International Journal ofOffender Therapy and

Comparative Criminology56(4) 503 –504

© The Author(s) 2012Reprints and permission:

sagepub.com/journalsPermissions.navDOI: 10.1177/0306624X12449006

http://ijo.sagepub.com

449006 IJO56410.1177/0306624X12449006PalermoInternational Journal of Offender Therapy and Comparative Criminology

Corresponding Author:George B. Palermo, M.D., M.Sc., Ph.D. 2169 Silent Echoes Drive Henderson, NV 89044 USAEmail: palermogb@juno.com

Psychopaths and Posttraumatic Stress

George B. Palermo

Psychopaths and psychopathic behaviors have no doubt existed since the beginning of civilization, but the construct of psychopathy dates to the time of Pinel and Lombroso, who were followed by a long line of criminological scholars up to the present (Palermo, in press). Cleckley (1955), in his seminal work, The Mask of Sanity, described the psychopath as grandiose, arrogant, callous, superficial, manipulative, cold, distant, and free of apparent anxiety about the distress he causes his victims and showing no empathy for them. Hare (2003) introduced the Psychopathy Checklist (PCL), a two-factor model, for use in research and in forensic setting assessments of these persons, and in a later revised form, the PCL-R, he proposed a four-factor model. Basically it is a 20-item symptom construct grouped together into two or four clusters. The PCL-R scales offer a reliable assessment of psychopathy in the tested individual. Briefly stated, the PCL-R shows each factor composed of two facets: Factor 1 is com-posed of one interpersonal and affective facet and Factor 2 by lifestyle and antisocial facets.

Prior to Hare’s PCL-R scale, Gray, 1970 (cited in Fowles & Dindo, 2006) had pro-posed a theory of an anxiety deficit in psychopathy, stating that an anxiety response to traumatic situation is under the activity of the Behavioral Inhibition System (BIS) and its counterpart the Behavioral Activation System (BAS). These two systems, together with the amygdala, usually balance anxiety reactions.

Later, Gray and McNaughton (2000) pointed out that fear and anxiety are nega-tively associated with PCL-R Factor 1 (interpersonal and affective facets), whereas Factor 2 (lifestyle and antisocial facets) dimensions lead to disinhibited aggressive behavior. Simply put, according to this thinking, a traumatic stress situation addresses Factors 1 and 2 in different ways, and a high Factor 1 tends to minimize a traumatic-anxiety effect on the individual. Therefore, there will be no posttraumatic stress (PTS). Vice-versa trauma impinging on Factor 2 is conducive to PTS.

In this issue of the International Journal of Offender Therapy and Comparative Criminology, Jochem Willemsen, Julie De Ganck, and Paul Verhaeghe, in a well-written and well-researched article, ask the question of whether a psychopath—callous, distant,

Editorial

by guest on February 25, 2015ijo.sagepub.comDownloaded from

504 International Journal of Offender Therapy and Comparative Criminology 56(4)

and apparently indifferent to the pains of his victims—is free from anxiety or PTS due to the traumatic situation that he himself caused. They examined two theoretical models of the interaction between psychopathy, traumatic exposure, and lifetime PTS in a sample of 81 male detainees. They found that the interpersonal/affective facets of Factor 1 are negatively associated with anxiety and PTS. In other words, a high Factor 1 protects the psychopath from PTS. However, they were unable to confirm the positive association of Factor 2, the frequency and versatility of traumatic experiences, and PTS as previously posited. This is an interesting finding that obviously needs further investigative research.

Clinical experience indicates that the psychopath certainly appears to be free from postcrime anxiety or lifetime PTS. And it is a common assumption that as time goes by, the psychopath becomes even more callous, ruthless, and unconcerned about his crimes and their frequency, and shows no anxiety related to them. However, before drawing conclusions in such investigations, the possibility of the presence of dissocia-tive subtypes of psychopathy should be taken into consideration. Recent research shows that brain imaging findings of those psychopaths show excessive prefrontal cortical activity and the suppression of anxiety-producing amygdala activity. The psy-chopaths themselves show no evidence of anxiety or PTS (Moran, 2012).

The article by Willemsen and colleagues is very thought provoking and together with the other articles in this issue will certainly stimulate our criminological thinking.

George B. Palermo, M.D., M.Sc.Crim., Ph.D.Editor-in-Chief

Clinical Professor of Psychiatry, University of Nevada School of Medicine, Reno, NV, USA

Medical College of Wisconsin, Milwaukee, WI, USA Adjunct Professor of Criminology, Marquette University, Milwaukee, WI, USA

References

Cleckley, H. (1955). The mask of sanity: An attempt to clarify some issues about the so-called psychopathic personality. St. Louis, MO: C. V. Mosby.

Fowles, D. C., & Dindo, L. (2006). A dual-deficit model of psychopathy. In C. J. Patrick (Ed.), Handbook of psychopathy (pp. 14-34). New York, NY: Guilford Press.

Gray, J. A. (1970). The psychophysiological basis of introversion-extraversion. Behaviour Research and Therapy, 8, 249-166.

Gray, J. A., & McNaughton, N. (2000). The neuropsychology of anxiety: An enquiry into the functions of the septohippocampal system (2nd ed.). Oxford, UK: Oxford University Press.

Hare, R. D. (2003). The Hare Psychopathy Checklist–Revised (2nd ed.). Toronto, CA: Multi-Health Systems.

Moran, M. (2012, April 6). Recent data lead to shift in PTSD criteria. Psychiatric News, p. 33.Palermo, G. B. (In press). In J. B. Helfgott (Ed.), Criminal psychology (Vols. 1-4). Westport,

CT: Praeger.

by guest on February 25, 2015ijo.sagepub.comDownloaded from