A Study of Psychopathy

Psychopathy is believed to affect approximately 1% of the general population, 15-25% of the male and female prison population (Hare, 1991, 2003), and 10-15% of substance abuse populations (Alterman and Cacciola, 1991; Alterman et al., 1993, 1998).'

As it is statistically shown that up to 1/4 of the prison population is a psychopath, it can be said that they are prone to criminal behaviour. The study of psychopathy therefore is of significant importance due to the danger that psychopaths may present to the public.

What we now call psychopathy was first described by the psychiatrist Pinel (1792 as cited in Cleckley, 1941) as 'madness without delirium' two centuries ago. Such other terms as 'sanity masked' have been used to describe their apparent normal life, but there is nothing normal about these people. Unlike most of us, they lack emotions. Not completely for they do posses such emotions as anger or frustration when they do not get what they want, to express it in Clarkey's words: 'If he really feels anything at all, they are emotions of only the shallowest kind.' The emotions which they lack are those of empathy, how other people might feel in a certain situation, rightly so called by some researchers as 'emotional blunting'. It might be said that this lack of empathy is one of the reasons why psychopaths in extreme cases have been found to be involved in ritualistic cannibalism. Like the lion in the wild eating his pray, unable to comprehend that the pray might be suffering gravely, the psychopath is free of emotional guilt.

Of course not all psychopaths are cannibals, those are very extreme cases. Psychopaths make 1-2 percent of the population, as such they are found amongst us conducting a normal life, but with an advantage. While most of us would feel guilt when exploiting someone, hurting someone, the psychopath is unable to have such feelings. This might explain why most of them do so well in commercial or political fields.

The lack of empathy in psychopaths can be shown by a study conducted by Patrick et al., 1993(as cited in Khiel, 2005). It was shown that 'psychopaths do not show the normal pattern of blink modulation when processing negatively valenced stimuli as do nonpsychopaths and healthy individuals'. Another finding was that while nonpsychopaths 'elicit a larger blink reflex response than that elicited during viewing of neutral or positive stimuli', this was not true for psychopaths as they elicited the same blink reflexes when viewing positive and negative stimuli. One interpretation for such differences might be that: 'they had an appetitive response to the negative stimuli'. Not many other studies have been conducted on the effect that emotions have on psychopaths however. One study tries to replicate the above study, but with sound stimuli rather than pictures and found similar results (Curtin et.al, unpublished).

It has been suggested that the neural bases of psychopathy are to be found in the frontal cortex. The psychological functions of the frontal cortex are: 'the capacity for foresight, planning, and, in general, the regulation of impulses (Luria, 1966)'. One scholar has used the metaphor of a plane to describe the frontal lobe. He states that 'if the brain were an aircraft then the frontal lobes would be the pilot. Like a plane, the brain is a complex 'machine' that needs the guidance and control of the frontal lobes in order to function properly'.

The importance of the role of the frontal lobe can be shown by the famous case of Gage who suffered penetrating damage to the prefrontal cortex. After the accident his transformation was described as a person who had become 'an impulsive, irresponsible, sexually promiscuous, verbally abusive individual (Harlow, 1848)'. Other studies have shown that the orbital frontal cortex has a significant effect on some traits linked to psychopathy (Blumer and Benson, 1975; Damasio, 1994). The transformation that arises from such damages was named pseudo-psychopathy (Blumer and Benson, 1975), which includes 'reactive aggression, motivation, empathy, planning and organization, impulsivity, irresponsibility, insight, and behavioral inhibition (Malloy et al., 1993; Stuss et al., 1983)'.

Against such background, we set to find if there is a link between psychopathy and the frontal lobe functioning. Instead of using the CLR-H scale to measure psychopathy as it would be rather impractical and require a great length of time, money and resources, we measured only one trait of psychopathy, namely empathy.

Method

We used a questionnaire to measure empathy. For the measuring of the frontal lobe we used two trail tasks and a verbal task. The trail tasks were fairly simple in that all they needed to do was connect through a line 1 to 2 to 3 and so on, this is Trail A. The second trail test was as the above except that they had to connect 1 to A then from A to 2 then from 2 to B from B to 3 from 3 to C and so on which is called Trail B. This can measure another trait of psychopaths, namely impulsivity, as well as the frontal lobe functioning. The time taken to complete Trail A was recorded as well as the time taken to complete Trail B. The final task was the verbal test which asked participants to write down as many words as they can starting with S in one minute. 50 participants took part, they were a mixture of opportunistic sampling and random sampling.

Results

The adjusted R square is 0.032, with a standard error of 2.5. There seems to be a very week correlation between all the variables, namely only a 3% predictability. The results do not seem to be significant as shown by (F (3, 46) =0.49, p= 0.691). The Standard Beta Coefficient for trail A is 0.126, for trail B is 0.033 and for the Verbal task it is –0.084. As you can see from the results, there seems to be no connection between the variables. That is rather surprising.

From the studies mentioned above you would expect that an increase of empathy would lead to either an increase or decrease in the time taken to complete the trails or the number of words starting with S. To get myself out of this inconsistency, I could mention that each of us collected a certain number of data, therefore I can not be certain of their validity, but before going onto blaming someone, lets us try and establish the validity of the tests.

