Saturday, May 12, 2012

Can You Call a 9-Year-Old a Psychopath?


By the time he turned 5, Michael had developed an uncanny ability to switch from full-blown anger to moments of pure rationality or calculated charm — a facility that Anne describes as deeply unsettling. “You never know when you’re going to see a proper emotion,” she said. She recalled one argument, over a homework assignment, when Michael shrieked and wept as she tried to reason with him. “I said: ‘Michael, remember the brainstorming we did yesterday? All you have to do is take your thoughts from that and turn them into sentences, and you’re done!’ He’s still screaming bloody murder, so I say, ‘Michael, I thought we brainstormed so we could avoid all this drama today.’ He stopped dead, in the middle of the screaming, turned to me and said in this flat, adult voice, ‘Well, you didn’t think that through very clearly then, did you?’ ”   (...)

Over the last six years, Michael’s parents have taken him to eight different therapists and received a proliferating number of diagnoses. “We’ve had so many people tell us so many different things,” Anne said. “Oh, it’s A.D.D. — oh, it’s not. It’s depression — or it’s not. You could open the DSM and point to a random thing, and chances are he has elements of it. He’s got characteristics of O.C.D. He’s got characteristics of sensory-integration disorder. Nobody knows what the predominant feature is, in terms of treating him. Which is the frustrating part.”

Then last spring, the psychologist treating Michael referred his parents to Dan Waschbusch, a researcher at Florida International University. Following a battery of evaluations, Anne and Miguel were presented with another possible diagnosis: their son Michael might be a psychopath.

For the past 10 years, Waschbusch has been studying “callous-unemotional” children — those who exhibit a distinctive lack of affect, remorse or empathy — and who are considered at risk of becoming psychopaths as adults. To evaluate Michael, Waschbusch used a combination of psychological exams and teacher- and family-rating scales, including the Inventory of Callous-Unemotional Traits, the Child Psychopathy Scale and a modified version of the Antisocial Process Screening Device — all tools designed to measure the cold, predatory conduct most closely associated with adult psychopathy. (The terms “sociopath” and “psychopath” are essentially identical.) A research assistant interviewed Michael’s parents and teachers about his behavior at home and in school. When all the exams and reports were tabulated, Michael was almost two standard deviations outside the normal range for callous-unemotional behavior, which placed him on the severe end of the spectrum.

Currently, there is no standard test for psychopathy in children, but a growing number of psychologists believe that psychopathy, like autism, is a distinct neurological condition — one that can be identified in children as young as 5. Crucial to this diagnosis are callous-unemotional traits, which most researchers now believe distinguish “fledgling psychopaths” from children with ordinary conduct disorder, who are also impulsive and hard to control and exhibit hostile or violent behavior. According to some studies, roughly one-third of children with severe behavioral problems — like the aggressive disobedience that Michael displays — also test above normal on callous-unemotional traits. (Narcissism and impulsivity, which are part of the adult diagnostic criteria, are difficult to apply to children, who are narcissistic and impulsive by nature.) (...)

The idea that a young child could have psychopathic tendencies remains controversial among psychologists. Laurence Steinberg, a psychologist at Temple University, has argued that psychopathy, like other personality disorders, is almost impossible to diagnose accurately in children, or even in teenagers — both because their brains are still developing and because normal behavior at these ages can be misinterpreted as psychopathic. Others fear that even if such a diagnosis can be made accurately, the social cost of branding a young child a psychopath is simply too high. (The disorder has historically been considered untreatable.) John Edens, a clinical psychologist at Texas A&M University, has cautioned against spending money on research to identify children at risk of psychopathy. “This isn’t like autism, where the child and parents will find support,” Edens observes. “Even if accurate, it’s a ruinous diagnosis. No one is sympathetic to the mother of a psychopath.”

by Jennifer Kahn, NY Times |  Read more:
Photo: Elinor Carucci/Redux