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89-435: A bedwetter is a person who engages in nocturnal enuresis . Bedwetter may also refer to: Nocturnal enuresis Nocturnal enuresis ( NE ), also informally called bedwetting , is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Complications can include urinary tract infections . Most bedwetting
178-445: A bedwetting child is not at fault for the situation. Many medical studies state that the psychological impacts of bedwetting are more important than the physical considerations. "It is often the child's and family members' reaction to bedwetting that determines whether it is a problem or not." Whether bedwetting causes low self-esteem remains a subject of debate, but several studies have found that self-esteem improved with management of
267-448: A child of at least 5 years of age and not due to either a drug side effect or a medical condition . There are a number of management options for bedwetting. The following options apply when the bedwetting is not caused by a specifically identifiable medical condition such as a bladder abnormality or diabetes. Treatment is recommended when there is a specific medical condition such as bladder abnormalities, infection , or diabetes . It
356-522: A decreased activation of the fusiform and extrastriate cortical regions. The underlying biological surfaces for processing expressions of happiness are functionally intact in psychopaths, although less responsive than those of controls. The neuroimaging literature is unclear as to whether deficits are specific to particular emotions such as fear. The overall pattern of results across studies indicates that people diagnosed with psychopathy demonstrate reduced MRI, fMRI, aMRI, PET, and SPECT activity in areas of
445-446: A disorder when it persists after the age at which bladder control usually occurs (4–7 years), and is either resulting in an average of at least two wet nights a week with no long periods of dryness or not able to sleep dry without being taken to the toilet by another person. New studies show that anti-psychotic drugs can have a side effect of causing enuresis. It has been shown that diet impacts enuresis in children. Constipation from
534-425: A family with a child who wets nightly will pay about $ 1,000 a year for additional laundry, extra sheets, diapers, and mattress replacement. Despite these stressful effects, doctors emphasize that parents should react patiently and supportively. Bedwetting does not indicate a greater possibility of being a sociopath , as long as caregivers do not cause trauma by shaming or punishing a bedwetting child. Bedwetting
623-512: A further study using the same tests found that prisoners scoring high on the PCL were more likely to endorse impersonal harm or rule violations than non-psychopathic controls were. The psychopathic offenders who scored low in anxiety were also more willing to endorse personal harm on average. Assessing accidents, where one person harmed another unintentionally, psychopaths judged such actions to be more morally permissible. This result has been considered
712-457: A medical condition, such as a bladder infection. Psychologists are usually allowed to diagnose and write a prescription for diapers if nocturnal enuresis causes the patient significant distress. Psychiatists may instead use a definition from the DSM-IV , defining nocturnal enuresis as repeated urination into bed or clothes, occurring twice per week or more for at least three consecutive months in
801-440: A minute burst of antidiuretic hormone (also known as arginine vasopressin or AVP). This hormone burst reduces the kidney 's urine output well into the night so that the bladder does not get full until morning. This hormone cycle is not present at birth. Many children develop it between the ages of two and six years old, others between six and the end of puberty , and some not at all. The second ability that helps people stay dry
890-539: A narrow and broad sense, such as MedlinePlus from the U.S. National Library of Medicine . On the other hand, Stedman's Medical Dictionary defines "psychopath" only as a "former designation" for a person with an antisocial type of personality disorder. The term psychosis was also used in Germany from 1841, originally in a very general sense. The suffix -ωσις (-osis) meant in this case "abnormal condition". This term or its adjective psychotic would come to refer to
979-576: A poor diet can result in impacted stool in the colon putting undue pressure on the bladder creating loss of bladder control ( overflow incontinence ). Some researchers, however, recommend a different starting age range. This guidance says that bedwetting can be considered a clinical problem if the child regularly wets the bed after turning 7 years old. Secondary enuresis occurs after a patient goes through an extended period of dryness at night (six months or more) and then reverts to night-time wetting. Secondary enuresis can be caused by emotional stress or
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#17327902085151068-562: A reflection of psychopaths' failure to appreciate the emotional aspect of the victim's harmful experience. The word psychopathy is a joining of the Greek words psyche ( ψυχή ) "soul" and pathos ( πάθος ) "suffering, feeling". The first documented use is from 1847 in Germany as psychopatisch , and the noun psychopath has been traced to 1885. In medicine, patho- has a more specific meaning of disease (Thus pathology has meant
