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The subtypes of the psychopath, part 4

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The MMPI and the Millon Clinical Multiaxial Inventory both posit distinct subtypes of psychopathy. He notes one researcher who identified clinical subtypes of psychopathy with the MMPI, identifying as many as 5 subtypes.

1) The primary psychopath

2) The hostile psychopath

3) The paranoid schizoid psychopathy

4) The neurotic psychopath

5) The confused psychopath (This one present with serious mental illness that led to disorganized behavior)

They note another study which divides subtypes into "undercontrolled" vs. "overcontrolled" subtypes, which are further divided into four types:

1) Primary psychopaths - These are extraverted, grandiose, confident, hostile and impulsive.

2) Secondary psychopaths - These are moody, highly anxious, hostile and impulsive. They are similar to the first category exhibit they exhibit high levels of moodiness and anxiety, and tend to be withdrawn.

3) Controlled personalities - These are socially conforming, lacking in emotion and defensive.

4) Inhibited personalities - these tend to be withdrawn, controlled and depressed. It is common among introverts.

Millon goes as far as to postulate 10 subtypes of psychopathic personalities. While potentially useful, the authors note, such a wide variety with distinctly psychodynamic presuppositions may be difficult to operationalize. Such a list of subtypes may help correlate certain kinds of psychopathy with certain Cluster B personality disorders.

In another study, Millon divides the psychopath into 3 subtypes:

1) Unprincipled psychopath - similar to antisocial personality disorder.

2) Covetous psychopath - similar to narcissistic personality disorder.

3) Malevolent psychopath - similar to sadism.

The authors hope to base their subtypes purely on empirical validation, and they hope to distinguish subtypes in terms of those personality traits that are not typical of all psychopaths. They postulate, as noted above, a distinction between the sadistic psychopath, the borderline psychopath, the antisocial psychopath and the narcissistic psychopath. The antisocial psychopath, they note, is the typical Cleckleyan psychopathw ho lacks remorse, guilt, anxiety and empathy. Their method of distinguishing the various subtypes, furthermore, is based on differences in patterns of criminal behavior.

The narcissistic psychopath - This psychopath is characterized primarily in terms of grandiosity callousness and entitlement. They liken this psychopath to Millon's covetous psychopath, and Gabbard's oblivious narcissist. It is correlated with the DSM category of narcissistic personality disorder (NPD).

The borderline psychopath - They note that this type is similar to that described by Blackburn. Such a psychopath exhibits significant behavioral overlap with those diagnosed with borderline personality disorder.

The sadistic psychopath - these exhibit a tendency to enjoy causing suffering to others. This type corresponds to Millon's malevolent psychopath. They are capable of recognizing the suffering of others, unlike the primary psychopath, except that they enjoy inflicting such suffering rather than exhibiting remorse over it.

The antisocial psychopath - this is similar to Millon's unprincipled psychopath. It also overlaps with the DSM description of antisocial personality disorder, and is defined primarily in terms of a parasitic lifestyle, poor impulse control, and a constant need for stimulation. This psychopath similar does what he wants, when he wants. He does not necessarily delight in the suffering of others or exhibit grandiosity or emotional instability. He simply sees what he wants and he takes it.

Carolyn Murphy, Ph.D., & James Vess, Ph.D. SUBTYPES OF PSYCHOPATHY: PROPOSED DIFFERENCES BETWEEN NARCISSISTIC, BORDERLINE, SADISTIC AND ANTISOCIAL PSYCHOPATHS. Psychiatric Quarterly, Vol. 74, No., 1, Spring 2003.

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