PSYCHODYNAMIC PERSPECTIVES ON PSYCHOPATHY

Psychodynamic Perspectives on Psychopathy

Psychodynamic Perspectives on Psychopathy

Introduction

In the Diagnostic and Statistical Manual of Mental Disorders—4th Edition (DSM-IV; [American Psychiatric Association, 1994]), longstanding patterns of antisocial and violent behavior are captured by a single category, antisocial personality disorder (APD). However, chronic antisocial behavior likely is a function of a host of factors other than personality deviation [Blackburn, 1998a]. Moreover, there is preliminary evidence that individuals classified with APD can differ substantially from one another both behaviorally and characterologically [Cunningham and Rogers]. The probable over-inclusiveness of the APD diagnosis [Lilienfeld, 1994] is reflected in the finding that this “disorder” tends to be the rule rather than the exception in correctional settings, with 50-80% of offenders typically meeting diagnostic criteria [Hart and Widiger].

Although psychopathy has typically been construed as a relatively uniform construct, several scholars have postulated the existence of specific variants of psychopathy. First, the multidimensional factor structure of the PCL-R itself reflects the possibility of distinctive subgroups of criminal offenders. Although most research has focused on the predictive utility of PCL-R total scores, early factor analyses suggested that the PCL-R was composed of two correlated factors (e.g., [Harpur et al]). Factor 1 emphasizes “personality” traits consistent with Cleckley's conceptualization of psychopathy (e.g., callousness and grandiosity), whereas Factor 2 emphasizes the “social deviance” and criminality (e.g., impulsivity and parasitic lifestyle) associated with recent APD diagnostic criteria [Lilienfeld, 1998]. More recent research [Cooke ] suggests that the PCL-R may be underpinned by three, rather than two, factors. This model subdivides the “personality” domain of the PCL-R into separate facets that represent an arrogant and deceitful interpersonal style and the deficient affective experience thought to be characteristic of psychopathy.

To the extent that psychopathy is etiologically heterogeneous, the outlook for treating and managing some variants need not be so pessimistic. As described later, several authors have argued that psychopaths differ in their symptomatology, characteristic patterns of violence, and amenability to treatment. For example, different psychopathic variants may be more or less amenable to conventional psychotherapies, based on differences in etiology and affective capacities. Similarly, there may be differences in characteristic types of aggression among psychopathic variants, with some disproportionately involved in instrumental aggression and others more impulsive, angry, and reactively violent (see [Hart and Hart ]). Clearly, if variants were characterized by different risk factors for, and pathways to, antisocial and violent behavior, this finding would have key implications for violence risk assessment, management, and treatment. Before assessment and treatment can be tailored to individuals as a function of differential psychopathic/antisocial features, however, their feature constellations must be identified.

Psychodynamic theories of offending

Freud's theory of the psyche

In Freud's psychodynamic theory personality (or the psyche) has three distinct components: the id, representing primitive desires and the need for gratification, the superego, representing moral and social constraints, and the ego, representing reality and the ability to delay gratification. Within this framework it is the role of the ego to strike a balance between the demands of the id and the constraints imposed by ...