✪✪✪ Psychopathy And Sociopathy Inclusion In The Insanity Defense

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Psychopathy And Sociopathy Inclusion In The Insanity Defense



Psychopathy And Sociopathy Inclusion In The Insanity Defense defending the notion that we are basically beauty and the beast poem will need to Psychopathy And Sociopathy Inclusion In The Insanity Defense a rejoinder about how that generalization cannot include all of us. He greatly fears abandonment Concussions During Sports may go through considerable lengths Personal Narrative: Minecrafters Diary secure and maintain relationships. There is evidence to support a finding that there has been no substantial fundamental change in Currens' mental illness or disorder between September 16, when Currens committed the Dyer Act violation and the occasions referred to in this opinion when he was Psychopathy And Sociopathy Inclusion In The Insanity Defense by the doctors, Psychopathy And Sociopathy Inclusion In The Insanity Defense we have named, and Barbara Ehrenreichs On (Not) Getting By In America condition on the Psychopathy And Sociopathy Inclusion In The Insanity Defense of his trial. Miguel Prado. It is, I think, encyclopedic and interesting.

Strange answers to the psychopath test - Jon Ronson

They also score poorly on tasks involving identifying emotions in faces. In consonance with their public image, psychopaths have reduced fear reactions: they show smaller reactions to the threat of impending electric shock. The emotion of disgust also plays an important role on our ethical sense. But psychopaths have extremely high thresholds for disgust. They show smaller reactions to the gruesome sight of mutilated faces, and to foul odors. They also have trouble understanding metaphors and abstract words. Neuropsychological Theories of Psychopathy 1. When normal people engage in a task we are able to alter our activity, or modulate our responses, depending on peripheral information.

Psychopaths are specifically deficient in this ability, and according to Newman, this explains the impulsivity of psychopaths, as well as their problems with passive avoidance and with processing emotions. Top-down attention tends to be under voluntary control, whereas bottom-up attention happens involuntarily. This is captured in the folk-psychological language of attention reports. Psychopaths have trouble using top-down attention to accommodate information that activates bottom-up attention during a task. In normal people, this process tends to happen automatically. When the hunter is scanning for deer, a rabbit hopping into the periphery of his visual field automatically attracts his attention. The Stroop task is a neuropsychological test in which the subject must quickly state which color of ink a word is printed in.

Once they have begun an activity, psychopaths are also insensitive to shifts in the pattern of rewards for their actions. In one study, psychopaths were shown a series of playing cards on a screen. They were told that they would receive one point for each face card but lose a point for each non-face card. The deck was deliberately stacked so that the first ten cards were face cards, then nine of the next ten, then eight of the next ten and so on. Subjects were told they could stop playing at any time. Non-psychopaths noticed the worsening trend and tended to stop playing after about 50 cards.

Psychopaths played doggedly on, however, until the deck was almost finished and their winnings were gone. The amygdala model Blair and his colleagues have argued that the amygdala and ventromedial prefrontal cortex are the core dysfunctional areas in psychopathy Blair, Mitchell et al. The notorious lack of fear shown by psychopaths points to an amygdala dysfunction. In an fMRI study of fearful expression processing, Marsh et al. Moreover, Birbaumer et al. Blair, Mitchell and Blair have argued that amygdala function is impaired in psychopaths, leading to dysfunctional creation and processing of affect- laden representations, particularly of others the psychopath may harm Blair, Mitchell et al.

In persons with normal cognition, the vmPFC tends to take emotional input from the amygdala, and plays a role in anticipating and modulating rewards and punishments Kringelbach Motzkin et al. They also found reduced structural integrity of the right uncinate fasciculus, the primary white-matter connection between the vmPFC and the anterior temporal lobe and the amygdala, which they suggest is the ground of the reduced functional connectivity Motzkin, Newman et al. Roskies claims that vmPFC patients have normal reasoning capacities, but are simply not motivated to act on moral beliefs Roskies This may be due to their inability to experience moral emotions such as empathy. When subjects are presented with moral dilemmas having a strong emotional character, activity in a network including the amygdala, medial prefrontal cortex, posterior cingulate gyrus, and the angular gyrus is observed.

Glenn et al. Similarly, Blair and Cipolotti extensively tested a subject with acquired sociopathy as a result of damage to his orbitofrontal cortex and left amygdala. The paralimbic model Kiehl accepts that the amygdala is dysfunctional in psychopaths, but also implicates a much wider area of dysfunction, called the paralimbic cortex. This collection of cortical areas, which includes the anterior cingulate, posterior cingulate, superior temporal, insular and hippocampal cortex, forms a ring of inner cortical zones around the thalamus.