1157-840: A result. In considering the issue of possible reunification of some sex offenders into homes with a non-offending parent and children, it has been advised that any sex offender with a significant criminal history should be assessed on the PCL-R, and if they score 18 or higher, then they should be excluded from any consideration of being placed in a home with children under any circumstances. There is, however, increasing concern that PCL scores are too inconsistent between different examiners, including in its use to evaluate sex offenders. The possibility of psychopathy has been associated with organized crime , economic crime and war crimes . Terrorists are sometimes considered psychopathic, and comparisons may be drawn with traits such as antisocial violence,
1246-532: A secret report originally prepared for the Office of Strategic Services in 1943, and which may have been intended to be used as propaganda , non-medical psychoanalyst Walter C. Langer suggested Adolf Hitler was probably a psychopath . However, others have not drawn this conclusion; clinical forensic psychologist Glenn Walters argues that Hitler's actions do not warrant a diagnosis of psychopathy as, although he showed several characteristics of criminality, he
1335-622: A self-centered disposition, unreliability, poor behavioral controls, and unusual behaviors may disadvantage or preclude psychopathic individuals in conducting organized terrorism. It may be that a significant portion of people with psychopathy are socially successful and tend to express their antisocial behavior through more covert avenues such as social manipulation or white collar crime . Such individuals are sometimes referred to as "successful psychopaths", and may not necessarily always have extensive histories of traditional antisocial behavior as characteristic of traditional psychopathy. The PCL:YV
1424-456: A selfish world view that precludes the welfare of others, a lack of remorse or guilt, and blame externalization. However, John Horgan, author of The Psychology of Terrorism , argues that such comparisons could also then be drawn more widely: for example, to soldiers in wars. Coordinated terrorist activity requires organization, loyalty and ideological fanaticism often to the extreme of sacrificing oneself for an ideological cause. Traits such as
1513-599: A sense of empathy or morality, but sociopathy as only differing from the average person in the sense of right and wrong. Ancient writings that have been connected to psychopathic traits include Deuteronomy 21:18–21 and a description of an unscrupulous man by the Greek philosopher Theophrastus around 300 BC. The concept of psychopathy has been indirectly connected to the early 19th century work of Pinel (1801; "mania without delirium") and Pritchard (1835; " moral insanity "), although historians have largely discredited
1602-433: A somewhat lower average value of 17.5. Studies have found that psychopathy scores correlated with repeated imprisonment, detention in higher security, disciplinary infractions, and substance misuse. Psychopathy, as measured with the PCL-R in institutional settings, shows in meta-analyses small to moderate effect sizes with institutional misbehavior, postrelease crime, or postrelease violent crime with similar effects for
1691-488: A spontaneous cure rate of 14% per year. Adolescents 10 to 18 years old have a spontaneous cure rate of 16% per year. As can be seen from the numbers above, a portion of bedwetting children will not outgrow the problem. Adult rates of bedwetting show little change due to spontaneous cure. Persons who are still enuretic at age 17 are likely to deal with bedwetting throughout their lives. Studies of bedwetting in adults have found varying rates. The most quoted study in this area
1780-405: A strong genetic component. Children whose parents were not enuretic have only a 15% incidence of bedwetting. When one or both parents were bedwetters, the rates jump to 44% and 77% respectively. These first two factors (aetiology and genetic component) are the most common in bedwetting, but current medical technology offers no easy testing for either cause. There is no test to prove that bedwetting
1869-638: Is a developmental delay —not an emotional problem or physical illness. Only a small percentage (5 to 10%) of bedwetting cases have a specific medical cause. Bedwetting is commonly associated with a family history of the condition. Nocturnal enuresis is considered primary when a child has not yet had a prolonged period of being dry. Secondary nocturnal enuresis is when a child or adult begins wetting again after having stayed dry. Treatments range from behavioral therapy , such as bedwetting alarms , to medication, such as hormone replacement , and even surgery such as urethral dilatation . Since most bedwetting
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#17327902085151958-414: Is a hormone that reduces urine production at night. The second is the ability to wake up when the bladder is full. Children usually achieve nighttime dryness by developing one or both of these abilities. There appear to be some hereditary factors in how and when these develop. The first ability is a hormone cycle that reduces the body's urine production. At about sunset each day, the body releases
2047-451: Is a personality construct characterized by impaired empathy and remorse , in combination with traits of boldness , disinhibition , and egocentrism . These traits are often masked by superficial charm and immunity to stress , which create an outward appearance of apparent normalcy. Hervey M. Cleckley , an American psychiatrist , influenced the initial diagnostic criteria for antisocial personality reaction/disturbance in
