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An MRI scan cannot diagnose psychopathy or identify sociopaths

This past week I was talking on the telephone with my student and research assistant when he was mugged by a group of 5-7 thugs. One hit him from behind, knocking him down and another punched him in the abdomen. Ironically, among the items stolen was a copy of “Without Conscience” by Robert Hare.

Yesterday, my student asked me, “Those guys in the group who do have empathy and guilt, how do they feel about doing this? What makes them do it?” To which I replied, “I don’t think they feel a thing. They are likely all psychopathic (sociopaths). No one wants to admit just how many of them there are. So they draw an artificial line based on the PCL-R (a psychopathy test) and say these thugs are psychopaths and these thugs are non-psychopaths. They call them non-psychopaths even though their scores on the test are far from normal. They do this because they want to hold on to hope that most of them can change.”

Dr. Reid Melloy, a forensic psychologist with years of experience working with criminals has a method of classifying them that I think is more correct. He has four groups, not two, based on the PCL-R, non-psychopaths, and mild, moderate and severe psychopathy. I do concede that the thugs that assaulted my student likely had the syndrome to varying degrees; and we know the ring leader is likely severely affected.

That gets me to a recent article that received a great deal of news coverage. In one Fox News article were comments from experts who in the past I have criticized for irresponsible public comments. The article discusses data from a study published in a top journal, it doesn’t give the title but it is, The Antisocial Brain: Psychopathy Matters a Structural MRI Investigation of Antisocial Male Violent Offenders.

The title should say, “the degree of psychopathy matters”. When you see stories like this you have to watch out because my colleagues have rotating definitions of psychopathy that they pull out depending on what they need to fit their data. In some studies like this one, they use a cut-off high PCL-R score. In other studies they separate offenders into groups depending on whether or not they show empathy and remorse. So groups may contain the same PCL-R score but be defined in terms of differing symptoms.

The study basically showed that higher scores on the PCL-R are associated with a higher likelihood of finding a shrunken “emotional brain”. Before you go writing me asking that your ex be forced to undergo an MRI which will prove the presence of psychopathy, let me tell you what is not in the news article. You cannot use an MRI scan to diagnose psychopathy.

A diagnostic test has to be sensitive, meaning that it picks up your ex and everyone else with the condition. Well we already know that there is mild, moderate and severe. So do we want the test to pick up the mild or the severe group? That will depend on what your ex actually scored on the PCL-R. I am sure that a “mild” case of psychopathy, does not make for a good life partner. That is why for the purposes of Love Fraud any comparison between “ASPD” and psychopathy is meaningless.

A diagnostic test also has to be specific meaning that only psychopaths show the abnormality. There is no test for psychopathy that is sensitive and specific enough to be useful. This article only shows us the obvious, that very high levels of psychopathy are more likely to be related to observable changes in the brain than are lower levels of psychopathy.

Since the brain produces behavior, their brains have to be different. The behavior they produce is different. All of the thugs who attacked my student to steal “without conscience” have something wrong with their brains.



84 Comments on "An MRI scan cannot diagnose psychopathy or identify sociopaths"

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  1. breckgirl says:

    This was an eye opening blot post. Disheartening in a way although on examination not surprisisng… that is the slight/moderate/severe categories. Makes it seem then like a much higher percentage of people are disordered and therefore dangerous. And I think Liane is courageous to stand up and call her peers on their – lack of objectivity?

    The N that brought me here displayed paranoia too but it seems like I remember it as being afraid of of P/N/S types that he had pwronged who might try to get him back… later when he really lost his mind he believed people were making movies about him; people wanted to kill him and that he was a billionaire and his family and random public figures wanted to steal his money. This insanity was what he did to his brain using drugs because he needed constant stimulation which I think is part of the N thing.

    I would say that not everyone who is suspicious of others and who exhibits some paranoia is projecting. I know at points during my recovery and as I began to clean the less than kind people out of my life I felt despair and fearful that I would forever attract crazy people as that has been most of my life experience. At one point I wondered if I just was born missing something because I felt so fragile. As I toughened up emotionally I started to wonder if my exposure to the N had made me an N as sometimes I feel numb to truly disgusting events… maybe numb is wrong word – just not as shocked as I once was – not sure I know how to put into words. Too much stresses for me to be as responsive to stressors as I once was? Maybe I am depressed from it all and have not recovered as much as I would have hoped.



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  2. breckgirl says:

    Looking at my post above and sorry for typos. I dumped coffee on my keyboard yesterday morning and my laptop is in the repair shop and I am using a kindle which was hard to type on for me…



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  3. Ox Drover says:

    Breckgirl, I think we all wonder about ourselves and if the problem is us not them at times, so that is a normal part of this experience I think, and it will pass.

    Drugs do damage brains and make people paranoid and crazy and that is just the way they become after using street drugs.

    I also understand the “numb” feeling, and I think that is normal too as part of the HIGH stress-induced state that we are in.

    Being depressed is also part and parcel of the recovery process and wishing we were further along the road toward healing. It does NOT happen fast…it takes TIME. You can’t get a baby in 1 month by getting 9 women preg, so you can’t rush some things, they just take TIME.



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