Part I
Crime and Violence: Who are the Perpetrators and why do they do it?
1
The Psychopathology of Crime
During most of the 20th century, psychiatric diagnosis was an impressionistic art form and studies showed that even experienced practitioners often could not agree in classifying the same patients except in a very general way. Diagnoses sometimes were based on highly subjective inferences about the patientâs unconscious impulses and motivations or on the clinicianâs unsystematic and even quirky observations accumulated over years of practice. The American Psychiatric Association (APA) published its first Diagnostic and Statistical Manual DSM) in 1952 but it was not until the third edition, known as DSM-III, appeared in 1980 that some measure of diagnostic consistency was finally achieved. This was accomplished in DSM-III, in the subsequent revision, DSM-III-R, and in the current DSM-IV, published in 1994, by formulating diagnostic criteria that were relatively objective and noninferential. For the most part, the criteria were arrived at by consensus of committees of clinicians rather than by statistical analysis of empirical data.
Antisocial Personality Disorder
In this diagnostic scheme, antisocial personality disorder (APD) takes the place of such earlier labels as psychopathy, sociopathy, and dyssocial personality. To be diagnosed with APD, an individual must show (a) âa pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years,â and (b) the person must be at least 18 years of age. Moreover, there must be (c) âevidence of conduct disorder with onset before age 15.â In addition, (d) âthe occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episodeâ (APA, 1994, pp. 649â650). In DSM-III-R, Criterion C could be satisfied by any 3 of 12 quite specific facts about the individualâs behavior before age 15 (e.g., âwas often truantâ) and Criterion A required evidence of at least 4 of 10 relatively specific adult behaviors (e.g., âlacks ability to function as a responsible parent, as indicated by one or more of the following: (a) malnutrition of child, ⊠(f) repeated squandering, on personal items, of money required for household necessitiesâ). No special psychiatric knowledge or insight was required to make a diagnosis on the basis of these guidelines, a fact that no doubt accounts for the good reliability or interrater agreement achieved by DSM-III-R.
In DSM-IV, the four general APD criteria recur but the specific criteria are fewer in number and somewhat less specific in content. Because at least some degree of judgment is required in using the new criteria, reliability may diminish slightly but it seems likely that the epidemiological and other findings relating to APD that were gathered using DSM-III-R criteria will hold as well for the new ones. The DSM-IV criteria for APD are as follows:
301.7 Antisocial Personality Disorder
- There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:
- failure to conform to social norms with respect to lawful behaviors indicated by repeatedly performing acts that are grounds for arrest.
- deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
- impulsivity or failure to plan ahead.
- irritability and aggressiveness, as indicated by repeated physical fights or assaults.
- reckless disregardful for safety of self or others.
- consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
- lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
- The individual is at least age 18 years.
- There is evidence of Conduct Disorder with onset before age 15 years.
- Occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode. (APA, 1994, pp. 649â650)
The cookbooklike, relatively objective character of this list of criteria is obvious; what is not so apparent is the fact that there is no theoretical nor empirical basis for supposing that this scheme carves Nature at her joints. Because there may be a variety of psychological causes for a given action, classifying people by their actions rather than their psychological dispositions or traits, although perhaps natural for the purposes of the criminal law, is less useful for the purposes of psychiatry or science. Note that the cut-off age of 18 years for the APD diagnosis makes more sense in legal, rather than in psychiatric terms; in most of the United States, 18 is the age of legal responsibility although, of course, it is absurd to suppose that delinquent youth undergo some psychological transformation on their 18th birthday. In view of the alarming recent increase in the number of homicides and other major crimes by youngsters under age 18, many of them now being tried as adults and incarcerated for long periods, it is noteworthy that none of them could be classified as APD.
As one might expect from reviewing these diagnostic criteria, a large proportion of those heterogeneous individuals we call common criminals could be classified as APD as well as many feckless citizens who do not commit serious crimes. Consider, for example, persons meeting Criteria A1, A2, A4, and A7; these might be the garden-variety sociopaths who populate most jails and prisons. Persons who meet Criteria A3, A5, and A6, but not the others, might also be diagnosed APD although they are not criminals but, rather, drifters or addicts or drunks. APD is plainly a heterogeneous category in respect to etiology and also in respect to the psychological characteristics that give rise to the varied patterns of socially deviant behavior that serve to meet the criteria.
