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An Empirical Study of Object Relations and Defensive Operations in Antisocial Personality Disorder
Journal of Personality Assessment
Abstract
This study assessed the object relations, defensive operations, and level of psychopathy and narcissism in a group of antisocial personality disordered offenders. The Rorschach protocols of 33 subjects who met the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R], American Psychiatric Association, 1987) criteria for antisocial personality disorder were analyzed utilizing Kwawer's (1980) criteria for borderline object relations categories (borderline phenomena), the Lerner and Lerner (1980) Defense Scale, and a number of experimental criteria including Cooper and Arnow's (1986) defense criteria. Level of narcissism was assessed utilizing Exner's (1973) Self-Focus Sentence Completion Test. Hare's Psychopathy Checklist was used as an independent variable to determine a subject's level of psychopathy. Those subjects scoring 30 or more on the psychopathy checklist were compared to subjects scoring less than 30. The level of narcissism or proportion of defenses did not differ significantly between the severe psychopaths (greater than or equal to 30) and the moderate psychopaths (less than 30). The severe psychopaths produced a significantly greater number of borderline object relations. I conclude that antisocial individuals tend to be highly egocentric, and that narcissism is one component of psychopathy. Severe psychopaths, as a group, tend to be more borderline in their functioning than those exhibiting moderate levels of psychopathic disturbance. I also conclude that individuals who are incarcerated for felony offenses and also meet the DSM-III-R criteria for antisocial personality disorder exhibit degrees of borderline personality organization.
... Despite the paucity of AGM in ASPD subjects, other aggressive imagery appeared in abundance. Gacono observed multiple categories of imagery (Gacono, 1988(Gacono, , 1990) which led to the development (Gacono, 1988(Gacono, , 1990) and refinement Gacono & Meloy, 1994) of five additional scoring categories: AgC, AgPast, AgPot, AgV, and SM. Gacono and Meloy (1994) were not the first, and hopefully not the last, to study, classify, and attempt to link Rorschach aggressive imagery to real-world behavior (Devos, 1952;Elizur, 1949;Finney, 1955;Holt, 1977;Lindner, 1946;Rose & Bitter, 1980;Sommer & Sommer, 1958;Storment & Finney, 1953). ...
... Despite the paucity of AGM in ASPD subjects, other aggressive imagery appeared in abundance. Gacono observed multiple categories of imagery (Gacono, 1988(Gacono, , 1990) which led to the development (Gacono, 1988(Gacono, , 1990) and refinement Gacono & Meloy, 1994) of five additional scoring categories: AgC, AgPast, AgPot, AgV, and SM. Gacono and Meloy (1994) were not the first, and hopefully not the last, to study, classify, and attempt to link Rorschach aggressive imagery to real-world behavior (Devos, 1952;Elizur, 1949;Finney, 1955;Holt, 1977;Lindner, 1946;Rose & Bitter, 1980;Sommer & Sommer, 1958;Storment & Finney, 1953). ...
... A search of PsycINFO between 1989 (AgScores were introduced in Gacono, 1988) and 2003 using the keywords Rorschach and aggressive, aggression, AgC, AgPot, AgPast, sadomasochism, sado-masochism, Gacono, or Meloy, revealed eight published articles (Gacono, 1990;Baity & Hilsenroth, 1999;Baity & Hilsenroth, 2002;Kamphuis et al., 2000;Mihura & Nathan-Montano, 2001;Mihura et al., 2003) and 12 dissertations (additional dissertations came from other searches) that have included one or more of the Extended AgScores . A similar analysis between 2004 and 2022 produced 15 additional published articles (Domjan, 2018;Benjestorf et al., 2013;Huprich et al., 2004;Joubert & Webster, 2017;Kivisto & Swan, 2013;Kochinski et al., 2008;Liebman et al., 2005;Nørbech et al., 2016;Rosso et al., 2015;Rovinski et al., 2018;Schug, 2021;Smith et al., 2020Smith et al., , 2021bSmith et al., 2019;Weizmann-Henelius et al., 2006) and two dissertations (Dehass, 2014;Kiss, 2017). ...
Determining a patient's aggressivity is a function of assessing multiple factors, including personality vulnerabilities, past behaviors, and potential future circumstances. Evaluating the nature and predominance of aggressive drive, impulse control, affect lability, inhibitory mechanisms, cognitive deficits, and conscious and unconscious attitudes (e.g.
... Fortunately, other Rorschach aggressive imagery occurs that while not meeting the criteria for AG can be reliably coded . Gacono (1988) proposed four Rorschach aggressive scores (Extended Aggression Scores) that he and Heaven observed when assessing antisocial male offenders: 1) Aggressive Content (AgC), 2) Aggressive Potential (AgPot), 3) Aggressive Past (AgPast), and 4) Sado-Masochism (SM) (Gacono, 1988(Gacono, , 1990Gacono & Meloy, 1994;Meloy & Gacono, 1992). AgC was defined by those responses that appeared as "predatory, dangerous, malevolent, injurious, or harmful" (Meloy & Gacono, 1992, p. 105). ...
... AgPot was coded for those responses where an aggressive act was about to occur (Meloy & Gacono, 1992) and the response suggested identification as a predator/victimizer. AgPast captured aggressive acts that had occurred in the past or where the object had been the target of aggression (Gacono, 1988(Gacono, , 1990. These aggressively damaged objects correlated with being a victim and in antisocial individuals provides a marker for their entitlement and a belief that they have the right to then victimize others. ...
... These aggressively damaged objects correlated with being a victim and in antisocial individuals provides a marker for their entitlement and a belief that they have the right to then victimize others. The SM score contains aggressive, morbid, or devalued content accompanied by pleasurable affect expressed by the subject (Gacono, 1988(Gacono, , 1990. Finally, aggressive vulnerability (AgV), a rarely produced response, is scored when the precept contains protective imagery or a fear of being attacked. ...
Psychopathy is an essential construct in forensic mental health. While male psychopathy and aggression has been thoroughly studied, less is known about this relationship with female psychopathy. In this article, the relationship between female psychopathy (Psychopathy Checklist-Revised [PCL-R] total, factor, and facet scores) and the Rorschach Aggression indices (Aggressive Movement [AG], Aggressive Content [AgC], Aggressive Past [AgPast], Aggressive Potential [AgPot], Sadomasochistic Aggression [SM]) were examined. Rorschach Aggression indices between female psychopathic (PCL-R total score ≥ 30; N = 84) and non-psychopathic female offenders (PCL-R total score ≤ 24; N = 39) were also compared. PCL-R total score was significantly correlated (p <.05) with AgC,
AgPast, AgPot, and SM and there were also significant correlations between the Aggression scores and PCL-R Factor/facet scores. The female psychopaths produced more AgC, AgPast, and AgPot responses than the non-psychopathic females. Rorschach aggression indices supported theory and suggested that the violence in psychopathic women stems from their identification with aggression and pervasive feelings of entitlement. Psychopathic women evidenced higher levels of these variables than the non-psychopathic offenders. The results add to the link between aggression and psychopathy as well as a better understanding of aggression in female offenders.
... From the cognitive perspective, automatic thoughts and cognitive distortions promote conscious and nonconscious information processing consistent with underlying schemas. A cursory review of several primitive defenses identified within the dynamic tradition provides a context for understanding interpersonal interactions commonly observed in working with the psychopath (Gacono, 1988(Gacono, , 1990Gacono & Meloy, 1994). ...
