A Rant About Personal Rubbish (feel free to ignore)

Okay... time to shout at cyberspace because if I don't I think I may actually hit someone. Multiple times. In the face. With a hammer.

Now, I won't use names... because I'm a grown-up so I should be above name dropping.

Now, my younger sister is a nice girl. Yeah, she has a temper, is flirty, and can be extremely stubborn. But she's a good person. She helps her friends, she stands up for them, she's kind, and a lot of other nice things. However, there is one friend who has been a consistent jackass to her and is the ONLY person I know who's insults have actually made her cry. We'll call him... J. Anyway, J has a long list of indiscretions which in my opinion warranted dropping him like a bad joke ages ago. These include: blatantly using my sister to get answers for homework, regularly insulting her in front of her other friends (not "ha ha friendly ribbing" insults - actual malicious ones), attempting to instigate a friends-with-benefits relationship with her while in a monogamous relationship, and a few other things. However, I wish to rant about two major issues.

Anyway, last year she got a crush on one of her friends and felt safe in telling one of her other friends this. The friend she told is the person I would like to hit. You see, she asked this friend if he could subtly find out if the first friend had similar feelings towards her. At the time he then reported back a little later saying that the friend did not reciprocate... while laughing.

It was recently found that he didn't "subtly" find out - he told the friend that she had a crush on him and asked. Now, I suppose that's forgivable, but the laughing while hurting my sister's feelings? Not so much.

Especially... bad when his girlfriend admitted that he told her about this and they both had a good laugh about it. She was apparently proud of this.

Next issue. the girlfriend, J, and my sister share a mutual friend, T, who loves trains. So my sister came up with the idea to order him in a custom-made train from England with his name on it for his birthday. However, this would be expensive so she gathered a few of T's friends to pay for it - only $33 each. It was a Facebook arrangement so there were some people she didn't know personally - but that was okay, because J and his GF did! Right? Despite the fact that they only had to contact 2 of the 8 people involved in the event they didn't do it - they were busy. Now... my sister attends college with them  - she knew their classes and their jobs and exactly how much free time they had. Now, I'm not saying that they should have dropped everything to get this - but they had 3 weeks to arrange 15 minutes to collect money from 2 people. Not exactly difficult. My sister ended up getting it done herself so that she could order in the train.

They insisted on a number of things - such as getting my sister's bank details. No. Just... no. There is such a thing called privacy and having a person's bank details is a serious thing. Not to mention them knowing that there was no way in Hell that my mum would let that happen.

Several delays on the train company's behalf occurred and the price changed - because of the Pound/Dollar exchange rate. The increase was somewhere between $50 and $80 but my sister covered the difference - she wasn't gonna go and track down a few dollars from each person. Note: this was not a detail she disclosed to T, but she did tell it to J and GF, saying that it was okay.

Now, the train finally arrives so it has to be given to T. T's birthday was in April, which was also when he was informed about the gift by the whole group. It is now basically June. So maybe, just maybe, we want to get the present to him as soon as possible? Sister tries to get J and a few others around to be there for the "giving of the gift". However after one botched chance, sister informs them that as soon as sees T he will be given the gift. I have a Facebook page full of "Okay - that'd be great :)" in front of me to prove that pretty much everyone agreed. Miss GF didn't see until after it occurred (today), so she then promptly sent my sister an abusive message (where she revealed that she and J laughed it up earlier). I would be understanding of this, if not for the following.

The GF has declared herself T's "best friend" - not that I say "declared". Well, I would hardly call someone T's best friend if they not only admitted that "If J wasn't chipping in [she] wouldn't have even bothered". She often complained about how inconvenient the entire event was for her despite the fact that she was only asked to do one thing which ended up being done by my sister anyway.

As I see it, she just wanted to take credit. Also having met her more than a few times, by "take credit" I mean take ALL the credit. I will mention that my sister was not the only person present at the "gift giving".

