Disease or Diversity: Learning from Autism

by Jillybeth Burgado



The following post is part of a special series emerging from Contemporary Issues in Neuroethics, a graduate-level course out of Emory University’s Center for Ethics. Jillybeth is a senior undergraduate double majoring in neuroscience and behavioral biology and religion. She hopes to pursue a PhD in neuroscience after working as a research assistant after graduation.

Chipmunka Publishing 

The idea that variation in behaviors arises through natural differences in our genome was popularized in the 1990s and termed “neurodiversity.” Led in large part by autism spectrum disorder (autism) activists, this movement challenged the established notions of autism as a disease that needed to be eradicated, championing the acceptance of a wide array of neural differences in the population. Rejecting terms such as “normal,” proponents of neurodiversity questioned common messaging and goals of research organizations (e.g. autism is not something that needs to be eradicated or “cured”). In this post, I briefly summarize the neuroethical concerns of ground-breaking neuroscience research, with particular focus on autism diagnostic research. I will then introduce a less well-known movement, Mad Pride, and discuss how we can apply some of the concepts and lessons from the autism and neurodiversity movements to understand and evaluate the claims of those involved with Mad Pride.



Autism is a developmental disorder characterized by challenges with social interactions as well as with verbal and nonverbal communication (Walsh et al., 2011). Importantly, autistic phenotypes are quite diverse, making diagnosing individuals a difficult task. Patients are typically diagnosed by psychiatrists who employ screening tools, such as the Modified Checklist of Autism in Toddler (M-CHAT), and psychological interviews and exams that evaluate the development of speech, social, and intellectual behaviors. However, advances in genetic and neurological understandings of autism may be increasing the room for more biological methods of diagnosis (Pellicano & Stears, 2011). The search for biomarkers that can be used to predict, diagnose or develop treatment and intervention programs has slowly moved forward in the past decade. Genetic variations that may explain susceptibility are an exciting but difficult area of research due to low predictive reliability and generalizability (Walsh et al., 2011). Conversely, brain scans (such as MRI) and electroencephalography (EEG) have proven to be promising techniques in predicting and/or diagnosing autism. In particular, MRI and diagnostic algorithms use structural differences in the brain associated with autism to diagnose individuals, with accuracy ranging from 80 to 90% in some studies (reviewed in Walsh et al., 2011). Similarly, EEG used in infants has been able to predict autism with 80% accuracy (Walsh et al., 2011). In the future, these techniques may be able to replace or supplement long, exhaustive interviews among psychiatrists, children and parents. Furthermore, this research may provide better and more detailed information about the neurological processes of the autistic brain and better therapeutic strategies.



This research is promising but not without significant ethical issues. Many autistic individuals and their families argue that autism is not a disorder or disability, but rather a different way of being. In particular, these advocates remind researchers and doctors that the challenges associated with the disorder are frequently paired with certain strengths, such as focus and perception, strengths that are valued in particular fields and social contexts (Pellicano & Stears, 2011; Walsh et al., 2011; PBS, 2013). More importantly, autistic personalities are viewed as part of a continuum that can eventually fit into society if we allow it to do so. Interestingly, advocates of neurodiversity also lie on a spectrum of perspectives: some individuals value neurobiological research and its interest in providing treatment and therapeutic options whereas others hold the position that autistic individuals should not be changed. The latter position stands at odds with the mission statements of governmental funding agencies. For example, the mission statement for the U.S.’s National Institute of Mental Health (NIMH) states that the organization’s purpose is “to transform the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure” (NIMH, 2008).



