Psychopathy equals violence. Whatever rubric is used identifies a person with a greater likelihood of violence, often motivated by opportunism, sadism or material gain. Treatment responsivity and harm reduction as treatment success in high-risk or repetitive offenders seems overreaching. It would be ideal and even a magic bullet to be able to predict dangerousness with absolute certainty but, currently, there's no successful model for intervention and a diagnosis of psychopathy mostly means that treatment is unlikely to work.
[...] D., & Harpur, T. J. (1991). Psychopathy and the DSM- IV criteria for antisocial personality disorder. Journal of Abnormal Psychology 391-398. Hare, R. D. (1996). Psychopathy: A clinical construct whose time has come. Criminal Justice and Behavior 25-54. Hare, R. D. (1998). Psychopaths and their nature: Implications for the mental health and criminal justice systems. In T. Millon, E. Simonson, M. Burket-Smith & R. Davis (Eds.), Psychopathy: Antisocial, Criminal and Violent Behavior (pp. 188-212). New York, NY: Guilford Press. Hare, R. D., Clark, [...]
[...] standard prison programs have no beneficial effect on psychopaths, at least with respect to re-offending, the question is, It could be because, as aforementioned, psychopaths learn more about manipulation and deception than about themselves and that they are, or become, able to convince therapists or staff that they have made good progress when they have not or, as also previously discussed, it could be poor design and poor execution of the programs that are in place. (Hare at al p. [...]
[...] So there are causes for frustration and pessimism and there are causes for hope and pursuing intervention “Therapeutic nihilism'' may not be warranted in the case of antisocial personality disorder, where treatment outcome is not as dismal (Gacono, 1998; Meloy, 1995). Most treatment-related publications, including this one to some extent, discuss the benefits of searching for other diagnoses, addressing specific behaviors (such as substance abuse or violence), and/or overall social management, but have little to say about treatment of the underlying personality disorder itself. [...]
[...] It's described as “intense eye contact, distracting body language, charm and a knowledge of the listener's vulnerabilities are all part of the psychopaths armamentarium for dominating, controlling, and manipulating others. We pay less attention to what they say than to how they say it style over substance,” and, which may begin to diagnose the reason that treatment is needed but may not work, cognitive and linguistic problems often go undetected. (Hare p. 46) Which comes back to an overwhelming key concern, that the psychopath, not unlike an eating disorder or a compulsive shopper, has absolutely no interest in changing even though their repeated action has repercussions that would stop a non-psychopath: Pain and anxiety, and the dread of their return, are primary motivators for patient change. [...]
[...] Interestingly, some less typical psychopaths (sometimes called neurotic psychopaths) are impulsive, have great anger and stress and attack because of negative emotions. All of the constructs discussed here have accurate observations, but it's hard not to judge them by their results. Based on statistical goodness of fit, in taking a model of psychopathy, treatment and its recidivism rates, none of them have had consistent successes. As such, once again, the validity of the constructs is suspect. Something's missing. Psychopathy is difficult to assess but the PCL-R is the most influential conception and, theoretically, has the least likelihood of detrimental consequences for offenders. [...]
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