Anyway in this conversation somehow culminated in the GF calling my sister a coward. Now, I've read the conversation about... 5 times already and I only see one train of thought that could have lead to it (that being afraid to confess about having a crush - then again, it was a crush on one of her best friends so a degree of awkwardness can be expected) but it bore no relevance whatsoever on the whole train thing. This GF has also often accused my sister of being cruel to J - the guy who she helps with his homework regularly, listens to him bitching about GF, hangs out with (for some god-unknown reason), and you know, is a friend to.

Their friendship is over, and I'm fine with that - J treats a lot of his friends like shit and it's about time one of them walked away. What annoys me the most though is that while my sister is friends with a lot of people, none of them have been able to do more than give sympathetic hugs at best or tell her that she's being extreme at worst. These people who are only Facebook friends with J and the GF - as in, "I friended you and invited you because you are friends with so-and-so". These people who have seen J treat my sister like shit and who she has actually cried to them about.

Anyway, this rant is done... it's just...

Is this how people treat friends?

Mood Music: Angels

More music, reflecting my current mood. Damn you melancholy distrust thing, I have enough on my plate without dealing with silly emotions.


 Within Temptation - Angels



Sparkling angel, I believedYou were my savior in my time of need.Blinded by faith, I couldn’t hearAll the whispers, the warnings so clear.  I see the angels, I’ll lead them to your door.There’s no escape now, no mercy, no more.No remorse ’cause I still rememberThe smile when you tore me apart! You took my heart:Deceived me right from the start.You showed me dreams;I wished they’d turn into realYou broke a promise and made me realize:It was all just a lie! Sparkling angel, I couldn’t seeYour dark intentions, your feelings for me.Fallen angel, tell me why,What is the reason, the thorn in your eye? I see the angels, I’ll lead them to your door.There’s no escape now, no mercy, no more.No remorse, ’cause I still rememberThe smile when you tore me apart! You took my heart:Deceived me right from the start.You showed me dreams;I wished they’d turn into real.You broke the promise and made me realize:It was all just a lie! Could have been forever,Now we have reached the end! This world may have failed you;It doesn’t give you a reason why—You could have chosen a different path in life... The smile when you tore me apart! You took my heart:Deceived me right from the start.You showed me dreams;I wished they turn into real.You broke the promise and made me realizeIt was all just a lie! Could have been forever,Now we have reached the end...

Tourniquet

I tried to kill my pain
But only brought more
So much more
I lay dying
And I'm pouring crimson regret and betrayal
I'm dying, praying, bleeding and screaming
Am I too lost to be saved
Am I too lost?

Recently I’ve been thinking of suicide – not thinking of suicide as in “suicidal thoughts” but just thinking about the concept of suicide and its implications. Specifically religious implications. Probably because I've been listening to Tourniquet a lot lately - hence the title.

Okay, while not all religions were against suicide – for instance in ancient Japan it was believed to be more honourable kill oneself than to surrender and some mythologies were similar – those descended from Judaism were vehement on the matter: it was forbidden.

In the original versions of the Seven Deadly Sins that Despair was originally a mortal sin because it symbolized a loss of faith and hope – no longer trusting in God. Suicide is taking God’s most precious gift and getting rid of it. Those who take their own life cannot enter the Kingdom of Heaven.

This is where my musing actually starts – what about drugs? So many medications out there, especially anti-depressants, include suicidal thoughts as a side-effect.

Also, take into account mental illness - it's estimated that 87%-98% of suicides had a mental disorder. The obvious ones are Depression and Bipolar Disorder, but there are others. Of suicides, mood disorders are present in 30%, substance abuse in 18%, schizophrenia in 14%, and personality disorders in 13% of suicides. These are all chemical imbalances - either caused by the illness, causes the illness, or by the medication for the illness. (In Swing a Little More I mention that while Lithium is the most effective medication in regards to suppressing suicidal impulses/thoughts, the medication to stop the kidney damage from lithium increases such thoughts.)