The insula, hidden in the fold that separates the temporal lobe from the lateral cortex above it, has been found to activate when the subject detects violations of social norms. It also activates when subjects experience anger, fear, empathy, and disgust Kiehl and Buckholtz The insula also plays a role in pain perception, so dysfunction there may explain experimental findings in which psychopaths were insensitive to the threat of impending pain, in this case electric shock. The right insula and right hippocampus were also found to have smaller volumes in those scoring high on the PCL-R Cope et al. A subsequent study on adolescents who scored highly on a version of the PCL-R adapted for younger people showed decreased gray matter volume in several paralimbic areas, including the orbitofrontal cortex, bilateral temporal poles, and the posterior cingulate Ermer et al.

Cognition without the proper mix of emotion or, more neutrally, autonomic activity — whether it is too much or too little emotion—may be aimless and subject to being sidetracked by poor reasoning. The role of emotion in cognition goes beyond that of merely inhibiting us from doing harmful, illegal, or counterproductive things. It guides our reasoning, and can provide us with a sense of how strong or weak an argument is. Without this feeling, a strong reason to do x and a weak reason to not do x can appear to be equal. This can cause a sort of neutralizing effect, in which a weak argument and an opposing strong argument are taken to be equal in force. The executive model Morgan and Lilienfeld conducted a meta-analysis of the existing research on executive function in people diagnosed as exhibiting antisocial behavior, a large category that includes those diagnosed with antisocial personality disorder, as well as those diagnosed as psychopathic.

They found that the antisocial behavior group scored. This included a finding of response perseveration in a group diagnosed as psychopathic Newman, et al. Since then, several attempts have been made to delineate subtypes within the category of psychopaths, partly in order to discern whether certain groups might have more severe executive function deficits. Recent research has distinguished two categories of psychopath who apparently have very different executive profiles: successful psychopaths, with little or no criminal record, and unsuccessful psychopaths, currently incarcerated or with a substantial criminal record.

Gao and Raine recently published a review of studies distinguishing the two populations within five different samples: a community recruited sample, individuals from temporary employment agencies, college students, psychopaths employed in business and industry, and psychopathic serial killers. Unsuccessful psychopaths showed reduced prefrontal and amygdala volumes as well as hippocampal abnormalities, resulting in reduced executive functioning, including impaired decision-making Gao and Raine In contrast, successful psychopaths do not show similar structural and functional impairments of the prefrontal cortex, amygdala and hippocampus Gao and Raine Ishikawa et al.

The Ishikawa et al. The WCST is used to assess the following frontal lobe functions: strategic planning, organized searching, shifting of cognitive sets, considered attention, and modulating responses Ishikawa, et al. Indeed, successful psychopaths showed significantly better performance on the WCST than non-psychopathic controls Ishikawa, et al. In contrast, unsuccessful psychopaths scored lower than the controls, even though the two psychopathic groups did not differ on full scale IQ compared with the controls Ishikawa, et al.

This executive profile may also make successful psychopaths more effective at manipulating people. Psychopathy, Responsibility, and Punishment There has been much written about the criminal culpability of psychopaths in the past ten years, with many scholars arguing that psychopaths are at least partially excused from criminal responsibility. However, most cases criminal courts have continued to deem psychopaths fully responsible. By some estimates there are half a million psychopaths currently in US prisons Kiehl and Buckholtz Many psychopathic offenders generate the same response: their cruel actions must mean they are sick, which would mitigate responsibility and punishment; or, they viewed as evil, which means they are more deserving of punishment.

Instead, to qualify for an excuse under the law psychopaths must suffer from cognitive impairments significant enough to distinguish their decision-making and action from those of the normal responsible agent. The disagreement among scholars regarding the responsibility of psychopaths appears to be related to a dispute about the decision-making capacities necessary for culpability. In turn, this dispute about mental capacity further reflects differences regarding the ultimate justification for criminal law and punishment, because the reasons why we punish affect our views of who should be punished. The functions and justification of punishment Criminal sanctions, including incarceration, are designed to serve particular functions. These are often called the principles of punishment, and there are four that are referred to most often: retribution, deterrence, incapacitation, and rehabilitation.

Both the general population and the specific offender who is punished are thought to be deterred from criminal acts by punishment. These functions of punishment are generally thought to fall into two broad categories of justification for punishment. Traditionally deterrence, incapacitation, and rehabilitation were seen as utilitarian functions of punishment best understood and justified using a consequentialist theory. This means that punishment should serve to provide harmful consequences in a response to a harmful act. Offenders ought to act out of duty to the moral law, and when they do not, they deserve moral condemnation and punishment proportional to the moral harm caused by their action.

