Studies have linked psychopathy to alternative dimensions such as antagonism (high), conscientiousness (low) and anxiousness (low). [50] It has been suggested that psychopathy may be comorbid with several other conditions than these, [191] but limited work on comorbidity has been carried out. This may be partly due to difficulties in using inpatient groups from certain institutions to assess comorbidity, owing to the likelihood of some bias in sample selection. [186] Sex differences [ edit ] To aid a criminal investigation, certain interrogation approaches may be used to exploit and leverage the personality traits of suspects thought to have psychopathy and make them more likely to divulge information. [72] United Kingdom [ edit ] High levels of testosterone combined with low levels of cortisol and/or serotonin have been theorized as contributing factors. Testosterone is "associated with approach-related behavior, reward sensitivity, and fear reduction", and injecting testosterone "shift[s] the balance from punishment to reward sensitivity", decreases fearfulness, and increases "responding to angry faces". Some studies have found that high testosterone levels are associated with antisocial and aggressive behaviors, yet other research suggests that testosterone alone does not cause aggression but increases dominance-seeking. It is unclear from studies if psychopathy correlates with high testosterone levels, but a few studies have found that disruption of serotonin neurotransmission disrupts cortisol reactivity to a stress-inducing speech task. Thus, dysregulation of serotonin in the brain may contribute to the low cortisol levels observed in psychopathy. Cortisol increases withdrawal behavior and sensitivity to punishment and aversive conditioning, which are abnormally low in individuals with psychopathy and may underlie their impaired aversion learning and disinhibited behavior. High testosterone levels combined with low serotonin levels are associated with "impulsive and highly negative reactions", and may increase violent aggression when an individual is provoked or becomes frustrated. [157] Several animal studies note the role of serotonergic functioning in impulsive aggression and antisocial behavior. [158] [159] [160] [161]

Walters, GD (April 2004). "The trouble with psychopathy as a general theory of crime". International Journal of Offender Therapy and Comparative Criminology. 48 (2): 133–48. doi: 10.1177/0306624X03259472. PMID 15070462. S2CID 40939723. Babiak, Paul; Neumann, Craig S; Hare, Robert D (April 2010). "Corporate psychopathy: Talking the walk". Behavioral Sciences & the Law. 28 (2): 174–93. doi: 10.1002/bsl.925. PMID 20422644. S2CID 15946623.

The Theme of Dominance

Buss, David M. (2009). "How Can Evolutionary Psychology Successfully Explain Personality and Individual Differences?". Perspectives on Psychological Science. 4 (4): 359–66. doi: 10.1111/j.1745-6924.2009.01138.x. PMID 26158983. S2CID 2565416. Psychopathy, as measured with the PCL-R in institutional settings, shows in meta-analyses small to moderate effect sizes with institutional misbehavior, postrelease crime, or postrelease violent crime with similar effects for the three outcomes. Individual studies give similar results for adult offenders, forensic psychiatric samples, community samples, and youth. The PCL-R is poorer at predicting sexual re-offending. This small to moderate effect appears to be due largely to the scale items that assess impulsive behaviors and past criminal history, which are well-established but very general risk factors. The aspects of core personality often held to be distinctively psychopathic generally show little or no predictive link to crime by themselves. For example, Factor 1 of the PCL-R and Fearless dominance of the PPI-R have smaller or no relationship to crime, including violent crime. In contrast, Factor 2 and Impulsive antisociality of the PPI-R are associated more strongly with criminality. Factor 2 has a relationship of similar strength to that of the PCL-R as a whole. The antisocial facet of the PCL-R is still predictive of future violence after controlling for past criminal behavior which, together with results regarding the PPI-R which by design does not include past criminal behavior, suggests that impulsive behaviors is an independent risk factor. Thus, the concept of psychopathy may perform poorly when attempted to be used as a general theory of crime. [4] [83] Violence [ edit ] Van Goozen, Stephanie H. M.; Fairchild, Graeme; Snoek, Heddeke; Harold, Gordon T. (2007). "The evidence for a neurobiological model of childhood antisocial behavior". Psychological Bulletin. 133 (1): 149–82. CiteSeerX 10.1.1.326.8003. doi: 10.1037/0033-2909.133.1.149. PMID 17201574. Scientist debunks 'warrior gene' ". News. NZ Herald News. September 12, 2009. Archived from the original on 2020-08-07 . Retrieved 2009-09-11.