Even without looking to specific mental disorders, it's been found that those who attempt suicide have low seratonin levels (mood modulator and neurotransmitter), and those who complete it have the lowest levels.

Is a chemical imbalance someone willingly throwing their life away? Or would it be considered differently? Are there exceptions, a rule, a second chance?

My next question is this: what about those who willingly endanger their lives?
Just to clarify – I am not saying that my following examples should be considered the same as suicide-by-free-will. My thoughts are... odd on this matter so I’m trying to properly categorize them. How is saying “Hey, I don’t care if I die” different to saying “I don’t want to live”?
If those who are chemically imbalanced towards hurting themselves in a fatal way get penalized (forgive the word), what happens to those who are mentally healthy but through themselves off cliffs attached to a chord, or diving into the rift, or other “thrill seeking” activities. I mean, I know we all take risks with our lives just by leaving the house but we don’t run in front of the cars! These guys sign contracts that explicitly state that if they die then it’s not the company’s problem!

Ok, I know that may be irrational but I don’t see why if someone who is supposedly in full possession of their faculties could care so little about their lives that they may as well throw them away...
I know that they probably don’t think that it’s possible that they may die – at least it’s not in the forefront of their mind. Like for surfers – they don’t have to sign a contract to go in the ocean.

Not on the “thrill seeker” side of things there are soldiers – men who willingly risk their lives for what they perceive is a worthy cause. They know full well that they could die. I know they aren’t happy with the idea and they aren’t seeking to die but they know it’s a risk.

I guess it’s that a suicide intends to die, while the soldier accepts that it’s a possibility but doesn’t want to, and the thrill seeker doesn’t really consider it. It is intention.

I’m not saying that stupidity or honour is on par with actually taking one’s life – what I am saying is that since suicide could be the result of mental illnesses and drug side-effects can they really be considered to be taking their life of their own volition? I mean real free-will? I know some can resist these impulses – but what if the imbalance is that bad or the illness that far progressed?

I’ve never read an exclusion clause. I’d like to think that there’s something to help but I don’t believe in reincarnation or past-lives despite the romanticism behind them – mainly because I don’t like the idea that my personality as it is has nothing to do with my soul and I could have just as easily been a male born in 1955. However, I know that Judaism has explicit mention of past-lives, and that Christianity isn't mutually exclusive with the idea. Hell, a younger me thought that it was a good explanation as to why Heaven wouldn't be overcrowded.

Actually, I’d be likely to believe such a theory if said second chance took the form of them being reborn without said illness or imbalance thus giving them a chance to relive their life over... however that would be unfair to those who don't get a second chance unless everything except said imbalance/illness was the same but that would go against the concept of free-will which is something I believe in thus I couldn't believe that theory anyway...
Not to mention that it would seem to imply that I either I monumentally frakked up my past life attempts and am on my nth chance with God, or that I haven't frakked up but am still supposed to live all this out again and risk on of my future lives frakking up the afterlife for all of "me". On top of that I have no small amount of distaste for the idea that if I could have married multiple people already at that once I die whatever vows I made/make ultimately mean nothing. But that's getting into my personal weirdness.

And then we look to those who were dying and then committed suicide. For instance, a person dying of a particularly painful disease. They have days, weeks, maybe months to live but all in complete agony. Is it so bad that maybe they don't want to wither away like that? By that same token, would a person refusing further medical help be considered suicide if said treatment could extend their life? Personally, I don't know - I'd imagine my thoughts may change if a relative/friend chose such a route.
I so love chasing myself in a circle... not.
This post doesn’t involve me coming to some sort of brilliant conclusion, a minor epiphany, or even some weird little decision. It’s just me wondering what is going on here.

My wounds cry for the grave:
My soul cries for deliverance.
Will I be denied?
Christ!
Tourniquet!
My suicide...