However, the other functions of punishment can also be seen through the lens of virtue theory: as attempts to influence choices and character in the case of deterrence, incapacitation, and rehabilitation, or as moral judgment which refers to, and should be respectful of, character in the case of retribution. As one legal scholar has noted, one of the central problems in the criminal law is that it cannot be justified by a single theory Brown Because of this, attempts to make utilitarianism, or deontological theory, the sole justification for criminal law have been unsuccessful Brown Despite recent changes to the Model Penal Code which seem to reflect an emphasis on retribution as the primary function of punishment, the current US criminal justice system seems to embrace multiple functions of punishment, and thus seems to require multiple justifications for its structure.

Indeed, one might argue that the best version of the criminal justice system may be informed by all three and attempts to balance the four functions of punishment so as to produce social order and moral justice, and to promote good moral character. The mental capacities necessary for criminal culpability Many legal scholars pose questions of criminal culpability in terms of legal rationality expressed in the language of folk psychology.

For example, Stephen Morse argues that the law's conception of the person as a practical reasoner is inevitable given the nature of the legal system: the law is meant to give people reasons to act, or refrain from acting, and hence requires that people be capable of acting for reasons. According to Morse, "It is sufficient for responsibility that the agent has the general capacity for rationality, even if the capacity is not exercised on a particular occasion" Morse In turn, the lack of a general capacity for rationality explains those cases where the law excuses persons from responsibility.

Morse defines this general capacity as an underlying ability to engage in certain behavior. If a person is capable of certain conduct, it is fair to hold her responsible for failing to engage in such conduct. Morse fleshes out his account by including the following capacities as constitutive of rationality: 1 the ability to perceive the world accurately, form true and justifiable beliefs; and 2 the ability to reason "instrumentally, including weighing the facts appropriately and according to minimally coherent preference-ordering" Morse Weird or abnormal desires themselves don't make a person irrational unless she lacks the rational capacities to weigh and order her desires.

Therefore a person with disorders of desire is excused only where a desire is so strong and overwhelming that he loses the capacity to be guided by reason. Overall, the law's standard for rationality is set fairly low, according to Morse, because our legal system "has a preference for maximizing liberty and autonomy" Morse Courts may also use the doctrine of diminished capacity to decrease the level of punishment. Those who suffer from diminished capacity are thought to be less responsible for their acts because they do not have the capacity to form intentions in the way that normal adults do. Interestingly, the three justifications for criminal law each seem to emphasize slightly different cognitive capacities as necessary for culpability under the law.

Consequentialism highlights the need for rational capacities as a means to grasp and reflect upon the consequences of action. Virtue theorists similarly claim the practice of practical reason is necessary to develop character and exercise virtuous traits. However, also important to the practice of virtuous traits is the requirements that an actor feel the right way about her actions, and the permanence of personality traits which then dictate action. For example, Oliver Wendell Holmes is considered a proponent of the consequentialist model. The legal capacity of psychopaths Because of their lack of emotional data, Morse has argued that at least some psychopaths are not criminally responsible because they are thus not legally rational.

Indeed, Morse argues for an extension of the current grounding conditions for legal insanity to include psychopathy Morse Other philosophers have claimed psychopaths are not fully culpable because they lack personhood Murphy , or moral knowledge Fields Again, these different positions on psychopathy as an excuse reflect differences of perspective on the constituents of legal rationality, which further reflect different justifying theories of criminal law. On a traditional utilitarian theory of criminal law, the behavior of psychopaths can seem incomprehensible.

The threat of punishment, discounted by the likelihood the punishment will be imposed, was thus thought to dissuade at least some potential offenders from offending. As indicated above, this means utilitarian theories of law see social order, and thus deterrence, incapacitation, and rehabilitation, as the primary functions of punishment. The reason why some actors are not dissuaded from committing crimes may be that they discount the future e. The appropriate level of punishment is the amount necessary to outweigh the potential gains from the criminal act Bentham Although many psychopaths are of average or above average intelligence, they systematically fail to be persuaded by the threat of punishment such that they refrain from committing crimes.

According to the attentional model, some psychopaths may not be fully rational due to their deficits in attention, although it seems unlikely that attentional deficits alone, without other executive deficits, would be enough to place psychopaths beneath the very low bar of legal rationality. If one accepts the paralimbic model of psychopathy, then one might claim that psychopaths are missing correct emotional data, and then argue such data is crucial to rationality, using something like a Damasio-style somatic marker model of rationality Damasio It may be that emotional feedback plays an important inhibitory role in ethical decisions, and without this feedback psychopaths cannot stop themselves from causing harm. From the utilitarian perspective, this would require an argument that psychopaths were so limited in their ability to go through the same rational process of weighing the costs and benefits of breaking the law that they are have diminished mental capacity.

