Traumatic Experiences in Childhood and Psychopathy

4/12/2015
Traumaticexperiencesinchildhoodandpsychopathy:astudyonasampleofviolentoffendersfromItaly
EurJPsychotraumatol.20134:10.3402/ejpt.v4i0.21471.
PMCID:PMC3871837
Publishedonline2013Dec20.doi:10.3402/ejpt.v4i0.21471
Traumaticexperiencesinchildhoodandpsychopathy:astudyonasampleofviolent
offendersfromItaly
GiuseppeCraparo, 1AdrianoSchimmenti, 1andVincenzoCaretti2,*
1
FacultyofHumanandSocialSciences,UniversityofEnnaKore,Enna,Italy
2
DepartmentofPsychology,UniversityofPalermo,Palermo,Italy
*
Correspondenceto:VincenzoCaretti,DepartmentofPsychology,VialedelleScienze,Ed.15,90100Palermo,Italy,Tel:(+39)063219337,Email:
vincenzocaretti@gmail.com
Received2013May17Revised2013Jul26Accepted2013Aug25.
Copyright2013GiuseppeCraparoetal.
ThisisanopenaccessarticledistributedunderthetermsoftheCreativeCommonsAttributionLicense,whichpermitsunrestricteduse,distribution,and
reproductioninanymedium,providedtheoriginalworkisproperlycited.
ThisarticlehasbeencitedbyotherarticlesinPMC.
Abstract
Goto:
Background
Thelinkbetweenearlytraumaticexperiencesofabuse/neglectandcriminalbehaviourhasbeenwidely
demonstrated.Lessisknown,however,abouttherelationshipbetweentheseexperiencesandthedevelopmentof
psychopathicpersonality.
Objective
ThisstudyinvestigatedchildhoodrelationaltraumainagroupofviolentoffendersfromItaly.Wehypothesiseda
higherlevelofearlyrelationaltraumaassociatedwithhigherscoresonpsychopathy.
Method
Twentytwooffendersconvictedforviolentcrimesaged2260(M=38,SD=11)participatedinthisstudy.
ParticipantswereselectedbytheItalianjusticesystemforanexperimentalresearchprogrammeaimingatthe
evaluationofpsychopathicpersonalitytraitsamongviolentoffenders.Withinthegroup,14participants(64%)had
committedmurder,4(18%)hadcommittedrape,and4(18%)wereconvictedchildsexoffenders.TheTraumatic
ExperienceChecklistwasusedtoassesschildhoodrelationaltraumatheHarePsychopathyChecklistRevised
(PCLR)wasusedtoassesspsychopathy.
Results
Therewasahighprevalenceofchildhoodexperiencesofneglectandabuseamongtheoffenders.Higherlevelsof
childhoodrelationaltraumawerefoundamongparticipantswhoobtainedhighscoresonthePCLR.Therewas
alsoasignificantnegativeassociationbetweenageoffirstrelationaltraumaandpsychopathyscores.
Conclusions
Findingsofthisstudysuggestthatanearlyexposuretorelationaltraumainchildhoodcanplayarelevantroleinthe
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3871837/
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developmentofmoreseverepsychopathictraits.
Keywords:Psychopathy,childabuseandneglect,violentoffenders,highriskgroups
Psychopathyisacomplexpersonalitydisorder,characterisingindividualswithemotionaldeficitswholackaregard
forsocialnorms,empathy,andremorse(Hare,1991,1993).Intheearlyyears,Cleckley(1976)describedthe
inabilitytoparticipatein,orunderstand,theemotionalaspectsofhumanityasoneofthefundamentalfactorsin
psychopathy:
Letussaythat,despitehisotherwiseperfectfunctioning,themajoremotionalaccompanimentsareabsentor
soattenuatedastocountforlittle.Ifwegranttheexistenceofafarreachingandpersistentblocking,
absence,deficit,ordissociationofthissort,wehaveallthatisneeded,atthepresentlevelofourinquiry,to
accountforthepsychopath.(p.371).