Moreover, the search for biological markers of autism introduces ethical concerns because it is frequently associated with the desire to cure or fix autistic people. Earlier detection of autism is beneficial to individuals and their families because it can allow for better and more efficient treatment options. However, improved diagnostic techniques can also become the foundation for determining and treating what is wrong with the autistic brain, consequently pathologizing autism and distinguishing the normal individual from the autistic one. Importantly, some behavioral components are detrimental to the well-being of an autistic person and cause significant distress. Many argue that these characteristics should be treated by physicians or psychiatrists in order to alleviate the autistic person’s pain. Nonetheless, many autistic characteristics are only detrimental to individuals because of established social norms. If we can decrease these social stigmas and teach acceptance of “different” behaviors, then autistic individuals may be able to become more integrated members of the community. A wide array of other ethical concerns exist in the autism and neurodiversity conversation, including issues regarding preventative methods during pregnancy or early childhood and treatment options and availability (these concerns are not addressed here).



Looking inside the brain has introduced specific ethical concerns that must be addressed by scientists, the general public, and physicians in regards to autism research. For example: What/who should be treated? What is a disorder and what is part of neurodiversity? How should advances in diagnostic methods and treatment be viewed and used by the research community and general public? Should research continue to focus on changing the affected individuals? Here, I propose that these same questions and concerns can also be applied to mental illnesses such as depression, bipolar disorder, and psychosis.



Depression, bipolar, and psychosis, like autism, are not clearly diagnosed using biomarkers and their phenotypes vary greatly in the population. Two individuals diagnosed with depression may experience very different distresses. Recent advances in neuroscience research have opened the possibility for a larger role of neurological methods in predicting, diagnosing, and treating of mental illnesses. Like advocates interested in autism, individuals with mental illnesses have also adopted the neurodiversity movement. For example, Mad Pride, a loosely organized movement in numerous countries, including the US, Canada, Australia and the UK, aims to bring awareness and acceptance of people who in the past or present classify themselves as having a mental illness. Interestingly, some individuals participating in Mad Pride argue that these categories of mental disorders are not disorders at all, rather they represent typical variation in the population. They further assert that some potential strengths are associated with mental illness, such as creativity and new perspectives.



The main question at hand is whether psychiatrists and therapists should attempt to treat, and therefore normalize, those with depression, bipolar disorder, and schizophrenia. The answer to this question will in turn influence how neurological findings are accepted by those diagnosed with mental illnesses as well as affect the way mental illness research is designed and conducted. The Mad Pride movement example provides an interesting and relatively new perspective on the “illness” component of “mental illness,” one that may continue to raise questions about neurodiversity and the distinction between disease and difference.



References:



Pellicano, E., & Stears, M. (2011). Bridging autism, science and society: Moving toward an ethically informed approach to autism research. Autism Research, 271–282. http://doi.org/10.1002/aur.201 



Walsh, P., Elsabbagh, M., Bolton, P., & Singh, I. (2011). In search of biomarkers for autism: scientific, social and ethical challenges. Nature Reviews Perspectives, 12: 603-612. Retrieved from http://dx.doi.org/10.1038/nrn3113



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Burgado, J. (2015). Disease or Diversity: Learning from Autism. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/05/disease-or-diversity-learning-from.html

Forget the Map; Trust Your Brain: The Role Neuroscience Plays in Free Will

by Fuad Haddad



The following post is part of a special series emerging from Contemporary Issues in Neuroethics, a graduate-level course out of Emory University’s Center for Ethics. Fuad is an undergraduate junior at Emory studying neuroscience and behavioral biology and ethics. He currently performs research at Yerkes National Primate Research Center under Dr. Larry Young, studying the relationship of single nucleotide polymorphism and pair bonding. His other research interests are the relationship between oxytocin and allopatric grooming as a model of empathy. 

Lizzie laughs as we drive down Briarcliff. “What do you mean an adventure?” she chuckles at me. I have a propensity to get lost for fun, an unhealthy and interesting habit. We approach a stop light. “Left, right, straight – pick one!” I say. As we arrive at a consensus, we journey onward until we reach a green highway sign that signals the exit to Athens. Her smile gives her motive away; I think, “Sorry Emory, but I’m going to be a Bull Dog today.” 