... Both cognitive and object relations theories suggest that devaluation is a common process among narcissistic, antisocial, and psychopathic disorders (Gacono, 1988(Gacono, , 1990Gacono, Meloy & Berg, ...
... Psychopaths may also experience powerful attractions and, just as they are prone to express intense hostility directly, they may also be prone to express intense affiliative impulses directly. Because such attractions are not based on empathy or a mature appreciation of another person, these positive affectional links are often likely to be fleeting, tenuous, and based on illusory perceptions of others (Meloy, 1988;Gacono, 1988Gacono, , 1990. Although expressions of intense sexual or affiliative impulses may be somewhat less common during extremely structured interactions (e.g., court-ordered examinations), they may nevertheless exert powerful effects on clinicians who encounter them and may contribute to descriptions of some psychopaths as charming or charismatic. ...
... This is particularly true when considering the vast heterogeneity within the ASPD diagnosis, which has been examined at length elsewhere (e.g. Gacono, 1990;Gacono et al., 2001;Lilienfeld, 1998). ...
... Researchers have argued that psychopathic individuals operate at a borderline level of personality organization (Gacono, 1990;Gacono et al., 1992;Meloy, 1988). The borderline level of personality is defined by the following specific features/characteristics. ...
... Meloy (1988) stated that there was evidence of the borderline functioning hypothesis Cleckley's writings, because the later editions of Cleckley's texts reveal a shift in Cleckley's thinking that is more in with Kernberg's borderline level of functioning. In addition, Gacono (1990) found that male felons who met criteria for severe psychopathy were more borderline in their functioning than those with low or moderate levels of psychopathy, as evidenced by the severe psychopaths producing a greater number of borderline object relations responses. ...
The personality disturbance of psychopathy is one of the most researched and debated conditions in psychopathology and has been considered one of the most important constructs in the criminal justice system. This syndrome has been widely examined in males but remarkably less attention has been given to females, even though contemporary researchers and theorists have suggested that there is a different expression of psychopathy based on gender. The current study utilized the Rorschach Inkblot Method and the Psychopathic Personality Inventory-Revised (PPI-R) to explore the personality characteristics of 77 incarcerated females. Participants were imprisoned for a variety of offenses and were recruited from a medium-security state prison. The level of psychopathy, as determined by the PPI-R, was compared to a select number of Rorschach variables that measure self-perception and interpersonal functioning. In addition, a Rorschach composite score of the variables used in the study was created with the aim of developing a profile for psychopathic females. The association between psychopathy and these variables was investigated using Pearson correlations and hierarchical regression analyses. Results partially confirmed the hypotheses of the study in that certain, but not all, hypothesized Rorschach variables were related to level of psychopathy. In general, results suggested that females do not display disturbance in self-perception and instead demonstrated evidence of psychological mindedness. Most results regarding interpersonal relationships were consistent with prior research findings that psychopathic females are more interpersonally-oriented and seek out attention from others, but also experience dysfunction in their interactions. As a whole, results provided some additional support to the growing notion that psychopathic females have a histrionic/hysteric personality organization, as opposed to the grandiose, narcissistic personality structure of their male counterparts. Explanations for and implications of these results were discussed, and directions for further research were explored.
... b --Male incarcerated rapists Levy (1998) 14 93% 97% 98% --Physically abused children 30 95% 100% 96% --ASPD incarcerated males Mihura & Nathan-Montano (2001) 50 .85 a .76 a .85 a --Undergraduate college students Mihura et al. (2003) tion (Gacono, 1988), there have been eight published articles (Gacono, 1990;Baity & Hilsenroth, 1999;Baity & Hilsenroth, 2002;Kamphuis, Kugeares, & Finn, 2000;Mihura & Nathan-Montano, 2001;Mihura, Nathan-Montano, & Alperin, 2003) and approximately 12 dissertations (several additional dissertations were discovered through additional searches) that have included the Extended Aggression Scores. When interrater agreement was reported, it has been excellent (i.e., > .75 ...
... Studies that investigated SM, however, produced findings consistent with the interpretation of SM as ref lecting a sadistic orientation. Gacono (1988Gacono ( , 1990 first reported frequencies for SM in groups of psychopathic and nonpsychopathic ASPD offenders. In an expanded sample (N = 43), Meloy and Gacono (1992) found that SM differentiated between Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991) identified psychopathic ASPD (PCL-R > 30) and nonpsychopathic ASPD offenders (P-ASPDs = 41%; NP-ASPDs = 14%). ...
... However, the fact that a particular Rorschach response can be censored does not mean that it was censored. For the original Gacono (1988Gacono ( , 1990) ASPD samples and later Meloy (1992, 1994) samples, consistent findings across age groups and discrepancies between interview and Rorschach administration suggest an ego-dystonic relationship to aggressive impulses that stimulates AG production. ...
The Extended Aggression Scores were developed to quantify the aggressive Rorschach imagery produced by violent Antisocial Personality Disordered (ASPD; American Psychiatric Association, 1980) offenders. Despite their histories of real world violence, these subjects produced few Aggressive Movement (AG; Exner, 1993) responses. Why didn’t violent children, adolescents, and adults produce more AG responses? Considering their expression of uncensored pleasurable affect when relating their aggressive acts during their interviews, conscious censoring (Exner, 1993; Meloy, 1988) did not adequately explain the paucity of AG responses among sentenced adults. Why would they describe their violent acts with pride and bravado during an interview and subsequently censor AG on the Rorschach? Conscious censoring among the Conduct Disorder (CD) children and adolescents, who frequently produced sexual content, seemed an equally unlikely explanation (Gacono, 1997).
Earlier Rorschach research (Holt & Havel, 1960; Rapaport, Gill, & Schafer, 1946, 1968; Schafer, 1954) provided clues to understanding the discrepancies between Rorschach production and the interview/historical data. Direct or implicit aggressive content was thought to imply tensions of aggressive impulse (Rapaport et al., 1946\1968). Initial findings (Gacono, 1988, 1990; Heaven, 1988) suggested that the paucity of symbolized aggression, represented by AG movement, might be due, in part, to the ego-syntonic nature of aggression in ASPD and psychopathic subjects. The clinical logic was that AG symbolized tensions of ego-dystonic aggression when produced by violent, antisocial patients. In the absence of binding the aggressive impulse, the violent individual would, instead, act it out, thus vitiating the need to symbolize it. Existing data supported this hypothesis: Exner’;s (1995) character disordered sample produced lower AG frequencies than his adult nonpatients; violent children and adolescents produce lower AG frequencies than child and adolescent nonpatients; and the majority of the forensic subjects with known histories of violence produce less AG than nonpatients and the Gacono and Meloy clinical samples without histories of violence (Gacono, 1997; Gacono & Meloy, 1994).
Despite the paucity of AG responses in ASPD records, other aggression imagery was not absent. Rather, the presence of other potentially scoreable aggressive imagery (see Gacono, 1988, 1990, 1997) allowed for the development (Gacono, 1988) and refinement (Gacono & Meloy, 1994; Meloy & Gacono, 1992) of five additional scoring categories: Aggressive Content (AgC), Aggressive Past (AgPast), Aggressive Potential (AgPot), Aggressive Vulnerability (AgV), and Sado-Masochism (SM).