RobertHareshedlightontheaffectiveandinterpersonalrelatedissueslinkedtopsychopathy.Hisapproach
operationalisedinthegoldenstandardHarePsychopathyChecklistRevised(PCLRHare,2003)contributed
totheunderstandingoftheoriginsandmaintenanceofthedisorderleadingtotheimportantdistinctionbetween
psychopathyandantisocialpersonalitydisorder(Rutherford,Cacciola,&Alterman,1999).ThePCLRenabledthe
distinctionofpsychopathyfromantisocialpersonalitydisorderthroughspecifictraits,suchasemotional
detachment,grandiosesenseofselfworth,manipulativeness,lackofempathy,superficialcharm,shallowaffect,
parasiticlifestyle,irresponsibility,impulsivity,andsocialdeviance(Cooke&Michie,2001).
ThecharacteristicsofpsychopathyidentifiedbythePCLRcontributedtotheunderstandingofhighrecidivism
ratesinpsychopathicsamples.Intheirstudyof93releasedprisoners,Serinandcolleagues(1990)demonstrated
thattheseverityofpsychopathywascorrelatedwithrecidivism.Hartandcolleagues(1988)showedthatoutof231
individualsonparole,only38%withadiagnosisofpsychopathyandonly54%withamildlevelofpsychopathy
werenotreconvictedayearafter.ThisfindingwascorroboratedbyHareandcolleagues(2000)whohighlighted
inasampleof728offendersthat81.8%ofpsychopathswerefoundguiltyforanothercrimewithin2yearsafter
release.
Karpman(1941),Lykken(1995),andPorter(1996)putforwardtheideaofpsychopathyasaresultof
dysfunctionalinterpersonalexchangesandadverseenvironmentalfactors,includingchildabuseandneglect.Thisis
mirroredinmorerecenttheoreticalandclinicalresearchonattachmenttheory(Bowlby,1969,1973,1980)
suggestingarelationshipbetweenchildabuse/neglectandpsychopathy(Caretti&Craparo,2010).However,
researchinthisfieldisstillscant,andtherearefewstudiesdemonstratingthatpsychopathymaybelinkedtoa
disruptivedevelopmentalhistory,includingexperiencesofearlytrauma(Lang,Klinteberg,&Alm,2002Marshall
&Cooke,1999).
Thus,thecausalroleofearlytraumaticexposureinpredisposinganindividualtocriminalbehaviourhasbeenwell
demonstrated(Ardino,2011Ardino,2012Caretti,Ciulla&Schimmenti,2011Craparo,Faraci,Rotondo,&Gori,
inpressMaxfield&Widom,1996Widom,1989),whereasthelinkbetweenearlyadversechildhoodexperiences
andpsychopathyremainscontroversial(DiLalla&Gottesman,1991).
Someliteraturesuggestsaspecificlinkbetweenabuseandpsychopathicfeatures.Morespecifically,someauthors
havehypothesisedthatabuseresultsinadiminishedcapacitytorespondwithempathy.Forexample,indiscussing
thepossiblemechanismsbywhichpsychopathymediatedtheabuseviolenceassociationintheirsample,Weiler
andWidom(1996)suggestedthatasaresultofearlyabuse,achildmightbecomedesensitisedtofuturepainful
oranxietyprovokingexperiencesandthatthisdesensitisationmightmakehimorherlessemotionallyand
physiologicallyresponsivetotheneedsofothers,tobecallousandlackempathy,andtolackremorseorguilt(p.
264)similarly,Porter(1996)indicatedthatthecapacityforempatheticrespondingisturnedoffwithrepeated
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disillusionmentofthechildthroughphysicalorsexualabuseorothermistreatmentthechild'semotionbeing
dissociatedfromorunconnectedwithcognitionandbehaviourovertime(p.183).Porter'stheorisingimpliesthat
traumaticeventscantriggeradissociationofaffectivecapacities.
Theaimofthisstudywastoexploretherelationshipbetweenanearlytraumaticexposureandalaterdevelopment
ofpsychopathy.Indetail,thestudyaimstoinvestigatetheprevalenceofearlytraumaticexperiencesinagroupof
violentconvictedoffendersandtheassociationbetweenearlytraumaticexposureandseverityofpsychopathyas
measuredbythePCLR.Itwashypothesisedthatindividualswithanexperienceofearlytraumawouldhave
scoredhigherinpsychopathylevelsasmeasuredbythePCLR.
