Psychopaths

The killings and other horrific acts perpetuated in Nithari, Noida, have been in the news for quite some time. A married man with grown up children, apparently aided and abetted by his domestic help, raped, murdered and eviscerated around 40 children. The motive of the two, however, is still unclear. How on earth could any civilised human do so vile a deed? Were they cannibals? Or paedophiles with a lucrative donor organ trade as a sideline? However, the most plausible explanation is that two people with antisocial personality disorder (ASPD) drifted into a relationship that was mutually beneficial, psychologically and financially. ASPD in varying degrees of severity is common in about three per cent of the total male and one per cent of the total female populations. US prison statistics indicate that 20 per cent of the long-term inmates suffer from this disorder. If chronic criminal offenders are studied, between 30 and 80 per cent would fit this profile. A person with ASPD is Corrupt. Such individuals exhibit the following traits — C — cannot follow the law O — obligations ignored R — remorselessness R — recklessness U — underhandedness P — planning deficit T — temper There are no specific tests to identify this disorder. The diagnosis is made after the age of 18 if at least three of the above symptoms have been present from the age of 15 years. The diagnosis is based on clinical interviews, self-rating personality surveys, and ratings from co-workers and family. Colour brain scans, as used while interrogating the accused from Noida, can also be used. These scans are based on the observations made by scientists while studying normal, healthy volunteers. It has been seen that varying emotions make different areas of the brain light up. Video clips of happy and neutral faces were shown to normal individuals and those diagnosed with ASPD. Both groups showed increased activity in the same areas of the brain. However, in ASPD sufferers, the response was less and slower, indicating emotional blunting. When fearful, frightening photographs were shown, healthy volunteers showed marked agitation but the response was minimal in those with ASPD. This has led researchers to conclude that though ASPD sufferers have intact neural and biochemical pathways to process emotions, the response is blunted and of low intensity. Unable to biochemically process emotional signals, people with ASPD fail to recognise facial and other signals of distress and pain. They feel no sympathy or empathy and can proceed deliberately with horrific acts of violence. Such people stride forward boldly where others fear to tread, as they are unable to plan for the future or foresee negative consequences of their actions. They make excellent mercenaries as they have no loyalty except to themselves, are indifferent to the possibility of physical pain or punishment, and show no fear when threatened. The ASPD-affected may survive and succeed due to their ability to take risks. They attract others with similar personalities. They may then band together (this is what probably happened in Noida) to form criminal gangs capable of unimaginable cruelty and violence towards the weaker members of society. The tendency to developing ASPD can be suspected in children who exhibit three warning signs, the MacDonald Triad of prolonged bedwetting, cruelty to animals and pyromania (sense of loneliness, followed by rage). During the teenage years, these individuals show a persistent disregard for the feelings and rights of others, poor academic performance, recklessness, depression and a tendency for addiction and substance abuse. When investigated, results indicate a family history of male members with milder versions of this disorder. The fathers tend to be abusive violent drug addicts or alcoholics. The mothers, too, are undemonstrative, showing little or no affection towards the children. The home environment with this combination as parents is unsatisfactory, with inadequate random inconsistent discipline and vague behavioural boundaries. In adoption studies, it was found that genes played a role in the inheritance of this personality disorder. However, the disorder was fully expressed only in those who also grew up in unsatisfactory home environments, with inadequate nurturing before five years of age. Although some people with ASPD do become successful but cruel dictators, most eventually end up in prison. In others, drug or alcohol abuse controls their lives. Treatment, with psychotherapy or medication, is difficult and not very successful. ASPD can be prevented to some extent With nurturing during the first five years of life, from caring individuals if the parents are unavailable Satisfactory parenting with consistent reasonable and logical discipline which is not harsh and arbitrary Starting psychiatric counselling in childhood if pyromania or cruelty to animals is noticed Paying attention to academic performance in the teenage years Watching for signs of drug addiction or crime in teens Not arranging a marriage for an alcoholic or drug addict in the hope that matrimony and family responsibility will provide a miraculous cure. Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in