Wednesday, May 14, 2008

Empathy and lack of empathy: Lili Marlene's article about .....

Empathy and lack of empathy; two of the stupidest and most offensive fads in popular science writing today

(last edited August 2008)

Many autism experts and autism-related organizations want the public to believe that the autistic spectrum is The Most Important Problem Facing Society Today. They have vested interests in promoting this message. They want you to believe that terrible, terrible things will happen in the future if we don’t give them a lot of money to spend on their projects that aim to eradicate, medicate or remediate autism. Some of these people with vested interests in the autism industry will go so far as promoting the idea that solving the “puzzle” of autism will provide an explanation for just about everything that is bad and dysfunctional about humankind and human society. Some cite testosterone as an explanation for male violence, war crimes and man’s inhumanity to man in general, and then they go on to argue that autism is the most extreme example of the biological and social effects of this supposedly demonic hormone. Why did the Holocaust happen? Testosterone! Why are males over-represented in the population of convicts? Must be testosterone! You don’t need to be a genius to pick up the message that is written between the lines; that autism is a bad, bad thing and that autistic people do bad, bad things.

Writers of bestselling pop science books and articles in popular science magazines appear to have uncritically embraced this dominant view of autism as the condition that typifies a “lack of empathy”. These writers, many of them renowned psychologists, many of them in senior academic positions, appear to be content to cut and paste their writings on the subject of autism and empathy almost directly from texts produced by influential autism experts. They cite the same texts in their lists of references and notes. For a group of people who are supposed to be highly educated independent investigators of the scientific realm, they certainly seem to behave like a flock of stupid sheep. In books and articles written for a general readership it is common to see psychopathy and autism discussed as though the two very different conditions were almost interchangeable. This is the worst kind of intellectual sloppiness.

This shoddy work is inexcusable when one considers that an abundance of evidence has always been available in the scientific literature to those who choose to search independently. There is some clinical evidence that clearly indicates that autism (uncomplicated with other conditions) and anti-social type personality disorders may in fact be mutually exclusive. One study of temperament and character in adults with Asperger syndrome, that involved 31 people with AS, categorized these people into Cloninger’s temperament types and eight different temperament types were found, but not one of these 31 people with AS were found to fall into the category of Antisocial temperament type (Soderstrom, Rastam & Gillberg 2002). Another study of the impact of ADHD and autism spectrum conditions on temperament, character and personality development, which involved, among other subjects, 47 people who had an autism spectrum condition only, found that among this group of patients many cases of various personality disorders could be identified, but no cases at all of Antisocial personality disorder were identified in this group (Anckarsäter Stahlberg Larson et al 2006 Table 3). A number of different teams of researchers have found clear differences between autism and psychopathy. Severe malfunction or deficit in the “theory of mind” “mental module” is thought to be a central feature of autism. In one study psychopaths were found to have performed at the same level as non-psychopath incarcerated controls, and significantly better than highly able adult autistic people in an advanced test of theory of mind abilities (Blair et al 1996). Another study has found no generalized impairment in theory of mind in psychopaths (Richell et al 2003). It appears that psychopaths have no problem with “theory of mind”. It appears that psychopathy and autism are profoundly different conditions. Another study has found that psychopathic and non-psychopathic subjects who met clinical criteria for Antisocial Personality Disorder (ASPD) had generally intact theory of mind abilities, with the psychopath sub-group subtly more capable. In one test of mentalizing ability the results suggested that the ASPD subjects had more indifference than lack of ability to understand in relation to social faux pas (Dolan & Fullam 2004). A study of autistic boys conducted by researchers that included autism experts found no relationship between “severity” of autism and “psychopathic tendencies”, and found that such tendencies did not appear to be related to core autistic deficits. These researchers concluded that psychopathic tendencies are not a facet of autism but can in some cases be found in addition to autism (Rogers et al 2006). More recent research is also turning up evidence that calls into question the currently fashionable model of autism and empathy. Science News recently reported two brain-scanning studies involving autistic and normal control subjects which gave results that would surprise some people (Saey 2008).

The most recent example of stupid science writing on the subject of empathy that I have noticed is A. C. Grayling’s recent commentary piece in New Scientist magazine. Grayling writes about morality and moral relativism and mirror neurons, and then asserts that “This strongly suggests that the ability to understand others, read their intentions, interpret their emotional states, predict their behaviour and respond appropriately – the very basis of social capacity itself, and thus of morality – is linked to the involuntary modelling of others that mirror-neuron activity makes possible.” If you find this statement credible it follows that you must regard people who don’t have an ability to understand others, presumably because they don’t have properly functioning mirror-neurons, as being immoral or at least partly incapable of acting as moral agents. Grayling mentions that some researchers believe malfunctioning mirror-neurons are “a factor in autism”, so you are left in no doubt as to whom these morally-disabled people might be. But there is a very questionable jump in Grayling’s argument. He asserts that morality is based upon “social capacity”, but he offers no argument to support this bold assertion. You can say this all you like Mr Grayling, I still wont believe it is true. I know lots of very sociable and popular people who don’t appear to have had very much morality rub off onto them, and some of the most decent people that I know are socially clumsy loners. Please explain, Mr Grayling.