Method
Goto:
Participants
Participantsofthisstudyincluded22convictedmaleoffendersagedbetween22and60[meanage(M):38.05
SD=10.76],alldiagnosedwithantisocialpersonalitydisorder.Amongthem,14hadcommittedmurder(64%)4
hadcommittedrape(18%)and4(18%)wereconvictedchildsexoffenders.Theywereselectedfromawider
samplerecruitedforacomprehensiveresearchprogrammecommissionedbytheItalianMinistryofJusticeaimedat
theevaluationofpsychopathicpersonalitytraitswithinthecriminaljusticesystem.
Measures
TraumaticExperienceChecklist TraumaticexperienceswereassessedwiththeTraumaticExperienceChecklist
(TECNijenhuis,VanderHart,&Kruger,2002),aselfreportedmeasureaddressing29typesofpotentially
traumaticevents.TECisareliableandvalidselfreportedmeasurethatcanbeusedinbothclinicalpracticeand
research.Differentscorescanbecalculatedincludingacumulativescore,andscoresforemotionalneglect,
emotionalabuse,physicalabuse,andsexualabuse.TheTEChasdemonstratedgoodconvergentvalidity,being
associatedwithallegedreportsandofficialrecordsoftraumaticexperiences.Inthissample,goodreliabilityhas
beenobtainedforgroupsofitemsrelatedtodifferenttypesofabuse/neglectwithaKR20reliabilityindexof0.65
orevenmoreforgroupsofonlythreeitems.
PsychopathytraitswereassessedwiththePCLR(Hare,2003),a20item
measurescoredonthebasisofaninterviewandonfileinformation.Eachitemisscoredas0(notpresent),1
(possiblypresent),or2(definitelypresent),resultingintotalPCLRscoresthatrangefrom0to40.ThePCLRhas
demonstratedgoodinternalconsistency,testretest,andinterraterreliabilityacrossdiversepopulations(e.g.
Alterman,Cacciola,&Rutherford,1993Hareetal.,1990Vitale,Smith,Brinkley,&Newman,2002).The
validationoftheItalianversionofthePCLR(Carettietal.2011)showedsimilarpsychometricproperties,witha
goodinternalconsistency(allscaleshadaCronbach's>0.85),goodinterraterreliability[allintraclasscoefficent
correlation(ICC)above0.90]andgoodconvergentvaliditywithothermeasuresofpersonalityandpsychopathy.In
thissample,Cronbach'swas0.93forthefullscale,withoffactorsandfacetsrangingfrom0.85to0.93.Two
independentratersscoredthePCLR,andtheICCforthefullscaleresultedas0.94.
HarePsychopathyChecklistRevised
Procedure
Allparticipantswereintroducedtotheaimofthestudyandwerebriefedtoensureresearchersthattheyhad
understoodallthestepsinvolvedinthisresearch.Itwasexplainedtothemthatdataweregoingtoberecorded
accordingtoastrictproceduretoguaranteetheconfidentialityofinformation.Datawerekeptanonymousbythe
substitutionoftheparticipantsnameswithacode.Researchersbriefedparticipantsthattheyhadtherightto
withdrawfromthestudyatanytimeandtorequesttodeletetheirresponsesfromthedatabase.Allparticipantshad
tosignaninformedconsentpriortoundertakingthestudy.
ThestudywasethicallyclearedbytheItalianMinistryofJusticeandbyanethicscommitteewithintheprison.The
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measureswereadministeredindividuallyinthepresenceofoneoftheresearchersinaquietroomwhereprisoners
usuallyreceivefamilyvisits.Forsafetyreasons,apoliceofficerwasavailableclosetotheroom.
Statisticalanalyses
Descriptivestatisticswerecomputedforallvariablesinvestigatedinthestudy.Independentsamplesttestand
Pearson'sChisquaretestwereusedtocompareparticipantswithhighandlowscoresonthePCLR.Thestatistical
packageSPSS19.0forWindowswasusedforalltheanalyses(SPSS,Chicago,IL,USA).