The incidence of APD is twice as high among inner-city residents as among persons living in small towns or rural areas, and more than five times higher in males than in females (among Blacks, however, the gender rates are less divergent; Robins, 1978a). APD is higher among first-degree relatives of APD probands and higher still if the proband is female. The prevalence of APD was estimated at 3% in males during the early 1980s but had risen to 4.5% by 1990 for reasons that are explained later (Robins, 1978a, 1978b; Robins, Tipp, & Przybeck, 1991). Robins found that about 70% of the adolescents in her samples who met criteria for conduct disorder as children were not classifiable as APD as adults, although many of them showed other psychiatric problems. However, at least up to the time when the DSM-III criteria were formulated, she knew of no documented instance of an adult sociopath who had not also displayed antisocial behavior during childhood (Robins, 1978a).
For its first 150 years or so, psychiatry attempted to account, not for ordinary criminals, but for that subset of amoral, often criminal individuals, the people who are classified here as psychopaths, who came from apparently normal middle-class backgrounds and who therefore were harder to understand than the unsocialized offspring of parents who were themselves unsocialized. With DSM-III and the concept of APD, however, American psychiatry took a sharp turn toward conventional criminology. In their quest for diagnostic reliability through the use of specific and noninferential criteria, they devised a category into which most common criminals will comfortably fit. It seems evident that the people who fall within this category must be psychologically heterogeneous, their antisocial dispositions widely varied as to etiology. Identifying someone as âhavingâ APD is about as nonspecific and scientifically unhelpful as diagnosing a sick patient as having a fever, or an infectious or a neurological disorder.
In spite of the heterogeneity of the group classified by the DSM-IV criteria, APD does demarcate a category of individuals that is socially important because many of these people are the reasons why we lock our doors, stay off the streets at night, move out of the cities and send our children to private schools. A majority of inmates in our prisons meet these criteria for the diagnosis of APD1 so it is not unreasonable to conclude that these criteria identify more than half of the men whom we normally refer to as common criminals. The largest and most important subcategory of APD includes those people who, in this volume, are called socio-paths. This is the group that is growingâmetastasizingâso rapidly that it already threatens to overwhelm our criminal justice system. Wolfgang and associates studied two cohorts of boys born in Philadelphia, the first in 1945 and the second in 1958 (Tracy, Wolfgang, & Figlio, 1990). Of the 1945 cohort, 6% became chronic criminals responsible for 61% of the Uniform Crime Report (UCR) Index Crimes (from 69% to 82% of the violent crimes). Of the 1958 cohort, 8% were chronic recidivists, accounting for 68% of the UCR Index Crimes. Based on the 50% increase in the incidence of APD since 1984, we can estimate that perhaps 12% of the males born in Philadelphia in 1970 may be recidivist criminals by now. According to the broader ECA study, the incidence of childhood conduct disorder (CD) among males born from 1961 to 1972 was nearly three times higher than the incidence among men born from 1926 to 1945 and the incidence of adult APD, which by definition must be preceded by CD, has increased in parallel.
In the 1958 birth cohort, the dangerous recidivist group comprised 3% of the White males and 11% of the Black. Because Blacks and Hispanics are greatly overrepresented among these unsocialized predators, the extraordinary improvements in minority opportunities and interracial harmony that have been achieved since the 1940s in the United States are being threatened. That young man you see approaching along the deserted city street at nightâthe odds are much higher that he makes his living mugging people if he is Black than if he is White (Levin, 1992). Such facts must inevitably lead to a recrudescence of the very racism that we have tried so hard as a society to overcome.
The Psychopath
In her important study of mental illness in non-Western, primitive societies, Murphy (1976) found that the Yupic-speaking Eskimos in northwest Alaska have a name, kunlangeta, for the
man who, for example, repeatedly lies and cheats and steals things and does not go hunting and, when the other men are out of the village, takes sexual advantage of many womenâsomeone who does not pay attention to reprimands and who is always being brought to the elders for punishment. One Eskimo among the 499 on their island was called kunlangeta. When asked what would have happened to such a person traditionally, an Eskimo said that probably âsomebody would have pushed him off the ice when nobody else was looking.â (p. 1026)
Because traditional methods of socialization are so effective in tribal societies, where the extended family rather than just a particular parent-pair participate in the process, the kunlangeta probably possesses inherent peculiarities of temperament that make him unusually intractable to socialization. Such a man I classify as a psychopath, an individual in whom the normal processes of socialization have failed to produce the mechanisms of conscience and habits of law-abidingness that normally constrain antisocial impulses.
In 1957 I published an experimental study of this type of antisocial character. Since then, a substantial research literature on the psychopath has accumulated and, in this book, I summarize what we know now about these warped individuals whose character defects seem to have a biological basis. Yet, as one now surveys the current state of crime and violence in the United States, it is clear that the role played by the primary psychopath is only one small part of this broader picture.
