The Biological Perspective

Biological factors may be divided into two kinds: those known to directly affect the development of the organism and those that often accompany the appearance of a syndrome but with an uncertain developmental role. The former include temperament and some genetic conditions; the latter include congenital factors, physical constitution, hormonal patterns, brain structure, and neurotransmitter patterns. The most definitive and interesting line of research that links biology with the violation of shared standards of social living is associated with the construct of psychopathy. The following findings might, or might not, generalize across psychopathic, antisocial, and sociopathic individuals.

Casual observers have often remarked that antisocials and psychopaths appear to have inborn temperaments that make them seem tough, aggressive, fearless, impulsive, hotheaded, and sensation seeking. Naturally, such traits tend to send the individual down certain life trajectories rather than others, namely, toward the development of delinquent and antisocial behaviors and away from the development of prosocial or altruistic attitudes. In an interesting chapter, one of the leaders of the field, David Lykken (1995) discusses his pet bull terrier, a breed that crosses the strength and temperament of a bulldog with the agility of a terrier, thus providing, according to Lykken, something of an "animal model" of psychopathy. Pups easily and playfully destroy household items with their powerful jaws, he states, and are almost indifferent to punishment. Consequently, raising a bull terrier requires patience and fortitude. Drawing on four parenting styles described by Baumrind (1971, 1980), Lykken suggests that the authoritarian style produces an adult who is obedient when faced with strength, but surly and dangerous to the weak. Permissive parents fail to set limits, thus producing an animal that is ultimately uncontrollable. Neglectful or rejecting parenting produces a "bully outlaw." Only a firm but loving authoritative style, Lykken argues, yields an animal that is ultimately sociable, loyal, and controllable, despite its aggressive genetic heritage.

Presumably, the same holds true for the socialization of antisocials and psychopaths. Parents often report that children who chronically act out were just born that way, unimpressed by punishment, rigidly resistant to control, and almost unmanageable from birth. Such children explore the environment more assertively, frequently intrude on others, and just naturally get into trouble more often. Without firm limit setting and competent parenting, their destiny is that of the unsocialized bull terrier pup, who pursues its own will without deterrence. The hope is that patience, consistent discipline, and prosocial role models will produce internalized value systems sufficiently strong to contain a biologically fueled aggression or at least channel it in socially acceptable ways—what the psychodynamic perspective calls sublimation.

Nevertheless, even among human beings, it appears that there are children who even the best parents could not socialize—children born to normal, traditional, loving, nuclear families, who go on to gross violations of social norms. Cleckley (1988) provides such examples, including many who have murdered, conned, and swindled. Cleckley (1950) argued that these individuals, then termed primary psychopaths, suffer what he called a "semantic aphasia." Semantic refers to meaning, and aphasia is broadly considered a class of disorders related to the understanding or production of language. What Cleckley believed, however, is that psychopaths suffer an inborn inability to understand and express the meaning of emotional experience, even though their understanding of language is normal.

Unable to understand the suffering their behavior creates, they do not develop a conscience and thus are left without empathy or remorse. Many are shrewd and calculating and struggle to learn the emotional mechanics of interpersonal communication, thus masking their disorder. Nevertheless, the significance of embarrassment, shame, or fearfulness, for example, is just lost on them. For psychopaths, statements such as, "I apologize," or "You have made me so happy!" are meaningless social conventions. Some psychopaths have even been known to purchase psychology books explicitly to develop an understanding of human emotional reactions, of "what makes people tick," a "necessary evil" in adapting to an alien world of the empathic and socialized.

In the past several decades, Cleckley's conjecture has been pursued experimentally, with a number of interesting findings. For example, most people process linguistic data faster when they are received through the right ear than through the left ear. Because the auditory nerve from each ear connects directly to the opposite brain hemisphere, the pathway connecting the right ear to the language centers of the left hemisphere is simply shorter. In contrast, information from the left ear must first travel to the right hemisphere and then on to the language centers of the left, a longer pathway. Studies have shown, however, that psychopaths possess a smaller speed advantage for the right ear than do normals (Hare & McPherson, 1984). Presumably, then, their language skills are not as strongly lateralized to the left hemisphere.

