Influence of childhood trauma in psychopathy

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The influence of childhood trauma on the development of psychopathy in adulthood remains an active research question. According to Hervey M. Cleckley, a psychopathic person is someone who is able to imitate a normal functioning person, while masking or concealing their lack of internal personality structure. This results in an internal disorder with recurrent deliberate and detrimental conduct. Despite presenting themselves as serious, bright, and charming, psychopathic people are unable to experience true emotions. Robert Hare's two factor model and Christopher Patrick's triarchic model have both been developed to better understand psychopathology; however, whether the root cause is primarily environmental or primarily genetic is still in question.

Contents

Psychopathy is a personality disorder of affective, interpersonal, and behavioral dimensions that begins in childhood and manifests as aggressive actions in early or late adolescence. Childhood trauma affects vulnerability to different forms of psychopathology and traits associated with it. Parental behaviors such as rejection, abuse, neglect or over protection show some relationship with the development of detrimental psychopathic traits. Disinhibition mediates the relationship between physical abuse and two components of psychopathy (social deviation and affective interpersonal). Sexual abuse is directly correlated with the social deviation factor, and physical abuse is directly correlated with the affective interpersonal factor. [1] Gender differences have also been observed in psychopathy. For example, psychopathic antisocial personality traits are more noticeable in males while histrionic personality traits are more evident in females. In addition, women are more likely to experience internalizing psychopathology than men [2] and males may exhibit a stronger association between boldness and the experience of neglect as a child, as well as between meanness and the experience of childhood maltreatment.

Psychopathy

Psychopathy or psychopathic personality is a clinical condition that was first researched extensively by the American psychiatrist, Hervey M. Cleckley, who wrote about the personality pathology in his book, The Mask of Sanity . Cleckley describes the psychopathic person as “on the exterior, someone who can flawlessly imitate a normal functioning person, masking or concealing a fundamental lack of internal personality structure (e.g., the organization of the personality in terms of its basic, enduring components and their relationships to one another), resulting in an internal disorder that leads to recurrent deliberate harmful conduct, frequently more detrimental to oneself than to others." Psychopathic people, despite their outward appearance of being serious, bright, and even charming, are unable to experience true emotions. Cleckley wonders if this act of sanity is willingly undertaken in order to conceal a lack of underlying structure, but finds that it conceals a major conceptual neuropsychiatric flaw that has yet to be properly defined.

From Cleckley's work and conceptualization of psychopathy, Canadian psychologist Robert Hare developed the Psychopathy Check List (PCL-R), which was designed to detect and measure the presence of psychopathy. Hare formulated psychopathy into two factors: factor one (primary) which he defines as “selfish, callous and remorseless use of others," and factor two (secondary) which he defines as "chronically unstable, antisocial and socially deviant lifestyle.” [3]

Using a combination of Cleckley and Hare's work along with his own conceptualizations, psychologist Christopher Patrick formulated the triarchic model of psychopathy to better understand psychopathic assessment and to address unsolved issues within the field. Patrick's model formulates psychopathy as encompassing three distinct but interrelated phenotypic dispositions: boldness (social dominance and fearlessness), meanness (aggression towards others) and disinhibition (problems controlling impulses). [4]

The question of what causes someone to develop psychopathy or psychopathic personality traits has been researched for years. A dominating question in the field is whether one's social environment or genetics are more influential in the development of the pathology. Some have argued that genetics is at the core of psychopathy with regards to the emotional dysfunction and reduced emotional responsiveness. [5] However, others claim that environmental and social factors (such as childhood trauma) are at the forefront of the disorder, but dependent on whether they fall into Hare's conceptualization of "primary" or "secondary" psychopathy. [6]

Childhood trauma

Childhood trauma can entail a wide variety of experiences including death, divorce, violence, sexual abuse, illness and others. [7] In 2018 the World Health Organization released that per year, 40 million youths under the age of 15 are victims of violence. [8]

There are four commonly defined types of childhood abuse and neglect: [9]

