How to Recognize a Psychopath

Kids with psychopathic traits have a significant deficiency in their automatic, unconscious processing of certain cues -- especially fear cues, but also cues for disgust.
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Hannibal Lecter is arguably the world's most famous psychopath. I know -- he's not real. Still, the anti-hero of "The Silence of the Lambs" embodies the chilling constellation of traits generally associated with this rare mental disorder. A highly-intelligent physician and psychiatrist, Lecter is superficially charming, even urbane -- at least when he's not cannibalizing his innocent victims. He is rarely emotional, and despite the brutality of his crimes, he shows absolutely no evidence of empathy or a guilty conscience.

That's what makes psychopaths so mysterious and incomprehensible -- the lack of normal human feeling. How could somebody's child develop into that kind of merciless automaton? What did Hannibal Lecter's inner life feel like as he was growing up?

One leading idea is that this psychopathic derangement is linked to childhood temperament, specifically fearlessness, which lays the groundwork for the development of full-blown psychopathic disorder in adulthood. There is evidence to support this notion: Psychopaths have great difficulty learning about pain -- learning to avoid electrical shocks and loud noises, for example -- and their ability to recognize fearful faces is also impaired. Perhaps most notably, psychopaths don't respond normally to fear-inducing punishments -- making it very hard for parents and others to teach them right and wrong.

Despite the popularity of the so-called "fearlessness hypothesis," a growing number of experts question whether it goes deep enough. Perhaps, they argue, the problem is even more fundamental, perhaps neurological -- a problem with attention, which makes psychopaths unresponsive to fear-provoking cues in the world. According to this competing theory, psychopaths appear fearless because they aren't paying close enough attention to the things that normally scare people. This theory has inspired clinical interventions that train kids to consciously focus on emotional cues around them -- an approach that has not been especially successful.

Now, another group of psychological scientists is going even further, suggesting that the roots of the disorder may reach deep into the unconscious mind. Patrick Sylvers, of the University of Washington, working with Patricia Brennan and Scott Lilienfeld of Emory, suspected that psychopaths may suffer from a deficit in "preattentive processing" -- the constant, automatic scanning of one's surroundings that takes place outside of conscious awareness. Theoretically, if children lack this basic cognitive machinery, they would never learn to decode normal signs of danger, and without this acquired fear, they would fail to socialize into adults with conscience.

At least that's the theory, which the scientists decided to test in the laboratory. They recruited 88 boys, between 7 and 11 years old, who had troublesome histories both at school and at home, and screened them for what's called "callous unemotionality." This includes an unsettling disregard for others' needs, shallow emotions and lack of remorse and empathy -- very similar to the core traits of the adult disorder. They also tested them for impulsivity and conduct problems and for signs of narcissism, like bragging a lot, which is also seen in many adult psychopaths.

Following this screening, the scientists gave the boys a visual test that measures unconscious emotional processing. Specifically, they wanted to see if the test subjects, compared with normal boys of the same age, were slower to become aware of fearful faces that were flashed rapidly -- so rapidly that they were not registered by the conscious mind. If so, this would be evidence that the troubled boys are not automatically assimilating threatening cues in their world. They also flashed happy, disgusted and neutral faces for comparison.

The results, reported online in the journal Psychological Science, were clear and provocative. Indeed, they comprise the first evidence ever that kids with psychopathic traits have a significant deficiency in their automatic, unconscious processing of certain cues -- especially fear cues, but also cues for disgust. Fear and disgust are closely related in the primitive mind, and the findings suggest that these troubled kids have a fundamental impairment in recognizing -- "in the blink of an eye" -- any kind of social danger. So perhaps the childhood roots of Hannibal Lecter's murderous personality lay not in fearlessness itself, nor even in his conscious thought processes, but rather in his general social cluelessness.

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