Many studies have found other strange discrepancies in the language of psychopaths. Normal subjects react strongly to the emotional dimension of statements or pictures, but psychopaths do not (Williamson, Harpur, & Hare, 1991), nor do they emphasize distinctions between neutral and emotional words as much as do normals in ordinary speech (Louth, Williamson, Alpert, Pouget, & Hare, 1998). Cerebral blood flow studies, which tap patterns of information processing in the cortex, have found that the processing of emotional words differs between psychopaths and nonpsychopaths (Intrator, Hare,

Stritzke, & Brichtswein, 1997). Gillstrom and Hare (1988) argue that the language of psychopaths is broken into smaller conceptual units. Collectively, these and many other studies converge in supporting Cleckley's original hypothesis.

Other researchers have examined brain functioning, broadly conceived. Because the frontal lobe is implicated in executive functions such as long-term planning, coordination of goals and subgoals, judgment, and attention, its study is naturally relevant to the study of psychopaths. Brain wave recordings show that the EEG patterns of adult psychopaths resemble those of young children, suggesting a developmental delay in the physical maturity of the brain, though these findings are controversial (Hare, 1993). Some (Elliott & Gillett, 1992) even argue that deficits in frontal lobe activity help explain the psychopath's inattention to morality. Deckel, Hesselbrock, and Bauer (1996) have shown that increased activity in the left frontal lobe is associated with a lower likelihood of antisocial personality disorder. Compared to Alzheimer's subjects, individuals with dementia of the frontal and temporal lobes exhibit more antisocial behavior (Miller, Darby, Benson, & Cummings, 1997), including assault, indecent exposure, and shoplifting. Furthermore, acting-out behavior is a well-known effect of traumatic injury to the frontal lobes. Siever, Klar, and Coccaro (1985) suggest that antisocial personalities are less cortically aroused but more motorically disinhibited and, therefore, tend to act before they can take time to reflect.

Another research tradition (Eysenck, 1964; Lykken, 1957; Quay, 1965) suggests that psychopaths are difficult to arouse physiologically. Physiological reactions are closely linked to the experience of many emotions, especially fear. Unable to become aroused, such individuals seem fearless under conditions of objective threat and are unable to profit from experience. Numerous studies have shown that whereas the heart rate of normal subjects increases in anticipation of some aversive stimulus, such as a loud noise or electric shock, the heart rate of psychopaths tends to remain the same or increases only at the last moment (Hare, 1978). Unable to appraise a potentially dangerous situation by gauging their own fear, they plow ahead violently, regardless of risk—a deficiency that eventually develops into a lifestyle. A lower autonomic baseline did, in fact, predict the development of delinquency a decade later in Danish adolescents (Loeb & Mednick, 1977). Other writers have suggested that such individuals experience life as chronically boring and might, therefore, require voracious amounts of sensation and excitement simply as a means of feeling alive. The penchant of many antisocials and psychopaths to "stir up some excitement" is well known.

Many other biological bases for psychopathy or antisocial personality have been proposed. Cloninger (1987b) regards the primary psychopath as being high in novelty seeking, low in the desire to avoid harm, and low in dependence on external rewards, the three main dimensions of his neurobiologic model of personality. Such individuals, according to Cloninger, are aggressive, oppositional, and opportunistic, essentially resembling the Cleckley psychopath. Gray (1987) suggests that three brain systems control emotional behavior. Individual differences in one of these, the behavioral inhibition system, leads some persons to react strongly to experiences associated with past aversive events, while others react very little. If this system is weak, the person tends to condition poorly to fear and exhibits an absence of anxiety.

A variety of other neurochemical findings have been reported. Low serotonin levels are associated with displays of aggression, violence, and impulsivity in the personality disorders generally (Siever & Trestman, 1993). They are also associated with antisocial personality disorder and comorbid substance abuse (Moss, Yao, & Panzak, 1990). Similarly, decreased levels of the hormone cortisol have been found in violent adult male

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