In ‘Rethinking Disease’, Powell and Scarffe1 propose what in effect is a modification of Jerome Wakefield’s2 3 harmful dysfunction analysis (HDA) of medical (including mental) disorder. The HDA maintains that ‘disorder’ (or ‘disease’ in Powell and Scarffe’s terminology) is a hybrid factual and value concept requiring that a biological dysfunction, understood as a failure of some feature to perform a naturally selected function, causes harm to the individual as evaluated by social values. Powell and Scarffe accept both the HDA’s evolutionary (...) biological function component and its incorporation of a value component. Their proposed ‘new twist’ is to revise the value component: ‘Our proposed definition of disease is as follows: a biomedical state is a disease only if it implicates a biological dysfunction that is, or would be, properly disvalued’. So, they propose that a disorder is a ‘properly disvalued dysfunction’ rather than a ‘harmful dysfunction’, an approach they term ‘thickly normative’ in contrast to the thin normative approach of the HDA. There has been a surge of interest recently in better understanding the ‘harm’ component of the HDA. Powell and Scarffe’s analysis is a helpful contribution to this discussion. We focus here exclusively on their proposal regarding the analysis of the concept of disorder and ignore many important related issues that the authors address, ranging from prioritising resource allocation between disorders and non-disorders to whether the concept of disorder should be replaced by a generic welfarist concept. The resolution of these additional issues depends on first understanding ‘disorder’. The authors’ proposed changes to the HDA also deserve evaluation because the HDA, which has been endorsed by leading nosologists,4 plays an influential role in nosological debate across categories of disorder ranging, for example, from sexual paraphilias5 to psychopathy.6 A basic problem is that Powell and Scarffe misinterpret …. (shrink)

One of the philosophical discussions stimulated by the recent scientific study of psychopathy concerns the mental illness status of this construct. This paper contributes to this debate by recommending a way of approaching the problem at issue. By relying on and integrating the seminal work of the philosopher of psychiatry Bill Fulford, I argue that a mental illness is a harmful unified construct that involves failures of ordinary doing. Central to the present proposal is the idea that the notion of (...) failure of ordinary doing, besides the first personal experience of the patient, has to be spelled out also by referring to a normative account of idealised conditions of agency. This account would have to state in particular the conditions which are required for moral responsibility. I maintain that psychopathy is a unified enough construct that involves some harms. The question whether the condition involves also a failure of ordinary doing, as this notion is understood in this paper, is not investigated here. (shrink)

The harm usually associated with psychopathy requires therapeutically, legally, and ethically satisfactory solutions. Scholars from different fields have, thus, examined whether empirical evidence shows that individuals with psychopathic traits satisfy concepts, such as responsibility, mental disorder, or disability, that have specific legal or ethical implications. The present paper considers the less discussed issue of whether psychopathy is a disability. As it has been shown for the cases of the responsibility and mental disorder status of psychopathic individuals, we argue that it (...) is undecided whether psychopathy is a disability. Nonetheless, based on insights from disability studies and legislations, we propose that interventions to directly modify the propensities of individuals with psychopathic tendencies should be balanced with modifications of the social and physical environments to accommodate their peculiarities. We also suggest how this social approach in some practical contexts that involve non-offender populations might be effective in addressing some of the negative effects of psychopathy. (shrink)

The recurring claim that the construct of psychopathy is value laden often is not qualified in enough detail. The chapters in this part of the volume, instead, investigate in depth the role and significance of values in different aspects of the construct of psychopathy. Following these chapters, but also by offering a background to them, we show how certain values are involved in the characterisation of psychopathy, inform societal needs satisfied by this construct, and have a central role in determining (...) whether psychopathy is a mental disorder. Moreover, we relate this description to our criticism of the view that the entrenchment of the notion of psychopathy with values in principle renders it irreconcilable with sound psychiatric theory and practice. However, we also recognize that the value-ladenness of psychopathy leaves open other important challenges. Meeting them needs addressing interdisciplinary interrelated issues that have empirical, normative, and theoretical dimensions. (shrink)

Editorial introduction to the special issue of the European Journal of Analytic Philosophy.