Take a moment to fast forward four months. On a September afternoon, I sit in the same car, with the same girl, leaving from the same place. “Left, right, straight?!” I ask again. Like before, we haphazardly trek through the jungle of northeast Atlanta. In the midst of yet another game of “where can we get lost now?” a peculiar phenomenon occurs. Slamming on the brakes, the car comes to a halt. Almost instantaneously we both realize that in this seemingly random choice in direction, our choices lead us back to the same green sign again and even more interestingly, through the same path. 

I guess Robert Frost isn’t going to Athens. From southeastroads.com

Consequentially, this scenario kindled a discussion regarding my ability to make decisions. Within the same environment, how, under the presumption of voluntary action, was I was able to reenact temporal steps to guide me to the same location? Therefore, my thoughts diverted towards the idea of my free will and subsequently, the process in which I ostensibly choose my voluntary actions. These inquiries lead to a discussion with Dr. Banja, a professor at the Emory Center for Ethics, in which he presented an interesting perspective that resonated with me.  

“Could Have Chosen Otherwise - Under Identical Conditions” (CHACO-UIC) is what it sounds like – if under identical conditions, down to the sub-atomic level, an agent could have performed contrary to the original action. The paradigm is a standard tool for separating two trains of thought on free will: libertarianism and determinism. Libertarianists would agree with CHACO-UIC premise while determinists would not (PFW 4.1). Banja antiquates CHACO-UIC by attacking its ecological validity. The ecological validity of CHACO-UIC stands upon the faulty premise that all conditions can be identically replicated. Within choices exist coupling factors determined by our previous actions. How can one determine humankind’s first unpreceded action? Therefore, Dr. Banja has made a hybrid contra-causal stance with his theory of “adaptive” free will. 

By decaying CHACO-UIC, the choosing of free will can now be classified as “adaptive” rather than “otherwise.” Free will then arises from “an ineluctable product of bioevolutionary processes.” Couched in a somewhat deterministic approach (where biology does determine behavioral processes), he credits decision-making to the "smart" choices organisms must make to adapt and survive in a dynamic environment (Banja 1). While Dr. Banja mentions the importance of the brain-based mechanisms of intentionality, the question still remains regarding the mechanisms by which this occurs. 

One example that illustrates a brain-based mechanism of intentionality is a study performed by Drs. Packard and McGaugh. In this hallmark experiment they trained a set of rats in a T-maze to determine which arm contained a reward (in this case, a food pellet). The standard paradigm is to switch the orientation of the apparatus to determine if the rat responds by going left or right. 

During the experiment, researchers lesioned specific brain regions in arrays, the hippocampus and the caudate nucleus. They found that the hippocampus mediates spatial memory while the caudate mediates stimulus-response learning. In addition, spatial learning was acquired before stimulus-response learning (Packard 65). 

Although the projected study used rats as a model, several other studies exhibit similar claims using human subjects (Schwabe et al., Skelton et al.) In the context of my situation, the first time I wandered in my car, I had somewhat of a spatial dependent awareness of where I was. Unfamiliar with my current situation, I relied on the crossroads and visual cues that my hippocampus used to guide me to my goal (Athens). However, the second time might have been dictated by a stimulus-response pathway (habit of turning left, left, and right) in the same temporally acquired order as the rat experiment. 

Working back towards the idea of “adaptive” free will, the results of this experiment display that there exist fundamental feedback loops in the brain, a neurological basis. Proponents may argue that the evidence of a neurological basis disproves the capacity of free will; I argue that such neurological basis provides the deterministic answers for the “adaptive” model. The niche of neuroscience regarding free will then lies in revealing the determinism of our actions. The future of our conceptualizations of free will then sits not upon the throne of introspection, but the illuminating neurological discoveries that may come. 

References

Banja, John. "Could Have Chosen Otherwise under Identical Conditions: An Evolutionary Perspective on Free Will" AJOB Neuroscience, In Press. Web.