The Sociopath
In Western, and especially in Western urban society, the socialization of children is entrusted largely just to the parents, often to a single parent, and if the parents are overburdened or incompetent or unsocialized themselves then, as I document below and in Part IV, even a child of average temperament may grow up with the antisocial tendencies of a psychopath. In this book I use the term sociopath to refer to persons whose unsocialized character is due primarily to parental failures rather than to inherent peculiarities of temperament. The psychopath and the sociopath can be regarded as opposite endpoints on a common dimension with difficult temperament maximized at the psychopathic end and inadequate parenting maximized at the sociopathic end.
I believe that it is both scientifically interesting and socially important to continue to improve our understanding of the psychopath and most of this book is dedicated toward that end. However, the pure case psychopath is relatively rare; there was only one among the 499 residents of Murphyâs Eskimo community. Those whom I call sociopaths, on the other hand, who are just as dangerous and as costly to society as psychopaths, occur in Western society in ever-increasing numbers, especially in our cities. We know of no cure for either condition. The best we can do with a truly unsocialized 20-year-old is to sequester him until late middle age when his antisocial impulses begin to wane in strength (or, perhaps, to âpush him off the iceâ!). We can probably find ways of preventing potential psychopaths from developing first into delinquents, then into criminals, once we better understand the nature of the inherent differences that make them so difficult to socialize. But I believe that we could certainly and substantially reduce the incidence of sociopaths in our society, whom we are currently producing with factorylike efficiency and at enormous cost. To do this will require that we find ways to reduce the numbers of children in each generation who are raised byâor domiciled withâ incompetent parents. I discuss these social policy issues and propose what I think would be a workable solutionâperhaps the only workable solutionâbriefly in chapter 16.
In the remainder of this first chapter, I explain how I intend to define the basic concepts of socialization and criminality, then introduce the simple diathesis-developmental model of criminality which is the main thesis of this treatise.
Socialization
Socialization is defined as the aggregate of an individualâs acquired habits of conformity to the rules and expectations of the society in which he lives. Socialization includes three principal components:
1. Conscientiousness: This is a general disposition to avoid antisocial behavior. This avoidance normally results from fear of punishment, including the self-inflicted punishments of guilt and shame, together with the tendency to reject, on rational utilitarian grounds, the criminal alternative. This does not mean that socialized people are continually confronting and overcoming temptation. For most adults, crime avoidance becomes automatic; we are not often tempted to strike out, to just take what we want, or to drive off without paying, because doing the right thing, obeying the rules, has become habitual. One reason crime rates peak during late adolescence is that these habits have not yet been consolidated in many teenage youngsters.
2. Prosociality: The second component of socialization is a general disposition toward prosocial behavior; it includes all of the individualâs nurturant, affectional and altruistic impulses and it is accomplished through the cultivation of his or her ability to empathize with others, to participate in and to enjoy affectionate relationships, and to admire prosocial role models and wish to emulate them.
3. Acceptance of Adult Responsibility: The third component of socialization consists in the motivation and associated skills required to âpull oneâs own weightâ in the communal effort; it involves the acquisition of the work ethic, the aspiration to achieve through personal effort, and the acceptance of conventional family and social responsibilities.
If the first obligation of parenthood is to provide basic nurturance, to feed, shelter, and protect the offspring, then one can say that the second most important function of parents is the socialization of their children. I argue that socialization (hence, also, conscientiousness) is a product of two factors, parenting and innate characteristics. By parenting I mean to refer to all the learning experiences tending away from antisocial behavior and tending toward prosocial activities; the most important of these experiences are usually at the hands of a parent or parents. Parenting is perhaps one of the most difficult tasks that humans undertake in this modern world2 and some parents are much better at itâmore successful in socializing their childrenâthan other parents are.
Families of antisocial children are characterized by harsh and inconsistent discipline, little positive parental involvement with the child, and poor monitoring and supervision of the childâs activities. (Patterson, DeBaryshe, & Ramsey, 1989, p. 329)
As Patterson and his colleagues have documented, the child who is poorly socialized at home tends to be rejected by the normal peer group and to fail academically in school. The nearly inevitable progression in such circumstances is into membership in deviant peer groups or gangs where antisocial behavior is both learned and reinforced, whereas normal or prosocial behavior is discouraged or punished. Moreover, there are certain innate characteristics that make some children harder than others to socialize. As a rule, children who are more venturesome, impulsive, or aggressive, less intelligent or less talented, are harder to socialize successfully.
Conscientiousness Versus Criminality
Socialization is a multifaceted concept and only one of the facets consists in the avoidance of criminal behavior. Some well-socialized persons, under extreme circumstances, will commit crimes; it is a paradox of prison life that murderers, if that one impassioned act is the only blemish on their records, often make the best trusties. Some habitual criminals are conscientious wo...