2136-460: Is also considered when bedwetting may harm the child's self-esteem or relationships with family/friends. Only a small percentage of bedwetting is caused by a specific medical condition, so most treatment is prompted by concern for the child's emotional welfare. Behavioral treatment of bedwetting overall tends to show increased self-esteem for children. Parents become concerned much earlier than doctors. A study in 1980 asked parents and physicians
2225-414: Is an "unconscious, involuntary [...] act". Bedwetting can be connected to past emotions and identity. Children under substantial stress, particularly in their home environment, frequently engage in bedwetting, in order to alleviate the stress produced by their surroundings. Trauma can also trigger a return to bedwetting (secondary enuresis) in both children and adults. It is not bedwetting that increases
2314-473: Is an active field of research. The term is also used by the general public, popular press, and in fictional portrayals . While the abbreviated term "psycho" is often employed in common usage in general media along with "crazy", " insane ", and "mentally ill", there is a categorical difference between psychosis and psychopathy. Socially, psychopathy typically involves extensive callous and manipulative self-serving behaviors with no regard for others, and often
2403-455: Is an adaptation of the PCL-R for individuals aged 13–18 years. It is, like the PCL-R, done by a trained rater based on an interview and an examination of criminal and other records. The "Antisocial Process Screening Device" (APSD) is also an adaptation of the PCL-R. It can be administered by parents or teachers for individuals aged 6–13 years. High psychopathy scores for both juveniles (as measured with these instruments) and adults (as measured with
2492-537: Is argued to be more due to a personality disorder caused by neurological deficits interacting with an adverse environment. For many, but not all, childhood onset is associated with what is in Terrie Moffitt's developmental theory of crime referred to as "life-course- persistent" antisocial behavior as well as poorer health and economic status. Adolescent onset is argued to more typically be associated with short-term antisocial behavior. It has been suggested that
2581-553: Is associated with repeated delinquency, crime and violence. Mentally, impairments in processes related to affect and cognition , particularly socially related mental processes, have also been found. Developmentally, symptoms of psychopathy have been identified in young children with conduct disorder , and suggests at least a partial constitutional factor that influences its development. Disagreement exists over which features should be considered as part of psychopathy, with researchers identifying around 40 traits supposedly indicative of
2670-434: Is based on research which suggests that those with conduct disorder who also meet criteria for the specifier tend to have a more severe form of the disorder with an earlier onset as well as a different response to treatment. Proponents of different types/dimensions of psychopathy have seen this as possibly corresponding to adult primary psychopathy and increased boldness and/or meanness in the triarchic model. Dysfunctions in
2759-436: Is dependent on three factors: 1) nocturnal urine production, 2) nocturnal bladder function and 3) sleep and arousal mechanisms. Any child will experience nocturnal enuresis if more urine is produced than can be contained in the bladder or if the detrusor is hyperactive, provided that he or she is not awakened by the imminent bladder contraction. Primary nocturnal enuresis is the most common form of bedwetting. Bedwetting becomes
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2848-447: Is dissociable from and not synonymous with violence. It has been suggested that psychopathy is associated with "instrumental aggression", also known as predatory, proactive, or "cold blooded" aggression, a form of aggression characterized by reduced emotion and conducted with a goal differing from but facilitated by the commission of harm. One conclusion in this regard was made by a 2002 study of homicide offenders, which reported that
2937-593: Is evidence from DT-MRI of breakdowns in the white matter connections between these two important areas. Although some studies have suggested inverse relationships between psychopathy and intelligence , including with regards to verbal IQ, Hare and Neumann state that a large literature demonstrates at most only a weak association between psychopathy and IQ , noting that the early pioneer Cleckley included good intelligence in his checklist due to selection bias (since many of his patients were "well educated and from middle-class or upper-class backgrounds") and that "there
3026-407: Is motivated in part by a desire to publicly embarrass the child into compliance, as neighbors would recognize why the child was knocking on their door. Parents and family members are frequently stressed by a child's bedwetting. Soiled linens and clothing cause additional laundry. Wetting episodes can cause lost sleep if the child wakes and/or cries, waking the parents. A European study estimated that
3115-400: Is no obvious theoretical reason why the disorder described by Cleckley or other clinicians should be related to intelligence; some psychopaths are bright, others less so". Studies also indicate that different aspects of the definition of psychopathy (e.g. interpersonal, affective (emotion), behavioral and lifestyle components) can show different links to intelligence, and the result can depend on