Since their introduction (Gacono, 1988), the Extended Aggression Scores have received considerable clinical interest and empirical study. As noted in the Rorschach Workshops’ Alumni Newsletter (2000) concerning the work of the Rorschach Research Council, “Another project on which there has been good progress is the special score for Aggressive Content (AgC). Council has reviewed the criteria and guidelines for its applications and has evaluated the literature concerning it .. . A more precise interpretation of AgC responses will probably hinge on findings for other variables .. .” (p. 13). Additionally, the ROR-SCAN Version 6 Rorschach Interpretive Scoring System (Caracena, 2002) now includes AgC, AgPast, AgPot and SM.. What began as an attempt to expand the scoring of Rorschach aggressive imagery in CD and ASPD subjects, has evolved into a larger study of aggression on the Rorschach. In this article we present information concerning the reliability, psychometric properties, and construct validity of the scores and discuss their clinical meanings. We conclude that while AgPotential, AgVulnerability and Sado-masochism need additional research, the current research supports inclusion of the more frequently appearing AgContent and AgPast scores in the Comprehensive System.
... Although aggressive movement was lacking in the present, Gacono (1988) observed other kinds of aggressive imagery in the Rorschach protocols of antisocials. This led to the development (Gacono, 1988(Gacono, , 1990Meloy, 1988) and refinement of additional categories for coding aggression: namely, Aggressive Content (AgC), Aggressive Potential (AgPot), Aggressive Past (AgPast), and Sado-Masochism (SM). Several studies subsequently demonstrated reliability and suggested concurrent validity for these additional aggression scores (Gacono, 1990;Riquelme, Occupati, & Gonzales, 1991;Margolis, 1992;Ephriam, Occupati, Riquelme, & Gonzales, 1993; also see Gacono & Meloy, 1994, Chapter 8). ...
... This led to the development (Gacono, 1988(Gacono, , 1990Meloy, 1988) and refinement of additional categories for coding aggression: namely, Aggressive Content (AgC), Aggressive Potential (AgPot), Aggressive Past (AgPast), and Sado-Masochism (SM). Several studies subsequently demonstrated reliability and suggested concurrent validity for these additional aggression scores (Gacono, 1990;Riquelme, Occupati, & Gonzales, 1991;Margolis, 1992;Ephriam, Occupati, Riquelme, & Gonzales, 1993; also see Gacono & Meloy, 1994, Chapter 8). Margolis (1992) found our aggression scores provided more sensitive information for scoring aggression than that offered by the Comprehensive System: "individuals who have documented histories of aggression will have an increased amount of aggression scores on the Rorschach when a more comprehensive method for scoring is used" (p. ...
... Several studies provided support for other constructs. Psychopathic antisocial personality disordered subjects (P-ASPDs) and nonpsychopathic antisocial personality disordered subjects (NP-ASPDs) were found to be different; the P-ASPDs produced significantly greater proportions of Kwawer's (1980) primitive modes of relating (borderline object relations; Gacono, 1988Gacono, , 1990. Kwawer's (1980) indices for P-ASPDs were produced at a rate similar to outpatient borderline personality disordered (BPD) males but less than that found in outpatient narcissistic personality disordered males (NPD; Gacono, Meloy, & Berg, 1992). ...
Depuis des décennies, les cliniciens se sont intéressés à l’utilisation du Rorschach dans le diagnostic de la psychopathie. Pourtant, c’est seulement depuis une quinzaine d’années que ce type d’investigation est devenue vraiment pertinente à travers des recherches valides et fiables, grâce aux progrès réalisés dans l’évaluation de la psychopathie et la technologie du Rorschach.
En 1984, armés de cette “nouvelle” technologie, nous avons entamé nos recherches sur les personnalités antisociales et psychopathiques. Utilisant le Trouble de la Personnalité Antisociale (TPA) et la Psychopathie comme mesures indépendantes, et les variables Rorschach comme mesures dépendantes, nous avons tenté de comprendre le continuum antisocial d’un point de vue psychodynamique et développemental, tout en tenant compte des aspects psychobiologiques, psychodynamiques et de style cognitif.
Nous avons posé plusieurs questions: le Rorschach peut-il “établir la carte” du fonctionnement de la personnalité et de la structure intrapsychique des individus présentant des Troubles de la Conduite (TC) et des TPA, et est-ce que cette “carte” Rorschach validerait de manière empirique les modèles théoriques tels que la pathologie de l’attachement, l’absence d’anxiété, l’agressivité, et l’aspect grandiose qui sont associés à la psychopathie? Compte tenu des différences parmi les délinquants, le Rorschach saurait-il discriminer entre groupes TC et TPA d’après leurs niveaux de pathologie? Et encore, le Rorschach pouvait-il discriminer entre les TPA et les autres troubles de personnalité de Type B?
Nous avons obtenu un haut degré de concordance entre les données empiriques et la théorie. Nous avons trouvé des déficits de l’attachement (T = 0) chez 88% des troubles de comportement chez les enfants, 86% des adolescents TC, 71% des femmes TCA, 79% des hommes TCA, 91% des hommes psychopathes et 70% des hommes TCA schizophrènes. Les résultats du Y sont congruents avec le passage à l’acte considéré comme une défense contre l’angoisse dans les groupes d’enfants et adolescents TC. Contrairement aux enfants non consultants et aux adultes psychopathes, les enfants TC s’évaluent de manière négative lorsqu’ils se comparent aux autres (EGO < 0,33 = 72%).
Les adolescents TC diffèrent aussi des adolescents dysthymiques et non consultants: ils montrent moins de capacité d’attachement, sont moins anxieux, et manifestent moins d’intérêt pour les autres en tant que des objets entiers et humains réels. Les adolescents TC psychopathes présentent les même déficits. Les psychopathes TCA adultes de sexe masculin montrent moins de capacité d’attachement, éprouve moins d’anxiété et sont plus grandioses que les TCA non psychopathes. Les psychopathes se montrent tout aussi grandiose que les hommes aux Troubles de Personnalité Narcissique non hospitalisés, tout aussi “limites” que les hommes aux Troubles de la Personnalité Limite, cependant qu’ils sont moins anxieux et moins attachés. Les femmes adultes antisociales, bien qu’elles manifestent plus d’affects dysphoriques que les hommes TCA psychopathes, montrent moins de capacité d’attachement et d’affect que les femmes aux Troubles de la Personnalité Limite. L’expression de l’aspect grandiose diffère entre hommes psychopathes, enfants TC et femmes TCA, ce qui suggère des différences dans les niveaux de développement et selon le sexe.
Bien que le Rorschach ne doive pas être utilisé de manière isolée à des fins de diagnostic psychologique, nos premiers résultats montrent tout l’intérêt qu’il présente pour comprendre la psychologie des personnalités antisociales et psychopathiques. Nos travaux sur le Rorschach constituent aussi un modèle pour l’étude d’autres troubles de personnalité.