This idea that morality is “hard-wired” into all normal people’s brains would have been laughed at 20 years ago. I am old enough to remember the days when parents, churches and other religious groups took on the responsibility to teach their young what is right and what is wrong. While this process was in many ways flawed and sometimes failed, I believe it was a whole lot better than sitting back hoping that the younger generation will somehow be given a sound moral education by means of empathizing or mirror-neuron activity or peer socialization. These days many children receive most of their moral guidance from their teachers and headmasters at their local government-run school, after the child has breached the moral code in some way. The moral virtues are now a formal subject in the curriculum in the government primary school system in the state of Australia where I live. Apparently mirror-neurons alone aren’t sufficient moral guidance for Australian children.

All of these people, who say and write and insinuate these things about autism, usually fail to do a number of very important things. Firstly, they fail to make important distinctions between the many and varied forms of “anti-socialness” and of altruism. They often write about the subject of empathy with a vagueness and an evasiveness that often has the effect of making their writing meaningless. Their arguments often cannot be challenged or contradicted or disproved with the findings of research studies, because their arguments are often so sloppy and vague that they could be taken to mean almost anything. And I believe that’s exactly what they aim to achieve.

In a related form of vagueness, these writers fail to clearly define what they mean by “empathy”, or they move beyond their stated definition without explanation or warning, when it suits their purposes. Even though there is a confusing variety of different definitions of the meaning of the word “empathy”, and different authorities give different accounts of different types of empathy, one can still discern one specific meaning of the word that appears to be common to most writing on the subject. This definition of empathy is that it is the identification with or experiencing of the feelings or thoughts of another person. When one reflects on this definition, it is a quite narrow concept. Identifying with another person’s feelings or thoughts is not the same as identifying with their best interests. It is not the same thing as caring about someone else’s health or wealth or social standing. It is not the same thing as generally identifying with another person. It is not the same thing as being motivated to do anything to assist another person; it is quite possible that a person may empathize with another person’s misery, but do nothing to improve their situation. How many times have you felt empathy for disaster victims shown on the TV news, but have not bothered to donate to any charity that is working on that project? Imagine you are taking care of a drug addict going through a tough withdrawal process. If you truly empathize with your patient’s immediate feelings, does that mean you feel compelled to give them a dose of their favourite drug to make the bad, bad feeling go away? Pop science writers never pause to point out what a limited and narrow concept empathy really is. They never admit that empathy isn’t the most useful or beneficial feature of human psychology. Who would dare to express criticism of the latest big fad in pop psychology? They are happy to leave the reader to possibly confuse empathy with other related, but broader or more important concepts, such as altruism or compassion. They want you to believe that they are writing about really big and important things, when in fact the subject of their writing may be not much more than a scientific curiosity.

Another failure of most pop science writing about empathy is that the writers never, ever explore the view that there is something irrational, delusional even possibly pathological about the idea of empathy, or empathy itself. It appears that the entire non-autistic section of the human race lacks an understanding that it is not literally possible to experience someone else’s emotions or thoughts. We all have different, unique brains. Even the brains of identical twins are not exactly the same. It is most likely that our feelings and subjective experiences are not identical, and may even be very different. Anyone who has read a book of neurological anecdotes by Oliver Sacks, or an account of synaesthesia or autism, will understand that there can be important differences between the inner lives of people (yes, autistic people, synaesthetes and the subjects of Oliver Sacks’ anecdotes are all people). It might be impossible for you to understand or experience what I experience. And the brains of humans cannot communicate directly. Feelings cannot be communicated directly between people, we can only resort to verbal, textual or body language, which are all failure-prone. We cannot assume that others’ feelings can be accurately simulated, imitated or imagined, because we can never know for sure what it actually feels like to be someone else. People always bring their own experiences and neurological differences to any attempt to interpret the experiences of others. As one pop science writer recently wrote on the subject of people trying to understand what is within other’s minds and hearts; “When we judge others’ behaviours, attitudes, values and beliefs, we anchor on ourselves and extrapolate – we assume other people like what we like, want what we want and believe what we believe, …” (Brunstein 2008). When people who believe in ESP claim that they can read the minds of others, most sensible people dismiss such claims as nonsense. Why are sensible people obliged to take claims about mind-reading made by psychologists any more seriously?

When writing about autism and empathy, most pop science writers commit the sin of failing to inform their readers that the vast majority of anti-social behaviour, of criminal acts, of child neglect, of murders, of sex offences, of malicious gossip, of domestic violence, of workplace bullying, of harmful addiction-related behaviour and of corporate greed, is committed by people who are not in any way autistic. These so-called experts fail to admit the fact that that the vast majority of crimes are committed by people who have disorders that are nothing to do with the autistic spectrum. These writers fail to explain the many important differences between autism and the other conditions that are known to be, and in some instances are defined as being, associated with criminal or anti-social activities. These people either don’t know or don’t care about the real characteristics of psychopathy and criminality. Perhaps they are afraid that they might recognize something of themselves in the clinical descriptions of the psychopathic personality.

Perhaps the worst omission in the writing of pop science writers who delve into the subject of empathy is the failure to acknowledge the fact that it is perfectly normal, even desirable, to “lack empathy” or repress empathy, in many social situations. Normal people lack empathy. They lack empathy for people of other races (consciously or unconsciously). They lack empathy for people who are not members of their own social groups. Followers of other religions or ideologies are demonized. Outsiders are distrusted and bullied. Many people distance themselves from or even celebrate the misfortunes of their enemies. The results of one scientific study, reported in Current Biology and also in New Scientist magazine, suggest that learning how to control or repress feelings of empathy may be an essential part of the training of medical doctors (Cheng et al 2007). Ironically, the suppression of empathy practiced by physicians while they were watching videos of acupuncture procedures was associated with more activity in parts of the brain involved in theory of mind and regulation of emotion. Here we have “theory of mind” associated with an apparent decrease in feelings of empathy, which sits oddly with the established theory that “lack of empathy” in autistic people is due to some deficit in “theory of mind”.