Packard, M. "Inactivation of Hippocampus or Caudate Nucleus with Lidocaine Differentially Affects Expression of Place and Response Learning." Neurobiology of Learning and Memory 65.1 (1996): 65-72. Web.

Schwabe, Lars, Melly S. Oitzl, Christine Philippsen, Steffen Richter, Andreas Bohringer, Werner Wippich, and Hartmut Schachinger. "Stress Modulates the Use of Spatial versus Stimulus-response Learning Strategies in Humans." Learning & Memory. Cold Spring Harbor Laboratory Press, n.d. Web. 25 Mar. 2015.

Skelton, Ronald W., Cindy M. Bukach, Holly E. Laurance, Kevin G.f. Thomas, and Jake W. Jacobs. "Humans With Traumatic Brain Injuries Show Place-Learning Deficits in Computer-Generated Virtual Space." Journal of Clinical and Experimental Neuropsychology (Neuropsychology, Development and Cognition: Section A) 22.2 (2000): 157-75. Web.

The Problem of Free Will. Retrieved March 24, 2015, from Information Philosopher Web site http://www.informationphilosopher.com/freedom/problem/

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Haddad, F. (2015). Forget the Map; Trust Your Brain: The Role Neuroscience Plays in Free Will. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/05/forget-map-trust-your-brain-role.html

Is Multilingualism a Form of Cognitive Enhancement?

The following post is part of a special series emerging from Contemporary Issues in Neuroethics, a graduate-level course out of Emory University’s Center for Ethics.



People often ask me what language I dream in. I usually tell them that I dream in both languages – Romanian and English – and that it depends on the content of the dream and on the people featured in it. I associate emotional states with my native Romanian, while organized, sequential thinking is easier in English. Most of the time, I am not even aware of the identity of the language I produce and hear in my dreams.



Leaving the mysterious dimension of dreams behind, how does the multilingual brain navigate the world? Faced with an information-dense environment, it is able to switch its language of appraisal at the moment’s need. Consider the increasingly large group of bilingual English-speaking Hispanics in the United States. Most of them use English in their academic and work environments, then effortlessly switch to Spanish when talking to family members and other Spanish speakers. They also retrieve autobiographical memories in the original language of encoding without losing any more details than a monolingual individual. Given a context, multilingual individuals are able to adjust to the linguistic requirements of the situation. The multilingual brain is, therefore, an adaptable brain.



This leads us to the next point of inquiry. How does speaking several languages sculpt the brain? The Brain and Language Laboratory for Neuroimaging led by Dr. Laura-Ann Petitto has been investigating the differential activity in monolingual and bilingual brains during comprehension tasks, and has found that bilinguals show increased activation in the left inferior frontal cortex, an area associated with semantic processing and behavior inhibition. Another group led by Dr. Jubin Abutalebi has found that the brain of bilinguals recruits more areas when processing language than the brain of monolinguals. Finally, a recent study replicated the finding that learning a second language early in life changes the structure of white matter in the brain. This study is of particular interest, because it suggests that learning a second language later in life and using it concurrently with the first has the same effects on the brain.

Image by Harriet Russell. From www.nytimes.com

So what are the behavioral manifestations of these properties of the multilingual brain? Research shows that there are many. First, multilingual individuals show better cognitive abilities. They easily block out distractions and switch between tasks, which gives them the ability to multitask efficiently. Second, they have better metalinguistic skills. This was shown in a study in which investigators gave monolingual and bilingual 5-year olds the sentence “Apples grow on noses” and asked them whether this sentence is grammatically correct. Monolingual children were able to report that the sentence was silly, but had no further insight on its grammatical structure. In contrast, multilingual children were able to recognize that the given sentence, although meaningless, was grammatically correct. Thirdly, multilingual individuals have better verbal and spatial abilities, probably a result of their metalinguistic capacity. Last but not least, the ability to speak several languages fluently has been associated with better memory skills, and research by a Canadian team suggests that bilingualism confers protection against Alzheimer’s disease. On a socioeconomic level, bilingual instruction has been associated with significant earning bonuses. Multilingualism also promotes cultural exchange and tolerance by improving communication between different groups of people.