Adverse experiences in one's childhood have been linked to a wide array of negative mental health and biological outcomes including: [11]

Influence of childhood trauma on psychopathy

Many question the influence that childhood traumatic experiences can have on a person's level of psychopathy. While many have found genetics to contribute to psychopathy, [12] genetics alone cannot account for the etiology of psychopathy. [13] The effects of childhood trauma can be seen in the relation it has with both psychopathic traits and inhibition of altruistic attitudes. [14] In childhood, males who show higher levels of psychopathic traits are more likely to have experienced abuse and neglect, specifically emotional neglect, emotional abuse, physical abuse and sexual abuse. [15] Because psychopathy has been heavily associated with interpersonal and social deficits, the effects of emotional neglect are of importance in assessment. [16] This can bring challenges as emotional neglect does not show the physical signs of damage that physical abuse does, and yet can influence detrimental psychopathic effects. This is not to say that child abuse and neglect cause psychopathy; rather, it is highly unlikely that persons with severe psychopathic features did not suffer from abuse and neglect as children.

A caretaker's interaction with their children is imperative for the children's healthy development and survival. [17] The behavior that a parent exhibits (e.g., rejection, overprotection, emotional warmth) [18] towards their child shows implications towards the development of psychopathic traits. The model of psychopathy created by Christopher Patrick indicates associations between disinhibition, meanness and boldness in response to childhood maltreatment and parental behaviors. [19] Specifically, disinhibition is linked to practically every facet of childhood maltreatment, with the exception of sexual abuse, overprotective parenting, and parental behavior (e.g., rejection and emotional warmth). Emotional neglect and mother overprotection have positive connections with meanness, while maternal and paternal emotional warmth have negative associations. Finally, both emotional maltreatment and physical neglect were linked to characteristics found in boldness.

Gender differences

Christopher Patrick's triarchic model of psychopathy suggests that the dispositions of disinhibition and meanness are associated with self-reported childhood maltreatment. [20] The association between boldness and childhood neglect is found to be stronger in males than females; the relationship between disinhibition and meanness and childhood maltreatment is also shown to be stronger in males than females. This shows that males with more marked boldness traits are less likely than females to report or suffer childhood trauma, likely because males with these traits have an advantage in mobilizing resilience and are less likely to perceive past painful events as maltreatment. It's possible that men with higher levels of disinhibition and meanness are more likely to report or experience these consequences.

Related Research Articles

Antisocial personality disorder is a personality disorder characterized by a limited capacity for empathy and a long-term pattern of disregard or violation of the rights of others. Other notable symptoms include impulsivity and reckless behavior, a lack of remorse after hurting others, deceitfulness, irresponsibility, and aggressive behavior.

<span class="mw-page-title-main">Physical abuse</span> Medical condition

Physical abuse is any intentional act causing injury, trauma, bodily harm or other physical suffering to another person or animal by way of bodily contact. Physical abuse is a type of abuse that involves physical violence, such as hitting, kicking, pushing, biting, choking, throwing objects, and using weapons. Physical abuse also includes using restraints or confinement, such as tying someone up, locking them in a room, or restraining them with drugs or alcohol. Physical abuse can also include withholding basic needs, such as food, clothing, or medical care. In addition to the physical injuries caused by physical abuse, it can also lead to psychological trauma, such as fear, anxiety, depression, and post-traumatic stress disorder. Physical abuse can occur in any relationship, including those between family members, partners, and caregivers. It can also occur in institutional settings, such as nursing homes, schools, and prisons. Physical abuse can have long-term physical, psychological, and social consequences, and can even be fatal.

Robert D. Hare is a Canadian forensic psychologist, known for his research in the field of criminal psychology. He is a professor emeritus of the University of British Columbia where he specializes in psychopathology and psychophysiology.

<span class="mw-page-title-main">Child abuse</span> Maltreatment or neglect of a child

Child abuse is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to act by a parent or a caregiver that results in actual or potential harm to a child and can occur in a child's home, or in the organizations, schools, or communities the child interacts with.