A Little Whimsy

Partially because I don't feel like posting and have not finished any of my drafts, and partially because I'm in an odd mood I present instead... music!

This song just makes me smile when I listen to it, so there.

Lisa Mitchell - Coin Laundry



There I was
Sitting on the top of the world
In a coin laundry.
Well I could have been royalty
Sitting in the palace like a queen.

Do you have a dollar?
Do you have a dollar for me?
Have you got a house on a hill
And a bed for three?

Oh do you have a story
Do you have a story for me?
Do you know the one where
We'll all live happily?

Do you, do you?
Do you, do you?

So now I'm here
Sitting on the edge
Throwing these stones to the long lost friends.
I could have been a common thief
Sitting in the dirt quite happily.

Do you have a dollar?
Do you have a dollar for me?
Maybe just an hour or two
And a pot of tea?

Have you got a memory
Have you got a memory for me?
Tell me about the days when
You were seventeen.

Do you, do you?
Do you, do you?

Do you have a dollar?
Do you have a dollar for me?
Have you got a little old house
And a lemon tree?

Do you have a reason?
Do you have a reason for me?
Can I be the girl that you met in a coin laundry?

Can I be the girl that you met,
Can I be the girl that you met,
Can I be the girl that you met in the coin laundry?

Oh can I be the girl that you met,
Can I be the girl that you met,
Can I be the girl that you met in the coin laundry?

Wrong Role Models

Recently I've been thinking about how the media can effect people. Particularly their view on relationships and such.
I don't just mean TV, I mean music and movies too.

This idea came to me while I was sitting through an episode of "Friends" - a famous American sitcom which my Mum loves and which I watched for the sake of one character. Those familiar with the show know that for most of the series we sit on the edge of our seats, waiting for Ross and Rachel to get together. I realized that Ross was a horrible male "role model" - that is a horrible model of a male for women. He cheats, he's spoilt, he's arrogant, he's not a good catch. At all. But we're supposed to think he is.

Then I realized that this happened in most sitcoms, especially the ones of note.

Happy Days had the Fonz, whose influence upon society was so great that when he bought a library card in the show US library card sales skyrocketed. With the exception of a short story line, he has multiple girls on his arms and is never seen with the same one twice. And despite him going through women like tissues all the girls still wanted him and the guys wanted to be him. In the Happy Days universe, everyone treats him as something special.

The aforementioned Friends had Ross Gellar and Joey Tribiani. While I know quite a few people who despise Ross, we still had to hear the "audience" ooh and aaah over his every action. Cheat on Rachel? But look how sad he is! Say Rachel's name when getting married to Emily? Awwww, he's in love with Rachel. Some guy leaves Rachel a phone message? Oh of course hide the message Ross, that's the mature thing to do. But he's in love with her! Never mind that he can date other women!
And then we have Joey, who will sleep with anything. Sure he's sweet and kind to his friends - just hope you're not one of his one-night stands.
The only male left is Chandler - who is pretty much the butt-monkey of the group despite being the only one whose One True Pairing isn't disfunctional as hell.

Finally, the worst of all offenders, and I know this isn't a popular opinion, is How I Met Your Mother - my sister's favourite program and one that I have seen every goddamned episode of.
I'm not going to mention Barney though - Ted's the one I take issue with. The lead character, the one out for "true love". One one-night-stand at a time. I understand that we have a girl-of-the-week show here so I shouldn't be expecting long term relationships. I know that he was serious about Stella (that was a sad storyline - I do feel sorry for him there). But look at the how many girls - look at the breakup with Robin. He, like Ross, got all up in arms after Robin started dating one guy despite all the girls he had dated since. Also, we do realize that he's telling his kids these stories? And not in a cautionary way or anything.
Not to mention how the "moral of the story" of each show almost always results in "Ted's right". And even if it doesn't result in that we have things like "Nothing good happens after 2am". Really? Blame it on the time? I've stayed up later than that and still managed not to act like a douchebag. Barney at least owns up to the fact that he's a manwhore - more importantly, so does everyone else in the program. Ted is just "looking for The One" - and that's how everyone treats it.