3204-596: Is not known whether this is reflected in reduced experience of state fear or where it reflects impaired detection and response to threat-related stimuli. Moreover, such deficits in threat responding are known to be reduced or even abolished when attention is focused on the threatening stimuli. In terms of simple correlations, the PCL-R manual states an average score of 22.1 has been found in North American prisoner samples, and that 20.5% scored 30 or higher. An analysis of prisoner samples from outside North America found
3293-1093: Is often claimed that the PCL-R does not include low anxiety or fearlessness, such features do contribute to the scoring of the Facet 1 (interpersonal) items, mainly through self-assurance, unrealistic optimism, brazenness and imperturbability. Indeed, while self-report studies have been inconsistent using the two-factor model of the PCL-R, studies which separate Factor 1 into interpersonal and affective facets, more regularly show modest associations between Facet 1 and low anxiety, boldness and fearless dominance (especially items assessing glibness/charm and grandiosity). When both psychopathy and low anxiety/boldness are measured using interviews, both interpersonal and affective facets are both associated with fearlessness and lack of internalizing disorders. The importance of low anxiety/fearlessness to psychopathy has historically been underscored through behavioral and physiological studies showing diminished responses to threatening stimuli (interpersonal and affective facets both contributing). However, it
3382-516: Is only a developmental delay, and genetic testing offers little or no benefit. As a result, other conditions should be ruled out. The following causes are less common, but are easier to prove and more clearly treated: In some bedwetting children there is no increase in ADH (antidiuretic hormone) production, while other children may produce an increased amount of ADH but their response is insufficient. Two physical functions prevent bedwetting. The first
3471-502: Is positive correlation between early negative life events of the ages 0–4 and the emotion-based aspects of psychopathy. There are moderate to high correlations between psychopathy rankings from late childhood to early adolescence. The correlations are considerably lower from early- or mid-adolescence to adulthood. In one study most of the similarities were on the Impulsive- and Antisocial-Behavior scales. Of those adolescents who scored in
3560-476: Is reported that offenders with psychopathy (both sexual and non-sexual offenders) are about 2.5 times more likely to be granted conditional release compared to non-psychopathic offenders. Hildebrand and colleagues (2004) have uncovered an interaction between psychopathy and deviant sexual interests , wherein those high in psychopathy who also endorsed deviant sexual interests were more likely to recidivate sexually. A subsequent meta-analysis has consolidated such
3649-424: Is simply a developmental delay, most treatment plans aim to protect or improve self-esteem . Treatment guidelines recommend that the physician counsel the parents, warning about psychological consequences caused by pressure, shaming, or punishment for a condition children cannot control. Bedwetting is the most common childhood complaint. A review of medical literature shows doctors consistently stressing that
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3738-657: Is waking when the bladder is full. This ability develops in the same age range as the vasopressin hormone, but is separate from that hormone cycle. The typical development process begins with one- and two-year-old children developing larger bladders and beginning to sense bladder fullness. Two- and three-year-old children begin to stay dry during the day. Four- and five-year-olds develop an adult pattern of urinary control and begin to stay dry at night. Thorough history regarding frequency of bedwetting, any period of dryness in between, associated daytime symptoms, constipation, and encopresis should be sought. Nocturnal urinary continence
3827-527: The Diagnostic and Statistical Manual of Mental Disorders (DSM), as did American psychologist George E. Partridge . The DSM and International Classification of Diseases (ICD) subsequently introduced the diagnoses of antisocial personality disorder (ASPD) and dissocial personality disorder (DPD) respectively, stating that these diagnoses have been referred to (or include what is referred to) as psychopathy or sociopathy . The creation of ASPD and DPD
3916-689: The Psychopathic Personality Inventory , known as Fearless Dominance. To some, it is evidence of psychopathy not being a more extreme version of ASPD, but as an emergent compound trait that manifests when Antisocial Personality Disorder is present in combination with high levels of Fearless Dominance (or Boldness as it's known in the Triarchic Model). Analyses showed that this Section III ASPD greatly outperformed Section II ASPD in predicting scores on Hare’s (2003) Psychopathy Checklist-Revised. Section III ASPD including
4005-543: The construct of psychopathy does not necessarily add value to violence risk assessment . A large systematic review and meta-regression found that the PCL performed the poorest out of nine tools for predicting violence. In addition, studies conducted by the authors or translators of violence prediction measures, including the PCL, show on average more positive results than those conducted by more independent investigators. There are several other risk assessment instruments which can predict further crime with an accuracy similar to
