Description: Without thinking about diagnostic criteria conjure up a mental image of a psychopath in the form of a movie character. Who or what does your image look like? Anthony Hopkins from Silence of the Lambs? Heath Ledger as the Joker from Dark Knight? Maybe Sean Connery and James Bond? Even if you did not picture one these characters the person you DID picture was most likely male and this would agree with what other people (and even the FBI) tend to think. Also notice that most of the characters are also VERY criminal (antisocial), with the possible exception of James Bond who has a “license to kill.” So, can a psychopath be female and/or non-criminal? In the Diagnostic and Statistical Manual of mental disorders (DSM) there is no specific diagnostic category of psychopath. Instead, psychopathic tendencies are covered in a sub-category of personality disorders called Antisocial Personality Disorder. There has been a lot of debate in recent years among those involved in reviewing and possibly re-working the DSM personality disorder diagnostic categories. A big part of those debates involves the question of whether it fits the data and supports clinical practice to treat personality disorders as categoric (i.e., meet the diagnostic criteria and you HAVE the disorder, do not meet the diagnostic criteria and you DO NOT have the disorder) or whether the fit and clinical utility would be better if personality disorders were treated as continuums or dimensions (i.e., like personality traits) along which people could be located based on their presenting characteristics and behaviors. This sort of dimensional approach would open up the possibility of talking about and doing research on whether it makes sense to say that people may fall somewhere along a dimension of spectrum of psychopathy without having to be a criminal or a movie villain/monster. Related to this debate is the question of what the dimensions (i.e., more than one) of psychopathy might be and whether it makes sense to look at different ways that psychopathological dimensions or traits might be expressed (e.g., perhaps by CEO’s or successful entrepreneurs or perhaps by women). Think a bit about what this more dimensional approach to psychopaths might look like if applied more broadly and then have a read through the article linked below which provides a rich but concise overview of the use of psychopathology as a disorder or pattern of behaviors and then which examines the extension of the term psychopath to include women.

Source: What it’s like living as a female psychopath, Megha Mohan, The Health Gap, Psychology, BBC.

Date: March 19, 2023

Image by Pexels from Pixabay

Article Link: https://www.bbc.com/future/article/20221111-what-its-like-living-with-psychopathy

When we look at how gender is or is not related to psychological concepts or diagnostic categories we must contend with the question of whether apparent gender differences in presentation or behavior are linked to sex (i.e., biology) or to socio-cultural variations of expression. Violence in relationships, for example, is more likely to be perpetrated by males and male offenders tend to become less violent as they age. This could be due to levels of testosterone in males (that fall off with age) but it could also be linked to societal norms of male privilege. Also, there are other forms of aggression other than physical aggression and their gender patter might be different. The point is that in relation to things like psychopathy it could be that our tendency to see it as a condition much more common in males that females ties us too closely to an essentialist, biological argument while it may be that psychopathy is actually expressed differently in females compared to males. Looking into possible differences in expression open up a whole new and much broader scope of study into psychopathy. And yes, more research IS needed!

Questions for Discussion:

1. Based on the examples shown most often in movies what are psychopaths like?
2. What are some of the diagnostic and application consequences of possibly shifting from a  categorical framework for thinking about and diagnosing personality disorders and moving towards a dimensional approach (especially for psychopathy)?
3. How do our definitions or conceptualization of psychopathy need to change if we are to include women in the category or along the dimension of psychopathy?

References (Read Further):

Arrigo, B. A., & Shipley, S. (2001). The confusion over psychopathy (I): Historical considerations. International Journal of Offender Therapy and Comparative Criminology, 45(3), 325-344. Link

Pemment, J. (2013). Psychopathy versus sociopathy: Why the distinction has become crucial. Aggression and Violent Behavior, 18(5), 458-461. Link

De Brito, S. A., Forth, A. E., Baskin-Sommers, A. R., Brazil, I. A., Kimonis, E. R., Pardini, D., … & Viding, E. (2021). Psychopathy. Nature Reviews Disease Primers, 7(1), 49. Link

Crego, C., & Widiger, T. A. (2015). Psychopathy and the DSM. Journal of personality, 83(6), 665-677. Link

Sharp, C., & Wall, K. (2021). DSM-5 level of personality functioning: Refocusing personality disorder on what it means to be human. Annual Review of Clinical Psychology, 17, 313-337. Link

Sleep, C. E., Weiss, B., Lynam, D. R., & Miller, J. D. (2020). The DSM–5 section III personality disorder criterion a in relation to both pathological and general personality traits. Personality Disorders: Theory, Research, and Treatment, 11(3), 202. Link

Busmann, M., Wrege, J., Meyer, A. H., Ritzler, F., Schmidlin, M., Lang, U. E., … & Euler, S. (2019). Alternative Model of Personality Disorders (DSM-5) predicts dropout in inpatient psychotherapy for patients with personality disorder. Frontiers in Psychology, 10, 952. Link

Thomson, N. D., Bozgunov, K., Psederska, E., & Vassileva, J. (2019). Sex differences on the four‐facet model of psychopathy predict physical, verbal, and indirect aggression. Aggressive behavior, 45(3), 265-274. Link

Landay, K., Harms, P. D., & Credé, M. (2019). Shall we serve the dark lords? A meta-analytic review of psychopathy and leadership. Journal of applied psychology, 104(1), 183. Link

Dolan, M., & Völlm, B. (2009). Antisocial personality disorder and psychopathy in women: A literature review on the reliability and validity of assessment instruments. International journal of law and psychiatry, 32(1), 2-9. Link

Wynn, R., Høiseth, M. H., & Pettersen, G. (2012). Psychopathy in women: theoretical and clinical perspectives. International journal of women’s health, 257-263. Link