Psychopathic behavior is associated with a construct of social and behavioral problems including violence, criminal activity, and overall failure to conform to social standards. In this study, psychopathic and antisocial personality disorder-based traits are measured. Using reliability and factor analyses were used to validate the inventory and create factor-based indices that were used to predict anti-social behavioral outcomes including violence, seeking revenge on people and assisted suicidal plans for other people.
Rationale
The particular mental disorders I intend to look more closely into is a personality disorder also known as “Anti-Social Personality Disorder” (ASPD). Anti-Social Personality Disorder, or what’s also referred to as “Narcissistic Personality Disorder”, is a more formal way of describing what psychologists and psychiatrists would refer to as a Narcissist, a Sociopath and a Psychopath. The study is based on a qualitative research content analysis of numerous films. When society is seen from a social constructionist perspective, the social worker becomes equally influenced as the rest of the population by the image that the media conveys and produces. One prejudiced or biased social workers will not achieve the effectiveness of their profession or the purpose of their profession. I am investigating the comparison between ASPD sufferers in film as opposed to real life and if there are any visible cultural differences in use and description of psychopathy as concepts or a psychopath as a person in film.
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“Psychopaths, people who have an antisocial personality disorder, are described mostly as “Criminals” or “Madmen” (Jonas Molin 2013). In films, there have been many misconceptions created about people who suffer from a form of mental health disorder, particularly ASPD.
- Rope (1948) “Two men attempt to prove they committed the perfect crime by hosting a dinner party after strangling their former classmate to death”.
- Peeping Tom (1960) “Where a young man murders a woman while using a movie camera to film their dying expression of terror”.
- Once Upon a Time in the West (1968) “Where a mysterious stranger who plays a harmonica joins forces with a gang of notorious desperados to protect a widow from an assassin working for the railroad”.
- Aguirre, the Wrath of God (1972) “Set in the 16th Century. A ruthless and insane knight known as Don Lope de Aguirre leads a Spanish expedition in search of El Dorado”.
- Henry: Portrait of a Serial Killer (1986) “The main character, a drifter, commits a series of brutal murders, supposedly operating with impunity and without a conscience”.
- Blue Velvet (1986) “The discovery of a severed human ear found in a field leads a young man on an investigation related to a beautiful, mysterious nightclub singer and a group of psychopathic criminals who have kidnapped her child”.
- Misery (1990) “Originally a novel by Stephen King and adapted into film format by writer William Goldman. After a famous author is rescued from a car crash by a fan of his novels, he comes to realize that the care he is receiving is only the beginning of a nightmare of captivity and abuse”.
- Cape Fear (1991) “A convicted rapist, released from prison after serving a fourteen-year sentence, stalks the family of the lawyer who originally defended him”.
- Primal Fear (1996) “A psychopathic altar boy is accused of murdering a priest, and the truth is then buried”.
- Scream (1996) “A year after the murder of her mother, a teenage girl is terrorized by a new killer, who targets the girl and her friends by using horror films as part of a deadly game”.
- Training Day (2001) “On his first day on the job as a Los Angeles narcotics officer, a cop goes beyond a full work day in training within the narcotics division of the Los Angeles Police Department with a rogue detective who isn’t what he appears to be”.
- Seven Psychopaths (2012) “A struggling screenwriter inadvertently becomes entangled in the Los Angeles criminal underworld after his crime craving friends kidnap a gangster’s pet dog”.
- Nightcrawler (2014) “A con man desperate for work, gets himself involve in the work of Los Angeles crime journalism and blurs the line between observer and participant to become the star of his own story”.
- Gone Girl (2014) “With the main character’s disappearance having become the focus of an intense media circus, a man sees the spotlight turned on him when it’s suspected that he may not be innocent”.
- The House That Built Jack (2018) “The story follows Jack, a highly intelligent serial killer, over the course of twelve years and depicts the murders that really develop his inner insanity”.
One of the films I intend to look at more closely is Misery: The character of Annie Wilkes (Kathy Bates) is a retired nurse who rescues famed novelist Paul Sheldon (James Caan) from a devastating car crash. While looking after him, she claims to be his biggest fan and demands that Sheldon should change the plot of his new book and if she is still not happy with the result she will ‘kill’ him. Due to Sheldon’s injuries from the car crash, making it near impossible for him to leave, this is in an indirect explanation that Wilkes has “kidnapped” Sheldon.
Another film I looked at was American Psycho (2000) Directed by Mary Harron. The novel was written by Bret Easton Ellis and was adapted into the film by Mary Harron herself. Starring Christian Bale who portrayed the character of Patrick Bateman, a successful New York Banking Executive who starts in the film as a perfectly “normal” person, eventually goes into a constant rage “killing” several other people including some members of the main cast. While viewing this film, during certain scenes I found some of the things that triggered Bateman’s psychopathic behavior very abnormal. Certain things like becoming violent after being touched on the shoulder by a homeless man or one of the main cast members showing him their new business card. “To react in an angry but subtle response to something like having a more valued possession would not necessarily be the sign of a psychopath, sociopath or narcissist” (Hare, 1993). It would be merely be an example or jealousy, which is an emotion that anyone can feel and not just people with mental disorders. However, despite this, Bateman ends up brutally ‘murdering’ the character of Paul Allen (Jared Leto) with an axe in his apartment because one possession had ‘triggered’ Bateman into doing it.