4094-807: The prefrontal cortex and amygdala regions of the brain have been associated with specific learning impairments in psychopathy. Damage to the ventromedial prefrontal cortex, which regulates the activity in the amygdala, leads to common characteristics in psychopathic individuals. Since the 1980s, scientists have linked traumatic brain injury , including damage to these regions, with violent and psychopathic behavior. Patients with damage in such areas resembled "psychopathic individuals" whose brains were incapable of acquiring social and moral knowledge; those who acquired damage as children may have trouble conceptualizing social or moral reasoning, while those with adult-acquired damage may be aware of proper social and moral conduct but be unable to behave appropriately. Dysfunctions in
4183-614: The 'Psychopathic Traits Specifier' can be seen on page 765 of the DSM-5 or Page 885 of the DSM-5-TR. The term is used in various ways in contemporary usage. Robert Hare stated in the popular science book Snakes in Suits that sociopathy and psychopathy are often used interchangeably, but in some cases the term sociopathy is preferred because it is less likely than is psychopathy to be confused with psychosis , whereas in other cases
4272-607: The Affective facet of the PCL-R predicted reduced offense seriousness. Studies on perpetrators of domestic violence find that abusers have high rates of psychopathy, with the prevalence estimated to be at around 15-30%. Furthermore, the commission of domestic violence is correlated with Factor 1 of the PCL-R , which describes the emotional deficits and the callous and exploitative interpersonal style found in psychopathy. The prevalence of psychopathy among domestic abusers indicate that
4361-512: The PCL-R and Fearless dominance of the PPI-R have smaller or no relationship to crime, including violent crime. In contrast, Factor 2 and Impulsive antisociality of the PPI-R are associated more strongly with criminality. Factor 2 has a relationship of similar strength to that of the PCL-R as a whole. The antisocial facet of the PCL-R is still predictive of future violence after controlling for past criminal behavior which, together with results regarding
4450-424: The PCL-R and other measurement tools) have similar associations with other variables, including similar ability in predicting violence and criminality. Juvenile psychopathy may also be associated with more negative emotionality such as anger, hostility, anxiety, and depression. Psychopathic traits in youth typically comprise three factors: callous/unemotional, narcissism, and impulsivity/irresponsibility. There
4539-536: The PCL-R and some of these are considerably easier, quicker, and less expensive to administer. This may even be done automatically by a computer simply based on data such as age, gender, number of previous convictions and age of first conviction. Some of these assessments may also identify treatment change and goals, identify quick changes that may help short-term management, identify more specific kinds of violence that may be at risk, and may have established specific probabilities of offending for specific scores. Nonetheless,
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#17327902085154628-440: The PCL-R may continue to be popular for risk assessment because of its pioneering role and the large amount of research done using it. The U.S. Federal Bureau of Investigation (FBI) reports that psychopathic behavior is consistent with traits common to some serial killers , including sensation seeking, a lack of remorse or guilt , impulsivity , the need for control , and predatory behavior. It has also been found that
4717-464: The PPI-R which by design does not include past criminal behavior, suggests that impulsive behaviors is an independent risk factor. Thus, the concept of psychopathy may perform poorly when attempted to be used as a general theory of crime. Studies have suggested a strong correlation between psychopathy scores and violence , and the PCL-R emphasizes features that are somewhat predictive of violent behavior. Researchers, however, have noted that psychopathy
4806-542: The United States, about 25% of enuretic children are punished for wetting the bed. In Hong Kong, 57% of enuretic children are punished for wetting. Parents with only a grade-school level education punish bedwetting children at twice the rate of high-school- and college-educated parents. In Korea and in small parts of Japan , there is a folk tradition whereby bedwetters are made to wear a winnowing basket on their head and sent to ask their neighbors for salt. This
4895-468: The age that children should stay dry at night. The average parent response was 2.75 years old, while the average physician response was 5.13 years old. Punishment is not effective and can interfere with treatment. Simple behavioral methods are recommended as initial treatment. Other treatment methods include the following: Doctors frequently consider bedwetting as a self-limiting problem, since most children will outgrow it. Children 5 to 9 years old have
4984-517: The amount of psychological harm depends on whether the bedwetting harms self-esteem or development of social skills. Key factors are: Studies indicate that children with behavioral problems are more likely to wet their beds. For children who have developmental problems, the behavioral problems and the bedwetting are frequently part of/caused by the developmental issues. For bedwetting children without other developmental issues, these behavioral issues can result from self-esteem issues and stress caused by