... The potential association between psychopathy and Rorschach responses has attracted increasing interest during the past 20 years, due to the work of Carl Gacono and J. Reid Meloy, who published a series of empirical articles in the early 1990s (Gacono, 1990;Gacono & Meloy, 1991Gacono, Meloy, & Berg, 1992;Gacono, Meloy, & Heaven, 1990;, culminating in their influential book The Rorschach Assessment of Aggressive and Psychopathic Personalities . These six articles and the book drew on psychopathy data from a sample of male inmates, all of whom were diagnosed with ASPD. ...
... The inmates were incarcerated in California state prisons, a county jail, and a federal correctional facility. The initial research was based on a sample of 33 inmates (Gacono, 1990). However, the sample size increased over the years, so that the findings reported in Gacono and Meloy's 1994 book were based on data obtained from 82 inmates (including data from the original 33 participants). ...
... The methodology of Gacono and Meloy's (e.g., Gacono, 1990;Gacono & Meloy, 1991 articles was straightforward. Inmates were administered the original version or the revised version of the Hare Psychopathy Checklist (PCL, PCL-R; Hare, 1980Hare, , 1991, as well as the Comprehensive System for the Rorschach (CS;Exner, 1986). ...
Gacono and Meloy (2009) have concluded that the Rorschach Inkblot Test is a sensitive instrument with which to discriminate psychopaths from nonpsychopaths. We examined the association of psychopathy with 37 Rorschach variables in a meta-analytic review of 173 validity coefficients derived from 22 studies comprising 780 forensic participants. All studies included the Hare Psychopathy Checklist or one of its versions (Hare, 1980, 1991, 2003) and Exner's (2003) Comprehensive System for the Rorschach. Mean validity coefficients of Rorschach variables in the meta-analysis ranged from -.113 to .239, with a median validity of .070 and a mean validity of .062. Psychopathy displayed a significant and medium-sized association with the number of Aggressive Potential responses (weighted mean validity coefficient = .232) and small but significant associations with the Sum of Texture responses, Cooperative Movement = 0, the number of Personal responses, and the Egocentricity Index (weighted mean validity coefficients = .097 to .159). The remaining 32 Rorschach variables were not significantly related to psychopathy. The present findings contradict the view that the Rorschach is a clinically sensitive instrument for discriminating psychopaths from nonpsychopaths.
... Subsequent researchers have made significant contributions in the identification and measurement o f these and other defenses. Additional defenses which may be selectively drawn upon include: dissociation and its subsidaries, depersonalization and derealization; splitting (prestage and defensive) and its derivatives-projection, projective identification, omnipotence, idealization, and devaluation; and rationalization (Campo & Jubert, 1969;Cooper, 1989;Cooper & Amow, 1984Cooper, Perry, & Amow, 1988aCramer, 1983Cramer, , 1987Cramer, ,1991Cramer, Ford, & Blatt, 1988;Cramer & Gaul, 1988;Gacono, 1988Gacono, ,1990Gacono, ,1992Gacono & Meloy, 1988Grotstein, 1981;Kemberg, 1984Kemberg, ,1986Kemberg, ,1989; H. Lemer & P. Lemer, 1980;Meloy, 1985Meloy, , 1986Meloy, , 1988aMeloy, , 1988bMeloy, , 1989Meloy & Gacono, 1994;Moberly 1983Moberly , 1985Moberly , 1986Ramchandani, 1989; G. Vaillant, 1971;G. Vaillant & Drake, 1985;G. ...
... From a forensic psychoanalyticly oriented object relations perspective, Meloy (1988a), Gacono (1988Gacono ( , 1990, Meloy (1988,1994), Gacono, Meloy, and Heaven (1990), Gacono, Meloy and Berg (1992), and Weber, Meloy and Gacono (1991) evaluated the cognitive-affective complex of psychopathic personalities and suggested that these individuals experience an internal dividedness where feelings of inner emptiness and worthlessness exist simultaneously with highly unrealistic and overvalued self representations. Their self perceptions contain three beliefs: (a) they are totally worthless, a "nothing," all bad; (b) everyone else shares this dim view; and (c) this state of being a nothing will last forever (Gacono et al. 1990, p. 476). ...
... Splitting, and its subsidiary defenses of projective identification, primitive idealization, devaluation and omnipotence, have received particular focus (Amow & Cooper, 1984Cooper & Amow, 1984Cooper & Perry, 1983;Cooper, Perry. & Amow, 1988a;Cooper, Perry, Hoke, & Richman, 1985;Gacono, 1988Gacono, ,1990Gacono, ,1992Goldstein, 1991;Grala, 1980;Grotstein, 1981;Kemberg, 1967Kemberg, ,1976Kohut, 1978;Litchenberg & Slap, 1973: Meloy, 1988a: Moberly, 1983Modell, 1975Modell, ,1984Ogden, 1983;H. Lemer, 1988: P. Lemer, 1988: P. Lemer & H. Lemer, 1980M. ...
Thesis (Ed. D.)--Boston University, 1995. Vita. Includes bibliographical references (p. 283-311). Photocopy. s
... Largely in response to the failure of AG to capture the aggressive imagery produced by antisocial and psychopathic prisoners, and based on the research observations of Gacono (1988) and Heaven (1989), four Rorschach aggressive scores were developed which have been found to be scored reliably (Extended Aggression Scores; Baity et al., 2000;Gacono, 1988Gacono, , 1990Gacono & Meloy, 1994;Meloy & Gacono, 1992;Gacono et al., 2008;Mihura et al., 2003;Smith et al., 2020a): (1) Aggressive Content (AgC), (2) Aggressive Potential (AgPot), (3) Aggressive Past (AgPast), and (4) Sado-Masochism (SM). ...
... The SM response is scored 6 when devalued, aggressive, or morbid content is accompanied by pleasurable effects and correlates with both psychopathy and sexual homicide behavior (Gacono & Meloy, 1994;Huprich et al., 2004). AgPast is coded for any response in which an aggressive act has occurred, or the object has been the target of aggression (Gacono, 1988(Gacono, , 1990). AgPast responses relate to self-damage, masochism, or an early traumatic experience of having been aggressed against (Gacono & Meloy, 1994). ...
Managing the incarcerated population is the primary task within correctional settings. Using psychological assessment to predict institutional behavior, the psychologist has a unique set of skills essential to the management of prisoners. PCL-R, PAI, and Rorschach data were compared with institutional infractions (total, physical, verbal, non-aggressive) among 126 incarcerated women. Multiple binary logistic regression analyses were used which found significant correlations between PCL-R total score, PAI scales (BOR, ANT, VPI), and Rorschach variables (ROD, EGOI, TCI, AgPot, AgPast, SumV, SumC’, MOR) with total, verbal, physical, and nonviolent incident reports. Each of these measures adds incrementally to the assessment and understanding of institutional misbehavior for incarcerated women. Clinical implications of the findings were presented.
... For psychopathic males, the grandiose self-structure is self-regulating. It serves to bolster an omnipotent sense of self while circumventing both internal and external threats to self-image (Gacono, 1990;Kernberg, 1967Kernberg, , 1975Kernberg, , 1976Meloy, 1988). The women lack the men's grandiose self-structure. ...
