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The Psychopath Whisperer

9/16/2016

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​The Psychopath Whisperer: The Science of Those Without Conscience 
Author:  Kent A. Kiehl PhD
ISBN: 13: 9780770435868
 
APA Style Citation
Kiehl, Kent (2014). The Psychopath Whisperer: The Science of Those Without Conscience.
New York: Broadway Books.
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Book Description
Author Dr. Kent Kiehl is a neuroscientist whose research involves utilizing brain imaging and clinical interviews to study mental illness especially criminal psychopathology.  His research has involved taking mobile fMRI machines into prisons to study the brains of inmates he has determined were psychopaths based on clinical interviews and the Hare Psychopathy Test.  Kiehl is currently a Professor of Psychology, Neuroscience, and Law at the University of New Mexico.  He has compiled brain scans from over 3,000 offenders at eight different prisons.  Dr. Kiehl is the protégé of the world famous expert in psychopaths and creator of the influential psychopath checklist, Dr. Robert Hare. The book opens with Dr. Kiehl’s first encounter with a psychopath during his graduate work at a Canadian prison.  The book traces Kiehl’s career and depicts how a variety of academic experiences led him to become an expert in this field.  His early work using EEGs to examine the brain waves of killer whales, experience with fMRI machines, and clinical work under the leading expert in psychopathy all contributed to this interesting research area.  His research eventually led him to conduct fMRI research on prisoners and has resulted in the discovery of important physiological differences in the brains of psychopaths.  His work provides insight into the symptoms, diagnosis, and treatment of psychopathy. 
 
The author gives a thorough explanation of a question that comes up in nearly every introductory or abnormal psychology course, “What is the difference between a psychopath, a sociopath, and an individual with antisocial personality disorder?” The term psychopath was first used by the German psychiatrist J.L.A. Koch (1841-1908) to describe individuals who exhibited these traits throughout their entire life history and across most areas of their lives.  Koch narrowed the term to differentiate these individuals from others who were merely criminals.  Koch’s use of the term psychopath was based on biological causes.  This purely biological explanation for psychopathology soon was criticized by the growing influence of Behaviorism.  If individuals were blank slates at birth, then the traits described by Koch would have environmental causes.  The term sociopathy was first used in the 1930’s and was created to describe individuals with the same traits as psychopaths but whose cause was social and not physiological.  The simple answer then is that psychopaths are created by “nature” and sociopaths are created by “nurture.”  For the author, the terms sociopathy and psychopathy are very different.  Sociopathy would involve a very wide range of individuals who behave in antisocial ways as a result of negative environmental influences whereas psychopathy is a concept based on genetics and biology with measurable brain differences. 

Today, psychopathy is diagnosed based on the 20 items of the Hare Psychopathy Checklist-Revised, the clinical rating tool considered the gold standard for the assessment of psychopathy.  The Hare Psychopathy Checklist-Revised is given by a trained clinician who conducts a semi-structured interview lasting approximately two hours and collects extensive additional files on the individual.  The additional files often include police reports, assessments completed by other mental health workers, family history, employment history, educational records, childhood history, and criminal history.  Based on this information the individual is given a score for each of the 10 traits that describe the affective, impulsive, and antisocial symptoms of psychopathy.  Each item receives a score ranging from 0-2.  A score of 0 indicates that the trait is not present in the individual, a score of 1 indicates the trait describes the individual in some areas of their life, and a score of 2 indicates that the trait is present in all aspects of the individual's life.  The 20 traits on the Hare Psychopathy Checklist- Revised are described in detail in the book and are listed below:
  1. Glibness (insincerity or thoughtless) and Superficial Charm
  2. Grandiose Sense of Self-Worth
  3. Need for Stimulation
  4. Pathological Lying
  5. Conning/Manipulation
  6. Lack of Remorse or Guilt
  7. Shallow Affect
  8. Callous/Lack of Empathy
  9. Parasitic Lifestyle
  10. Poor Behavioral Controls
  11. Promiscuous Sexual Behavior
  12. Early Behavioral Problems
  13. Lack of Realistic, Long-Term Goals
  14. Impulsivity
  15. Irresponsibility
  16. Failure to Accept Responsibility for Own Actions
  17. Many Short-Term Marital Relationships
  18. Juvenile Delinquency
  19. Revocation of Conditional Release (Repeated failure to learn from punishments)
  20. Criminal Versatility
The author doubts that the average clinician can diagnose psychopaths accurately because they have difficulty reliably detecting the affective criteria such as lack of empathy, guilt, and remorse.  One common mistake that leads to overrating on the affective criteria is an excessive focus on the index crime (the one specific bad thing that the individual did which often leads to arrest).  For an individual to be diagnosed as a psychopath, these traits must be expressed across multiple areas of their lives and have existed for most of their life as evidenced by events from childhood.  One trick that the author suggests is to evaluate the individual on the psychopath checklist without using any information related to the index offense.  An actual psychopath would receive a high rating on traits even if the index offense were not included.  Also, according to the author, non-experts are often prone to giving excessively high scores across all areas if an individual has committed an extremely horrific crime, which may or may not be warranted.  The best way to prevent misdiagnosis is to have clinicians who work with individuals in forensic settings to undergo specialized training. 
 