Finally, take some pop music from the 70s or 80s and listen to the love songs in particular. You will be hardpressed to find one where the theme isn't "I'll die without you", or "Let's get physical (and that will fix everything / show how much I love you)". Mum says that the music my generation listens to is bad - at least it's not trying to disguise it's meaning. The songs of her generation seem to spout the myth that sleeping with a person is the magical fix-it to every relationship problem which, when combined with the sitcoms and even on it's own, is a bloody awful message.

Ultimately, my problem here is that these males are being portrayed as "good". Really look at them. They're men who believe that they are entitled to a sexual past but the women they want aren't - or a future after them. Everything bad that happens is never their fault. Basically, they're full of double standards - and they're portrayed sympathetically. It's much like the biggest complaint about Twilight - Bella doesn't even recognize that the relationship is abusive.

The message is that this is what a good man is. Maybe for some women this is their dream guy, but a show needs to portray them for their flaws too and not try to turn those flaws into some sort of "awww how cute" thing.

The media needs to realize the subtle messages it's sending. It's not the Barneys who's dangerous to the generations watching him - it's the Teds because their flaws aren't addressed in-universe (at least not for more than one episode). If those around the problem don't recognize it, then the viewers (especially the younger ones) don't recognize it as one.

Change in Schedule

Due to my university timetable, I am changing updates from Mondays and/or Wednesdays to Thursdays and/or Fridays until the previously mentioned timeslot becomes convenient again.

So... yeah.

Disturbing the Disturbed: Breaking All the Rules

Hey again – you may remember me: Nixie, that chick who was doing a series about mental illnesses called Disturbing the Disturbed?
Well, I’ve actually gotten myself into gear to work on the post! [cue gasps of shock]

As a note, for this post I looked exclusively at medical sites and Wikipedia (and checking Wikipedia’s references >_>) rather than other blogs and such. This is because I wanted to avoid the blunt force trauma that my skull would be subject to from slamming it into the desk repeatedly. The fact that looking up “psychopath” kept leading me back to a lot of sites on narcissism also played a part... but it was mainly the blunt force trauma.

This week, we cover Antisocial Personality Disorder, Sociopathy, and Psychopathy and the differences between them. Firstly, as you can see psychopathy is its own illness – being mentally ill, insane, or disturbing is not the sole criteria to be a psychopath. Let’s get to it, shall we?

FIRST: antisocial does not mean "doesn't like socializing". That is asocial. Antisocial is what goes against society's norms. Just had to say that.

Antisocial Personality Disorder (ASPD) is defined by the American Psychiatric Association’s Diagnostic and Statistical Manual (DSM) as a personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood".

While Sociopathy and Psychopathy are subtypes of ASPD, under the DSM and ICD they are used as synonyms. The specifics will be covered later.

The symptoms of ASPD are not so clean-cut as the symptoms of other mental illnesses as there are a variety of things that could be considered symptoms. So I shall list the diagnosis under the DSM-IV and the World Health Organization’s ICD.

Under the DSM-IV

• A) There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following:
1. failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
2. deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
3. impulsiveness or failure to plan ahead;
4. irritability and aggressiveness, as indicated by repeated physical fights or assaults;
5. reckless disregard for safety of self or others;
6. consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;
7. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another;
• B) The individual is at least age 18 years.
• C) There is evidence of conduct disorder with onset before age 16 years.
• D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode. 

Note the explicit exclusion under section D – this is to cater for other disorders that on occasion have aspects of ASPD. As we know from my post on Bipolar Disorder, sufferers become reckless during a manic episode and may experiment with drugs and other socially deviant behaviour. I will cover schizophrenia in a later post.

Since evidence has indicated ASPD can be developed in children due to environmental as well as genetic factors, the limit on age has been included here. However, it has been found that those diagnosed with ASPD as adults were often diagnosed with conduct disorder as children.