... We found the findings supported both the characterological issues related to psychopathy (narcissism, hysteria, paranoia; Gacono & Meloy, 1994;Smith et al., 2021) and the presence of a borderline level of personality functioning among psychopathic characters (Gacono, 1990;Gacono & Meloy, 1988, 1994Kernberg, 1967Kernberg, , 1975Kernberg, , 1976Kernberg, , 1984Meloy, 1988). The findings also provided additional support for gender differences within psychopathy that we have discussed here (Cunliffe & Gacono, 2005;Forouzan & Cooke, 2005;Gacono & Meloy, 1994;Pauli et al., 2018;Smith et al., , 2019Smith et al., , 2020aSmith et al., , 2021. ...
Erratum--please note on page 116, the total score of 34 should be 37. Also, the text should read "might receive" instead of receive, accounting for the potential individual items scoring.
... For psychopathic males, the grandiose self-structure is self-regulating. It serves to bolster an omnipotent sense of self while circumventing both internal and external threats to self-image (Gacono, 1990;Kernberg, 1967Kernberg, , 1975Kernberg, , 1976Meloy, 1988). The women lack the men's grandiose self-structure. ...
... We found the findings supported both the characterological issues related to psychopathy (narcissism, hysteria, paranoia; Gacono & Meloy, 1994;Smith et al., 2021) and the presence of a borderline level of personality functioning among psychopathic characters (Gacono, 1990;Gacono & Meloy, 1988, 1994Kernberg, 1967Kernberg, , 1975Kernberg, , 1976Kernberg, , 1984Meloy, 1988). The findings also provided additional support for gender differences within psychopathy that we have discussed here (Cunliffe & Gacono, 2005;Forouzan & Cooke, 2005;Gacono & Meloy, 1994;Pauli et al., 2018;Smith et al., , 2019Smith et al., , 2020aSmith et al., , 2021. ...
Recently in Psychoanalytic Psychology, Gullhaugen et al. (2021) proposed a Dynamic Model of Psychopathy (DMP) to better understand psychopathic traits. Several issues with the authors' methodology, including the use of the Psychopathy Checklist: Screening Version (PCL: SV) as an independent measure and a small sample size (N = 16) relative to their conceptual approach and the number of statistical analyses conducted, limit the conclusions that can be drawn from their data. Additionally, the authors discuss their findings as if the data from this study with all males could apply to women. In this article, we use the methodological issues presented in the Gullhaugen study to discuss problems with the broader psychopathy literature. We also provide a psychodynamic model of psychopathy consistent with theory and empirical data.
... The personality functioning of the psychopathic male is best understood as a form of pathological narcissism (Kernberg, 1967(Kernberg, , 1975(Kernberg, , 1976Gacono & Meloy, 1994, Meloy, 1988, while the psychopathic female displays a form of malignant hysteria 1 (Cale & Lilienfeld, 2002;Cunliffe et al., 2016;Forouzan & Cooke, 2005;Gacono & Meloy, 1994;Kreis & Cooke, 2011;Smith et al., 2014Smith et al., , 2018. The grandiose self-structure is self-regulating for psychopathic males, bolstering an omnipotent sense of self while circumventing both internal and external threats to self-image (Gacono, 1990;Kernberg, 1967Kernberg, , 1975Kernberg, , 1976Meloy, 1988). Psychopathic women lack men's grandiose self-structure and are not immune from experiencing themselves as damaged. ...
... The findings in this study strongly support both the characterological issues related to psychopathy (narcissism, hysteria, paranoia; Gacono & Meloy, 1994;Gacono & Smith, 2021;Smith et al., 2021b) and the presence of a borderline level of personality functioning among psychopathic characters (Gacono, 1990;Gacono & Meloy, 1988, 1994Kernberg, 1967Kernberg, , 1975Kernberg, , 1976Kernberg, , 1984Meloy, 1988). ...
The psychopathic personality is organized at a borderline level of personality. Additionally, while male psychopaths are considered to manifest pathological narcissism, female psychopaths are best understood in terms of malignant hysteria. Using Kernberg's three components of borderline personality functioning (identity diffusion, reliance on primitive defenses, and transient lapses in reality testing),
... Through a series of studies (Gacono, 1990;Gacono, Meloy, & Heaven, 1990;Gacono & Meloy, 1991, 1994, the Rorschach has proven to be a sensitive instrument to discriminate between psychopathic and nonpsychopathic subjects. Psychodynamic differences include more pathological narcissism and sadism (Gacono, Meloy & Heaven, 1990), less anxiety, and less capacity for attachment (Gacono & Meloy, 1991). ...
... Psychodynamic differences include more pathological narcissism and sadism (Gacono, Meloy & Heaven, 1990), less anxiety, and less capacity for attachment (Gacono & Meloy, 1991). Personality organization (Kernberg, 1984) is predominately at the borderline level (Gacono, 1990). ...
In the present chapter, we discuss the role of the Hare Psychopathy Checklist-Revised (PCL-R) and Rorschach in forensic psychological assessment. We stress the importance of using a multi-method over a mono-method assessment approach and advocate for the incremental validity of psychological testing over interviews alone as an essential aspect of assessment practice. The ability to integrate the nomothetic strengths of the PCL-R with the idiographic potential of the Rorschach allows for conclusions to be refined into nuanced person-context interactions most useful in areas such as risk assessment, forming diagnostic impressions, and determining treatability. A case example involving an incarcerated antisocial male with a history of exclusively affective violence is presented.
... Another important issue present in the Wood et al. (2010) meta-analysis concerns the high degree of inaccurate statements, careless mistakes, and misinformation. The authors wrote that Gacono and his colleagues used the original Psychopathy Checklist (PCL; Hare, 1980) in some studies and the PCL-R in others and incorrectly cited Gacono (1990), and Meloy (1991, 1992) when they asserted that the authors had used the "original version or the revised version of the Hare Psychopathy Checklist" (Wood et al., 2010, p. 337). This statement is incorrect, since the early Gacono studies used a pre-publication edition of the PCL-R and not the PCL. ...
... Although Lindner (1943;1946;1950) was working prior to the advent of the PCL-R (Hare, 1991;, he developed a psychopathic diagnostic checklist of 31 symptoms ("symptom-complex" reflective of psychopathy; Lindner, 1943Lindner, , 1946 based upon the literature available at the time. As they did with the work of Gacono, Meloy, and others (Gacono, 1990;, 2009Cunliffe & Gacono, 2005, Wood et al. (2010) mischaracterized the work of Lindner as an attempt to use the Rorschach as a measure of the independent variable, psychopathy. Lindner (1943) actually wrote that "The 'sign' approach, perhaps a technique of value with other disorders, is valueless for psychopathy" (pg. ...
Wood et al. (2010) published a meta-analysis in which the authors challenged the utility of the Rorschach Inkblot Test in delineating key differences between psychopathic and non-psychopathic individuals identified by the Psychopathy Checklist-Revised (PCL-R; Hare, 1991/2003). In this article, Gacono et al.’s (2001) five conceptual and four methodological criteria for the evaluation and interpretation of psychopathy/Rorschach literature were employed to provide a detailed review of the approach and procedure used by Wood et al. (2010). We identify and discuss a number of conceptual and methodological problems with the meta-analysis including confusion of the related but distinct terms of diagnosis and assessment, selection of studies, categorical versus dimensional interpretations of data, characterization of PCL-R and Rorschach findings, and meta-analytic methodology. Finally, recommendations for the essential components of well designed and implemented PCL-R and Rorschach studies are provided.