In a fascinating chapter, the author examines the historical records to evaluate two infamous individuals according to the Psychopath Checklist-Revised.  The two individuals were both nineteenth-century presidential assassins:  John Wilkes Booth, who assassinated President Abraham Lincoln and Charles Guiteau, who assassinated President Garfield. The author draws upon the historical record and provides the reader with insight into how the criteria are measured and assessed.  Based on the author’s assessment of the historical record Charles Guiteau scores in the 99th percentile of psychopathy by scoring a 37.5/40 on the Psychopath Checklist-Revised.  John Wilkes Booth, on the other hand, earned an 8.4/40 on the checklist which although is two times the score of the average American male is below average for a criminal and not high enough for a diagnosis of psychopathy.
 
The text also discusses how psychopathy relates to the diagnosis of antisocial personality disorder found in the DSM-5.  The DSM does not include psychopathy as a specific diagnosis but does include antisocial personality disorder.  According to Dr. Kiehl, the DSM antisocial personality disorder criteria will result in getting a clinician about halfway to a diagnosis of psychopathy according to the Psychopathy Checklist-Revised.  If an individual meets the criteria for antisocial personality disorder, then they likely have a very difficult personality.  The author advises that clinicians working in forensic settings not even bother with the antisocial personality criteria but instead begin immediately by using the Psychopath Checklist-Revised instead of the DSM.  Kiehl also provides insight into the DSM diagnosis of conduct disorder, which he believes is flawed because it is based entirely on observable criteria without reference to emotional, interpersonal, or affective characteristics associated with psychopathy.  Since nearly 80% of individuals who are given a conduct disorder diagnosis outgrow the antisocial behaviors, the author argues that it is of little utility because it does not predict which children are likely to develop psychopathy or lifelong personality problems.  Clinicians in secure juvenile facilities do not even bother conducting assessments for conduct disorder since nearly all of the children would meet the criteria.
 
The Psychopath Whisperer offers an amazing level of insight into the diagnosis of psychopathy but also makes a large number of connections to various units across the psychology curriculum.  As a result, the book is an excellent resource to add high-interest material to units including the biological bases of behavior, sensation and perception, abnormal and treatment, motivation, and emotion, personality, testing and individual differences, learning, and cognition.
 
Other Related Resources

Author’s Websites
http://kentkiehl.com/
The author’s site includes links to articles related to neuroscience, law, and psychopathy as well as videos and other resources. The website also has information about Dr. Kiehl’s research.
 
http://www.psychopathwhisperer.com/
This website includes author Kent Kiehl’s blog and other resources that are specifically related to the book.
 
http://www.mrn.org/people/kent-a-kiehl/principal-investigators/
The Mind Research Network’s website that includes resources, research articles, and information about Kiehl’s project.
 
Wired Interview with Kent Kiehl, Ph.D. about the Psychopath Whisperer
http://www.wired.com/2014/04/psychopath-brains-kiehl/
What It’s Like to Spend 20 Years Listening to Psychopaths for Science: An interview with the author about his research and the stories behind the book.
 
NPR Story:  Inside A Psychopath's Brain: The Sentencing Debate
http://www.npr.org/templates/story/story.php?storyId=128116806
 
Psychological Figures and Concepts
Paul Broca
Sigmund Freud
Phineas Gage
Michael Gazzaniga
Robert Hare
Patient HM
John Nash
Peter Salovey
Adderall
ADHD
Affect
Amnesia
Amygdala
Anterior and Posterior Cingulate Cortex
Antisocial Personality Disorder
Atkins v. Virginia (2002)
Behaviorist Theory
Bipolar Disorder
Borderline Personality Disorder
Callous and Unemotional (CU) Trait
Child Psychopathy Scale
Cognitive Behavioral Therapy
Conduct Disorder
Corpus Callosum
Death Penalty
Delusion
Depression
Diagnostic and Statistical Manual Of Mental Disorders (DSM) III, IV-TR, 5
EEG (Electroencephalogram)
Ego
Emotional Intelligence
Empathy
Factor Analysis
Frontal Lobe
Functional Magnetic Resonance Imaging (fMRI)
Hallucination (auditory, command, visual)
Hippocampus
IQ
Juvenile Justice System
Limbic System
Magnetic Resonance Imaging (MRI)
Minnesota Multiphasic Personality Inventory (MMPI)
National Institute of Mental Health (NIMH)
National Institute on Drug Abuse (NIDA)
National Institutes of Health (NIH)
Obsessive-Compulsive Disorder
Oppositional Defiant Disorder
Orbital Frontal Cortex
Posttraumatic Stress Disorder
Prefrontal Cortex
Psychopathic Trait
Psychopathy Checklist-Revised (PCL-R)
Recidivism
Schizophrenia
Self-Fulfilling Prophecy
Self-Report Inventory
Sleep-Wake Disorder
Sociopath
Substance Abuse
Youth Psychopathy Checklist
 
 
 
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    Laura Brandt, Nancy Fenton, and Jessica Flitter are AP Psychology instructors. Nancy Fenton teaches at  Adlai E. Stevenson High School in Lincolnshire, Illinois, Laura Brandt teaches at Libertyville High School in Libertyville Illinois and Jessica Flitter teachers at West Bend East High School in West Bend, Wisconsin.
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