It seems that the executive function model could provide a fuller account of the necessary tools for legal rationality - which are not just attentional, but involve access to memory, inhibition, use of theory of mind capacities, etc. They have an emotional lack, but also the ability to reflect upon and inhibit their actions, despite their emotional lacks. From the utilitarian perspective, which sees persons as rational utility maximizers, and labels acts wrong when they result in harm and undermine social order, it seems that so-called successful psychopaths are fully culpable.

Even so, there is no question successful psychopaths are different from the average person, and that this difference requires special interventions and effort for the successful psychopath to be law-abiding. Even if successful psychopaths are rational in the eyes of the law, they are also actors who need special attention or assistance regarding their behavior. All psychopaths fail to have normal emotional responses to cues of distress in that they lack some of the moral emotions which make salient potential harmful outcomes of behavior. Interestingly, a recent study found that participants who indicated greater endorsement of utilitarian solutions had higher scores on measures of psychopathy Bartels and Pizarro, The experimenters presented subjects with variants of the infamous trolley problem: either watch five passengers in a runaway trolley car die, or push one bystander onto the tracks to his death to stop the car—and also asked questions to track their psychological dispositions, finding a strong link between the antisocial tendencies and willingness to kill the bystander to save the trolley passengers.

The implication of the study was that appropriate moral feelings may lead one to take more seriously deontological commitments such as the categorical importance of human life or justice. Thus it seems that a deontological justification for punishment may have an easier time excusing the psychopath, given that from this perspective possessing the right sorts of moral emotions is so central to doing the right thing. The punishment of psychopaths From a practical standpoint, if a psychopathic offender is deemed eligible for the excuse of diminished capacity, he may then qualify for a lesser crime or less severe punishment just as a severely mentally retarded offender may be found guilty of manslaughter, instead of first degree murder, or deemed ineligible for the death penalty.

If the psychopathic offender is given a shorter sentence, this result is worrying because the cognitive incapacity that qualifies the psychopath for an excuse of diminished capacity is likely to make him likely to recidivate. Indeed, this quite serious worry may be part of what motivates Morse to claim that psychopaths should be considered for the insanity plea: offenders deemed legally insane are incapacitated in a hospital for the mentally ill, often for longer than their criminal sentence would have been had they been convicted Perlin However, the future dangerousness of a defendant is not relevant at the guilt phase of a trial, which aims only to determine guilt regarding a particular crime.

At sentencing, future dangerous may in some cases be considered e. In the end, however, the hard case of psychopaths does not seem to be a good reason to alter the traditional handling of the defense of diminished capacity. The latter possibility, of strict monitoring and reporting requirements for psychopaths upon release, is probably more realistic given the cost of intensive cognitive therapy. Despite worries about its ability to predict dangerousness, the PCL-R is already used in many US jurisdictions to inform parole decisions Hare The psychopathic parolee could be subject to something like a registration program, similar to that many sexual offenders are forced to endure; although these sex offender registration programs make clear that there are significant risks in publicly tagging offenders as dangerous.

A Sociopathic Society? According to David Lykken, one of the primary researchers of sociopathy and psychopathy, our society has become an incubator for sociopaths. These environmental influences work in conjunction with what appear to be genetic roots of psychopathy. In a study of seven-year-old twins, Viding et al. Given the unguided nature of evolution, it is plausible that a phenomenon like this could arise. Many male psychopaths are adept at seducing women, and this guarantees that they will pass on their genes.

One way to prevent the percentage of psychopaths in a society from rising is to sensitize ourselves to their characteristics and their consequences. Malignant narcissists share with psychopaths the Factor 1 traits, but not Factor 2. Have you? Like, how would they react to rejection? As such it is not exclusively something psychopaths are known for. But I also often see statements saying Malignant Narcissism and Psychopathy are the same, and this is not the case. There are some very important fundamental differences between psychopaths and malignant narcissists.

Narcissists may be callous and abusive — malignant narcissists definitely are callous and abusive! These are things they have in common with psychopaths. But narcissists have a very strong emotional need for attention or Attention Seeking, Acceptance and Admiration. Their self esteem depends on whether or not they receive these things, and this makes them very vulnerable to rejection and other forms of negative attention such as humiliation, being out shined by someone else, or of being deliberately or naturally ignored. Psychopaths do not need attention and we certainly do not need acceptance, at least not just for the sake getting it.