According to these criteria, ASPD have a prevalence of 3% in males and 1% in females.

Under ICD-10 (where it is classified under the similar Dissocial Personality Disorder)

It is characterized by at least 3 of the following:

1. Callous unconcern for the feelings of others
2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
3. Incapacity to maintain enduring relationships, though having no difficulty in establishing them
4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
5. Incapacity to experience guilt or to profit from experience, particularly punishment.
6. Markedly prone to blame others or to offer plausible rationalizations for the behavior that has brought the person into conflict with society

There may be persistent irritability as an associated feature.
The diagnosis includes what may be referred to as amoral, antisocial, asocial, psychopathic, and sociopathic personality (disorder).
The criteria specifically rule out conduct disorders. Dissocial personality disorder criteria differ from those for antisocial and sociopathic personality disorders.
It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Now, since the World Health Organization decided to lump in ASPD with DPD but also specifically rule out some aspects of it, I’d advise that if you have need of this information (maybe for a book – since that is the only reason I’d sanction lest you’re a psychiatrist in which case you already knew this) to stick to the DSM-IV.

Millon also gives us five subtypes of ASPD:

• covetous antisocial – variant of the pure pattern where individuals feel that life has not given them their due.
• reputation-defending antisocial – including narcissistic features
• risk-taking antisocial – including histrionic features
• nomadic antisocial – including schizoid, avoidant features
• malevolent antisocial – including sadistic, paranoid features.

I will point out that the features of the “nomadic antisocial” are mostly benign – so, once again, no need to vilify.

Correlations and Causes

The fact is that a lot of other disorders are capable of coexisting with this one, and quite commonly do so: Anxiety disorders, Depressive disorder, Substance-related disorders, Somatization disorder, Borderline personality disorder, Histrionic personality disorder, and Narcissistic personality disorder. If alcohol is involved then there will be more frontal function deficits on neuropsychological tests (brain tests) that are greater than those associated with each involved condition.

Now, what’s interesting about ASPD is that there have been some correlations found with hormone levels. The roots of ASPD are said to be in genetics but are triggered by environmental factors, such as family relations. Traumatic events can lead to the disruption of the development of the central nervous system, thus changing what hormones are released when/where and changing the normal developmental patterns. A big player here is serotonin. In terms of function, serotonin is a mood moderator – tries to help against mood-swings and the like. Lower serotonin levels lead to higher levels of aggression and more instances of impulsiveness – two symptoms of ASPD.


Statistics
How common is ASPD? Well, apart from the aforemention DSM-IV related statistics, I have found a couple of contradictions on different sites in regards to prison populations. According to Wikipedia, a 2002 study found that ASPD was found in 47% of male prisoners and 21% of female prisoners. There is also a higher concentration than the norm within alcohol/drug treatment programs (Hare 1983).
However, according to Medicine.net, Wikipedia's Hare's Psychopathy Checklist page, and Internet Mental Health 50-80% of incarcerated individuals suffered from ASPD.

Either way, it is important to note that these statistics is about how many criminals have ASPD and not how many APD sufferers are criminals. After all, “disregard of lawful behaviours” is only one possible symptom of ASPD and with a minimal requirement of three of the listed symptoms it is more than likely that most ASPD sufferers do not present this symptom.
References for ASPD (I have just decided to list them in bulk because they overlap so much): the US National Library of Medicine, Medicine.net, PsychCentral, Internet Mental Health (which, despite the name and appearance, is pretty good provided you can navigate it - the search function is less than refined), and the Mayo Clinic (very good link, puts everything in layman's terms).


Now for Psychopathy... oh boy.

While Psychopathy was not used as an official term is refers to a personality disorder characterized by “an abnormal lack of empathy combine with strongly amoral conduct but masked by an ability to appear outwardly normal”. Note the use of the word “amoral” rather than “immoral” – while “immoral” means morally wrong, “amoral” is unconfined by the convention. They aren’t always doing things that are wrong or right – they just do the things that they want to do regardless of whether it’s considered one or the other.

