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Psychopathy: A Clinical Perspective
Transcript of Psychopathy: A Clinical Perspective
-- William March, The Bad Seed John Wayne Gacy
Junior Chamber of Commerce "Man of the Year" who entertained children as "Pogo the Clown," had his picture taken with President Carter's wife, Rosalynn, and murdered 32 young men in the 1970s, burying most of the bodies in the crawl space under his family's house. Clifford Olson
A Canadian serial murderer who persuaded the government to pay him $100,000 to show the authorities where he buried his young victims, does everything he can to remain in the spotlight. Psychopathy in the Media Ted Bundy
The "All-American" serial killer who was responsible for the murders of several dozen young women in the mid-1970s, claimed that he had read too much pornography and that a "malignant entity" had taken over his consciousness. "He will choose you, disarm you with his words, and control you with this presence. He will delight you with his wit and his plans. He will show you a good time, but you will always get the bill. He will smile and deceive you, and he will scare you with his eyes. And when he is through with you, and he will be through with you, he will desert you and take with him your innocence and your pride. You will be left much sadder but not a lot wiser, and for a long time you will wonder what happened and what you did wrong. And if another of his kind comes knocking at your door,will you open it?"
--From an essay signed, "A psychopath in prison." Key symptoms of Psychopaths: Emotional/Interpersonal
glib and superficial
egocentric and grandiose
lack of remorse or guilt
lack of empathy
deceitful and manipulative
shallow emotions Social Deviance
poor behaviour controls
need for excitement
lack of responsibility
early behavioural problems
adult antisocial behaviour "The total pattern of the psychopath's personality differentiates him from the normal criminal. His aggression is more intense, his impulsivity more pronouced, his emotional reactions more shallow. His guiltlessness, however, is the critical distinguishing trait. The normal criminal has an internalized, albeit warped, set of values. If he violates these standards he feels guilt.
--McCord and McCord. The Psychopath:
An Essay on the Criminal Mind The Development of a Young Psychopath:
repetitive, casual, and seemingly thoughtless lying
apparent indifference to, or inability to understand, the feelings, expectations, or pain of others
defiance of parents, teachers, and rules
continually in trouble and unresponsive to reprimands and treats of punishment
petty theft from other children and parents
persistent aggression, bullying, and fighting
a record of unremitting truancy, staying out late, and absences from home
a pattern of hurting or killing animals
early experimentation with sex
vandalism and fire setting Treatment efficacy is largely unknown due to the limited research and theory Contra-indicated treatment: Insight-oriented therapy Token System:
pro-social lifestyle Limits to the healing process because of the psychopath's characteristics Difficulty in diagnosing because of stigma The Diagnosis Not in the
DSM or ICD Robert Hare's
Psychopathy Checklist 1% of the general population-- 300,000 people in Canada and Australia?
15-25% of the prison population
approx. 1/5 persistent domestic abusers
responsible for more than 50% of serious crimes committed Current Treatments from a Clinical Perspective Implications from a Client Perspectives Nursing strategies needed for positive health changes... Psychopathy is a personality disorder defined by a distinctive cluster of behaviour's and inferred personality traits The 20 traits assessed by the PCL-R score are:
glib and superficial charm
grandiose estimation of self
need for stimulation
cunning and manipulativeness
lack of remorse or guilt
shallow affect (superficial emotional responsiveness)
callousness and lack of empathy
poor behavioural controls
early behavioural problems
lack of realistic long-term goals
failure to accept responsibility for own actions
many short-term marital relationships
revocation of conditional release
criminal versatility the average person would score a "5" on the PCL-R
the average PCL-R scores for incarcerated criminals are: 22 for men; 19 for women Psychopath
Antisocial Personality Disorder Diagnosis is based on thea accumulation of evidence that an individual satisfies at least the minimal criteria for the disorder The Ethics of Labelling A Tool Is Only as Good as Its User Protect Yourself
Know what you're dealing with
Try not to be influenced by "props"
Keep your guard up in high-risk situations
Be careful about power struggles
Set firm ground rules
Don't expect dramatic changes
Know yourself Care-focused Treatment