Results
WefirstcheckedforasymmetryandkurtosisinPCLRscoresPCLRscoreswerenormallydistributedinthe
sample.ThePCLRmeanscorewas19.49(SD=7.71)medianwas20.
ResearchwithPCLRusuallyshowedthreedistinctgroups,withparticipantsscoringbetween0and19considered
tohavelowpsychopathy,participantswithscoresrangingbetween20and29consideredashavingmedium
psychopathy,andparticipantsobtainingscoresof30ormoreconsideredasseverepsychopathshowever,inour
sampleonlyoneparticipantobtainedascoreof30onthePCLR.Thus,duetothereducedsamplesize,we
loweredthePCLRcutoffscoreto25,afterplottingthePCLRscoresandsplittingthedistributionofPCLR
scoresatthenearestpointtothe50thpercentileofPCLRscoresbetween20and30:weconsideredscoresof25or
moretothePCLRasindicatinghighriskforpsychopathy(HRP).Eightparticipants(36.4%)scored25ormore.
Thishighriskgroupwasmadeupoffiveconvictedmurderers(35.7%,withinthemurdererssubgroup),onerapist
(25%),andtwopaedophiles(50%).
All22participantsreportedhavinghadatleastonetraumaticexperienceintheirownlife.Amongthem,17
participants(77.3%)reportedearlytraumaticexperiences(emotionalneglectand/orphysical,sexual,emotional
abuse).Inmoredetail,4(18.2%)reportedsexualabuse,11(50%)reportedphysicalabuse,9(40.9%)reported
emotionalabuse,and15(68.2%)reportedemotionalneglect(seeTable1).Twelveoftheparticipants(55.5%)
experiencedatleasttwoformsofabuse.
Table1
Descriptivestatistics
Therewassomeevidencethattheriskforpsychopathyincreaseswhentraumaoccursearlyinlife.Resultsshowed
thatpeopleintheHRPsubgrouptendedtohaveexperiencedarelationaltraumaticeventearlieroninlifecompared
totherestofparticipants(meanage:5.6,SD=2.85vs.11.5,SD=8.86t(20)=2.18,p=0.05Fig.1).Dataalso
showedthatsevenoutofeightparticipants(87.5%)intheHRPgroupexperiencedarelationaltraumabeforethe
ageof10,whichistheageinwhichchildreninItalyterminatetheirprimaryeducation.TheChisquaretestshowed
thatpeopleintheHRPgroupweremorelikelytoexperiencetraumaticeventsbeforethisage,inrespectwithother
participants[2(1)=4.20,p=0.040Fig.2].Theseweremostlyrelatedtoabuseandneglectinfamilyenvironments
(6outof7).
Figure1
Boxplotrepresentingtheageinwhichparticipantsexperiencedtheirfirst
traumaticexperience.
Figure2
Childhoodtraumaamongparticipants.
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Althoughsuchfindingsdonotimplyadirectcauseeffectbetweenexperiencesofearlyrelationaltraumaand
psychopathy,resultssuggestarelationshipbetweenrelationaltraumainchildhoodandthedevelopmentof
psychopathictraitsourstudyindicatesthisisanimportantarea(therelationshipbetweenearlyrelationaltrauma
andpsychopathy)tobefurtherexploredinfuturestudies.
Discussion
Psychopathyrepresentsacomplexconstructandisthesubjectofamajorclinicaldebate.Theoryandempirical
researchmaintainthatpsychopathymaybelinkedtoahistoryoftrauma.
Amongstudiesreferringtotheheterogeneityofpsychopathy,Porter(1996)followingKarpman's(1941)
distinctionhasproposedthatprimarypsychopathymainlyreflectsacongenitalaffectivedeficitwhereas
secondarypsychopathyreflectsadetachmentofemotionsresultingfromnegativechildhoodexperiencesand
acquiredaffectivedisturbances.Also,Blackburn(2009Blackburn,Logan,Donnelly,&Renwick,2008)has
definedatypologyinwhichtwosubtypesofpsychopaths(secondarypsychopathsandinhibitedpsychopaths)were
moreassociatedwithhighanxietyandwithdrawal.Thesesubtypeshavebeenshowntobeassociatedwitha
historyoftrauma.Therefore,analysingtherelationshipbetweentraumaticstresssymptomsandthevariousfacetsof
psychopathyisofparticularrelevanceintermsofclinicalassessmentandtreatment.