All that being said, it appears that speaking more than one language enhances our cognition on multiple levels. With more than half of the world’s population being multilingual – that is, speaking at least two languages on a day-to-day basis – it seems relevant to reflect on who has access to instruction in multiple languages and who does not. If multilingualism is a form of cognitive enhancement and a protective measure against one of the most debilitating aging disorders, Alzheimer’s disease, how can we ensure that everyone can access it?

From www.thevici.com

Bilingual education is currently being reinvented in the United States, and research suggests that two-way immersion programs are showing results. The American Psychological Association reports that students who are part of bilingual programs such as that at The Hurley School in Boston have a better ability to pay attention in a learning environment. Furthermore, a study at Northwestern University reported reduced anxiety and better self-esteem.



Interestingly, most Americans are often surprised by the statistics, and consider multilingualism to be the exception, rather than the rule. Foreign languages are required in most schools, but not enough students achieve proficiency, at least not compared to other the levels achieved by students in other countries. Furthermore, some parents avoid teaching their children their own native language, fearing that knowledge of many languages will interfere with their children’s ability to achieve full control over any of them. This theory could not be farther from the truth. Children easily immerse themselves in multiple languages, and oftentimes obtain full speaking and reading proficiency in all of them.



Are monolingual children and adults at a disadvantage compared to their multilingual peers, and if so, are they even aware of these pitfalls in their linguistic and cognitive training? Just as scientists and bioethicists alike worry about the equal availability of cognitive enhancement drugs and technologies in the event they become legally available to the masses, so should they worry about the availability of multilingual education.



References:



Abutalebi J., Green D. (2007) Bilingual language production: The neurocognition of language representation and control. Journal of Neurolinguistics, 20(3), 242-275.



Barnett W.S., Yarosz D.J., Thomas J., Jung K., Blanco D. (2007) Two-way and monolingual English immersion in preschool education: An experimental comparison. Early Childhood Research Quarterly, 22(3), 277-293.



Craik F.I.M., Bialystok E., Freedman M. (2010). Delaying the onset of Alzheimer disease. Neurology, 75(19), 1726-1729.



Gollan T.H., Salmon D.P., Montoya R.I., Galasko D.R. (2011). Degree of Bilingualism

Predicts Age of Diagnosis of Alzheimer’s Disease in Low-Education but not in Highly-Educated Hispanics. Neuropsychologia, 49(14), 3826-3830.



Huang J., Zhu Z., Zhang J.X., Wu M., Chen H.C., Wang S. (2012). The role of left

inferior frontal gyrus in explicit and implicit semantic processing. Brain Research, 1440, 56-64.



Kovelman, I., Baker S.A., & Petitto L. (2008). Bilingual and monolingual brains compared: a functional magnetic resonance imaging investigation of syntactic processing and a possible “neural signature” of bilingualis. Journal of Cognitive Neuroscience, 20, 153-169.



Kovelman I., Shalinsky M.H., Berens M.S. & Petitto L. (2008). Shining new light on the brain’s “bilingual signature”: a functional near infrared spectroscopy investigation of semantic processing. Neuroimage, 39, 1457-1471.



Pliatsikas C., Moschopoulou E., Saddy J.D. (2015). The effects of bilingualism on the white matter structure of the brain. Proceedings of the National Academy of Science, 112(5), 1334-1337.



Schrauf R.W., & Rubin D.C. (2000). Internal languages of retrieval: the bilingual encoding of memories for the personal past. Memory and Cognition, 28(4): 616-623.



