Most psychopaths are not found in prisons, but roam free and undetected among us. For those who have been incarcerated for serious crimes, is recidivism inevitable?

Only a minority of diagnosable psychopaths are violent offenders. Most are subcriminal; manipulating, deceiving, and swindling the unsuspecting. But for psychopaths who have been snagged by the justice system, can this brand of offender be rehabilitated?

Can Psychopathy Be Reliably Diagnosed?

According to the DSM-IV-TR, the premier diagnostic manual of mental illness, Antisocial Personality, or Psychopathy, is a specific form of psychological personality disorder marked by lack of empathy, difficulty controlling impulses, and manipulative behaviors. Psychopaths can be charming, and are adept at focusing their cold, calculating efforts solely on self-gratification, typically at the expense of others. In order to determine if psychopaths are doomed to a continuing pattern of recidivism, it is necessary to have a way of reliably identifying the criminal psychopath and differentiating him from other violent offenders.

Dr. Robert Hare, a leading expert in psychopathy, and author of the book Without Conscience: The Disturbing World of Psychopaths Among Us, has spent much of his professional life developing a clinical checklist for assessing psychopathy; one that does not rely solely on the criminal’s own testimony of being rehabilitated. Hare’s tool, The Psychopathy Checklist, is now widely used by mental health professionals, and has proven to be very consistent and accurate in diagnosing psychopathy.

Can Psychopaths Be Rehabilitated?

What a person has done in the past is generally a good predictor of what he will do in the future, and therefore, it’s reasonable to assume that people with a history of criminal behavior are more dangerous that those without. But do psychopaths differ from other violent criminals in their likelihood to reoffend?

Psychopaths Aren’t your Average Criminal

Although criminals obviously don’t value or honor all of society's rule and norms, most have some rules, or type of internal code that they adhere to. Criminal behavior does not necessitate a complete lack of conscience.

Psychopaths have a specific emotional deficit, and are limited to a very narrow range of emotions. They know the difference between what society considers “right” and “wrong,” but do not experience, and cannot empathize with, the feelings of suffering, remorse, elation and love that are part of being human. Without that “little internal voice” we call conscience, psychopaths feel free to do whatever their needs and wants dictate, and their transgressions do not result in feelings of guilt (Hare 1999, Millon1998).

Not only do psychopaths lack emotions of conscience and empathy, but research has shown that individuals with Antisocial Personality Disorder (APD) are also indifferent to the threat of physical pain and to punishment in general. Without fear of punishment, there is little to deter the psychopath from committing criminal acts, if those acts represent the fastest route to gratification (Hare 1999).

Recidivism of Psychopaths

On average, about 20% of prison inmates are psychopaths, and psychopaths are responsible for more than 50% of violent crime. Studies examining the recidivism rate of federal offenders have revealed that reoffense occurs twice as often in the case of criminal psychopaths, and their violent recidivism rate is approximately triple that of other offenders.

There have been numerous, intensive programs designed to rehabilitate incarcerated psychopaths, and according to Dr. Hare, no program has yet proven to be effective. He notes that, in many cases, therapy can even help psychopaths hone their manipulative skills. His recommendation -- we all should educate ourselves about psychopaths in order to better recognize and avoid these predators (Black 1999, Hare 1999).

More Information on Psychopathy

Additional resourses on psychopathy and personality disorders in general include: Psychology Prof Online, The Mayo Clinic: Mental Health Center and the article Personality Disorders: Brief Summary of the Ten Disorders of Personality.

This Suite 101 article summarizes information on APD and psychopathy. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional help and counseling.

Additional APD Resources

Black, D. (1999) Bad Boys, Bad Men: Confronting Anisocial Personality Disorder. Oxford University Press.

Hare, R. D. (1999) Without Conscience: The Disturbing World of the Psychopaths among Us. Guiford Press.

Hare, R. D. (1985) Comparison of procedures for the assessment of psychopathy. Journal of Consulting and Clinical Psychology. 53, 7.

Millon, T. et al. (1998) Psychopathy: Antisocial, Criminal and Violent Behavior. Guiford Press.

American Psychiatric Association APA (2000) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)