19 January 2007

Psychopaths, Conservatives and Liberals

Evolving mental health research into the notion that some people are psychopaths has profound moral implications for criminal justice that go to the heart of policy differences between conservatives and liberals on criminal justice issues.

These developments were detailed in a December 9, 2006 issue of Science News (subscription only), an often stodgy weekly publication that mostly abstracts and translates interesting scientific journal papers into layman's language.

Although psychiatrists don't currently label psychopathy as a formal personality disorder, a wave of new research has yielded insights into how psychopaths think and suggested biological and temperamental roots of this condition.

The main conclusions

* Personality traits including "a lack of guilt, an unemotional demeanor, little concern about others' feelings or about school, a refusal to keep promises, and difficulty forming lasting friendships," are manifest in about 1 in 100 children.

* Psychopathy, in adults, involve people who "lack a conscience and are incapable of experiencing empathy, guilt, or loyalty." But, this doesn't prevent them from being "superficially charming, intelligent people."

* "Two conditions—sociopathy and antisocial personality disorder—often get confused with psychopathy. . . . Sociopaths have a sense of right and wrong that is based on the values of their criminal group. Antisocial personality disorder, an official psychiatric ailment, is a diagnosis applied to people who commit a broad range of aggressive and criminal acts. Some qualify as psychopaths, but many don't."

* These traits are manifest, at least, by the time children are elementary school aged, and possibly as early as age three.

* Twin studies show a strong genetic component to pesonality traits associated with psychopathy. Longitudinal studies show that these traits tend to be stable over long periods of time and resistent to education and parental intervention -- while a few percent with "high-quality parenting [who were] living in a wealthy family," showed improvement in a four year period, the vast majority did not. These children tend to respond to rewards, but not punishments.

* Most felons are not psychopaths, and psychopathy appears to be a matter of degree rather than a trait that one does or does not have. A test that tries to measure the trait produces notable results:

PCL-R scores range from 0 to 40. Most people in the general population score no more than 5 on this test. Hare estimates that 1 percent scores at least 30. Researchers typically use scores of 30 and above to indicate psychopathy . . .

The average PCL-R scores for men and women in prisons are 22 and 19, respectively. About 15 percent of male offenders and 10 percent of female offenders score 30 or more.

* Most murders are not committed by psychopaths, but they "committed the bulk of premeditated homicides" and "often applied torture, mutilation, or other forms of extreme violence to their victims." According to the journal article relied upon for the Science News story 93.3% of murders committed by people the author classifed as psychopaths were pre-meditated, while 48.4% of those committed by non-psychopaths fit this description.

Indeed, one way to understand the crime of 1st degree murder is as a crude way to distinguish the sorts of murders that a psychopath would tend to commit from the sorts of murders that a non-psychopath would tend to commit.

* Many crimes committed by psychopaths, however, involve fraud and confidence games that involve lies and the cold hearted manipulation of others. Nothing inherent in psychopathy alone includes violent tendencies, it is simply a personality in which the normal impacts of conscience to restrain those tendencies if they are otherwise present, isn't restrained.


Rehabilitation v. Incapacitation in Criminal Sentencing

The conservative view of criminal justice policy has at its root the notion that some people are inherently bad, and that we need to protect society from them with long prison terms and executions. The liberal view of criminal justice policy has at its root the notion that crime is overwhelmingly a product of environmental influences and that rehabilitation is often possible. Research on psychopathy suggests that both are right to a degree and provides an avenue for distinguishing the most fruitful approach in each case.

If the numbers cited above are correct about 14% of prison inmates are male psychopaths and about 0.5% of prison inmates are female psychopatha. A significant number of felons are instead borderline psychopaths (i.e. much closer to 30 than the typical person's 5 score on the PCL-R). If the evolving research is correct, rehabilitative efforts and changes in environment may do little to prevent these offenders from reoffending, even if they superficially appear to be complying well with prison rehabilitation programs.

On the other hand, a majority of prison inmates are neither pyschopaths nor borderline psychopaths. These people are quite amenable to rehabilitation and much more influenced by their environment. Also, while they may reoffend, they are less likely to commit the heinous crimes that every politician fears having given an ex-con a chance to commit, a fear eptiomized in the famous and politically notable Willie Horton case. This fear is what, to a great extent, drove the "tough on crime" attitude that has prevailed since the 1980s.