(Think old fashioned Fair Folk – like the Seelie or Unseelie… mainly the Seelie.)

However, there is a bit of a problem - no-one has agreed on a set criteria for what a psychopath is. Silly, isn't it?


While I usually don't cover the statistics until later, it's one of the things that are agreed on so it seems fitting that I should open with them. While about 80% of incarcerated criminals were diagnosed with ASPD, only 11-20% of these were found to be psychopaths. Also, a study was recently conducted that found that 1 in 25 of today's business leaders could fit the criteria for psychopathy.

(Side note: psychopathy used to be the term used for any mental illness and was derived from the Greek words “psyche” (mind) and “pathos” (suffering) – suffering mind.)

The first fact is that psychopathy is a personality disorder characterized by a pervasive pattern of disregard/violation of the rights of others. Also included are a total lack of empathy and remorse, and being regarded as selfish, insensitive, dishonest, arrogant, aggressive, impulsive, irresponsible, and hedonistic.

As is expected of the subject, Wikipedia’s entry has a “check for neutrality” tag. So I will cover what is discussed in the Hare’s Checklist as it’s backed up by the medical journals. Now, there are a number of proposed assessments for psychopathy, but here I will only cover the Hare Psychopathy Checklist as it’s the most commonly used and relates it back to ASPD. Other tests include the Psychopathic Personality Inventory (PPI), and the Cleckley Checlist (Mask of Sanity – symptoms of those he deemed psychopaths)

(It is important to note that neither the World Health Organization or the American Psychiatric Association have given this mental illness formal recognition in their International Classification of Diseases (ICD-10) and Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).)
The most commonly used “psycho-diagnostic tool” used to assess pychopathy is Robert D. Hare's Psychopathy Checklist, Revised (PCL-R). It was originally a test based on two factors:

Factor 1: Personality “Aggressive narcissism:

• Glibness/superficial charm
• Grandiose sense of self-worth
• Pathological lying
• Cunning/manipulative
• Lack of remorse or guilt
• Shallow affect (genuine emotion is short-lived and egocentric)
• Callousness; lack of empathy
• Failure to accept responsibility for own actions

Factor 2: Case History “Socially deviant lifestyle”

• Need for stimulation/proneness to boredom
• Parasitic lifestyle
• Poor behavioural control
• Lack of realistic long-term goals
• Impulsivity
• Irresponsibility
• Juvenile delinquency
• Early behavior problems
• Revocation of conditional release

The two separate factors are supposed to aim at identifying the “affective deficits” and ASPD symptoms respectively. (the first factor also correlates with Narcissistic Personality Disorder)

It makes a point of saying that promiscuous sexual behaviour, multiple short-term marital relationships, criminal versatility, and “acquired behavioural sociopathy/sociological conditioning (Item 21: a newly identified trait i.e. a person relying on sociological strategies and tricks to deceive)” are correlated with either factor.

However, further studies have been editing and making suggestions about the criteria. For instance Cooke and Michie have indicated 3 factors, where the items for factor two that strictly relate to ASPD are removed from the final model, with the remaining factors being divided into “Arrogant and Deceitful Interpersonal Style”, “Deficient Affective Experience” and “Impulsive and Irresponsible Behavioural Style”. It should be noted that this particular model has multiple problems with it statistically speaking so it’s best to ignore it in favour of the most recent edition of the PCLR-R, where Hare adds a 4^th factor, consisting of those Factor 2 items excluded from the previous model. (The factors now examine the “Interpersonal”, “Affective”, “Lifestyle”, and overt “Antisocial features” of the personality disorder.)