5073-416: The amygdala and ventromedial prefrontal cortex may also impair stimulus-reinforced learning in psychopaths, whether punishment-based or reward-based. People scoring 25 or higher in the PCL-R, with an associated history of violent behavior, appear to have significantly reduced mean microstructural integrity in their uncinate fasciculus — white matter connecting the amygdala and orbitofrontal cortex . There
5162-1010: The brain. Research has also shown that an approximate 18% smaller amygdala size contributes to a significantly lower emotional sensation in regards to fear, sadness, amongst other negative emotions, which may likely be the reason as to why psychopathic individuals have lower empathy. Some recent fMRI studies have reported that emotion perception deficits in psychopathy are pervasive across emotions (positives and negatives). Studies on children with psychopathic tendencies have also shown such associations. Meta-analyses have also found evidence of impairments in both vocal and facial emotional recognition for several emotions (i.e., not only fear and sadness) in both adults and children/adolescents. Psychopathy has been associated with amorality —an absence of, indifference towards, or disregard for moral beliefs. There are few firm data on patterns of moral judgment. Studies of developmental level (sophistication) of moral reasoning found all possible results—lower, higher or
5251-432: The chance of criminal behavior, but the associated trauma. Parental cruelty can result in "homicidal proneness". The etiology of NE is not fully understood, although there are three common causes: excessive urine volume, poor sleep arousal, and bladder contractions. Differentiation of cause is mainly based on patient history and fluid charts completed by the parent or carer to inform management options. Bedwetting has
5340-590: The combination of early-onset conduct disorder and ADHD may be associated with life-course-persistent antisocial behaviors as well as psychopathy. There is evidence that this combination is more aggressive and antisocial than those with conduct disorder alone. However, it is not a particularly distinct group since the vast majority of young children with conduct disorder also have ADHD. Some evidence indicates that this group has deficits in behavioral inhibition, similar to that of adults with psychopathy. They may not be more likely than those with conduct disorder alone to have
5429-421: The concept of psychopathy . It was used to indicate that the defining feature is violation of social norms , or antisocial behavior, and may be social or biological in origin. The terms sociopathy and psychopathy were once used interchangeably in relation to antisocial personality disorder , though this usage is outdated in medicine and psychiatry. Psychopathy, however, is a highly popular construct in
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#17327902085155518-479: The condition. Children questioned in one study ranked bedwetting as the third most stressful life event, after "parental war of words", divorce and parental fighting. Adolescents in the same study ranked bedwetting as tied for second with parental fighting. Bedwetters face problems ranging from being teased by siblings, being punished by parents, the embarrassment of still having to wear diapers, and being afraid that friends will find out. Psychologists report that
5607-614: The construct, though the following characteristics are almost universally considered central. Cooke and Michie (2001) proposed a three-factor model of the Psychopathy Checklist-Revised which has seen widespread application in other measures (e.g., Youth Psychopathic Traits Inventory, Antisocial Process Screening Device ). Cleckley's (1941) original description of psychopathy included the absence of nervousness and neurotic disorders, and later theorists referred to psychopaths as fearless or thick-skinned. While it
5696-528: The core characteristics of psychopathy, such as callousness, remorselessness, and a lack of close interpersonal bonds, predispose those with psychopathy to committing domestic abuse, and suggest that the domestic abuses committed by these individuals are callously perpetrated (i.e. instrumentally aggressive) rather than a case of emotional aggression and therefore may not be amenable to the types of psychosocial interventions commonly given to domestic abuse perpetrators. Some clinicians suggest that assessment of
5785-526: The diagnosis. The diagnostic category of sociopathic personality in early editions of the Diagnostic and Statistical Manual (DSM) had some key similarities to Cleckley's ideas, though in 1980 when renamed Antisocial Personality Disorder some of the underlying personality assumptions were removed. In 1980, Canadian psychologist Robert D. Hare introduced an alternative measure, the " Psychopathy Checklist " (PCL) based largely on Cleckley's criteria, which
5874-565: The equating of this to mean exclusively "in cold blood", more than a third of the homicides committed by psychopathic offenders involved some component of emotional reactivity as well. In any case, FBI profilers indicate that serious victim injury is generally an emotional offense, and some research supports this, at least with regard to sexual offending. One study has found more serious offending by non-psychopathic offenders on average than by offenders with psychopathy (e.g. more homicides versus more armed robbery and property offenses) and another that
5963-440: The homicide victims of psychopathic offenders were disproportionately female in comparison to the more equitable gender distribution of victims of non-psychopathic offenders. Psychopathy has been associated with commission of sexual crime , with some researchers arguing that it is correlated with a preference for violent sexual behavior. A 2011 study of conditional releases for Canadian male federal offenders found that psychopathy
