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Who Are These People?
25
adult psychopathy are fixed and immutable, but it does indicate
that the social environment will have a tough time in overcoming
what nature has provided. As noted in Without Conscience, the
elements needed for the development of psychopathy—such as
a profound inability to experience empathy and the complete
range of emotions, including fear—are provided in part by nature
and possibly by some unknown biological influences on the developing
fetus and neonate. As a result, the capacity for developing
internal controls and conscience and for making emotional
“connections” with others is greatly reduced.
To use a simple analogy, the potter is instrumental in molding
pottery from clay (nurture), but the characteristics of the pottery
also depend on the sort of clay available (nature).
The most reliable, valid, and widely used instrument for the assessment
of psychopathy is the Hare Psychopathy Checklist–Revised
(PCL-R). The PCL-R is a clinical rating scale, not a self-report test.
The person who is being evaluated does not answer questions, as is
the case with other psychological tests. Rather, a qualified psychologist
or psychiatrist familiar with the evaluation procedure completes
the assessment based on an in-depth interview and a review of information
contained in the person’s records. Then, for each trait or
characteristic, the psychologist or psychiatrist must make a judgment
as to whether or not each applies to the person being assessed. For
each trait, several criteria and tests must be applied. A technical manual
contains extensive definitions and behavioral examples for each
of the twenty psychopathic characteristics.
If the rater judges that a person clearly has a given trait, then 2
points are added to the total score; if a trait applies only partially or
sometimes, then only 1 point is added to the total. And if a trait just
doesn’t apply to the person, nothing is added to the total. Because
there are twenty traits on the PCL-R, someone can receive a total
score from 0 (meaning no psychopathy) to a high of 40 (a perfect
match to the prototypical psychopath).