Historians and social psychologists have discovered ample evidence of the highly selective nature of human empathy. Human empathy or compassion must be at least partly culturally or socially determined, because in different periods of history and in different societies, levels of general humanitarian sensitiveness appear to vary greatly. In a recent pop science book Steven Pinker pointed out that “In 16th century Paris, a popular form of entertainment was cat burning… the spectators, including kings and queens, shrieked with laughter as the animals, howling in pain, were singed, roasted, and finally carbonized.” (Brockman 2007). In one of her autobiographical books Temple Grandin described another horrific vision of animal cruelty that occurred as a part of the normal processing in a cattle slaughterhouse, which she set her mind to reforming. When autistic people display greater concern about cruelty to animals than many supposedly normal people display, it is sometimes theorized that autists empathize more with animals because we are more like animals than normal folk. If that is the case, I think it must be a nobler thing to be more like an animal than to be more like a callous slaughterhouse manager or a spectator splitting her sides at a 16th century cat burning.

The blatant sadism of cat burning as a public amusement is a reminder of one of the major flaws in the currently popular theories linking human morality with empathy; these theories fail to explain the psychology of the sadist. If people who lack empathy are people who are indifferent or detached from the emotions or suffering of others (including animals as others), then it seems to follow that these people would not derive any enjoyment from positively sadistic activities, because these people should have little or no sense of personal involvement in the situation of the victim. One would expect an essentially emotionally detached person to stare dispassionately at a cat burning, or show no interest at all. Why would such a person laugh? Clearly sadism and “lack of empathy” must be different psychological states. One could argue that sadism is an entirely different thing because it is a form of perversion, and therefore cannot be compared with states that consist of different levels of empathy, but I think any theory about “lack of empathy” that fails to explain what motivates some people to do deliberate acts of cruelty has got to have something seriously wrong with it. One of my biggest objections to many examples of recent writing about empathy is that the writers have failed to warn readers about the extent of human behaviour and mental states that they have not explained.

The author of one recently released book has gone against the trend, giving a thoughtful discussion of apparent similarities between psychopathy and autism, along with an intelligent account of the nature of psychopathy. Daniel Nettle hasn’t just snatched a few ideas and the odd study result from some autism expert, and woven these into a glib little side note that uses autism as device to further an argument for some grand theory, as many pop science writers have done. In his book Personality: what makes you the way you are”Nettle discusses his own research and takes the time to do justice to the subjects discussed. It just proves that other writers could certainly do better.

Today I read a review of a pop science book on the subject of empathy that has just come onto the market. There is no end in sight to this empathy fad. We might not have seen the worst of it. Perhaps the best remedy to the current epidemic of half-baked and one-eyed theorizing about empathy is to examine the different concepts that make up our cultural and scientific understanding of empathy, lack of empathy, and related subjects including morality, regardless of how absurd or irrelevant any of these may appear to be. Let me lead you on a merry jaunt through prisons, dictionaries, the Italian Renaissance, the DSM, the OMIM, US railways of the 1800s, scientific journals, personality questionnaires, pop psychology books, popular prejudices, down under to Colonial Australia, and beyond the pale. I invite you to browse my lists below, have a think, and make your own conclusions, and formulate your own questions.

Concepts, labels and conditions that are associated (correctly or incorrectly) with empathy, or are sometimes confused with empathy

Empathy – There are many different definitions, some appear to require an experiencing of others’ emotions, while others appear to require only intellectual understanding. Some definitions appear to be not limited to empathy between people.
Some definitions:
- power of projecting one’s personality into object of contemplation
- fully comprehending object of contemplation
- entering into the feeling of another
- entering into the spirit of another
- understanding
- understanding another’s feelings through imagining or remembering being in a similar situation
- understanding or experiencing the feelings or thoughts of another without having these feelings or thoughts explicitly communicated

Different psychologists use different models of empathy, and some also identify various sub-types of empathy:
- Professor Paul Ekman, a world expert on deception, emotions and facial expression, identifies three types of empathy; cognitive empathy, emotional empathy and compassionate empathy, and he explains that cognitive empathy is required in order to have the other types of empathy, but emotional empathy is not a pre-requisite for compassionate empathy. Ekman states that empathy is not an emotion, it is a reaction to the emotions of others.
- Internationally recognized autism expert Professor Simon Baron-Cohen has identified an affective component and a cognitive component of empathy.
- Daniel Nettle divides human theory of mind into two related capacities, which are empathizing and mentalizing. Mentalizing is attributing a mental state to another person. Mental states can include desires and beliefs. Empathizing is a more specialized form of mentalizing that involves representing the emotions of others, which has the potential to affect the empathizer. This definition of empathizing appears to be at odds with some definitions of empathy, in that it does not appear to require the empathizer to experience or be personally affected by the emotions of others, but it does allow for such a possibility.