<span class="mw-page-title-main">Emotional detachment</span> Inability and/or disinterest in emotionally connecting to others

In psychology, emotional detachment, also known as emotional blunting, is a condition or state in which a person lacks emotional connectivity to others, whether due to an unwanted circumstance or as a positive means to cope with anxiety. Such a coping strategy, also known as emotion focused-coping, is used when avoiding certain situations that might trigger anxiety. It refers to the evasion of emotional connections. Emotional detachment may be a temporary reaction to a stressful situation, or a chronic condition such as depersonalization-derealization disorder. It may also be caused by certain antidepressants. Emotional blunting, also known as reduced affect display, is one of the negative symptoms of schizophrenia.

<span class="mw-page-title-main">Sadistic personality disorder</span> Former personality disorder involving sadism

Sadistic personality disorder was a proposed personality disorder defined by a pervasive pattern of sadistic and cruel behavior. People with this disorder were thought to have desired to control others. It was believed they accomplish this through the use of physical or emotional violence. This diagnosis appeared in an appendix of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R). The later versions of the DSM do not include it. It was removed as psychiatrists believed it would be used to legally excuse sadistic behavior.

Emotion dysregulation is a range of emotional responses that do not lie within a desirable scope of emotive response, considering the stimuli.

Psychopathy is a mental health condition characterized by persistent antisocial behavior, impaired empathy and remorse, and bold, disinhibited, and egotistical traits. Different conceptions of psychopathy have been used throughout history that are only partly overlapping and may sometimes be contradictory.

<span class="mw-page-title-main">Psychopathy Checklist</span> Psychopathy scale

The Psychopathy Checklist or Hare Psychopathy Checklist-Revised, now the Psychopathy Checklist—revised (PCL-R), is a psychological assessment tool that is commonly used to assess the presence and extent of the personality trait psychopathy in individuals—most often those institutionalized in the criminal justice system—and to differentiate those high in this trait from those with antisocial personality disorder, a related diagnosable disorder. It is a 20-item inventory of perceived personality traits and recorded behaviors, intended to be completed on the basis of a semi-structured interview along with a review of "collateral information" such as official records. The psychopath tends to display a constellation or combination of high narcissistic, borderline, and antisocial personality disorder traits, which includes superficial charm, charisma/attractiveness, sexual seductiveness and promiscuity, affective instability, suicidality, lack of empathy, feelings of emptiness, self-harm, and splitting. In addition, sadistic and paranoid traits are usually also present.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

<i>The Mask of Sanity</i> Nonfiction psychopathy book by Hervey Cleckley

The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality is a book written by American psychiatrist Hervey M. Cleckley, first published in 1941, describing Cleckley's clinical interviews with patients in a locked institution. The text is considered to be a seminal work and the most influential clinical description of psychopathy in the twentieth century. The basic elements of psychopathy outlined by Cleckley are still relevant today. The title refers to the normal "mask" that conceals the mental disorder of the psychopathic person in Cleckley's conceptualization.

<span class="mw-page-title-main">Dark triad</span> Offensive personality types

The dark triad is a psychological theory of personality, first published by Delroy L. Paulhus and Kevin M. Williams in 2002, that describes three notably offensive, but non-pathological personality types: Machiavellianism, sub-clinical narcissism, and sub-clinical psychopathy. Each of these personality types is called dark because each is considered to contain malevolent qualities.

Child neglect, often overlooked, is the most common form of child maltreatment. Most perpetrators of child abuse and neglect are the parents themselves. A total of 79.4% of the perpetrators of abused and neglected children are the parents of the victims, and of those 79.4% parents, 61% exclusively neglect their children. The physical, emotional, and cognitive developmental impacts from early childhood neglect can be detrimental, as the effects from the neglect can carry on into adulthood.

