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Authors: Kent A. Phd Kiehl
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traditional symptoms of psychopathy. As a result,
DSM-IV
(and
DSM-5
) reintroduced some of the affective criteria that
DSM-III
left out, but in a compromise, they provided virtually no guidance about how to integrate the symptoms.
Perhaps more important—and dangerous—forensic practitioners may diagnose a client with
DSM
antisocial personality disorder but mistakenly draw upon the literature using the Psychopathy Checklist and incorrectly relate the latter findings on recidivism and treatment outcomes to a client with only minimal antisocial symptoms.
I routinely consult with lawyers and judges, and it is not uncommon for them to have been told by their consulting forensic practitioners that the Psychopathy Checklist and
DSM
antisocial personality disorder criteria are the same when they are absolutely not.
In professional training seminars, I sum up the relationship between
DSM-IV
antisocial personality disorder and psychopathy as assessed with the Psychopathy Checklist this way:
The
DSM
antisocial personality disorder criteria get you about halfway to the diagnosis of psychopathy using the Hare Psychopathy Checklist-Revised. If you are a clinician working in the community and you complete an interview with your client and he or she meets
DSM
criteria for antisocial personality disorder, you know you are dealing with someone with a difficult personality. But then clinicians need to go beyond the
DSM
criteria and assess for psychopathy using the Hare Psychopathy Checklist-Revised. In this way the clinician will know whether he or she is dealing with a psychopath or not, drawing upon all the thousands of papers that have been published on psychopathy to help develop a treatment and management strategy for a client. If you are working in a forensic setting, you should simply skip the
DSM
criteria and use the Hare Psychopathy Checklist-Revised.
The evolution of psychopathy has been full of twists and turns, but the scientific community has finally sorted out a common metric for the condition. In the next chapter, I’ll explore the symptoms of psychopathy in more detail, illustrated by case examples of two notorious assassins.
Chapter 3
The Assassins
Fact: Psychopaths kill more people in North America every year than the number killed in the terrorist attacks on September 11, 2001. 1
Americans were stunned twice in the latter half of the nineteenth century by presidential assassinations. The first assassination, of President Abraham Lincoln by John Wilkes Booth, occurred in 1865. Sixteen years later, in 1881, Charles Julius Guiteau assassinated President James A. Garfield. The two assassins used the same instrument to execute their malfeasance, a .44-caliber revolver, but that is where the similarities end.
John Wilkes Booth was a prominent stage actor who led a relatively charmed life. A Southern sympathizer, Booth murdered Lincoln just days following the surrender of Confederate general Robert E. Lee in an attempt to turn the tide of the Civil War back on the side of the South. Charles Guiteau’s crime, contrary to Booth’s, was utterly motiveless and simply mystified Americans. The trial of Guiteau for the assassination of President Garfield would fracture the medical and legal community over the diagnosis of
moral insanity
and its relationship to criminal responsibility.
Many people assume horrific crimes indicate the perpetrator has a disturbed, even deranged, personality. I am often asked whether all murderers are psychopaths. Many people assume they are. But as we’ve seen, psychopathy is more complicated than the details of any single crime can capture, no matter how despicable the act. In thepages that follow, I intend to assess the traits of psychopathy in two of the most notorious assassins in American history, to show how the scoring of an individual on the basis of those traits leads to a clinical diagnosis. As we know from Chapter 2 , psychopathy, as assessed by the Hare Psychopathy Checklist, is
DSM-IV
(and
DSM-5
) reintroduced some of the affective criteria that
DSM-III
left out, but in a compromise, they provided virtually no guidance about how to integrate the symptoms.
Perhaps more important—and dangerous—forensic practitioners may diagnose a client with
DSM
antisocial personality disorder but mistakenly draw upon the literature using the Psychopathy Checklist and incorrectly relate the latter findings on recidivism and treatment outcomes to a client with only minimal antisocial symptoms.
I routinely consult with lawyers and judges, and it is not uncommon for them to have been told by their consulting forensic practitioners that the Psychopathy Checklist and
DSM
antisocial personality disorder criteria are the same when they are absolutely not.
In professional training seminars, I sum up the relationship between
DSM-IV
antisocial personality disorder and psychopathy as assessed with the Psychopathy Checklist this way:
The
DSM
antisocial personality disorder criteria get you about halfway to the diagnosis of psychopathy using the Hare Psychopathy Checklist-Revised. If you are a clinician working in the community and you complete an interview with your client and he or she meets
DSM
criteria for antisocial personality disorder, you know you are dealing with someone with a difficult personality. But then clinicians need to go beyond the
DSM
criteria and assess for psychopathy using the Hare Psychopathy Checklist-Revised. In this way the clinician will know whether he or she is dealing with a psychopath or not, drawing upon all the thousands of papers that have been published on psychopathy to help develop a treatment and management strategy for a client. If you are working in a forensic setting, you should simply skip the
DSM
criteria and use the Hare Psychopathy Checklist-Revised.
The evolution of psychopathy has been full of twists and turns, but the scientific community has finally sorted out a common metric for the condition. In the next chapter, I’ll explore the symptoms of psychopathy in more detail, illustrated by case examples of two notorious assassins.
Chapter 3
The Assassins
Fact: Psychopaths kill more people in North America every year than the number killed in the terrorist attacks on September 11, 2001. 1
Americans were stunned twice in the latter half of the nineteenth century by presidential assassinations. The first assassination, of President Abraham Lincoln by John Wilkes Booth, occurred in 1865. Sixteen years later, in 1881, Charles Julius Guiteau assassinated President James A. Garfield. The two assassins used the same instrument to execute their malfeasance, a .44-caliber revolver, but that is where the similarities end.
John Wilkes Booth was a prominent stage actor who led a relatively charmed life. A Southern sympathizer, Booth murdered Lincoln just days following the surrender of Confederate general Robert E. Lee in an attempt to turn the tide of the Civil War back on the side of the South. Charles Guiteau’s crime, contrary to Booth’s, was utterly motiveless and simply mystified Americans. The trial of Guiteau for the assassination of President Garfield would fracture the medical and legal community over the diagnosis of
moral insanity
and its relationship to criminal responsibility.
Many people assume horrific crimes indicate the perpetrator has a disturbed, even deranged, personality. I am often asked whether all murderers are psychopaths. Many people assume they are. But as we’ve seen, psychopathy is more complicated than the details of any single crime can capture, no matter how despicable the act. In thepages that follow, I intend to assess the traits of psychopathy in two of the most notorious assassins in American history, to show how the scoring of an individual on the basis of those traits leads to a clinical diagnosis. As we know from Chapter 2 , psychopathy, as assessed by the Hare Psychopathy Checklist, is
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