Another film, on the other hand, I personally think is much more accurate in the description of a psychopath. The Silence of the Lambs (1991) Starring Anthony Hopkins portraying the character of Hannibal Lecter, who, according to Wikipedia, described as a ‘brilliant psychiatrist’. Throughout the film he is never seen committing any acts of terror or any crime of any kind. Of course, this is mainly due to the fact that he spends the entire film in captivity in a maximum-security prison. The knowledge I had gained from the film was based on the idea that even though psychopaths are born without ever feeling any empathy, it does not mean that they commit crimes for no reason, but rather they will commit a crime and simply feel no remorse for what they have done which could intend to lead them into doing it again.
The common misconceptions of this disorder reflect a larger misunderstanding of ASPD and its impact on individuals, families and society. We, as a society are quick to attribute bad behavior to shifting social mores, poor parenting, broken families, an excessive amount of time watching television, or countless other factors, many of which probably do influence acts and attitudes. Some of the worst types of people society has to offer are examples of this. The career criminals, drug addicts, abusive fathers and husbands – to name a few – all reveal symptoms of a psychiatric condition that has attracted notice ever since medicine probing the mysteries between the brain and mind. Blaming antisocial behavior on cultural influences and looking isolated acts rather than patterns of behavior diverts attention from the reality of ASPD. Many of the crimes and other social problems that shock and concern us can be traced in large part to a distinct group of individuals, most of them men, who act out in every conceivable way over lives filled with resentment, anger, dishonesty, and moral poverty.
“Visit any country, society or ethnic group, not matter how remote, and individual with anti-social personality disorder becomes evident in those individuals who persistently defy all norms, reject authority and act only out of blind selfishness” (Black, 1999).
As early as 1948, only 21 years after the invention of the television, films have created misconceptions about psychopaths in particular. Nearly all of the films listed do contain a brief description with many phrases and words that they all share in common. Such words as “Convicted”, “Rapist”, “Murdering”, “Kidnapping”, “Madman”, “Kill”, “Criminal” and “Crime”. These particular set of words are what many people would consider to be morally wrong and unpleasant and has led many viewers of some of these films to believe that this is a typicality of a psychopath yet, ironically, according to some psychologists, most sufferers of anti-social personality disorder are not always like this. “Although psychopathy is often equated with criminal behavior, research supports that most psychopaths have never and will never commit a crime”. I took this from the website neuroinstincts.com/psychopathy. The article was analysed by numerous psychologists.
Methodologies
A video on YouTube, uploaded by a channel known as “MedCircle” hosted by Kyle Kittleson who, using a qualitative research method, interviewed Dr. Ramani Durvasula, PHD, a Psychologist, Author, and a Professor of Psychology, explained very accurately the differences between the three types of sufferers of this disorder. “The fact is; a lot of people are using these terms interchangeably. Every psychopath is narcissistic, but not all narcissists are psychopathic” (Dr. Ramani Durvasula, https://youtu.be/6dv8zJiggBs).
“Many sufferers of anti-social personality disorder come in many different variations. When society is viewed in a social constructive manner, the social worker is as affected as the general population by the media and the images it portrays. A prejudice or bias social worker will not be as effective in his work as his intentions are” (Black, 1999).
The purpose of this research proposal is to discover if there are any differences in the usage and description of the concept of psychopathy or a psychopath themselves in the media, more specifically, in books such as “Anti-Social Personality Disorder” – The NICE guideline on treatment, management, prevention and diagnosis.
“We need to change our views about anti-social personality disorder. From being the ultimate diagnosis of exclusion to a condition requiring informed sympathetic management in a great leap. This guideline is one of the first to plot the way forward, and although we have far to go the path is clear” - Peter Tyrer, Professor of Community Psychiatry, Imperial College, London. The NICE guideline (National Institute for health and Care Excellence research) is a constructed qualitative research practice which is carried out by several psychiatrist and psychologists. The guideline on ASPD, carried out by NICE and developed by the National Collaborating Centre for Mental Health (NCCMH), sets out clear, evidence, and consensus-based evidence recommendations for staff working in mental health and social care and the criminal justice system on how to treat, manage and prevent ASPD.
The first step in evaluating patients is to construct an accurate history through a careful interview. Because objective criteria like lab tests, x-rays, and brain scans have little, if any, diagnostic value – aside from their capacity to rule out other problems – the patient's history is the most important basis for diagnosing ASDP. “A standard of set procedures and definitions provide guidelines for identifying anti-social personality disorder and other mental disorders, but the diagnostic is little more than an educated judgement call” (Black, 1999).