At its best, psychopathy evaluation in sentencing could make prosecutors, judges, legislators, and the public much more comfortable with making rehabilitation oriented sentencing available to a much larger group of convicted felons. Meanwhile, it could also better protect the public from particularly worrisome felons who show strong psychopathic tendencies and have confirmed their high risk of committing crimes in the future associated by committing a serious crime, with imposing long prison sentences for these convicted felons. An ability to make this distinction might be the development that could persaude policy makers to retreat from the mandatory sentencing regimes which so often met out long prison terms to not particularly culpable individuals.

In the sentencing context, where the status quo is so bad at distinguishing the hard core offender from the redeemable one, a less than perfect predictator could still be a great improvement, and the moral imperative to seperate the guilty from the innocent is much greater than the moral imperative to met out a precise punishment for a precise crime. If you commit a felony, one of the risks you take is that you will be convicted and end up with a harsher punishment than you really deserve. It is better to base this distinction on empirical mental health research, even if it is imperfect, than on the gut feeling of a judge in a quasi-theatrical sentencing hearing context influenced by a judge's cultural biases.

Indeed, another major attraction of some way to measure pyschopathy is that it is a risk factor, which, if tested properly, would be distinct from race, ethnicity, or other socio-economic biases. Taken together with other race and ethnicity neutral predictors of recidivism, this holds the promise of reducing expensive prison populations, while increasing the likelihood that the public will be protected from reoffending criminals.

Indeed, what a good measure of pyschopathy offers that other recidivism measures do not, is a chance to distinguish between raw recidivism (many of the most likely offenders to reoffend are those who commit low level, non-violent economically motivated crimes like theft and prostitution and drug dealing), from the kind of recidivism we worry most about, which is commission of violent and highly culpable crimes.

It also suggests the kind of rehabilitation efforst that may help most. Anger management and substance abuse control may be the key issues for the man who impulsively killed or seriously injured someone in an argument at a bar. Both may be useless for someone who committed a serious assault in a premeditated fashion out of boredom.

Likewise, a more refined sense of what pyschopathy is would provide a more reasoned argument for downgrading certain types of first degree murder which are less culpable (e.g. the parent who in a fit of rage shakes a child to death, or a minor accessory in a burglary gone bad who ends up facing felony murder charges) from those who are genuinely unredeemable killers.

Of course, over reliance on a diagnosis of psychopathy, which may often be quite unreliable, could lead to draconian sentences for minor offenses for people who don't have the traits that the tests attribute to them, imposing hellish conditions on criminal defendants more or less at random. Even worse, bad tests could disproportionately impact the wrong people, because psychopaths may be more adept at keeping their cool, lying and gaming the tests and the system than ordinary criminal defendants, once knowledge that these tests are in use becomes widespread.

Then again, would that be any worse than the status quo whose mandatory minimum sentencing laws impose draconian sentences for reasons that hardly even attempt to make sense?

Preventing Predictable Tragedies

An increasingly important policy idea is the notion that predictable tragedies should be avoided. We know that 95% of serious crimes are committed by males. We know that the 1% of males who show traits associated with psychopathy, which manifest at a young age, are far more likely to commit heinous crimes than the general population. We know that very young children, in large part because they lack the ability to do so, rarely commit serious crimes. So, out of the 3,000,000 or so children in any given school grade, say 7th grade for sake of example, at any one time, roughly 15,000 of them are at very high risk of committing serious crimes in the future.

Our long traditions of social justice say that we shouldn't punish people for a mere elevated likelihood that they will commit crimes in the future, particularly when this propensity is simply an accident of birth. Also, the ability of simple tests to distinguish psychopaths from non-psychopaths through psychological tests are nowhere near the accuracy that would justify the risk that a wrong decision could inflict immense personal hardship on an individual who has not committed a crime. But, simply ignoring a high risk of a tragedy that is likely to happen is also problematic.

The morally acceptable response, it seems, it to intervene intensely early on to do whatever is possible to prevent these boys from becoming monsters, even if this is a highly resource intensive project, in addition to considering this tendency when evaluating what sentencing options are appropriate when a crime is committed.

If you have 80 people in a room and know that without intervention that there is a statistical certainty that one of them will commit a pre-mediatated torture-murder, and that many more of them will end up committing serious felonies that do great harm to their victims, how much would you be willing to spend to reduce the likelihood that those crimes will be committed by those people?

