1 in 25 Business Leaders May Be a Psychopath

Psychopaths vs. Sadists: Brain Science, Public Fascination | Healthland | TIME.com:

'via Blog this'Psychopaths, of course, are well-known for their resistance to punishment. Their lack of fear means they don’t worry about physical pain or harm, and their lack of concern for the feelings of others means social punishment doesn’t work either. If you don’t care if you hurt or disappoint people — and aren’t bothered by rejection — you won’t feel ashamed or guilty or embarrassed, and consequently won’t be motivated to avoid those feelings.

Can Psychopathy Be Cured?
Adult psychopaths don’t fear the pain of punishment, and similarly, they aren’t bothered by social pain. Children with callous/unemotional traits are the same and, as a result, are extraordinarily difficult to manage. While simple conduct disorder can result from having antisocial tendencies and being raised in a violent or chaotic home — and can therefore often be helped by remedying that situation — CD with callous/unemotional traits seems to have a stronger genetic basis and is more intractable.

“Treatment programs for conduct disorder are very good, but the callous/unemotional group doesn’t respond to things like punishment, the naughty step, or time out,” says Blackwood. In the same way, psychopaths are much harder to reform than adults with ASPD.

Because they don’t respond to punishment, reward-based treatments work best for callous/unemotional children, even as they seem counterintuitive for the most badly behaved kids. “We have to open our eyes about what the neuroscience tells us,” says Decety. “We have intuitions [about what will work], but they are often wrong and not accurate.”

As a result, Blackwood and most other experts support separate diagnoses to emphasize the differences between the hotheaded adult antisocial personality and the cold-blooded psychopath, or in children, those with ordinary conduct disorder and those with CD plus callous/unemotional traits.

“In the DSM-5 [the pending update of the DSM], it looks reasonably clear that there will be specifications for CD with or without callous/unemotional traits, but there is no equivalent for adults. It’s still lumped together as ASPD, and I think it’s important to tease out these groups,” says Blackwood. That will be especially important given that labeling a child as a potential psychopath could itself have severely negative effects on his future.

Of course, these classifications say nothing about why one person becomes a psychopath while another becomes antisocial, or why some sadists develop a taste for masochism too. Decety’s research didn’t include sadists who weren’t sex offenders — but he would like to study the differences between people who engage in consensual and nonconsensual behavior. Researchers are also studying the life course of children identified with CD and callous/unemotional traits. Finding out what differentiates the group that becomes psychopathic from those who manage to master or outgrow these traits might help prevent some of the worst criminal behavior.

Then, perhaps, the most gruesome fiction will no longer involve real-world inspiration.

MORE: When You Go Hunting for Psychopaths, They Turn Up Everywhere

Szalavitz is a health writer for TIME.com. Find her on Twitter at @maiasz. You can also continue the discussion on TIME Healthland‘s Facebook page and on Twitter at@TIMEHealthland.

Read other related stories about this:

• Can You Call a 9-year-old a Psychopath? New York Times Magazine
• Why Do Some People Become Psychopaths? MSN Health