Are all psychopaths/sociopaths criminals and are all criminals sociopaths?

When Donna and I talked with Dr. Hare last week, he addressed the question of whether or not all psychopaths are criminals. He also sent us a paper he wrote on this topic. He said that it is possible for a person to score high on the PCL-R and not have an arrest record and not to have committed felonious crimes. He insisted, though, that “antisocial behavior” is central to the disorder and is found in all people who score highly on the PCL-R. The paper he wrote has the following quote regarding Dr. Hervey Cleckley, the psychiatrist who wrote the first book describing psychopathy.

Cleckley (1976) noted that he was “in complete accord” with the description of the psychopath as “simply a(n) antisocial individual” (p. 370). “Not only is the psychopath undependable, but also in more active ways he cheats, deserts, annoys, brawls, fails, and lies without any apparent compunction. He will commit theft, forgery, adultery, fraud, and other deeds for astonishingly small stakes, and under much greater risks of being discovered than will the ordinary scoundrel.”

If all psychopaths/sociopaths are by definition antisocial, then are all individuals who commit antisocial acts sociopaths/psychopaths? As described in the statement above, sociopaths/psychopaths are distinguished by how readily they commit antisocial acts. As the DSM puts it, a sociopath has a pervasive pattern of cheating, lying and disregarding the rights of others. Other recent scientific writers have equated “career criminals” to psychopaths, the idea being that career criminality indicates a pervasive pattern, not just a one or two poor choices.

Since many antisocial behaviors are also illegal, separating criminality from sociopathy/psychopathy is not that straight forward in practice. Where would we find a sociopath who does not engage in criminal deeds? Two groups set out to identify college students with psychopathic personality traits. They used a battery of psychological tests. On the basis of fancy statistics they identified a group of people they called “aberrant self promoters” (ISPs) These people promoted their own self-interest without regard to the rights of others.

Interestingly, as a group ISPs (like psychopaths) are characterized by the combination of narcissism and antisocial behavior. A close look at the group also revealed that they were not particularly law abiding citizens. One of the studies actually measured levels of psychopathy in aberrant self promoters. The average score for the group was 15, well below the cut off of 30 needed to diagnose “psychopathy.” It is also well below the average PCL-R score found in incarcerated criminals. This comparison indicates that many criminals are significantly psychopathic and that their levels of psychopathy exceed those of community “successful psychopaths.” The authors estimated the prevalence of ASP to be 10 percent of the non-incarcerated population. That is a lot of people who are significantly narcissistic and antisocial—but not necessarily felons.

Over the last three weeks I have discussed sociopathy as the combination of narcissistic personality traits and antisocial behavior. I can now say a few more things about psychotherapy and behavior therapy for sociopaths. Most therapy is aimed at reducing the antisocial behaviors that are so central to the disorder. Therapy has been found to be effective in reducing antisocial behaviors in people who are at the lower end of psychopathy/sociopathy. The high end folks are characterized by greater treatment resistance and more difficulty with change.

At the higher end of psychopathy, we see people who are very narcissistic and very antisocial. This combination is especially treatment resistant because grandiose people never think they have a problem.

I also heard again from one of our readers who is struggling to break away from a spouse who is psychopathic and in prison. If you are struggling to break away from a very harmful, antisocial, narcissistic person please help yourself by spending time with some loving, prosocial people. If you do not have anything to contrast the sociopath’s behavior to, it is easy to forget how abnormal they are. Even according to the most lenient criteria, psychopaths at most make up 10 percent of the population. Ask yourself if you want to spend the rest of your life with someone who is at heart, worse than an “ordinary scoundrel.”