The PCL-R, the PCL:SV, and the PCL:YV are highly regarded and widely used in criminal justice settings, particularly in North America. They may be used for risk assessment and for assessing treatment potential and be used as part of the decisions regarding bail, sentence, which prison to use, parole, and regarding whether a youth should be tried as a juvenile or as an adult. There have been several criticisms against its use in legal settings. They include the general criticisms against the PCL-R, the availability of other risk assessment tools which may have advantages, and the excessive pessimism surrounding the prognosis and treatment possibilities of those who are diagnosed with psychopathy. [4] Maori 'warrior gene' claims appalling, says geneticist". News. The New Zealand Herald News. August 10, 2006. Archived from the original on February 23, 2013 . Retrieved 2009-01-27. Walker, Sarah A., et al. "Primary and secondary psychopathy relate to lower cognitive reappraisal: A meta-analysis of the Dark Triad and emotion regulation processes." Personality and Individual Differences 187 (2022): 111394. Swogger, Marc T.; Walsh, Zach; Kosson, David S. (May 2007). "Domestic violence and psychopathic traits: distinguishing the antisocial batterer from other antisocial offenders". Aggressive Behavior. New York City: Wiley. 33 (3): 253–260. doi: 10.1002/ab.20185. PMID 17444531. The person's family and friends will often play an active role in making decisions about their treatment and care.

Diagnosing antisocial personality disorder

a b Kiehl K. A. (2006). "A cognitive neuroscience perspective on psychopathy: Evidence for paralimbic system dysfunction". Psychiatry Research. 142 (2–3): 107–128. doi: 10.1016/j.psychres.2005.09.013. PMC 2765815. PMID 16712954. Walters, Glenn D. (2006). "Hitler the Psychopath". Lifestyle Theory: Past, Present, and Future. Nova Publishers. pp.42–3. ISBN 978-1-60021-033-4. Archived from the original on 2017-03-23 . Retrieved 2016-02-03– via Google Books. The Hard Sell for Psychopathy Research Funding". Center for Science and Law. Archived from the original on 10 March 2016 . Retrieved 10 March 2016. Highlights of Changes from DSM-IV-TR to DSM-5" (PDF). DSM-5 Development. American Psychiatric Association. 2013. Archived (PDF) from the original on October 19, 2013 . Retrieved January 5, 2014.

Starting in the 1930s, before some modern concepts of psychopathy were developed, "sexual psychopath" laws, the term referring broadly to mental illness, were introduced by some states, and by the mid-1960s more than half of the states had such laws. Sexual offenses were considered to be caused by underlying mental illnesses, and it was thought that sex offenders should be treated, in agreement with the general rehabilitative trends at this time. Courts committed sex offenders to a mental health facility for community protection and treatment. [74] [215] It has been suggested that those who share the same emotional deficiencies and psychopathic features, but are properly socialized, should not be designated as 'psychopaths'. [45]Bluglass, R (1994). "Who's psychopathic now? A recent report has few new solutions and calls for more research". BMJ. 309 (6958): 826. doi: 10.1136/bmj.309.6958.826. PMC 2541046. PMID 7950601. Blair, R.J.; E. Colledge; D.G. Mitchell (2001a). "Somatic markers and response reversal: is there orbitofrontal cortex dysfunction in boys with psychopathic tendencies?". Journal of Abnormal Child Psychology. 29 (6): 499–511. doi: 10.1023/A:1012277125119. PMID 11761284. S2CID 1951812. It has been suggested that psychopathy is associated with "instrumental aggression", also known as predatory, proactive, or "cold blooded" aggression, a form of aggression characterized by reduced emotion and conducted with a goal differing from but facilitated by the commission of harm. [86] [87] One conclusion in this regard was made by a 2002 study of homicide offenders, which reported that the homicides committed by homicidal offenders with psychopathy were almost always (93.3%) primarily instrumental, significantly more than the proportion (48.4%) of those committed by non-psychopathic homicidal offenders, with the instrumentality of the homicide also correlated with the total PCL-R score of the offender as well as their scores on the Factor 1 "interpersonal-affective" dimension. However, contrary to the equating of this to mean exclusively "in cold blood", more than a third of the homicides committed by psychopathic offenders involved some component of emotional reactivity as well. [88] In any case, FBI profilers indicate that serious victim injury is generally an emotional offense, and some research supports this, at least with regard to sexual offending. One study has found more serious offending by non-psychopathic offenders on average than by offenders with psychopathy (e.g. more homicides versus more armed robbery and property offenses) and another that the Affective facet of the PCL-R predicted reduced offense seriousness. [4] a b c Hare, Robert D.; Neumann, Craig S. (2008). "Psychopathy as a Clinical and Empirical Construct" (PDF). Annual Review of Clinical Psychology. 4 (1): 217–46. doi: 10.1146/annurev.clinpsy.3.022806.091452. PMID 18370617. Archived (PDF) from the original on 2013-09-14.