Swick D., Ashley V., Turken A.U. (2008). Left inferior frontal gyrus is critical for response inhibition. BMC Neuroscience, 9(102).



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Lucaciu, I. (2015). Is Multilingualism a Form of Cognitive Enhancement? The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/05/is-multilingualism-form-of-cognitive.html

So You Want to be a “Successful” Psychopath?

The following post is part of a special series emerging from Contemporary Issues in Neuroethics, a graduate-level course out of Emory University’s Center for Ethics.

Within the past two years, the media has followed the recent turn toward exploring the characteristics of a “successful” psychopath. A simple Google search on “successful psychopathy” now renders a slew of attention-grabbing articles ranging from How to Protect Yourself from a Successful Psychopath to Why Psychopaths are More Successful to Is Your Boss a Psychopath? Together, these articles reference some of America’s more fascinating psychopathic fictional characters, such as Dexter, Jordan Belfort from The Wolf of Wall Street, and Frank Underwood from House of Cards, to create a case for an adaptive psychopath. The recent discussion about the successful psychopathic personality in the media most certainly raises questions about the nature of psychopathy and the ethical implications of concluding that some psychopathic tendencies may be adaptive.

From iDigitalTimes

Before delving into the nuances of successful psychopathy, one must first understand the basic characteristics of psychopathy more generally. Psychopathic personality, or psychopathy, is a disorder often characterized by a constellation of affective, interpersonal, and behavioral deficits. Psychopaths have been known to be especially callous, cold-hearted, impulsive, and superficially charming. This subset of people has also often been characterized as not possessing empathy and as unable to feel remorse for their actions. Criminal anthropologist Havelock Ellis (1890) portrayed psychopaths as “instinctive criminal[s]” and “moral monsters” (p.2.). Furthermore, in his pioneering work The Mask of Sanity, Hervey Cleckley (1941) described a psychopath as unable to “accept substantial blame for the various misfortunes which befall him and which he brings down upon others” (p. 343).



This characterization of psychopaths is largely negative. It is hard to think about how an uncaring, impulsive, cold-hearted person could seemingly flourish in any endeavor in life. The debate over whether certain psychopathic qualities could manifest adaptively remains a question that will largely be decided through refining the measurement techniques for assessing psychopathy. Of course, this will not be an easy debate to resolve. Throughout the history of psychopathy research, there has also been significant controversy over the criteria required for a psychopathy diagnosis. In an effort to elucidate some confusion, Robert Hare (1991/2003) developed the Psychopathy Checklist (PCL). The PCL is the most commonly used method to measure psychopathy traits. Factor analytic measures on the PCL have shown that psychopathy is supported by two factors: (1) interpersonal and affective traits and (2) disregard for social conventions. The first factor more closely aligns with typical conceptions of psychopathy, whereas the second factor captures a tendency to engage in maladaptive antisocial and lifestyle behaviors.



Aside from merely discerning the characteristics of a psychopath, researchers have also debated whether psychopathy is a categorical or dimensional construct. More recent scholarship suggests that there are not “psychopaths” or “non-psychopaths,” but individuals possess varying degrees of psychopathic tendencies (Lilienfeld, 1998). In my opinion, viewing psychopathy on a continuum helps to frame a case for the successful psychopath because one psychopath will vary from another.



People with psychopathic personality disorder may express certain personality tendencies to differing degrees and these differences are usually captured and clarified though developing more precise measuring tools and examining different underlying factors of psychopathy. The range of characteristics associated with psychopathy run the gamut from boldness, heightened levels of focus, superficial charm, intelligence, and carelessness. The quality most closely related to successful psychopathy is perhaps boldness and fearlessness (Smith, Watts, & Lilienfeld, 2014). Psychopaths that exhibit these qualities may perform exceedingly well in stressful business, legal, or academic environments. Nonetheless, more research is needed to examine what arrangement of traits is correlated with adaptive outcomes in psychopathic individuals.