But, the temptation to actually punish people who have committed no crime, but are merely likely to according to some test, may be particularly great when and if, for example, it becomes possible to definitively determine that someone does or does not have a "psychopathy gene" or set of genetic markers. Genetic testing technology and research in this area is getting increasingly close to making this kind of test possible, or even routine. This could sorely test our political systems ability to be nuanced in applying our sense of justice.

Distinguishing Incapacitation From Punishment

Of course, there is another way to look at the situation. Our criminal justice system is fundamentally based on the notion that people are informed of what is right and wrong, make voluntary choices to commit wrong acts, and are being punished because they made the wrong choices. We don't see people with a mental illness that destroys someone's ability to know that the act that they are committing is wrong (e.g. due to delusions about the facts they perceive) as culpable.

Suppose we can establish definitively that a major motivating factor for a serious criminal act is a genetic mental illness. Suppose further that this is a mental illness that does not prevent the person afflicted from knowing the difference between right and wrong, but does make it far more difficult for them, than for the average person, to care about that distinction. What does that do to the moral framework of criminal justice?

Does it suggest that criminal sentences for these people, while they should be incapacitating and protect the public, should not be punitive? The legal standard of involuntary mental health commitment is that someone is a great risk to themselves or others. This is surely the case when you have psychopaths who have already committed a violent crime. But, research suggests that these people are particularly incapable of appreciating and changing their behavior in response to punishment.

Conservatives are right that psychopathic felons should not simply be let loose onto the streets because they are mentally ill. But, while "hitting back" at them with cruel conditions (e.g. many conservatives tend to see allowing prison rape to flourish through neglect as a desirable punitive aspect of prison sentences, rather than as the gross betrayal of the warden's obligations that liberals see it as), this may not be a suitable lens with which to view the situation.

One of the ironies of the notion that some felons are psychopathic, is that the punishment interest in sentencing may make the most sense for those felons whom we have not historically considered the most culpable -- i.e. those with enough of a conscience to have felt real qualms about committing, and real remorse for having committed, their crimes.


Science News provides bibliographies for its stories. Here are the sources for this one (excluding the individuals, often authors of the sourced materials, who are interviewed):

Babiak, P., and R.D. Hare. 2006. Snakes in Suits: When Psychopaths Go to Work. New York: HarperCollins.

Blair, R.J.R. 2006. The emergence of psychopathy: Implications for the neuropsychological approach to developmental disorders. Cognition 101(September):414-442. Abstract available at http://dx.doi.org/10.1016/j.cognition.2006.04.005.

Dvorak-Bertsch, J.D. . . . and J.P. Newman. In press. Anxiety moderates the interplay between cognitive and affective processing. Psychological Science. Preprint available at http://dionysus.psych.wisc.edu/lit/InPress/BertschFinalRevision.pdf.

Edens, J.F. 2006. Unresolved controversies concerning psychopathy: Implications for clinical and forensic decision making. Professional Psychology: Research and Practice 37(February):59-65. Abstract available at http://content.apa.org/journals/pro/37/1/59.

Hare, R.D. 1993. Without Conscience: The Disturbing World of the Psychopaths Among Us. New York: Pocket Books.

Hawes, D.J., and M.R. Dadds. 2005. The treatment of conduct problems in children with callous–unemotional traits. Journal of Consulting and Clinical Psychology 73(August):737-741. Abstract available at http://content.apa.org/journals/ccp/73/4/737.

Hervé, H., and J.C. Yuille, eds. 2007. The Psychopath: Theory, Research, and Practice. Mahwah, New Jersey, and London: Lawrence Erlbaum Associates.

Viding, E., J.R. Blair, et al. 2005. Evidence for substantial genetic risk for psychopathy in 7-year-olds. Journal of Child Psychology and Psychiatry 46(June):592-597. Abstract available at http://dx.doi.org/10.1111/j.1469-7610.2004.00393.x.

Woodworth, M., and S. Porter. 2002. In cold blood: Characteristics of criminal homicides as a function of psychopathy. Journal of Abnormal Psychology 111(August):436-445. Abstract available at http://content.apa.org/journals/abn/111/3/436.

Lyman, D.R., and L. Gudonis. 2005. The development of psychopathy. Annual Review of Clinical Psychology 1(April):381-407. Abstract available at http://dx.doi.org/10.1146/annurev.clinpsy.1.102803.144019.

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