Sympathy – One could say that this word has the same meaning as “empathy”, but is not quite as scientific-sounding. Some dictionaries give definitions of sympathy that are practically identical to those given for empathy in some dictionaries.
Some definitions:
- compassion for
- agreement with in desire or opinion
- being affected with the same feeling as another simultaneously
- to share or claim to share another thing’s or person’s condition, sensation or emotion

Compassion – pity for the misfortune or suffering of another, may lead one to be helpful or to show mercy

Altruism – seeking the welfare of others

Scoring high for Agreeableness in personality tests – People who do this are described as empathetic, helpful, trusting, friendly and pleasant, with an optimistic view of human nature. Although there is a lot of overlap in scores between men and women, women as a group tend to score higher for agreeableness than men as a group.

Dependent personality disorder – In his book Personality Daniel Nettle has identified DPD as the closest thing that can be found in the population to a theoretical condition of being an extreme high scorer for the personality dimension of Agreeableness. DPD is more commonly identified in women than in men.

Scoring high for Conscientiousness in personality tests – People who do this are described as hard-working, reliable, conscious of rules, self-disciplined, careful and thorough. Low scores for conscientiousness are associated with ADHD, alcoholism, gambling and Antisocial Personality Disorder. Extremely high levels of conscientiousness are associated with Obsessive-compulsive Personality Disorder (OCPD) which is not the same as OCD. It is characterized by perfectionism, orderliness, adherence to rules, exercise of control, hoarding and problems with personal relationships. I have a strong suspicion that many people given this diagnosis are autistic people who have reached adulthood without being identified as such. Disorders associated with very high and very low conscientiousness are both substantially more prevalent in men (Nettle, 2007).

Extroversion/Extraversion – Some employers assume that job applicants who appear to have extroverted or sociable personalities are nicer or more empathetic people than more socially reserved job applicants. This may be an unwise prejudice. The personality trait of extroversion is associated with Factors 1a and 1b of the Psychopathy Checklist-Revised (PCL-R).

Down syndrome – a genetic chromosomal condition characterised by intellectual disability and a number of different physical traits and defects. People with Down syndrome are often described as sociable, affectionate and happy, but there are some people who have the dual diagnosis of Down syndrome with autism. I’m sure most people have had the experience at least once in their life of being spontaneously hugged by a stranger who has Down syndrome.

Williams syndrome (Williams-Beuren syndrome, WBS)
– a genetic syndrome associated with small head size, intellectual disability, very low IQ scores, physical defects, difficulty with literacy and arithmetic, poor visuospatial and motor ability, and attention deficit, but people with this syndrome may also have excellent verbal skills, superior and precocious musical ability, perfect pitch and a good memory for names and faces. People with this condition have been described as “empathetic, loquacious, and sociable”. It has been suggested that this syndrome is like the opposite of autism. Oliver Sacks wrote an interesting description of this condition in his recent book Musicophilia.

Cohen syndrome – a highly variable genetic syndrome associated with small head size, intellectual disability, visual disability, obesity, poor muscle tone and other features. People with this condition have been described as showing “overly friendly behaviour” with a characteristically “sociable”, “positive”, “cheerful” or “cooperative” personality. Autistic features have been identified in some people who have Cohen syndrome (Howlin 2001). One study has found some autistic-type behaviour in people who have Cohen syndrome, but failed to confirm that there is any increased prevalence of autism in Cohen syndrome (Chandler et al 2003).

Low Machs
– these are people who score low on a test for the psychological trait of Machiavellianism (see section below). These people tend to be trusting, empathetic, honest in dealings with others and optimistic about human nature. Extreme low scorers may be socially inept and passive. Some academics consider “Machiavellian intelligence” and “theory of mind” to be the same thing, implying that autistic people are deficient in Machiavellian intelligence, which might imply that autistic people should be “Low Machs”. This would seem consistent with the description of extreme Low Machs as socially inept, but there seems to be some inconsistency when one compares the personality traits associated with Machiavellianism. High Machs score low for the personality dimension of agreeableness and high for conscientiousness, and one might assume that Low Machs score the opposite, but being a high scorer for agreeableness and a low scorer for conscientiousness does not seem at all typical of an autistic personality.

Mirror-touch synaesthesia – In a study by Banissy and Ward that involved 10 people who have this neurological condition and 45 control subjects, the mirror-touch synaesthetes were found to score significantly higher in the Emotional reactivity subscale of the Empathy Quotient (EQ), but this was not found in their scores in the Cognitive empathy and Social skills subscales or their overall EQ scores.

Having properly functioning mirror neurons – Mirror neurons fire when an animal observes an action performed by another animal of the same species, and they also fire when the animal performs the same action. Mirror neurons have been directly observed in monkeys, and humans are thought to have them. These neurons are believed to mediate the understanding or imitation of the actions of others. Monkey see, monkey do. It has been theorized that mirror neurons play an important role in empathy, language and “theory of mind”, and some have theorized that autism is caused by some kind of deficiency in mirror neurons.

Ability to accurately monitor one’s own heartbeat – No truly, I am not joking. In the book The body has a mind of it’s own a study with a small number of subjects is described in which it was found that the four subjects who were best at monitoring their own heartbeats also scored the highest in an empathy questionnaire. It was not stated whether these high scores were due you any particular subscale of the empathy questionnaire.

Yawning in response to seeing others yawn - This behaviour is thought to be mediated by mirror neurons.

Parental instincts – Some people show more altruism towards their offspring than others. This is sometimes explained with reference to psychological bonding with newborns.

