some reprehensible act, the social environment is often surprised or even displeased.

This social mask is often used because it increases the likelihood of interacting with others in a profitable way. However, if relationships reach a greater degree of depth, it is difficult to maintain. This fact would explain why those closest to the psychopath emphasize for them a series of traits that differ, or are even diametrically opposed, to those used by people whose relationship with the psychopath is merely superficial.

6. Antisocial behaviors

Antisocial behavior is very frequent among psychopaths. It includes acts that generate some harm to third parties in the economic, psychological, physical or moral spheres; and that can be summarized as fights, theft, destruction, abuse, harassment, swindling, threat or other expressions of interpersonal violence. However, there is a high percentage of these people who never engage in them, so they are fully integrated into society.

The DSM5 manual includes antisocial personality disorder as the closest diagnosis to psychopathy (based primarily on the commission of violent behavior). (based mainly on the commission of crimes from an early age), but has no specific criteria for the latter. This form of classification is the subject of much criticism, since not all psychopaths carry out criminal acts in their lifetime.

7. Strong aggressiveness

People with psychopathy may exhibit very aggressive behaviors, in the broad sense of the term.. These are not limited only to their physical dimension, but can also adopt a covert and insidious expression (hostility), especially when they are impeded in their intentions. This aggressiveness is perceived by the person on the receiving end as excessive, and includes sudden, seemingly irrepressible outbursts of anger.

8. Inability to experience guilt

Psychopaths have difficulty feeling remorse as a consequence of their actions.. Guilt is a feeling that arises when we do something that is harmful to others, and is accentuated when we attribute voluntariness to ourselves or when we perceive that the possible alternatives for action were not exhausted. It is a painful and unpleasant experience for most of the population, and it reduces the probability that on future occasions we will choose to repeat the behavior that motivated it.

Thus, guilt allows us to learn from past mistakes and is connected to empathy. It is one of the main reasons why psychopaths are insensitive to punishment, as they perceive it as an injustice that merits rebellion. It is a way of processing information in which responsibility is excluded from the equation by which they try to explain reality.

There are many experimental studies that indicate that people with psychopathy show a low electrodermal reactivity to scenes of violence. This means that, when exposed to images to which a majority of people report an aversive emotion (mutilations, aggression, abuse, etc.), they feel indifference.

9. Egocentrism

Egocentrism implies a special emphasis on the importance that the person attributes to him/herself, in contrast to the importance that he/she assigns to the rest of the individuals around him/her. This way of thinking usually translates into a preference for relationships in which a dynamic of evident hierarchical inequality can be established. The psychopath would be located at the top of this pyramid, promoting an asymmetry in the rights and duties attributed to all parties.

Egocentrism may be accompanied by emotional immaturity, tendency to devalue others, exaggeration of self-worth and use of blackmail or extortion. This is why it ends up triggering conflicts within the family, which further degrade coexistence.

10. Possibility of adaptation

Many people with psychopathy are placed in high positions in the social hierarchy, including political or managerial positions (with a higher prevalence in these populations). (with a higher prevalence detected in these populations). In these contexts, asymmetrical relationships with subordinates or people under their charge can develop in a socially acceptable way. This adaptive capacity occurs among less impulsive psychopaths with superior planning ability.

Psychopaths adapt to the demands of the future with ease. This fact is due to an almost exclusive orientation towards the immediate, so that what will happen later is relegated to a second (or third) order of importance. As a consequence of this way of facing reality, they are people with a low level of anxiety.

Is psychopathy a disease?

As pointed out above, the current diagnostic manuals (DSM-5) do not include the figure of psychopathy, the current diagnostic manuals (DSM-5) do not include the figure of psychopathy among their proposals, so a diagnosis for psychopathy cannot be clearly established.Therefore, a diagnosis for psychopathy cannot be clearly established. Approaches to the phenomenon (such as antisocial disorder) are insufficient, as they focus their entire clinical description on purely behavioral aspects that do not capture the complexity of the phenomenon in question (especially at the cognitive and experiential level).

The truth is that most people sometimes react impulsively, or act with indifference in situations in which they should not do so (according to social norms). It is also very common to seek stimulation to escape boredom or monotony. Thus, the traits of psychopathy describe behaviors that occur (in general) in the whole population, although nuanced by the fact that in their case they extend in an absolute way to the whole daily experience (they are not a punctual exception).

Many studies are currently focusing their efforts on the study of the amygdala, the prefrontal cortex and the limbic region as the structures that could explain the particular affective and behavioral pattern of psychopathy. Advances in neuroimaging technologies will allow us to forge a better understanding of this issue and determine a root cause, finally clarifying whether we are dealing with a pathology or a particular way of being and feeling.

Bibliographical references:

• Anderson, N.E. and Kiehl, K.A. (2014). Psychopathy: Developmental Perspectives and their Implications for Treatment. Restorative Neurology and Neurosciencie, 32(1), 103-117.
• Gao, Y. and Raine, A. (2010). Successful and Unsuccessful Psychopaths: A Neurobiological Model. Behavioral Sciences and the Law, 28, 194-210.