... Evaluators should also be familiar with a growing database of forensic Rorschach samples (Bannatyne, Gacono, & Greene, 1999;Cunliffe & Gacono, 2008;Gacono, Meloy, & Bridges, 2000Singer, Hoppe, Lee, Olesen, & Walters, 2008), keeping in mind how these samples differ from Exner's nonpatient and clinical norms (Exner & Erdberg, 2005). A series of studies with antisocial and psychopathic patients (Gacono, 1988(Gacono, , 1990Gacono & Meloy, 1991, 1992, 1994Gacono, Meloy, & Heaven, 1990;Meloy, Gacono, & Kenney, 1994;Young et al., 2000) have validated the use of the Rorschach as a nomothetically sensitive instrument in discriminating between psychopathic ASPD and nonpsychopathic ASPD subjects (also see Smith, Gacono, &Kaufman, 1995, andRussell, 2000, for an extension of these findings to conduct-disordered adolescents), and supported the assertion that these individuals ...
... Compared to nonpsychopathic ASPDs, psychopathic ASPDs exhibit more pathological narcissism Young et al., 2000), less anxiety, less capacity for attachment (Gacono & Meloy, 1991), and some indications of increased sadism . Their Rorschach protocols indicate a virtual absence of idealization and higher-level neurotic defenses, coupled with a reliance on primitive defenses such as devaluation, denial, projective identification, omnipotence, and splitting (Gacono, 1990;Gacono, Meloy, & Berg, 1992). Object relations are also preoedipal, with psychopathic ASPDs evidencing significantly more Rorschach measures of narcissistic mirroring, boundary disturbance, and violent symbiosis when compared to nonpsychopathic ASPD Rorschachs . ...
The assessment of antisocial and psychopathic personalities presents special challenges for the forensic evaluator. This chapter emphasizes use of the Hare Psychopathy Checklist-Revised (PCL-R), Rorschach, and Minnesota Multiphasic Personality Inventory (MMPI) for a comprehensive evaluation of these patients. These measures lend incremental validity to understanding these difficult patients, especially when combined with testing of intelligence and cognitive functioning. Integrating data from multiple domains is essential to answering the psycholegal and forensic treatment questions surrounding the antisocial and psychopathic patient. The forensically trained clinical psychologist is best suited to assess psychopathy, a task that historically has been overlooked or avoided in traditional mental health settings.
... Specifically, some research has linked various types of Rorschach aggressive content responses with aggressive or violent behaviors, internal tension, and aggressive thought content (Baity & Hilsenroth, 1999;Mihura & Nathan-Montano, 2001;Mihura, Nathan-Montano, & Alperin, 2003). In contrast, other studies support the finding of lower aggression Rorschach scores in violent populations (Gacono, 1990;Gacono & Meloy, l992;Heaven, 1989, Kaser-Boyd, 1993, though the relationship has been rather weak (Hess, 2001). To date, there are no straightforward and robust studies demonstrating an association between these aggressive response contents and subsequent aggressive acts. ...
... The results of the present study therefore do not align with theoretical expectations that, if the quantities of aggressive responses on the Rorschach are associated with violent behavior, then violent males will produce more aggression responses than nonviolent males on the Rorschach. However, the results of the present study are also in contrast to previous research that found violent males produce fewer aggression responses than less-or nonviolent participants (Gacono, 1988(Gacono, , 1990Gacono & Meloy, l992;Heaven, 1989, Kaser-Boyd, 1993. A possible explanation for these inconsistent findings is that our small sample lacks power to detect small or medium between-groups differences. ...
This Rorschach study explored the suppression of aggression content when violent offenders and nonoffenders are asked to present themselves as not posing a threat of dangerousness in a court role-playing context. Aggressive content and complexity in this suppressive role-play context was compared to a neutral control condition. A total of 41 participants, approximately half violent offenders and half nonoffenders took the Rorschach under both conditions. Results indicate that both groups suppressed aggression content on the Rorschach without altering response complexity. This large effect size for testing condition may partly explain the inconsistencies across previous studies. It is possible that violent offenders have typically been tested in highly suppressive conditions whereas nonoffender or normative groups may have been tested in relatively low suppression conditions. If so, aggression score differences may be a reflection of the testing condition, not group differences. Both instructional sets produced similar levels of complexity, so that individuals do not simplify responses when they screen out aggressive attributions. Violent offenders did not differ from nonviolent offenders in terms of aggression content, but did produce more simplistic records. In addition, this study also undertook a semantic, textual analysis and found that individuals in the suppressive condition tended to eliminate many response elaborations, particularly those with negative of threatening connotations.
... Additionally, the influence of object relations on the formation of narcissistic and borderline personality traits has been an intriguing topic of investigation. Research has examined the impact of early attachment experiences on the development of narcissistic and borderline personality traits in both children and adults (Weise & Tuber, 2004;Gacono, 1990). ...
The aim of this study was to elucidate the psychological dynamics of marital relationships, which are among the most significant structures of society. The purpose of research was to examine the mediating roles of borderline and narcissistic personality traits in the relationship between object relations and marital adjustment, relationship satisfaction, and sexual satisfaction. The study group consisted of adult individuals aged 18 and older. Of the total 809 participants, 407 (50.3%) are female and 402 (49.7%) are male, all of whom are married. 320 participants are in the 18-30 age range, 318 are in the 31-45 age range, and 171 are 45 years old and above. Marriage Adjustment Scale, Relationship Satisfaction Scale (RSS), Golombok-Rust Sexual Satisfaction Scale (GRSS) Female-Male Form, Bell Object Relations and Reality Testing Inventory (BORRTI), Borderline Personality Inventory, and Narcissistic Personality Inventory were used as data collection instruments in the study. The data were analyzed using SPSS 27 program. Pearson Correlation Test and Process Macro 4.2 analysis methods were used. According to the research findings, a negative relationship was found between object relations and relationship satisfaction, marital adjustment, and sexual satisfaction. A positive relationship was identified between object relations and borderline and narcissistic personality traits. Furthermore, negative relationships were found between borderline and narcissistic personality traits and marital adjustment, sexual satisfaction, and relationship satisfaction. Finally, the mediation analyses conducted within the framework of the main purpose of the research, determined that object relations significantly predicted relationship satisfaction, sexual satisfaction, and marital adjustment, borderline and narcissistic personality traits partially mediated this relationship. Thus, the proposed model was supported.
... For example, individuals tend to be self-focused when they adopt antisocial strategies (Gilbert & Basran, 2019). Meanwhile, antisocial individuals also tend to be self-focused (Gacono, 1990). Antisocial attitudes usually drive people to focus on the self to a higher degree (Spengler et al., 2010). ...
Based on the need-threat model, we hypothesized that “warmth rejection” threatens belongingness more than “competence rejection,” whereas competence rejection threatens sense of efficacy more than warmth rejection. To restore threatened belongingness, warmth (vs. competence) rejection was predicted to result in higher affiliative responses. In contrast, to restore the threatened sense of efficacy, competence (vs. warmth) rejection would lead to higher self-focus. Across six studies, we found that the participants exhibited more affiliative responses after being rejected due to low warmth than due to low competence (Studies 1–6), whereas they became more self-focused after being rejected due to low competence than due to low warmth (Studies 3–6). Furthermore, the effect of warmth rejection on affiliation was mediated by perceived threat to belongingness (Studies 4–6), whereas the effect of competence rejection on self-focus was mediated by perceived threat to control and belongingness (Studies 4–6). The studies provided converging evidence that the effects of social rejection depend on the perception of why rejection occurs.