“Team spirit”
– People who are team sport fans and people who enjoy working as a part of a team at work tend to be more trusted or highly regarded than people who have no “team spirit”, for reasons that are unknown to the author.

– Human females are usually the primary care-givers of their biological offspring. Many people take this as proof that human females are biologically psychologically programmed to be more caring or altruistic than human males. There is one biological, non-psychological reason why males are not fully capable of taking on the role of primary care-giver at birth; males cannot lactate, and breast milk is still regarded as the best nutrition for infants up to the age of 1 year, and in many infants breastfeeding may also be beneficial to neurological development beyond 1 year.

Concepts, labels and conditions that are associated (correctly or incorrectly) with lack of empathy, or are sometimes confused with lack of empathy

– A long-term pattern of behaviour that is immoral, antisocial and predatory. This label is generally only given to adults, and is more commonly identified in males than in females. This category is not currently found in either of the major psychiatric diagnostic manuals, but there are diagnostic instruments applicable to psychopathy, as well as a large body of scientific literature about this disorder. It is thought that 1% of the general population and 20% of imprisoned criminals are psychopaths, with psychopathic criminals responsible for a substantial proportion of serious crimes. Psychopathy is thought to be incurable and untreatable.
Dr Robert Hare developed the Psychopathy Checklist-Revised (PCL-R). There are various legal definitions used in different regions for Psychopathy in addition to Hare’s clinical definition, some applied specifically to sex offenders or paedophiles. The term “psychopathy” also has an obsolete meaning no longer used in psychiatry, a blanket term for any form of mental illness or psychosis. The label “psychopath” is often applied to serial killers and murders by authors of popular literature and mass media journalists.

It is thought that psychopathy may be in some ways adaptive, at least in the short-term, and is not incompatible with a career in politics, law or the media. Psychopaths can be manipulative and charming and may also be violent and intimidating. They do not respond to punishment. Subtypes and sub-factors of psychopathy have been identified by some researchers. Some more characteristics that are associated with psychopathy include: impulsiveness, pathological lying, shallow affect, need for stimulation, irresponsibility, superficial charm, parasitic lifestyles, sexual promiscuity, multiple short-term marriages, early behaviour problems, juvenile delinquency, deficiencies regarding guilt, remorse and empathy, and a grandiose sense of self-worth. Factors 1a and 1b of the PCL-R are associated with extroversion. Factor 2 is correlated with suicide but Factor 1 is not.

In his book Personality Daniel Nettle describes psychopaths in terms of psychological personality dimensions, being extremely low scorers for the dimension of agreeableness, very low scorers for neuroticism and also low scorers for conscientiousness. As mentioned above, high extroversion in the dimensions of personality psychology may also be an element of the psychopathic personality.

Sociopathy – Sometimes used as a synonym for psychopathy. This term is used by some scientists to refer to immoral people who’s condition is thought to be more the result of childhood environment and sociological factors than genes or psychobiological abnormality. Factors thought to contribute toward sociopathy include childhood neglect, deviant peer group, poverty and extremely high or low level of intelligence.

Female psychopathy - Female psychopaths are less commonly identified than male ones, and researchers have found their mean scores in the PCL-R are lower, but some have argued that this is a reflection of gender bias. Criminal versatility and sexual promiscuity are two psychopathic traits that appear to be stronger indicators of Psychopathy in females than in males. It appears that many studies of psychopathy in women have been limited to prisoner populations.

Criminality - Short-term type – typically offend in their teen years, possibly as a response to peer pressure, and then generally grow out of it. May be at elevated risk of developing mental illness or drug abuse.

Criminality – Early-onset, Long-term type/Violent type – Thought to be identifiable from early childhood, having a biological disposition to behaviour issues which can lead to a life of crime if combined with negative environmental influences such as maltreatment. The strength of evidence for maltreatment as a causal factor has been questioned. In her book No two alike Judith Rich Harris scrutinized a well-publicized large study of New Zealander males. Harris pointed out that some of the experiences that fell under the definition of “maltreatment” in this study are associated with other environmental factors. Harris stated that she could think of alternative explanations for the study’s results, such as interaction between the identified high-risk gene and another unknown gene, or interaction between the identified gene and other negative environmental influences such as low-SES and being raised in a crime-riddled neighbourhood.

This mostly male group is thought to be characterized by having a combination of three conditions; low IQ, a diagnosis of ADHD and poor language skills. This group is thought to be responsible for a large proportion of violent crimes. This disorder is thought to be largely genetically determined and runs in families. One variant of the MAO-A gene is thought to be involved. This variant has been associated with high activity in a part of the brain called the amygdala, which is involved in processing emotions.

Criminality – Early-onset, Long-term type/Violent type – Callous and Unemotional (CU) traits subtype – Thought to account for 30% of children who show a pattern of antisocial behaviour. These youths are characterized by lack of fear, lack of empathy, lack of guilt, narcissism and thrill-seeking. They respond to rewards but are unresponsive to punishment, and have a normal level of intelligence. This group share many characteristics with adult psychopaths, a group that possibly has low levels of activity in the amygdala. This disorder is thought to be highly genetically determined, but there is some evidence that parenting interventions utilizing rewards to modify behaviour can be effective.

Undetected criminality – This is obviously a very difficult subject to study scientifically.