6052-472: The homicides committed by homicidal offenders with psychopathy were almost always (93.3%) primarily instrumental, significantly more than the proportion (48.4%) of those committed by non-psychopathic homicidal offenders, with the instrumentality of the homicide also correlated with the total PCL-R score of the offender as well as their scores on the Factor 1 "interpersonal-affective" dimension. However, contrary to
6141-614: The idea of a direct equivalence. Psychopathy originally described any illness of the mind, but found its application to a narrow subset of mental conditions when it was used toward the end of the 19th century by the German psychiatrist Julius Koch (1891) to describe various behavioral and moral dysfunction in the absence of an obvious mental illness or intellectual disability . He applied the term psychopathic inferiority ( psychopathischen Minderwertigkeiten ) to various chronic conditions and character disorders, and his work would influence
6230-494: The interpersonal/affective features and the deficits in emotional processing characteristic of adults with psychopathy. Proponents of different types/dimensions of psychopathy have seen this type as possibly corresponding to adult secondary psychopathy and increased disinhibition in the triarchic model. The DSM-5 includes a specifier for those with conduct disorder who also display a callous, unemotional interpersonal style across multiple settings and relationships. The specifier
6319-508: The later conception of the personality disorder. The term psychopathic came to be used to describe a diverse range of dysfunctional or antisocial behavior and mental and sexual deviances, including at the time homosexuality . It was often used to imply an underlying "constitutional" or genetic origin. Disparate early descriptions likely set the stage for modern controversies about the definition of psychopathy. An influential figure in shaping modern American conceptualizations of psychopathy
6408-442: The more severe mental disturbances and then specifically to mental states or disorders characterized by hallucinations , delusions or in some other sense markedly out of touch with reality . The slang term psycho has been traced to a shortening of the adjective psychopathic from 1936, and from 1942 as a shortening of the noun psychopath , but it is also used as shorthand for psychotic or crazed. The media usually uses
6497-512: The psychology literature. Furthermore, the DSM-5 introduced the dimensional model of personality disorders in Section III, which includes a specifier for psychopathic traits. According to the DSM, psychopathy is not a standalone diagnosis, but the authors attempted to measure "psychopathic traits" via a specifier. In one study, the "Psychopathic Features Specifier" has been modeled on Factor 1 of
6586-519: The same as non-psychopaths. Studies that compared judgments of personal moral transgressions versus judgments of breaking conventional rules or laws found that psychopaths rated them as equally severe, whereas non-psychopaths rated the rule-breaking as less severe. A study comparing judgments of whether personal or impersonal harm would be endorsed in order to achieve the rationally maximum ( utilitarian ) amount of welfare found no significant differences between subjects high and low in psychopathy. However,
6675-594: The study of disease since 1610, and psychopathology has meant the study of mental disorder in general since 1847. A sense of "a subject of pathology, morbid, excessive" is attested from 1845, including the phrase pathological liar from 1891 in the medical literature). The term psychopathy initially had a very general meaning referring to all sorts of mental disorders and social aberrations, popularised from 1891 in Germany by Koch's concept of "psychopathic inferiority" ( psychopathische Minderwertigkeiten ). Some medical dictionaries still define psychopathy in both
6764-513: The term psychopath to designate any criminal whose offenses are particularly abhorrent and unnatural, but that is not its original or general psychiatric meaning. The word element socio - has been commonly used in compound words since around 1880. The term sociopathy may have been first introduced in 1909 in Germany by biological psychiatrist Karl Birnbaum and in 1930 in the US by educational psychologist George E. Partridge , as an alternative to
6853-556: The three outcomes. Individual studies give similar results for adult offenders, forensic psychiatric samples, community samples, and youth. The PCL-R is poorer at predicting sexual re-offending. This small to moderate effect appears to be due largely to the scale items that assess impulsive behaviors and past criminal history, which are well-established but very general risk factors. The aspects of core personality often held to be distinctively psychopathic generally show little or no predictive link to crime by themselves. For example, Factor 1 of
6942-653: The top 5% highest psychopathy scores at age 13, less than one third (29%) were classified as psychopathic at age 24. Some recent studies have also found poorer ability at predicting long-term, adult offending. Conduct disorder is diagnosed based on a prolonged pattern of antisocial behavior in childhood and/or adolescence, and may be seen as a precursor to ASPD. Some researchers have speculated that there are two subtypes of conduct disorder which mark dual developmental pathways to adult psychopathy. The DSM allows differentiating between childhood onset before age 10 and adolescent onset at age 10 and later. Childhood onset