At the beginning of the interview in the attempt to diagnose a possible sufferer of ASPD, the interviewer will make their best effort to create a form of rapport with the patient. A useful strategy is to start by asking the patient about him/herself - what kind of work he/she does, where he/she goes to school, whether he/she is married or single, and so on. “Questions should be asked in a manner that conveys genuine interest and does not make the patient feel like they are under interrogation” (Black, 1999). After a relationship is established, the interviewer then focuses on more detailed and specific questions which circles on the patient's problem. They usually tend to be answered with a “yes” or a “no”.
The next stage in the diagnostic process is the Psychiatric History. This is the process which helps the interviewer to understand and better predict the future behavior of the patient. It also helps the interviewer find ways to persuade the patient to take any medication that the psychiatrist recommends. “We also take note of past treatment, including medications, hospitalization, psychotherapy or counselling” (Black, 1999).
The medical history of the patient is also taken into account. As physicians and psychiatrists are trained to assess the often-complex relationship with physical and mental health, the understanding of a patients’ history of illness, surgical procedures and medical treatment is vital. “Psychopaths and mainly sociopaths, commonly go through a state of mental trauma within their lives. While digging deeper in to the patients mind during the interview process, all of this information helps rule out some diagnostic possibilities and even suggest lifestyle modifications that can affect any possible symptoms” (Black, 1999).
Family history of the patient is also analysed. Whether it is due to genetics, environment, I.e. growing up in a rough neighborhood, or a combination of both, ASPD passes from generation to generation in some families, families that also may be troubled by depression, alcoholism and drug addiction. “Information about the emotional and psychiatric health of parents, grandparents, aunts, uncles, and other relatives can help identify risk factors linked to heredity or home environment and can suggest possible diagnoses.” (Black, 1999)
The next stage is the Personal and Social History of the patient. The details of a possible ASPD sufferer tend to emerge as questions are being asked to the patient from developmental milestones to criminal violations. This tends to be the toughest step while in the process of the diagnosis. “Collecting a broad range of evidence helps narrow the diagnostic possibilities, supporting or contradicting the patient's early hunches. Questions become focused and personal, probing information that the patient may be unwilling or unable to provide” (Black 1999)
Psychological tests and other clues are then carried out. This is an especially important area of study for the diagnosis. They look for things such as background information. During the diagnosis mental health professionals focus their attention on the patient’s appearance, habits and demeanour, noting the styles in clothing, attitude, or speaking style.
“Patients may speak with unusual speed or determination, may avoid eye contact, or may assume a defensive tone – all characteristics that shed light on their personalities and colour what they say. Their orientation to time, place and person; ability to reason; and memory can be assessed informally in a mental status examination. (MSE) The MSE can help show whether a patient suffers from delusions or has significant intellectual impairments” (Black, 1999). Donald W. Black, also used quantitative research by giving a list of assumptions while diagnosing a patient who could potentially be a sufferer of anti-social personality disorder. “While diagnosing a patient, mental health professionals try to analyse four elements of misbehavior in four main areas”:
Aggression to people and animals
- Often bullies, threatens, or intimidates others
- Often engages in physical fights
- Has used a weapon that can cause serious physical harm to others
- Has been physically cruel to people
- Has been physically cruel to animals
- Has stolen while confronting a victim
- Has forced someone into sexual activity
Destruction of property
- Has deliberately in fire setting with the intention of causing serious damage
- Has deliberately destroyed others property
Deceitfulness of theft
- Has broken into someone else’s house, building or car
- Often lies to obtain goods or favours to avoid obligation
- Has stolen items of non-trivial value without confronting a victim
Serious violation of rules
- Often stays out at night despite parental prohibitions. Beginning before the age of 13 years
- Has to run away from home overnight while living in parental or parental surrogate home
“Test of intelligence and educational achievement can also predict and provide useful information about the patient, though no particular result predicts any signs of antisocial personality disorder” (Hare 1993). Quantitative research is very rare when it comes to the diagnosis of a possible sufferer of ASPD. However, during the 1950’s and 1960’s, while computers were not as commonly used for testing, a low-tech method known as the “Rorschach”, or “Ink Blot” Test was used. While it is not used for diagnostic purposes since the results often vary, depending in who interprets or scores it. “The Rorschach test can offer clues to a patient’s thinking. It consists of 10 standard images that patients are asked to interpret, some black and white, some in color, but all meaningless” (Hare, 1993). Psychologist Robert Hare has developed a questionnaire that taps many of the characteristics considered typical of an ASPD sufferer. The “50 Item Psychopathy Checklist” is used mainly by researchers to measure the severity of the disorder in criminal populations, and the results appear to predict both criminal mindsets and parole violations.
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