Addiction – There are many different forms of addiction; alcoholism, smoking, heroin addiction, problem gambling, internet addiction, sex addiction, and almost all of them have considerable or serious anti-social effects. Addiction is generally an anti-social behaviour.

Conduct Disorder - A psychiatric disorder characterized by rule-breaking, cruelty to animals, cruelty to people and violence. It is a diagnosis that is typically given to children and adolescents, and is thought to be a precursor to Psychopathy in some cases. More males are given this diagnosis than females. Some have argued that this is the result of gender bias in the way this disorder is defined.

Oppositional-Defiant Disorder - a controversial diagnosis that is typically given to children, thought to be a precursor to Conduct Disorder or Psychopathy in some cases. It is also thought to be a less serious problem than Conduct Disorder.

Antisocial Personality Disorder – the closest thing to Psychopathy in the DSM, more commonly identified in males than in females, correlated strongly with criminality and Factors 2a and 2b of the Psychopathy Checklist-Revised, associated with reactive anger, impulsive violence and suicide. It is thought that something like 80% of imprisoned criminals fit the criteria for this disorder. In his book Personality Daniel Nettle writes that APD is a rather broad category which may describe a number of different personality configurations. ADP and problem gambling and addiction appear to be in some way interlinked, because these conditions are found within the same families more often than one would expect by chance.

Dissocial Personality Disorder – the closest thing to Psychopathy in the ICD-10.

Executive Dysfunction/Dysexecutive syndrome – A few years ago it was fashionable for writers in the areas of neuropsychology and autism to identify the part of the brain known as the amygdala as being a very important part of the brain responsible for empathy, and now it appears that “mirror neurons” are the latest fad amongst those who are anxious to localize empathy as a mental module somewhere inside the human brain, but 10 or so years ago it was all the fashion to identify the frontal lobes as the part of the brain that “does” empathy. Dysexecutive syndrome or executive dysfunction tends to follow a brain injury to the frontal lobe region of the brain. Some symptoms associated with this disorder or group of disorders include: lack of inhibition of emotions (including anger), “inappropriate” behaviour, and deficits in memory, attention, planning and reasoning. Deficits in social empathy are sometimes cited as resulting from frontal lobe damage.

Executive function and executive dysfunction are concepts that have still not been clearly defined in terms of expected behaviour, but this hasn’t prevented a generation of pop psychology bestseller writers in the 1990s from trotting out Phineas Gage, an American railroad worker who sustained a famous case of frontal lobe brain damage in 1848, as a case study of executive dysfunction associated with a Jekyll and Hyde transformation from a nice personality into a horrid personality. Many a time in the last decade or two I’ve been reading some psychology book and have thought to myself “Oh Christ! Not another recounting of the story of Phineas Gage!”

Gage has been described by many writers as an example of a person who lost his moral sense when a part of his brain was blown out of his head by a tamping iron, but was the post-accident Gage really a person without morality, empathy or organizing ability? The extent of Gage’s personality and mental changes post-accident are uncertain (Wikipedia 2008). I have read a book about Gage (Fleischman 2002), and I don’t recall reading that any murders, crimes, atrocities or frauds were ever committed by Gage. While accounts of Gage’s post-accident personality generally describe a man who is foul-mouthed, disrespectful, impaired in decision-making and unable to get along with other adults, it appears that there were discernable limits to the extent of Gage’s acquired disability. Fleischman recounts a description of a post-accident Gage showing a great fondness for children and animals, entertaining his nephews and nieces with stories. While Gage apparently lost his ability to behave as a social being among his age peers, this is certainly not the same thing as generally losing empathy. While Gage did lose the job as a foreman that he had before his accident, he did go on to work in other jobs, probably working as a coach driver at one time, in charge of a team of six horses. I would describe the post-accident Phineas Gage as being an outsider, but not a monster.

– is often co-morbid with anti-social type disorders that are typically diagnosed in young people, such as Oppositional-Defiant Disorder and Conduct Disorder.

Scoring low for Agreeableness in personality psychology questionnaires
– People who do this are described as self-interested, lacking empathy, unhelpful, unfriendly, non-compliant, socially manipulative, suspicious of the motives of others, and more competitive than cooperative. Some researchers have found a correlation between scores for this factor and scores on one “theory of mind” task, but not for another “theory of mind” task (Nettle 2007), suggesting possibly some kind of link between this dimension of personality and autism. Daniel Nettle states that psychopaths are at the most extreme end of low-agreeableness, but he also explains that criminal psychopathy is associated with other personality characteristics in addition to extreme low agreeableness.

Scoring low for Conscientiousness in personality psychology questionnaires
– People who do this are described as laid-back, impulsive, weak-willed, procrastinators, spontaneous and not motivated by goals. Low scores for conscientiousness are associated with ADHD, alcoholism, gambling and Antisocial Personality Disorder.

Alexithymia – A study by researchers at the University of Zurich using functional MRI has been reported in Science News to have results indicating that this condition may be associated with abnormalities regarding empathy, while this was not found in subjects who had Asperger syndrome without Alexithymia.

Normally functioning mirror neurons and hatred of homosexuals – In the book The body has a mind of it’s own it is speculated that mirror neurons, which have recently been associated with empathy, may also give rise to homophobia because they may force straight people to experience feelings that they find repugnant if they witness homosexual activity.