... Largely in response to the failure of AG to capture the aggressive imagery produced by antisocial and psychopathic offenders and based on the research observations of Gacono (1988) and Heaven (1989), four additional Rorschach aggressive scores were developed. They have been found to be scored reliably (Extended Aggression Scores; Baity et al., 2000;Gacono, 1988Gacono, , 1990Gacono & Meloy, 1994;Smith et al., 2020a;. These scores are 1) Aggressive Content (AgC), 2) Aggressive Potential (AgPot), 3) Aggressive Past (AgPast), and 4) Sado-Masochism (SM). ...
Murder is antithetical to any traditional conceptualization of femininity or the nurturer role. Women do, however, commit murder, as well as a plethora of other heinous offenses. Understanding the personality of women who murder is of both clinical and scientific interest. In this study, we present the PCL-R, PAI, and Rorschach data of 24 incarcerated women who have murdered. We explored the interpersonal, affective, cognitive, and self-concept vulnerabilities that contributed to this behavior within the female offender model. The results were placed within societal contexts (i.e., media) as well as providing recommendations for assessment and treatment of this population.
... This relation between neuroticism and criminality can seem contradictory since criminal behaviour is often associated with antisocial personality disorder and psychopathy that seemingly lack neurotic characteristics such as fear and anxiety (Bulten, Nijman, & Van Der Staak, 2009;Mitchell & Tafrate, 2012). However, research on affective states shows that such anxiety-free states rather can be a result of specific coping strategies (Brody & Rosenfeld, 2002;Gacono, 1990;Gacono, Meloy, & Berg, 1992). Lack of anxiety is assumed to be dependent on the immediate acting out of inner sensations in combination with denying own weakness (i.e. ...
The cognitive intervention programme ‘New Challenges’ targeting adult men with a criminal lifestyle was evaluated in a pilot study. The participants were divided into a cognitive treatment group (n = 32) and a control group (n = 11). In the control group, six participants had no treatment and five participated in 12-step treatment. The participants were measured pre and post using the Psychological Inventory of Criminal Thinking Styles (PICTS), the abridged version of sense of coherence (SOC), Positive and Negative Affect Scale, and Bergström’s quality of programme delivery (QPD). The results of the treatment group showed that criminal thinking patterns dropped significantly from high values to close to normal level. SOC and positive affect increased significantly in the treatment group. Both SOC and positive affect showed positive correlation with QPD. Regarding the possible influence of the 12-step treatment, there was no difference in the control group between participants receiving 12-step treatment and those not receiving treatment. The main conclusion is that the cognitive treatment programme ‘New Challenges’ can contribute to reduced criminal thinking and increased SOC and positive affect, which may prove to be important precursors of reduced criminality.
... Psychological defense mechanisms such as primitive idealization, projective identification, splitting, omnipotence and devaluation of others were also reported (Helfgott 2004), possibly indicating attempts to keep a distance (devaluation, omnipotence, splitting) and to achieve intimacy (idealization, projective identification), as well as difficulties with separating what is "mine" from what is another's (projective identification, splitting). This is in accordance with the borderline personality organization described by Kernberg (1986), which has been supported in several studies of psychopathic offenders (Gacono 1990;Meloy 2002;Meloy and Gacono 1998). Psychopathy was finally positively correlated with dominance and talkativeness (Manson et al. 2014 7 ;Rimé et al. 1978), possibly indicating a strive towards control or agency (Wiggins and Trapnell 1996). ...
Experts have long warned against psychotherapy with psychopathic offenders out of a fear that they will beguile therapists into believing they have been rehabilitated, only to commit new offenses upon release. Yet the question is not whether to communicate with psychopathic offenders, but rather how to do so in a way which can facilitate real change. In this article, we ask: What can we learn about psychopathic offenders by studying their communication? We review the literature and describe how psychopathy is manifested in communication, how psychopathy can be understood based on this communication, and how therapists may communicate with psychopaths to create change and avoid being fooled. We recommend that therapists do not withdraw from psychopathic offenders but rather study their communication more carefully.
... This relation between neuroticism and criminality can seem contradictory since criminal behaviour is often associated with antisocial personality disorder and psychopathy that seemingly lack neurotic characteristics such as fear and anxiety (Bulten, Nijman, & Van Der Staak, 2009;Mitchell & Tafrate, 2012). However, research on affective states shows that such anxiety-free states rather can be a result of specific coping strategies (Brody & Rosenfeld, 2002;Gacono, 1990;Gacono, Meloy, & Berg, 1992). Lack of anxiety is assumed to be dependent on the immediate acting out of inner sensations in combination with denying own weakness (i.e. ...
The treatment of offenders has changed from focusing on risk management to also emphasizing salutogenic experiences as a protective factor. The programme ‘A New Direction’ involves cognitive intervention combining the above-mentioned approaches to treat young criminals and young persons at risk of developing a criminal lifestyle. In evaluating this programme, 61 participants from the Swedish social services and youth care facilities were divided into two treatment groups and two control groups. All participants were subjected to pre- and post-measurements using two questionnaires: the Psychological Inventory of Criminal Thinking Styles (PICTS) and the Sense of Coherence (SOC-13). The two treatment groups followed the programme during one week and 9–30 weeks, respectively, with the control groups measured at approximately the corresponding time intervals. The results show reduced PICTS from high to low levels and increased SOC only for the multi-week treatment group. Although the recidivism analysis revealed a greater reduction of convicted offences in the multi-week treatment group compared with the control group, the finding is tentative because of small sample sizes. To conclude, cognitive intervention shows promise for reducing criminal thinking patterns and increasing sense of coherence, which may have beneficial effects on the behaviour of young offenders.
... and primitive defense (Gacono, 1990;Meloy, 2002) in severely psychopathic offenders. The author of the present thesis was not able to identify any other studies with the explicit intent of reviewing or searching for observations of suffering, vulnerability or pain in psychopathic offenders. ...
The concept of psychopathy is unlike most other mental disorders in the lack of observations of vulnerability and pain in those affected. Rather, the psychopath’s callous and self-centered ways are known to evoke suffering in others. Measures are developed to identify these characteristics in a reliable way. However, increased accuracy has not led to better treatment. As a consequence, this study aimed to investigate whether the current understanding of psychopathy is changing, or should be changed, and if central changes in the concept and measurement of psychopathy require a modification of the way we handle the problem today? Hallmarks of the current paradigm were challenged through 3 research questions:
1. Are psychopathy and suffering mutually exclusive constructs?
2. Is the psychopath more than the persistent callous, grandiose and ruthless characteristics that we usually see?
3. Is the psychopath deprived of a capacity to change?
The first article of the thesis reviews previously published (1980-2009) cases of offenders with severely psychopathic traits (n=11). Vulnerability and pain in psychopaths were consistent with empirical evidence and concepts associated with object relations theory, Reid (1986) and Martens’ (2002) clinical experience of suffering in psychopaths, and comorbid symptom- and personality pathology, as indicated by the authors’ assessment and the selfreport of individual offenders.