There are two questions which need to be answered, namely if a trail test and the verbal task are sufficient tests to measure the frontal lobe functioning. Another question might be if the questionnaire designed to measure empathy does in fact do so.

A test which measures the frontal lobe function needs to fulfil these criteria:

A test which Morgan is satisfied that it fits the above criteria is Part B of the Trail Making Test (TMT) and the verbal fluency test. There is therefore no doubt of the validity of these tests to measure frontal lobe functioning. Hence the question still remains. How can scholars claim that damage to frontal lobe functioning causes a lack of empathy, yet we were unable to find a relationship between tests which measure frontal lobe functioning and empathy?

One explanation might be that the questionnaire designed to measure empathy is forced choice as the only available option is yes or no. The questions are rather superficial, such as I can tell if someone is rude on profile, some of the participants did not even understand that question. Other questions ask if you can understand how little things can make a person so upset. In fact two of the participants went on to debate as to whether they can or cannot. Therefore I cannot but doubt the effectiveness of the questionnaire in measuring empathy.

A score between 0 and 12 is given to measure empathy. It can be argued that such a scale is hardly enough for measuring such abstract function as empathy, or for effective discrimination between levels of empathy. I can not think of any reason which might lead us to not believe that there are people who have no empathy, low empathy, medium empathy and high empathy. In a scale of 0 to 12 I only wonder where the distinction is made.

Another explanation might be that empathy as such is a social construct. What I mean is that there are certain social norms which we would expect everyone to know, even if they might not abide or actually know when for example a person is rude on profile. As I quoted in the beginning, psychopathy is 'sanity masked; as psychopaths pretend to know that someone is upset. I can imagine a psychopath comforting a woman while she is crying by saying sweet words to her. While trying to get himself out of the 'you have really hurt me' scenario, a psychopath is going to play by the rules of the game to try and get him out of the mess. He is going to play along and to do so he must know what is decent to do in such a situation. It would be naïve to suggest that only because a psychopath feels no guilt or empathy he does not know what to do in a situation where empathy is needed. Nonetheless the knowledge of what to do in such a situation and the gut feeling which comes from inside such as the feeling of guilt, deep sorrow or anger at yourself for being such a bad person cannot be more further from each other. The validity of the empathy questionnaire therefore or in fact any empathy questionnaire has to come into question.

I wonder if testing an empathy questionnaire on people who have frontal brain damages would increase such validity. I think not as what might have happened to the frontally damaged person is that he might have forgotten the rules of social norms, which might justify a low score in an empathy test, added to that might be his inability to have feelings towards others as he does not have the capacity to put himself in their shoes. While psychopaths too seem to not have the capacity to put themselves in others shoes, it should be noted that these are people who live amongst us, they have been raised and educated as anyone else, they tend to be popular too. Many of us when we were children where unable to understand the feelings that our brother would have if we ate the last cookie. We would simply be really happy that we managed to get it before him. This changes when our brother starts crying and then maybe we would say here have it, or maybe we would quickly eat it, but either way a lesson would be learned (conditional learning?). Other such lessons arise throughout our life and whether we do actually feel guilt or not if we inflict pain on someone, we know whether we should or should not feel guilt if for example we were talking to someone we were trying to court their friendship.

Other factors such as demand characteristics might have effected the empathy score. There usually were other people and friends when I conducted the questionnaires, hence the participants might have been tempted to answer the question as it should be rather than as it actually is. Another characteristic of psychopaths is compulsive lying, deception, manipulation and so on, hence a questionnaire cannot be relied entirely upon when assessing a psychopath as a questionnaire relies on the honesty of the participant and psychopaths are not honest.

 That all being said, there seems to be a curvilinear relationship between empathy and Trail A as shown from the graph below:

The graph above shows that as the empathy score increases from 3 to 4, the time taken to complete the graph sharply decreases, when empathy increases from 4 to 7, the time in seconds taken to complete the trail sharply increases and so on. This might be another reason why the multilinear regression does not show a relationship between empathy and the frontal lobe functioning tests. As the relationship fluctuates sharply from 4 to 7, 7 to 9 and then 9 to 11, there is no clear negative or positive relationship.

The relationship between Trail B and empathy can be shown by the graph below:

The relationship seems to be more static than that shown in the previous graph, especially when the empathy score is between 6 and 10. Nonetheless a clear correlational relationship between empathy and the frontal lobe functioning tests does not seem to exist as shown by the linear regression tests. The relationship is more of a fluctuating one, sharply decreasing at times and then sharply increasing. That does show a relationship between the variables but what counts for such a relationship is not clear. It can not be said that when the empathy score increases the time taken to complete the tests either increases or decreases. It might be reasonable to suggest that further research is conducted in this area to see how empathy relates to the frontal lobe functioning. I suggest that a between group study should be carried out. Three groups would suffice, one being the low empathy group, a medium empathy group and a high empathy group which then can be given tasks relating to the frontal lobe functioning and see how they relate to each other.

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