- the opposite of altruism
- lacking consideration of others
- mostly concerned with own pleasure or profit

- the opposite of compassion
- enjoyment of others’ misfortunes in a malicious way

Indifference to or detachment from the feelings of others – the opposite of empathy

- person who avoids human society
- one who hates mankind

Misanthropy – distrust, hatred or dislike of mankind

- morbid enjoyment of inflicting physical or mental pain
- deriving pleasure from inflicting or witnessing cruelty
- sexual gratification gained from causing humiliation or physical pain, a form of perversion

Sadistic personality disorder – This personality disorder appeared in one revised edition of the DSM that came out in 1987, but is not included in the current edition of the DSM.

High Machs – see below.

– a tendency to manipulate and deceive others for personal gain. A term used by some psychologists, and a test has been created to measure this trait. People who score high on this test are called “High Machs”. These people could be described as cold and calculating. They score low for the personality dimension of agreeableness and high for conscientiousness. They could be described as being somewhat like psychopaths, but much more mindful of consequences. Machiavelli was a political philosopher and diplomat from the Italian Renaissance.

Machiavellian intelligence
– a form of political or social intelligence that can involve the gainful use of behaviours such as lying, deception, rule-breaking and reneging on promises. Some academics consider Machiavellian intelligence and “theory of mind” to be the same thing, implying that autistic people are deficient in Machiavellian intelligence.

Lacking socially responsive body language - Some autistic people have body language that does not fit in with what is going on in the social environment, and may have body language that does not reflect their emotional state. People displaying the “negative symptoms” of schizophrenia may have the appearance of “blunted affect”, which can also be deceptive, as the level of emotionality can be normal or heightened in schizophrenia. Unfortunately many people judge others by appearances, and assume that a lack of emotional expression reflects an emotionless psychology or a lack of emotional involvement.

Autistic spectrum conditions/Autistic spectrum disorders (ASD) – Autism, Asperger syndrome and other conditions in the autistic spectrum are characterized by a number of core characteristics:
- an ability to focus attention very deeply and for sustained periods, a deep satisfaction in studying and working on one narrowly-defined subject or project in depth and for long periods of time
- a tendency to focus on the details or parts of a situation or thing rather than interacting with or thinking about the thing or situation as a whole or as an enclosed system
- difficulty with communication, including language and non-verbal communication
- difficulty with or lack of interest in imaginative play or pastimes
- difficulty with or indifference to social interaction, "lack of empathy"
- a need for stability in physical surroundings and timetable of activities, unexpected changes to plans or changes imposed by others may cause distress or anger and may disrupt existing systems of self-organization
- stimming
- sensory hypersensitivity, physical clumsiness and spatial thinking talents or deficits are some characteristics that are often but not always found in autistic people

There is a common belief that autistic people are unable to understand the concept of lying or are unskilled at lying. A lack of “mind-reading” ability in autistic people is believed to be the explanation. Anxiety and anxiety-related conditions such as OCD are often found to be co-occurring with autistic conditions.

Many theories have been put forward to explain autism. One recent theory is that autism is caused by some kind of deficiency in mirror neuron function. But according to the authors of a recent review of research on mirror neurons “…there is surprisingly little evidence to support the claim that a dysfunction in mirror neurons is the neural mechanism underlying ASD” and “Several studies report multiple anatomical differences between neurotypical and ASD individuals that include differences in cell morphology, cortical thickness, overall brain size and sub-cortical volumetric measurements mostly in brain areas not related to the ‘human mirror system’” (Dinstein et al 2008). The scientific consensus is that autism is highly genetically determined. Some researchers believe autism may be a catch-all diagnosis applied to a number of different unknown conditions that are caused by various genetic and/or environmental factors.

Narcissism/Narcissistic personality disorder -Correlated with Factors 1a and 1b of the Psychopathy Checklist-Revised, it may be more common in males.

Histrionic personality disorder
- Correlated with Factors 1a and 1b of the Psychopathy Checklist-Revised. More commonly identified in women than in men, and some have argued that this is a reflection of gender bias regarding which behaviours are considered acceptable in males and females.

Being a Loner – In her book Party of one: the loners’ manifesto Anneli Rufus described and refuted the common irrational prejudices against loners.

Not making eye contact – In his bestselling autobiography Look me in the eye John Robison did a smart job of describing and refuting the common incorrect belief that avoidance of eye contact is a sign that a person is hiding something or lying, or is a psychopath.

Maleness - The majority of prisoners and personnel in the armed forces are male. Boys are thought to have a greater preference for competitive and aggressive play activities than girls. This is taken by many as proof that males, as a group, essentially lack empathy. Males in general have stronger bodies than women, due to the effects of male hormones post-puberty. In most societies there is an expectation that males will take on the role of “breadwinner”, even in the cases of males who lack the intellectual, physical or social resources to take on this role effectively. Crime, sport and military service have traditionally been careers open to males who have limited work skills or limited academic achievement.

Australians – In the past it was a commonly held view that (white) Australians, as a race, are inferior or villainous due to the high representation of convicts as the founders of white Australian society. Winston Churchill was believed to have despised Australians. While racism, sexism and a fascination with criminals are features of Australian public life, Australia is in general a socially progressive nation in which human rights are recognized and sometimes even defended.

Social minorities – Xenophobia and prejudice against social minorities or anyone who is conspicuously different are human behaviours that are widespread in all societies.