7031-490: The two terms may be used with different meanings that reflect the user's views on its origins and determinants. Hare contended that the term sociopathy is preferred by those who see the causes as due to social factors and early environment, and the term psychopathy is preferred by those who believe that there are psychological, biological, and genetic factors involved in addition to environmental factors. Hare also provides his own definitions: he describes psychopathy as lacking
7120-503: The type of intelligence assessment (e.g. verbal, creative, practical, analytical). A large body of research suggests that psychopathy is associated with atypical responses to distress cues from other people, more precisely an impaired emotional empathy in the recognition of, and response to, facial expressions , body gestures and vocal tones of fear , sadness , pain and happiness . This impaired recognition and reduced autonomic responsiveness might be partly accounted for by
7209-501: The wetting. As mentioned below, current studies show that it is very rare for a child to intentionally wet the bed as a method of acting out. Medical literature states, and studies show, that punishing or shaming a child for bedwetting will frequently make the situation worse. It is best described as a downward cycle, where a child punished for bedwetting feels shame and a loss of self-confidence. This can cause increased bedwetting incidents, leading to more punishment and shaming. In
7298-779: Was American psychiatrist Hervey Cleckley . In his classic monograph, The Mask of Sanity (1941), Cleckley drew on a small series of vivid case studies of psychiatric patients at a Veterans Administration hospital in Georgia to provide a description for psychopathy. Cleckley used the metaphor of the "mask" to refer to the tendency of psychopaths to appear confident, personable, and well-adjusted compared to most psychiatric patients, while revealing underlying pathology through their actions over time. Cleckley formulated sixteen criteria for psychopathy. The Scottish psychiatrist David Henderson had also been influential in Europe from 1939 in narrowing
7387-533: Was done in the Netherlands. It found a 0.5% rate for 20- to 79-year-olds. A Hong Kong study, however, found a much higher rate. The Hong Kong researchers found a bedwetting rate of 2.3% in 16- to 40-year-olds. In the first century B.C., at lines 1026-29 of the fourth book of his On the Nature of Things , Lucretius gave a high-style description of bed-wetting: An early psychological perspective on bedwetting
7476-551: Was driven by the fact that many of the classic traits of psychopathy were impossible to measure objectively. Canadian psychologist Robert D. Hare later re-popularized the construct of psychopathy in criminology with his Psychopathy Checklist . Although no psychiatric or psychological organization has sanctioned a diagnosis titled "psychopathy", assessments of psychopathic characteristics are widely used in criminal justice settings in some nations and may have important consequences for individuals. The study of psychopathy
7565-491: Was given in 1025 by Avicenna in The Canon of Medicine : Psychological theory through the 1960s placed much greater focus on the possibility that a bedwetting child might be acting out, purposefully striking back against parents by soiling linens and bedding. However, more recent research and medical literature states that this is very rare. Psychopathy#Sociopathy Psychopathy , or psychopathic personality ,
7654-498: Was not always egocentric, callously disregarding of feelings or lacking impulse control, and there is no proof he could not learn from mistakes. Psychopaths are social predators who charm, manipulate, and ruthlessly plow their way through life, leaving a broad trail of broken hearts, shattered expectations, and empty wallets. Completely lacking in conscience and in feelings for others, they selfishly take what they want and do as they please, violating social norms and expectations without
7743-512: Was part of the Macdonald triad , a set of three behavioral characteristics described by John Macdonald in 1963. The other two characteristics were firestarting and animal abuse . Macdonald suggested that there was an association between a person displaying all three characteristics, then later displaying sociopathic criminal behavior. Up to 60% of multiple murderers, according to some estimates, wet their beds post-adolescence. Enuresis
7832-636: Was related to more violent and non-violent offences but not more sexual offences. For child molesters , psychopathy was associated with more offences. A study on the relationship between psychopathy scores and types of aggression in a sample of sexual murderers, in which 84.2% of the sample had PCL-R scores above 20 and 47.4% above 30, found that 82.4% of those with scores above 30 had engaged in sadistic violence (defined as enjoyment indicated by self-report or evidence) compared to 52.6% of those with scores below 30, and total PCL-R and Factor 1 scores correlated significantly with sadistic violence. Despite this, it
7921-490: Was revised in 1991 (PCL-R), and is the most widely used measure of psychopathy. There are also several self-report tests, with the Psychopathic Personality Inventory (PPI) used more often among these in contemporary adult research. Famous individuals have sometimes been diagnosed, albeit at a distance, as psychopaths. As one example out of many possible from history, in a 1972 version of
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