Thestudyexploredthislinkbyinvestigatingtheroleofchildhoodexperiencesofabuseandneglectinindividuals
whopresentedcriminalbehaviours.UnlikeastudypublishedbyPham(2012),inwhichpsychopathsreporteda
lowernumberoftraumaticevents,ourresearchhasshownahigherprevalenceoftraumaticeventsinmoresevere
violentoffenders.
Themainfindingofthisstudywasthatconvictedmaleoffenderswithhighlevelsofpsychopathictraitsweremore
likelytohaveexperiencedabuseandneglectduringchildhood,andtheywereevenmorelikelytohave
experiencedrelationaltraumaatanearlyage.
Indeed,comparingourresultstothosereportedbyNijenhuisandcolleagues(2002)onthesubsampleof57male
psychiatricoutpatientswhoparticipatedintheoriginalvalidationoftheTEC,theconvictedoffendersanalysedin
thisstudyreportedmorechildhoodexperiencesofemotionalneglect(z=2.7,p=0.008)andsexualabuse(z=2.2,
p=0.027)also,ahigherprevalenceofphysicalabuseandemotionalabusewasobservedinouroffendersample,
butgenderdifferencesonthesevariableswerenotreportedontheTECvalidationarticle,thusacomparison
betweenthetwosamplesisnotpossibleinthiscase.However,whenconsideringotherrobustandwellvalidated
measuresofchildneglectandabuse,suchastheChildhoodExperienceofCareandAbuse(Bifulco,Brown,&
Harris,1994),itwasobservedthatthesampledescribedinthisstudyreportedaveryhigherprevalenceof
emotionalneglect,emotionalabuse,physicalabuse,andsexualabuse(allp<0.001)withrespecttothenormal
samplewhoparticipatedintheItalianCECAvalidationstudy(Giannoneetal.2011).
Furthermore,almosteverysubjectinourHRPgrouphadexperiencedatraumabeforetheageof10,athreshold
selectedforitsconsistencywiththeItalianeducationalsystem.Itistobeunderlinedthatthisresultdoesnotmean
thatchildabuseandneglectleadtopsychopathyhowever,itmeansthatitisveryunlikelythatsubjectswhoshow
severepsychopathictraitsdidnotexperienceabuseandneglectinchildhood.Thiscanpositivelyinformtheir
assessmentandtreatment.
Thisstudyhassomelimitationstobeaddressed:first,thesmallsamplesizepreventedtheuseofmorecomplex
statisticalanalyses,thusnotallowingforageneralisationofresults.Second,eventhoughtheTECisavalidand
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reliablemeasure,theuseofaselfreportedmeasureforassessingchildhoodtraumamayproducebiasedresults,
althoughtherewereallegedreportsofadversechildhoodexperiencesformostofthesample.Hence,thereisaneed
forfurtherresearchontheheterogeneityofpsychopathsinrelationtoahistoryoftrauma.
Despitetheselimitations,datasuggestthatexposuretoearlyrelationaltraumacanplayarelevantroleintheonset
ofviolentoffendingbehaviour,andthiscanberelatedtoanearlyageofexposuretoabuseandneglectandthe
subsequentdevelopmentofpsychopathictraits.
Itisbeyondthescopeofthisstudytoadvanceadeterministicexplanationofthelinkbetweentraumaand
psychopathyhowever,itmaybeassumedthattraumaticmemoriesbuiltuponabuse,materialneglect,andlackof
emotionalcarecouldberesponsibleforafragmentedself(Meloy,2001Schimmenti,2012),whichisdysregulated
onapsychobiologicallevelandneedstohavepowerandcontroloverothersthroughmanipulation,deceptionand
evenviolence.
Notes
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Fortheabstractorfulltextinotherlanguages,pleaseseeSupplementaryfilesunderArticleToolsonline
Conflictofinterestandfunding
Goto:
Thereisnoconflictofinterestinthepresentstudyforanyoftheauthors.
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