Anckarsäter, H., Stahlberg, O., Larson, T., Hakansson, C., Jutblad, S., Niklasson, L., Nydén, A., Wentz, E., Westergren, S., Cloninger, C. R., Gillberg, C., and Rastam, M. (2006) The Impact of ADHD and Autism Spectrum Disorders on Temperament, Character, and Personality Development. American Journal of Psychiatry. 163:1239-1244, July 2006.

Banissey, Michael J. & Ward, Jamie (2007) Mirror-touch synaesthesia is linked with empathy. Nature Neuroscience. 17th June 2007. vol.10, p.815-816.

Baron-Cohen, Simon (2003) The essential difference. Penguin Books, 2003.

Blair, James, Sellars, C, Strickland, I, Clark, F, Williams, A, Smith, M, & Jones, L. (1996) Theory of mind in the psychopath. Journal of Forensic Psychiatry and Psychology. Volume 7, Issue 1, May 1996 , pages 15 – 25.

Blakeslee, Sandra & Blakeslee, Matthew (2007) The body has a mind of its own: how body maps in your brain help you do (almost) everything better. Random house, 2007.

Brockman, John (editor) What are you optimistic about? Simon & Schuster, 2007.

Brunstein, Ada (2008) You’re so vain. New Scientist. March 22nd 2008, number 2648, pages 30-33.
Online title: Being self-centred is the key to empathy

Chandler K E, Moffett, M, Clayton-Smith, J, Baker, G A (2003) Neuropsychological assessment of a group of UK patients with Cohen syndrome. Neuropediatrics. February 2003. 34 (1) p. 7-13.

Cheng, C. Lin, H. Liu, Y. Hsu, K. Lim, D. Hung, J. & Decety, Jean. (2007) Expertise Modulates the Perception of Pain in Others. Current Biology. October 9th 2007, Volume 17, Issue 19, p. 1708 - 1713.

Dinstein, I, Thomas, C, Behrmann, M, & Heeger, D (2008) A mirror up to nature. Current Biology. Vol 18, R13-R18, 8th January 2008.

Doctors 'switch off' feelings of empathy
New Scientist. issue 2624, 6th October 2007, page 22.

Dolan, M & Fullam, R. (2004) Theory of mind and mentalizing ability in antisocial personality disorders with and without psychopathy. Psychological Medicine. 2004 Aug;34(6):1093-102.;jsessionid=LcPQTnjn9n6QdQKHjVynj6d4TvqSyd19Fll9ZXTST9Ny31c6JL3n!2016747336!181195628!8091!-1

Ekman, Paul (2003) Emotions revealed: understanding faces and feelings. Weidenfeld & Nicholson, 2003.

Fleischman, John (2002) Phineas Gage : a gruesome but true story about brain science. Houghton Mifflin, 2002.

Gosline, Anna (2008) When kids go bad. New Scientist. April 12th 2008, number 2651 pages 39-41.
Online title and date: Nipping teen crime in the bud. 10 April 2008.

Grandin, Temple (1995) Thinking in pictures: and other reports from my life with autism. 1st edition. Doubleday. 1995.

Grayling, A. C. (2008) Our mirror on morality. New Scientist. May 3rd 2008, Number 2654, page 50.
Online title: Commentary: Our mirror on morality.

Howlin, Patricia (2001) Autistic features in Cohen syndrome: a preliminary report. Developmental Medicine & Child Neurology. 2001, 43: 692–696.

Jackson, Rebecca L. (2001) Assessment of Psychopathy in incarcerated females. (thesis, University of North Texas).

Nettle, Daniel (2007) Personality: what makes you the way you are. Oxford University Press, 2007.

Richell, R A, Mitchell, D G, Newman, C, Leonard, A, Baron-
Cohen, S, Blair, R J. (2003) Theory of mind and psychopathy: can psychopathic individuals read the 'language of the eyes'? Neuropsychologia. 2003;41(5):523-6.

Robison, John Elder (2007) Look me in the eye: my life with Asperger's. Crown, September 2007.

Rogers, J, Viding, E, Blair, R J, Frith, U, & Happe, F. (2006) Autism spectrum disorder and psychopathy: shared cognitive underpinnings or double hit? Psychological Medicine. 2006 Dec;36(12):1789-98. Epub 2006 Oct 3.;jsessionid=LcCSbW2yTFfv04qXQWLTLtbJ9vKGDnJ88GdYQRQQT3h0tfdhG1QT!2016747336!181195628!8091!-1

Rufus, Anneli (2003) Party of one: the loners' manifesto. Marlowe & Company, 2003.

Sacks, Oliver (2007) Musicophilia: tales of music and the brain. Picador, 2007.

Saey, Tina Hesman (2008) Asperger’s syndrome may not lead to a lack of empathy. Science News. April 24th 2008.

Soderstrom, Henrik, Rastam, Maria and Gillberg, Christopher (2002) Temperament and Character in Adults with Asperger Syndrome. Autism. Vol. 6, No. 3, 287-297 (2002).

Wikipedia contributors (accessed 2008) Hare Psychopathy Checklist. Wikipedia, The Free Encyclopedia. Wikimedia Foundation, Inc.

Wikipedia contributors (accessed 2008) Phineas Gage. Wikipedia, The Free Encyclopedia. Wikimedia Foundation, Inc.

Wikipedia contributors (accessed 2008) Psychopathy. Wikipedia, The Free Encyclopedia. Wikimedia Foundation, Inc.

Copyright Lili Marlene 2008.