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

These are individuals who have been portrayed as evil beings, capable of the most disturbing acts and wrapped 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 question that is asked very often: is psychopathy a disease?

To do this, it’s elementary to first go down to where it lives, 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 presented in all cases.

1. Difficulty in learning from the past

People with psychopathy have a lot of difficulties to learn from the facts they lived through in the past and that were harmful to them. For this reason, despite the fact that they are punished for carrying out a behaviour that transgresses the rights of others, the punishment imposed on them does not have any deterrent effect on them. Thus, they often continue their conduct 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. This is an argument often used to defend the use of harsher measures for those criminals who commit particularly tragic acts.

2. Low responsibility

People with psychopathy usually have a low sense of responsibility , so they may be unable to keep their job or studies long enough to progress. A certain need for stimulation and a substantial facility for boredom also contribute to this.

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).

Utilitarian vision of relationships

One of the most elemental characteristics of psychopathy is the pragmatic vision of social relations , which 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 it advances to a point where a certain 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, a deficit in the empathy of emotional type is observed (capacity to feel identified in the pain of others and to have compassion), but a total preservation of its cognitive dimensions (capacity to infer the internal states of the others and to anticipate its conduct). 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 , that is, in inhibiting a behaviour that may have adverse implications (for them or for others). This inability (together with intolerance to frustration) makes it difficult to manage emotions in situations where a goal they consider important is prevented, facilitating the outbreak of violent or dangerous acts.

The most frequent risk behaviors in these subjects would be: risky sexual encounters, substance use, extreme sensation seeking or fighting. This is one of the reasons why comorbid mental disorders can appear, especially drug dependence.

5. Surface Charm

People with psychopathy can be attractive in short distances and in contacts that do not imply depth , such as exchanges that take place in an academic or work context. These are individuals who are often described as charming, caring and polite; therefore, when they commit a reprehensible act, the social environment is usually surprised or even annoyed.

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

6. Antisocial behaviour

Anti-social behavior is very common among psychopaths. It includes acts that generate some damage to others in the economic, psychic, physical or moral areas; and that can be summarized as fights, robberies, destruction, abuse, harassment, swindling, threats or other expressions of interpersonal violence. However, there is a high percentage of these people who never incur them, so they are fully integrated into society.

The DSM5 manual includes antisocial personality disorder as the closest diagnosis to psychopathy (based mainly on the commission of crimes from an early age), but does not have 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 lives.

7. Strong aggressiveness

People with psychopathy can show 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 their purposes are impeded. This aggressiveness is perceived by the person who receives it as excessive, and includes sudden and seemingly uncontrollable 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 detrimental to others, and which is accentuated when we attribute to ourselves voluntariness or when we perceive that the possible alternatives for action have not been exhausted. It is a painful and unpleasant experience for most of the population, and 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, because they perceive it as an injustice that deserves a rebellion. It’s a way of processing information in which responsibility is excluded from the equation through which one tries to explain reality.

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

9. Egocentrism

Self-centeredness implies a special emphasis on the importance a person attaches to himself, in contrast to the importance he assigns to the rest of the individuals around him. 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 that are attributed to all parties.

Self-centeredness can be accompanied by emotional immaturity, a tendency to devalue others, exaggerated self-esteem, and the 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 (a higher prevalence is detected in these populations). In these contexts, asymmetrical relationships with subordinates or people under their charge can develop in a socially acceptable way. This ability to adapt occurs among psychopaths who are less impulsive and have a higher capacity for planning.

Psychopaths adapt to the demands of the future with ease. This 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, we are dealing with people with a low level of anxiety.

Is psychopathy a disease?

As previously mentioned, the current diagnostic manuals (DSM-5) do not include psychopathy among their proposals , so a diagnosis for psychopathy cannot be clearly established. The approaches to the phenomenon (such as antisocial disorder) are insufficient, since they focus all their clinical description on purely behavioral aspects that do not capture the complexity of the phenomenon at hand (especially at the cognitive and experiential level).

The truth is that most people sometimes react impulsively, or act indifferently in situations where they should not (according to social norms). It is also very common to seek stimulation to escape from boredom or monotony. Thus, the traits of psychopathy describe behaviours 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. The advance in neuroimaging technologies will allow to forge a greater knowledge on this issue and to determine a basic cause, finally clarifying if we are facing a pathology or a particular way of being and feeling.

Referencias bibliográficas:

  • Anderson, N.E. y Kiehl, K.A. (2014). Psicopatía: Perspectivas de desarrollo y sus implicaciones para el tratamiento. Restorative Neurology and Neurosciencie, 32(1), 103-117.
  • Gao, Y. y Raine, A. (2010). Successful and Unsuccessful Psychopaths: Un modelo neurobiológico. Behavioral Sciences and the Law, 28, 194-210.