In a recent study, we found a negative association between psychopathy and violence against genetic relatives. We interpreted this result as a form of nepotism and argued that it failed to support the hypothesis that psychopathy is a mental disorder, suggesting instead that it supports the hypothesis that psychopathy is an evolved life history strategy. This interpretation and subsequent arguments have been challenged in a number of ways. Here, we identify several misunderstandings regarding the harmful dysfunction definition of mental disorder (...) as it applies to psychopathy and regarding the meaning of nepotism. Furthermore, we examine the evidence provided by our critics that psychopathy is associated with other disorders, and we offer a comment on their alternative model of psychopathy. We conclude that there remains little evidence that psychopathy is the product of dysfunctional mechanisms. (shrink)

Recently, attempts have been made to determine the evolutionary status of psychopathy. However, there is still a gap in empirical literature regarding the connection between psychopathy and fitness. In the present study, we explored the relations between the four-factor model of psychopathy and reproductive success as a fitness indicator in a sample of male convicts (N = 181). Direct relations were analyzed, together with the interaction effects between psychopathy and family risk factors (presence of criminality, substance abuse, and maltreatment in (...) participants’ families). Basic regression models showed that the facet of interpersonal style is positively related to fitness, while other psychopathic characteristics had a negative connection with the criterion measure. Additionally, we found three significant interactions, which further clarified the relation between psychopathy and reproductive success. One of the interactions showed that affective traits can facilitate fertility in unfavorable environmental conditions. Results support a hypothesis of a possible adaptive function of psychopathy, broaden the concept of “successful psychopathy,” and confirm a view of psychopathy as a heterogeneous and complex construct, consisting of facets with distinct content. (shrink)

The problems psychopathic individuals impose on society and in their interpersonal relationships can be held in stark contrast to reports of their appeal and sexual success in some of those relationships. In the current paper, we seek to contextualize this enigma by focusing on the interpersonal dynamics of psychopathic individuals in romantic encounters. We first formulate a plausible evolutionary function, the sexual exploitation hypothesis, that proposes psychopathy exhibits “special design” features for subverting female mate choice, facilitating the induction of favorable (...) impressions and desire in prospective intimate relationships. We then test the hypothesis in two studies with university samples. Study 1 had young men assessed on psychopathy, social intelligence, and sociosexuality engage in a filmed dating interaction. Study 2 had young women view a subsample of the videos, rate them on desirability, and leave voice messages. Results show psychopathy was related to sociosexuality, specific factors of social intelligence, and generating higher desirability ratings from women after controlling for men’s physical attractiveness. Analyses involving comparisons of two men showed women’s ratings increased in favor of the more psychopathic man. Women’s voice pitch also changed, but only in response to different facets of psychopathy. The results provide preliminary support for the sexual exploitation hypothesis and suggest that more dynamic assessment of putative desirability in psychopathy may be required to capture its plausible special design features in prospective dating encounters. (shrink)

Three studies examined Jones’(Perspectives onPsychological Science, 9, 445-451,2014) suggestion that psy-chopathic individuals use mimicry to avoid detection. In study1, student, community, and offender participants posed fearfulfacial expressions while looking at a prototypical fear face.Expressions were coded for facial movements associated withfear and were rated on genuineness by a separate sample ofundergraduates. Across samples, psychopathic traits were as-sociated with increased use of typical action units for fearfulfacial expressions and with genuineness ratings. In study 2,undergraduates completed the Psychopathic PersonalityInventory and told a (...) story about a time when they did some-thing that theyshouldhave felt remorseful for but did not.Factor 1 traits were found to positively relate to genuinenessscores given by a separate sample of undergraduates. Finally,in study 3, four videos of false remorse stories told by violentoffenders were rated by a sample of undergraduates. Thetwo high factor 1 videos received significantly highergenuineness ratings, supporting the relationship betweenfactor 1 and affective mimicry. Overall, findings suggestthat the psychopathic traits (specifically, factor 1) may beassociated with the ability to accurately mimic emotionalexpression (fear and remorse) leading others to perceiveemotional genuineness. (shrink)