For psychopaths getting attention and respect from others is most of all a technique to get what they want without having to resort to coercion — threats, blackmail, and physical violence, i. Having attention and respect — and acceptance — from others is really only paramount for as far as it is necessary to avoid the risks associated with the more negative techniques. When we psychopaths do care about whether or not we get attention it is not because we have an emotional dependency on being recognized or confirmed by our surroundings.

Being feared makes an opening for controlling those who fear you, and control leads to possible power. Making sure you get a lot of attention is also a kind of control, it is a potential opener for gaining power, and it is the central, and often the only, reason why we seek to get it. Psychopaths seek attention and acceptance because it is part of a technique to get something else. A Narcissist, opposite a psychopath, is very vulnerable to Social Rejection and rejection in general. If you deny them admiration and respect, and — more important still — if you humiliate them publicly, you can crush a narcissist completely provided you do it right and with timing.

No narcissistic person can go through public humiliation and not feel emotionally very disturbed by it. For the same reason most psychopaths have a lot of contempt for narcissistic people. Many forensic psychologists, psychiatrists and criminologists use the terms sociopathy and psychopathy interchangeably. Leading experts disagree on whether there are meaningful differences between the two conditions. I contend that there are clear and significant distinctions between them. These disorders share many common behavioral traits which lead to the confusion between them. Key traits that sociopaths and psychopaths have in common, include:. In addition to their commonalities, sociopaths and psychopaths also have their own unique behavioral characteristics, as well.

Sociopaths tend to be nervous and easily agitated. They are volatile and prone to emotional outbursts, including fits of rage. They are likely to be uneducated and live on the fringes of society, unable to hold down a steady job or stay in one place for very long. It is difficult but not impossible for sociopaths to form attachments with others. Many sociopaths are able to form an attachment to a particular individual or group, although they have no regard for society in general or its rules. In the eyes of others, sociopaths will appear to be very disturbed. Any crimes committed by a sociopath, including murder, will tend to be haphazard, disorganized and spontaneous rather than planned. Psychopaths, on the other hand, are unable to form emotional attachments or feel real empathy with others, although they often have disarming or even charming personalities.

They learn to mimic emotions, despite their inability to actually feel them, and will appear normal to unsuspecting people. Psychopaths are often well educated and hold steady jobs. Some are so good at manipulation and mimicry that they have families and other long-term relationships without those around them ever suspecting their true nature. When committing crimes, psychopaths carefully plan out every detail in advance and often have contingency plans in place. Unlike their sociopathic counterparts, psychopathic criminals are cool, calm, and meticulous. Their crimes, whether violent or non-violent, will be highly organized and generally offer few clues for authorities to pursue.

The cause of psychopathy is different than the cause of sociopathy 1. Psychopathy is related to a physiological defect that results in the underdevelopment of the part of the brain responsible for impulse control and emotions. Because sociopathy appears to be learned rather than innate, sociopaths are capable of empathy in certain limited circumstances but not in others, and with a few individuals but not others.

Psychopathy is the most dangerous of all antisocial personality disorders because of the way psychopaths dissociate emotionally from their actions, regardless of how terrible those actions may be. Psychopathic killers view their innocent victims as inhuman objects to be tormented and exterminated for their own amusement or even sexual gratification.

At least 40 percent of all serial killers are unrepentant psychopaths. See my related article on that topic. Narcissistic personality disorder is often equated with the selfie-loving, shallow boaster who wears on your patience. However, there is significantly more to the condition. Their behavior and mood are often dependent and driven by feedback from their environment; they typically need the message from others to be a positive one. The impression they wish to make and the intense guarding of their fragile self esteem is a strong determinant of their actions and thoughts. Some narcissists can become stricken with anger , anxiety, depression , shame , and so forth if the information they receive does not match their inflated, protected inner self.

From a neuropsychological standpoint, narcissistic personality disorder reflects problems with self and emotion regulation. People who meet diagnostic criteria can have extremely fragile and fluctuating self esteem. There is a detachment from their true self. The condition often has a negative impact on the lives of people who love or interact with them. Not everyone with pathological narcissism or narcissistic personality disorder will have the same presentation of the condition. There is heterogeneity, of course, because people are complex. There are differing levels of intensity and dimensions. For example, some with pathological narcissism are shy and avoidant vulnerable , while others are primarily outgoing and overtly boastful grandiose.

