Benedict_Cumberbatch_filming_Sherlock_cropped2 April 25

Science: A Psychopathic Career Choice?

“I’m not a psychopath, Anderson, I’m a high-functioning sociopath. Do your research!” – Sherlock Holmes, Sherlock

What does it mean to be a psychopath?

Being just as ignorant  on the distinction between psychopath and sociopath, let alone the definitions of these conditions, as Anderson (a forensic technician and nemesis of Sherlock Holmes), I too had a need for doing research. My vague ideas of what psychopathy entails came mainly from a psychology-buff friend in college who repeatedly applied the term to an ex of our mutual friend. The term “sociopath” was less familiar to me. When” sociopathy” came up in a faculty panel in our ethics class (proposed as a condition which makes people highly suitable for academia), I decided it was time to find out more.

I discovered that the clinical term for psychopathy is antisocial personality disorder (ASPD), as defined by DSM.  ASPD “is characterized by a pervasive patter of disregard for, or violation of, the rights of others. There may be an impoverished moral sense or conscience and a history of crime, legal problems, impulsive and aggressive behavior.”

The DSM V evaluates APSD along four categories:  self functioning, interpersonal functioning, antagonism and disinhibition. The now outdated DSM IV criteria more closely overlap with the questions in the Hare Psychopathy Checklist (PCL, PCL-R), a questionnaire used for diagnosing psychopathy. Thus the DSM IV criteria for ASPD (below) are useful for understanding the general behavior of psychopaths, which includes:

1)      Failure to conform to social norms with respect to lawful behaviors ad indicated by repeatedly performing acts that are grounds for arrest;

2)      Deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;

3)      Impulsivity or failure to plan ahead;

4)      Irritability and aggressiveness, as indicated by repeated physical fights or assaults;

5)      Reckless disregard for safety of self or others;

6)      Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;

7)      Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

The term “psychopathy” is most commonly used in the criminal justice setting, as psychopathic behavior is frequently associated with criminal activity. It is important to note that despite the correlation between ASPD and criminal behavior, psychopathy is not the only driving force behind crime; social and environmental factors can be extremely motivating and play an influential role in decision-making about legal transgressions. For example, a study comparing convicted criminals in an Italian prison with mafia ties and without, found that mafia members committed acts of similar criminal severity but exhibited overall lower PCL-R scores than non-mafia controls. While numerous ideas exist about the differences between psychopathy and sociopathy (both of which fall under the clinical definition of ASPD), most suggest that psychopathy is the more severe of the two in some fashion. For the purposes of this post, I will refer to both conditions as psychopathy.

What does the brain of a psychopath look like?

James Fallon is a neuroscientist at UC Irvine who studies just this. He studies the brains scans of convicted psychopaths (among them murders), and finds that they often exhibit decreased activity in the orbital cortex, a finding that has been corroborated by other studies. He scanned his own brain and those of his family members and found that his own brain scan profile was similar to that of killers. Specifically, his brain, like other known psychopaths, showed decreased activity in the orbital cortex (OFC). Fallon describes being disturbed by this finding, as he has exhibited no evidence of violent or criminal behavior. He attributes his pro-social and functional life to his positive upbringing,  and proposes a model similar to the “two-hit hypothesis” whereby a genetic predisposition creates the potential for psychopathic behavior, but environmental factors and stresses facilitate negative outcomes, as an explanation for this. In his own case, Fallon proposes he had the first “hit” (genetic predisposition) but not the second “hit” (environmental stressors).

Does altered functioning of the OFC (indicative of latent psychopathic tendencies) have something to do with Fallon’s career choice, as suggested in the faculty panel of my ethics class? Is it true that people with psychopathic tendencies gravitate toward academia? Does this mean I and my peers have these tendencies? Is there a spectrum of psychopathy? Can understanding how the OFC functions inform our understanding of these issues?

What does the OFC do?

The OFC is a brain region implicated in many brain functions, including decision-making and reward valuation. Patients with damage to OFC that occurs midlife are known to make reckless decisions and spend enormous amounts of time and energy exploring possible options for trivial decisions, such as where to eat dinner. A quote from a paper chronicling the effects of the OFC on decision-making states the following: “The role of the OFC is to store associations between patterns of environmental inputs and somatic states that those inputs produce. When making a decision, OFC activates the somatic states, which can then bias decision-making. Damage to OFC destroys patients’ ability to activate the somatic states, and so all choice outcomes become emotionally equivalent….In effect, the patient loses the ability to make a decision by gut feeling.

Conversely, in a study of people who experience non-clinical psychosis (the experience of fleeting psychosis in the absence of any formal psychotic disorder) and controls, size of the OFC is associated with higher states of religiosity, measured in terms of intrinsic religiosity, organizational religiosity (e.g. church attendance) and time spent in prayer. One possible interpretation of this finding is that increased OFC structure or function allows one to believe in the absence of evidence. The detachment or suspension of reality and perception is present in both psychosis and faith.

If low activity or size in the OFC is related to a need for excessive collection of data or factual evidence before assessing rewards and making decisions, this might explain why psychopaths are incapable of feeling for others; they lack the ability to extrapolate feelings, which are intangible. Psychopaths show lower activity in OFC when inflicting pain on others, particularly others in “out-group” categories, providing further evidence for the involvement of OFC in psychopathy.

So what does this have to do with career choice?

I looked up career choices must commonly associated with psychopathy. This list  (below) originated from author Kevin Dutton’s book (“The Wisdom of Pscyhopaths: What Saints, Spies, and Serial Killers Can Teach Us About Success”), and suggests, if anything, the need for various psychological profiles for a functional society.  Academia and science are absent from this list and to my knowledge no one has done brain scans of the type Dr. Fallon conducts across professions. Still, some of evidence about the OFC could suggest academics tend toward the psychopathic. Perhaps the same detailed, emotionally-detached and fact-based decision-making that results wasted time and agony in daily life, is a skill necessary for an academician or scientist in the pursuit of truth. Perhaps, people with low-functioning OFC are driven to seek answers to the unknown in evidence-based rather than faith-based manner, creating a natural segregation of people with psychopathic tendencies into academia. Perhaps, like the fictional Sherlock Holmes, who makes inferences and predictions about the world based on his careful observations, as academic scientists, we too are “high-functioning” sociopaths. Or perhaps we need more evidence before we can make a claim as bold as this.

Psychopathic Careers Non-psychopathic Careers
CEO Care aide
Lawyer Nurse
Media (television/radio) Therapist
Salesperson Craftsperson
Surgeon Beautician/stylist
Journalist Charity worker
Police officer Teacher
Clergy person Creative artist
Chef Doctor
Civil Servant Accountant