To better illustrate the theoretical possibility of a successful psychopath: say that there exists a type of person that is especially bold, devoid of anxiety, and manipulative in a way that helps her advance in her career. It is not hard to envisage this type of person succeeding in her professional life because she may more readily engage in risky yet potentially profitable business ventures and exude a great deal of self-confidence in the face of uncertainty. This combination of traits may even appear enviable. There are most certainly times in which I wish I were less anxious about an important meeting or more bold when making important decisions. However, the successful psychopathy discussion must be careful not to venerate the notion of a so-called high-functioning psychopath. Just because a successful psychopath may very well exist does not mean that psychopathy in many other cases is not associated with highly problematic behavior.



In discussing successful psychopathy, we must be clear about what successful means and who makes that determination. For instance, a successful psychopath could be considered adaptive because she hasn’t been caught engaging in inappropriate actions, but other people may not think of her as successful if her behaviors were uncovered. Take Dexter the so-called “Avenging Angel” for example—he could be considered a very successful psychopath because he kills people without getting caught and subsequently punished. I would argue that he is successful in a sense, but not in an enviable way. Frank Underwood from House of Cards serves as another example: he is an especially astute political manipulator and lacks remorse for many of his morally questionable actions. I find these individuals fascinating, but I am not so sure many people would want to possess the characteristics of these individuals.

From Erwin Reviews

Alternatively, another conceptualization of a successful psychopath may stem from the idea that a psychopath recognizes her psychopathic tendencies but channels them in societally appropriate ways, such as acting in a heroic manner or taking necessary risks in the face of uncertainty or having great economic success. For instance, a person with a variant of psychopathic personality may find the job of a firefighter fitting for her fearlessness. Society would likely deem this person’s choice to seek out an occupation that matches with her interests admirable and respectable. This existence of such a person is still contentious and more research is needed to determine which underlying factors of psychopathy manifest into adaptive behaviors (Smith, Watts, & Lilienfeld, 2014). In the end, the intentional firefighter differs from sly, undercover serial killer, and we must be careful not to throw the word successful around without defining what one means by its use.



Regardless, the media’s portrayal of successful psychopathy ought to include a discussion of these nuances because these differences in the definitions of successful psychopathy are distinctions that make a difference in how the public perceives mental disorders, such as psychopathy. On one side, it would be problematic for the media to perpetuate a stigma against psychopaths or stigma against mental illness in general. It would be equally problematic if the media framed a successful psychopath as having a desirable personality disorder. The truth of the matter is that we simply do not know enough about successful psychopathy to make any generalizations about successful psychopathy. Just because a psychopath need not always be equivalent to Ted Bundy does not necessarily mean that a non-criminal psychopath is the type of person our society ought to deem “successful.”



Or does it? Only further research and time will begin to shed light on the curious character of a successful psychopath.

References

Ellis, H. (1916). The criminal (Vol. 7). W. Scott.

Cleckley, H. (1941/1976). The mask of sanity; an attempt to reinterpret the so-called psychopathic

    personality.

Hare, R. D. (1999). The Hare Psychopathy Checklist-Revised: PLC-R. MHS, Multi-Health Systems.

Lilienfeld, S. O. (1998). Methodological advances and developments in the assessment of

    psychopathy. Behaviour Research and Therapy, 36, 99-125.

Smith, S. F., Watts, A. L., & Lilienfeld, S. O. (2014). On the trail of the elusive successful

    psychopath. Psychological Assessment, 15, 340-350.

Successful Psychopathy Books of Potential Interest

The Psychopath Inside: A Neuroscientist’s Personal Journey into the Dark Side of the Brain

Snakes in Suits: When Psychopaths Go To Work

The Psychopath: A Journey Through the Madness of Industry

The Good Psychopath's Guide to Success



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Marshall, J. (2015). So You Want to be a “Successful” Psychopath? The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2015/04/so-you-want-to-be-successful-psychopath.html