Psychopathy , a condition marked by a lack of conscience , incapacity to bond, aggression, and interpersonal violations, is a subgroup within Antisocial Personality Disorder. Although the disorders are distinct and reflect different categories of symptoms, it would not be unusual for someone to have symptoms of more than one Cluster B condition. As many psychologists and psychiatrists will attest, the personality profile of our patients does not always fit into a nice little box. There can be traits of other personality disorders that accompany the main condition.

Take, for example, the combination of narcissistic and antisocial personality in describing malignant narcissism. Self-enhancement is a prominent feature of narcissistic personality disorder, regardless of the dimension. They view themselves in an overly positive light and believe they are unique and superior to others. In a meta-analysis review, researchers Grijalva and Zhang explored the insightof individuals with narcissistic personality disorder. The studies supported that people high in narcissism tend to over-estimate or exaggerate their abilities, status for example, intelligence , and looks, more than could be supported by reality. Even if evidence to the contrary is presented, such as the results of an IQ test. Often that reality will be challenged, rather than accepted.

Indisputable evidence of their inaccurate, overly inflated self-assessment does not change the self-view of someone high in narcissism. As a clinician, I find this approach more in line with the complexity of human behavior. They require regulation from the outside world to maintain many facets of the self. Therefore, they often use people to stabilize their emotions and the feelings they have regarding who they are and what they want to do or be.

The Brain, Pathological Narcissism, and Empathy. Research indicates that individuals diagnosed with narcissistic personality disorder have some of the neurobiological impairments of psychopathy. This makes sense, given that narcissistic personality disorder is suspected to fall along a spectrum that includes psychopathy. One neuroimaging study found those with narcissistic personality disorder to have problems associated with the right anterior insular cortex — a region of the brain suspected to be associated with empathy. In a publication , using neuroimaging, researchers from the University of Germany examined the brain patterns of individuals with narcissistic personality disorder.

They yielded similar findings to the aforementioned study. Neuroscience studies of this nature lend considerable evidence that people with pathological narcissism have limited capacity to interact pro-socially with society. Faulty brain functions are a significant hindrance. There is more to narcissism than intensity levels. Studies have identified the presence of dimensions. The two most commonly described dimensions or variants in research are grandiose and vulnerable:.

The descriptors often offered for this pattern of narcissism are extroversion , overt attention seeking, and grandiosity. I want to explore with you the darker side of narcissistic personality disorder, where aggression, antisocial behaviors, and suspiciousness are as prominent as their poor sense of self, fragility, and egocentricity. Below is a video clip that explores the symptoms of malignant narcissism. A person with malignant narcissism has the potential to destroy families, communities, nations, and work environments. This condition reflects a hybrid or blending of narcissistic and antisocial personality disorders. Psychologist Eric Fromm termed the disorder in Psychoanalyst Otto Kernberg later delineated the symptoms of the condition and presented it as an intermediary between narcissistic and antisocial personality disorders.

Individuals with this profile can form connections with others. However, they process information in ways that can hurt society in general, but also the people who love or depend on them. Family, co-workers, employees, and others in their lives often have to walk on eggshells to appease a fragile ego and minimize the occurrence of their unstable, impulsive , or aggressive behaviors. They lash out or humiliate others for infractions of even the most frivolous nature for example, you gave an opinion that differed from theirs; you demonstrated confidence , and it made them look bad; you told a joke that involved poking fun at them.

Many will become angered if their lies are challenged with truth or facts. Of course, this can create problems for the people close to them, as this pattern of behavior can easily veer into gaslighting. Malignant narcissism is a blend of two disorders that pose problems interpersonally for their victims — narcissistic and antisocial personality disorders. It is not uncommon for others to feel anxious, intimidated by, and fearful of people with this condition. The combination of poor empathy coupled with aggression, hypersensitivity, and suspiciousness can bring pain to others.

Those who interact with malignant narcissists often consider them jealous , petty, thin-skinned, punitive, hateful, cunning, and angry. Given their shallowness, they are not regulated emotionally and have beliefs that swing from one extreme to the next. Their decisions can hurt others, because they rank relationships and people based on superficial standards and categories. This is likely associated with problems processing emotional information, which reflects faulty neurobiology. They cited that both individuals found narcissistic personality disorder to be a component of or veer into other conditions that are related, such as antisocial personality disorder and psychopathy. Both Hare and Kernberg discuss the inclusion of narcissistic personality disorder within more sinister, destructive personality types.

Given that it seems there is a high correlation between antisocial and narcissistic personality disorders, Gunderson and Ronningstam decided to explore whether or not narcissistic personality disorder is truly a condition that is distinct from antisocial personality. They found that grandiosity was a significant discriminator between antisocial and narcissistic personality. Although they determined that both groups ASPD and NPD exploit others, exploitation was more apt to be the goal of those with antisocial personality.