The Psychopathic Personality Inventory (PPI-Revised) is a personality test for traits associated with psychopathy in adults. The PPI was developed by Scott Lilienfeld and Brian Andrews to assess these traits in non-criminal populations, though it is still used in clinical populations as well. In contrast to other psychopathy measures, such as the Hare Psychopathy Checklist (PCL), the PPI is a self-report scale, rather than interview-based, assessment. It is intended to comprehensively index psychopathic personality traits without assuming particular links to anti-social or criminal behaviors. It also includes measures to detect impression management or careless responding.

The Levenson Self-Report Psychopathy scale (LSRP) is a 26-item, 4-point Likert scale, self-report inventory to measure primary and secondary psychopathy in non-institutionalised populations. It was developed in 1995 by Michael R. Levenson, Kent A. Kiehl and Cory M. Fitzpatrick. The scale was created for the purpose of conducting a psychological study examining antisocial disposition among a sample of 487 undergraduate students attending psychology classes at the University of California, Davis.

Callous-unemotional traits (CU) are distinguished by a persistent pattern of behavior that reflects a disregard for others, and also a lack of empathy and generally deficient affect. The interplay between genetic and environmental risk factors may play a role in the expression of these traits as a conduct disorder (CD). While originally conceived as a means of measuring the affective features of psychopathy in children, measures of CU have been validated in university samples and adults.

Psychopathy, from psych and pathy, was coined by German psychiatrists in the 19th century and originally just meant what would today be called mental disorder, the study of which is still known as psychopathology. By the turn of the century 'psychopathic inferiority' referred to the type of mental disorder that might now be termed personality disorder, along with a wide variety of other conditions now otherwise classified. Through the early 20th century this and other terms such as 'constitutional (inborn) psychopaths' or 'psychopathic personalities', were used very broadly to cover anyone who violated legal or moral expectations or was considered inherently socially undesirable in some way.

Out-of-home placements are an alternative form of care when children must be removed from their homes. Children who are placed out of the home differ in the types and severity of maltreatment experienced compared to children who remain in the home. One-half to two-thirds of youth have experienced a traumatic event leading to increased awareness and growing literature on the impact of trauma on youth. The most common reasons for out-of-home placements are due to physical or sexual abuse, violence, and neglect. Youth who are at risk in their own homes for abuse, neglect, or maltreatment, as well as youth with severe emotional and behavior issues, are placed out of the home with extended family and friends, foster care, or in residential facilities. Out-of-home placements aim to provide children with safety and stability. This temporary, safe environment allows youth to have their physical, mental, moral, and social needs met. However, these youth are in a vulnerable position for experiencing repeated abuse and neglect.

<span class="mw-page-title-main">Machiavellianism (psychology)</span> Psychological trait

In the field of personality psychology, Machiavellianism is a personality trait characterized by interpersonal manipulation, indifference to morality, lack of empathy, and a strategic focus on self-interest. Psychologists Richard Christie and Florence Geis named the trait after Niccolò Machiavelli, as they used edited and truncated statements inspired by his works to study variations in human behaviors. Their Mach IV test, a 20-question, Likert-scale personality survey, became the standard self-assessment tool and scale of the Machiavellianism construct. Those who score high on the scale are more likely to have a high level of deceitfulness and a cynical, unemotional temperament.

<span class="mw-page-title-main">Juvenile sex offenders in the United States</span>

A juvenile sex crime is defined as a legally proscribed sexual crime committed without consent by a minor under the age of 18. The act involves coercion, manipulation, a power imbalance between the perpetrator and victim, and threats of violence. The sexual offenses that fall under juvenile sex crimes range from non-contact to penetration. The severity of the sexual assault in the crime committed is often the amount of trauma and/or injuries the victim has suffered. Typically within these crimes, female children are the majority demographic of those targeted and the majority of offenders are male. Juvenile sex offenders are different than adult sex offenders in a few ways, as captured by National Incident Based Reporting System: they are more likely to be committed in school, offend in groups and against acquaintances, target young children as victims, and to have a male victim, whereas they are less likely than their adult counterpart to commit rape.

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