Factors 1a and 1b are correlated with Narcissistic and Histrionic Personality Disorders, while 2a and 2b correlate with ASPD and criminality. However, to summarize, the criteria only highlight "What is missing, in other words, are the very qualities that allow a human being to live in social harmony".

Other facts of note are the only the minority of those diagnosed as psychopaths in institutions are violent offenders, and that while psychopaths are careless towards other people, they are also careless towards themselves. Also, psychopathy can coincide with anxiety disorders so “lack of nerves” isn’t a must-have-symptom.

Causes and precursors

Childhood precursors to psychopathy include a conduct disorder of some sort, or possibly Oppositional Defiant Disorder. (while the likelihood of a child with such a disorder becoming a psychopath is higher than the general population it must be stressed that the great majority do not become psychopaths as adults – or turn out to be disordered at all)

So far the most well-known test is known as the Macdonald triad: bedwetting (after the age of 12), cruelty to animals and firestarting. However, statistical analysis has proven the bedwetting to not be a significant factor. The other two factors, however, are still considered significant (as stated in my Classified Killers post).

Genetics also plays a role in what may bring about psychopathy, with studies finding that the “callous-unemotional traits” were strongly linked to genetics and were not influenced by the environment. This is also the belief of Robert Hare (of Hare’s Checklist) as expressed in his book "Without Conscience: The Disturbing World of Psychopaths Among Us" where he also expresses concern over the fact that the children of the psychopaths will be genetically predisposed to the disorder.
There are also hormonal links: psychopathy was also associated in two studies with an increased ratio of HVA (a dopamine metabolite) to 5-HIAA (a serotonin metabolite). Studies have indicated that individuals with the traits meeting criteria for psychopathy show a greater dopamine response to potential 'rewards' such as monetary promises or taking drugs such as amphetamines. This has been theoretically linked to an increased impulsivity. I explained the effects of dopamine in Mad Love.

A 2010 British study found that high prenatal estrogen exposure, was a "positive correlate of psychopathy in females, and a positive correlate of callous affect (psychopathy sub-scale) in males". This makes sense, especially when combined with the facts in my Battle of the Sex Hormones post... which makes even more sense when combined with the theory that high levels of testosterone with low levels of cortiso contribute since testosterone is "associated with approach-related behavior, reward sensitivity, and fear reduction" and cortisol increases "the state of fear, sensitivity to punishment, and withdrawal behavior". However, while some studies support the cortisol theory, the testosterone one has not been tested yet.
I would suggest checking out the neuroscience area since that isn't a subject I am particularly adept in (or researched very much, or have people to consult with about it) so I don't want to misexplain something.


Finally, in an interesting side-note, psychopathy can be a side-effect of other diseases. For instance, Wilson’s Disease (the body’s inability to process copper) results in a mental illness – one such illness it can result in is psychopathy.

References for Psychopathy: Medicine.net, Psychopathy, Hare's checklist, two articles in Scientific American, and  significant overlap with the references for ASPD (since it is considered a subtype).



The term Sociopath tends to be used interchangeably with both ASPD and Psychopathy - it doesn't even get it's own page on most sites. It is claimed by David T. Lykken, a claim that seems to be supported by most sites, that the only difference between Psychopathy and Sociopathy is that the psychopath is born with the temperment that lead to their behaviour, while the sociopath was born with a rather normal temperment and are more a product of their environment. Basically, it comes down to nature verses nurture - the psychopath being when nature wins out over nurture and the sociopath being when nurture wins out over nature. (some places refer to Primary and Secondary Psychopathy, which fit the Psychopathy and Sociopathy I have covered respectively)
Information gathered on Sociopaths were from the same sites as ASPD and Psychopathy.




Now, while the series isn't over yet I won't be posting it consistently and will have other posts in between. This is a combination of (a) busy life, and (b) the larger amount of research to cover the disorders I plan on covering. To make for easier reading, I have added the tag "Disturbing the Disturbed" to all posts on the series.


I'd like to thank those who have been reading so far. :) Hope you've learnt something.