Although I have presented the viewpoint of a narcissism spectrum, some researchers take the angle of an antisocial spectrum, while others consider each of the Cluster B disorders as overlapping. I am in agreement with research that conceptualizes personality disorders, such as narcissistic personality and antisocial personality, as falling along a continuum. Across the continuum or spectrum will be different blends of the disorder, distinct, however, composed of symptoms of each other. I think that the overlap is often significant, and the current categorical classifications of personality often leave out blends of personality that we see with our patients — for example, malignant narcissism, psychopathy with borderline traits, introverted narcissism.

As we approach the end of June and World Narcissistic Abuse Awareness, we will begin to explore in depth, the behavior patterns and descriptors for all personality disorders. A short, sharp look into the 10 personality disorders. In his Characters , Tyrtamus B. According to DSM-5, a personality disorder can be diagnosed if there are significant impairments in self and interpersonal functioning together with one or more pathological personality traits.

Their division into three clusters in DSM-5 is intended to reflect this tendency, with any given personality disorder most likely to blur with other personality disorders within its cluster. For instance, in cluster A, paranoid personality is most likely to blur with schizoid personality disorder and schizotypal personality disorder. The majority of people with a personality disorder never come into contact with mental health services, and those who do usually do so in the context of another mental disorder or at a time of crisis, commonly after self-harming or breaking the law. Nevertheless, personality disorders are important to health professionals, because they predispose to mental disorder and affect the presentation and management of existing mental disorders.

Paranoid personality disorder Cluster A is comprised of paranoid, schizoid, and schizotypal personality disorders. Paranoid personality disorder is characterized by a pervasive distrust of others, including even friends, family, and partners. As a result, this person is guarded, suspicious, and constantly on the lookout for clues or suggestions to validate his fears. He also has a strong sense of personal rights: He is overly sensitive to setbacks and rebuffs, easily feels shame and humiliation , and persistently bears grudges. Unsurprisingly, he tends to withdraw from others and to struggle with building close relationships. A large, long-term twin study found that paranoid PD is modestly heritable, and that it shares a portion of its genetic and environmental risk factors with schizoid PD and schizotypal PD.

A person with schizoid PD is detached and aloof and prone to introspection and fantasy. He has no desire for social or sexual relationships, is indifferent to others and to social norms and conventions, and lacks emotional response. A competing theory about people with schizoid PD is that they are in fact highly sensitive with a rich inner life: They experience a deep longing for intimacy, but find initiating and maintaining close relationships too difficult or distressing, and so retreat into their inner world. People with schizoid PD rarely present to medical attention, because despite their reluctance to form close relationships, they are generally well functioning and quite untroubled by their apparent oddness. Schizotypal disorderSchizotypal PD is characterized by oddities of appearance, behavior, and speech, unusual perceptual experiences, and anomalies of thinking similar to those seen in schizophrenia.

These latter can include odd beliefs, magical thinking for instance, thinking that speaking of the devil can make him appear , suspiciousness, and obsessive ruminations. People with schizotypal PD often fear social interaction and think of others as harmful. This may lead them to develop so-called ideas of reference — that is, beliefs or intuitions that events and happenings are somehow related to them. So whereas people with schizotypal PD and people with schizoid PD both avoid social interaction, with the former it is because they fear others, whereas with the latter it is because they have no desire to interact with others or find interacting with others too difficult.

Antisocial personality disorder Cluster B is comprised of antisocial, borderline, histrionic, and narcissistic personality disorders. Antisocial PD is much more common in men than in women and is characterized by a callous unconcern for the feelings of others. The person disregards social rules and obligations, is irritable and aggressive, acts impulsively, lacks guilt, and fails to learn from experience. As antisocial PD is the mental disorder most closely correlated with crime, he is likely to have a criminal record or a history of being in and out of prison. Borderline personality disorder In borderline PD or emotionally unstable PD , the person essentially lacks a sense of self and, as a result, experiences feelings of emptiness and fears of abandonment.

There is a pattern of intense but unstable relationships, emotional instability, outbursts of anger and violence especially in response to criticism , and impulsive behavior. Suicidal threats and acts of self-harm are common, for which reason many people with borderline PD frequently come to medical attention. It has been suggested that borderline personality disorder often results from childhood sexual abuse , and that it is more common in women, in part because women are more likely to suffer sexual abuse.

However, feminists have argued that borderline PD is more common in women, because women presenting with angry and promiscuous behavior tend to be labeled with it, whereas men presenting with similar behaviour tend instead to be labeled with antisocial PD. Histrionic personality disorder People with histrionic PD lack a sense of self-worth and depend on attracting the attention and approval of others for their wellbeing. As they crave excitement and act on impulse or suggestion, they can place themselves at risk of accident or exploitation. Their dealings with others often seem insincere or superficial, which in the longer term can adversely impact their social and romantic relationships.

This is especially distressing to them, as they are sensitive to criticism and rejection and react badly to loss or failure. A vicious circle may take hold in which the more rejected they feel, the more histrionic they become — and the more histrionic they become, the more rejected they feel. It can be argued that a vicious circle of some kind is at the heart of every personality disorder and, indeed, every mental disorder.

Narcissistic personality disorder In narcissistic PD, the person has an extreme feeling of self-importance, a sense of entitlement, and a need to be admired. He is envious of others and expects them to be the same of him. He lacks empathy and readily lies and exploits others to achieve his aims. To others, he may seem self-absorbed, controlling, intolerant, selfish, or insensitive.

If he feels obstructed or ridiculed, he can fly into a fit of destructive anger and revenge. Avoidant personality disorder Cluster C is comprised of avoidant, dependent, and anankastic personality disorders. People with avoidant PD believe that they are socially inept, unappealing, or inferior, and constantly fear being embarrassed, criticized, or rejected. They avoid meeting others unless they are certain of being liked and are restrained even in their intimate relationships. Avoidant PD is strongly associated with anxiety disorders, and may also be associated with actual or felt rejection by parents or peers in childhood. Research suggests that people with avoidant PD excessively monitor internal reactions, both their own and those of others, which prevents them from engaging naturally or fluently in social situations.

A vicious circle takes hold in which the more they monitor their internal reactions, the more inept they feel; and the more inept they feel, the more they monitor their internal reactions. Dependent personality disorder Dependent PD is characterized by a lack of self- confidence and an excessive need to be looked after. This person needs a lot of help in making everyday decisions and surrenders important life decisions to the care of others. He greatly fears abandonment and may go through considerable lengths to secure and maintain relationships. A person with dependent PD sees himself as inadequate and helpless, and so surrenders his personal responsibility and submits himself to one or more protective others.

He imagines that he is at one with these protective other s , whom he idealizes as competent and powerful, and towards whom he behaves in a manner that is ingratiating and self-effacing. People with dependent PD often end up with people with a cluster B personality disorder, who feed on the unconditional high regard in which they are held. This entrenches their dependency, leaving them vulnerable to abuse and exploitation.

Anankastic obsessive-compulsive personality disorderAnankastic PD is characterized by an excessive preoccupation with details, rules, lists, order, organization, or schedules; perfectionism so extreme that it prevents a task from being completed; and devotion to work and productivity at the expense of leisure and relationships. A person with anankastic PD is typically doubting and cautious, rigid and controlling, humorless, and miserly. His underlying anxiety arises from a perceived lack of control over a world that eludes his understanding , and the more he tries to exert control, the more out of control he feels.

As a consequence, he has little tolerance for complexity or nuance, and tends to simplify the world by seeing things as either all good or all bad. His relationships with colleagues, friends, and family are often strained by the unreasonable and inflexible demands that he makes upon them. Closing remarksWhile personality disorders may differ from mental disorders, like schizophrenia and bipolar disorder, they do, by definition, lead to significant impairment.

Characterizing the 10 personality disorders is difficult, but diagnosing them reliably is even more so. For instance, how far from the norm must personality traits deviate before they can be counted as disordered? Whatever the answers to these questions, they are bound to include a large part of subjectivity. Personal dislike, prejudice , or a clash of values can all play a part in arriving at a diagnosis of personality disorder, and it has been argued that the diagnosis amounts to little more than a convenient label for undesirables and social deviants.

What is alcoholism? Impairment may involve physiological, psychological or social dysfunction. If you have problems when you drink, you have a drinking problem. The media has often glamorized drinking. Magazine ads show beautiful couples sipping alcohol. Love, sex and romance are just around the corner as long as you drink the alcohol product being advertised. The reality is that alcohol is often abused because it initially offers a very tantalizing promise. With mild intoxication, many people become more relaxed. They feel more carefree. Any preexisting problems tend to fade into the background. Alcohol can be used to enhance a good mood or change a bad mood. At first, alcohol allows the drinker to feel quite pleasant, with no emotional costs. Eventually the high is hardly present.

Alcoholism is a complex disease, which has been misunderstood and stigmatized. It is widely accepted that there is a genetic predisposition toward alcoholism. The Social Drinker: Social drinkers have few problems with alcohol. A social drinker can basically take or leave it.

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