Articles two and three draw from an in-depth investigation of Norwegian high-security and detention prisoners with possible and strong indications of psychopathy (n=16) and controls (n=35). Results indicate important nuances in psychopathic offenders’ affective and interpersonal functioning in terms of relational uncertainties and pain, and a greater emotional range than what is previously reported. Results further indicate a link between empirical findings and clinical theory describing structural affective, relational and defensive nuances in pathologically extreme self-states, which should be considered in future treatment of psychopathy.
Results are incongruent with Cleckley’s (1941; 1988) recognized description, and the wellestablished primary-secondary psychopathy distinction (Karpman, 1941), and in agreement with the dimensional model of self- and interpersonal functioning advised in APA’s (2010) proposed revision of personality diagnoses. Future work should focus on the vulnerability and suffering, nuances and adjacent treatment of psychopathy. Such an approach would represent a paradigm shift in this field.
... An aspect of the psychopathic patient's personality is then perceived in the clinician and viewed as a threat that must be diminished. Higher-level or neurotic defenses, such as idealization, intellectualization, isolation, sublimation, and repression, appear to be virtually absent in the patient with ASPD and severe psychopathy (Gacono 1990). If neurotic defenses are present in the patient with ASPD, they suggest amenability to treatment. ...
... An aspect of the psychopathic patient's personality is then perceived in the clinician and viewed as a threat that must be diminished. Higher-level or neurotic defenses, such as idealization, intellectualization, isolation, sublimation, and repression, appear to be virtually absent in the patient with ASPD and severe psychopathy (Gacono 1990). If neurotic defenses are present in the patient with ASPD, they suggest amenability to treatment. ...
... It appears that no attempt has yet been made to directly compare the Comprehensive System quantitative interpretation and psychoanalytic interpretation, even in the United States where these two approaches are the most fully developed (Lerner, 1991;Erdberg, 1993). It is interesting to reinterpret the results obtained by the Comprehensive System psychoanalytically, as Gacono (1990), Berg (1990), and others have done, but it may also be meaningful to compare the process of interpretation itself. At a Comprehensive System workshop held in Japan in September, 1993, several cases of Japanese subjects were interpreted in detail. ...
L’étude porte sur une comparaison entre deux méthodes d’interprétation d’un protocole de Rorschach: une interprétation selon le Système Intégré, et une analyse psychanalytique des réponses proposée par l’auteur.
Les styles défensifs et adaptatifs majeurs du sujet se sont reflétés de manière évidente dans les deux approches, et l’interprétation des traits de personnalité était congruente. Les hypothèses concernant les désirs, en se fondant sur les représentation (contenus) parlantes du protocole, étaient aussi congruentes.
Quelques points de désaccord sont cependant apparus: faut-il considérer les troubles qui ne sont pas suffisamment graves pour augmenter significativement les indices spéciaux du Système Intégré comme relevant d’un fonctionnement névrotique ou comme des manifestations des traits de personnalité de base; doit-on expliquer les attitudes contradictoires comme étant l’une une formation réactionnelle par rapport à l’autre; et comment interpréter le Type de Résonance Intime ambiéqual? On indique comment ces différences dérivent des différences dans les théories de la personnalité, dans la façon d’appliquer les données, et dans l’hypothèse interprétative concernant le Rorschach.
La façon dont l’auteur emploie les opérations du Système Intégré dans son interprétation présente des avantages et des inconvénients, et il souligne qu’il existe une réelle continuité entre l’administration, le système de cotation, et l’interprétation propre à chaque approche. En outre, l’auteur met en avant le fait que, quelle que soit l’approche utilisée, l’aspect le plus difficile dans la pratique du Rorschach, celui qui fait tout particulièrement appel à son habileté, c’est l’élaboration d’une description de la personnalité à partir des informations que fournit chaque interprétation spécifique.
... Rorschach protocols were scored for the following scales and categories: Affective Inferences Scoring System -Revised (Boyer, Dithrich, Harned, Stone, 8c Walt, 1988); Anxiety and Hostility Scales (Elizur, 1949); Supply: Oral-receptive Orientation (Schafer, 1954); Aggressive Past and Aggressive Potential (Gacono, 1990); Primitive Interpersonal Modes (Kwawer, 1980); Malevolence -Omnipotent Control (derived from Urist, 1977). Information follows on these scales and categories, as well as the reasons that led us to choose them for this study. ...
Taking into account both normative and psychosocial objectives, the authors have been interested in examining whether psychological aspects of gender, phases in the adult life cycle, and realities of socioeconomic status are differentially reflected in the themes created on the Rorschach test. Rorschach contents have been interpreted in relation to numerous aspects of personality functioning, including interests, preoccupations, concerns, underlying conflicts, and self and object representations. The noncritical use of interpretation from the symbolic point of view has been specially troublesome. In their study the authors will interpret some contents as direct expressions of the individual or group experience (Mayman, 1977). Doing so, the authors think we shall get closer to what Weiner called a representative interpretation (Lerner, 1991). (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... For example, Gacono, Gacono, and Evans (2008) found that antisocial reference samples provided fewer AG responses than normative samples. Recognizing that AG responses were not necessarily associated with overt acts of aggression, various authors have suggested that AG represents ego-dystonic aggressive tension as opposed to aggressive behavioral tendencies per se (Gacono, 1990; Mihura & Nathan-Montano, 2001). Expanding on the CS's singular aggression score to more fully capture the aggressive imagery of violent antisocial offenders, Meloy and Gacono (1992; see also Gacono & Meloy, 1994) proposed the addition of four Rorschach measures of aggression, including Aggressive Content (AgC), Aggressive Potential (AgPot), Aggressive Past (AgPast), and Sado-masochism (SM). ...
This study sought to complement the archival research designs that have established the empirical foundations of Rorschach aggression scores, including Exner's (200316.
Exner , J. E. 2003. The Rorschach: A comprehensive system: Vol. 1. Basic foundations and principles of interpretation (4th ed.), New York, NY: Wiley. View all references) Aggressive Movement (AG) score and Meloy and Gacono's (199234.
Meloy , J. R. and
Gacono , C. B. 1992. The aggression response and the Rorschach. Journal of Clinical Psychology, 48: 104–114. [CrossRef], [PubMed], [Web of Science ®], [CSA]View all references) Aggressive Content (AgC), Aggressive Past (AgPast), and Aggressive Potential (AgPot) variables. Utilizing a highly controlled laboratory-based aggression paradigm and self-report measures of violence history in a sample of 35 undergraduate males with an average age of 19.38 (SD = 2.11), this study found that only AgC was positively associated with in vivo aggression (r = .40, p = .02). None of the Rorschach measures of aggression were significantly associated with self-reported violence history, although there were several trends approaching significance. Theoretical and methodological implications are discussed.
... It appears that this lack of emotional control could lead to violent outbursts (McCord, 1988) and possibly, as Porter (1996) speculates, the development of psychopathy, a concept that has been used as a predictor of violence (Gacano et al., 1990;Gacono, 1990). ...
The present study sought to explore the relationship between trauma and violence, as measured by the Traumatic Events Questionnaire and the Conflict Tactics Scale. Using Multiple Regression Analysis, several types of traumatic experiences were studied as predictors to violent behavior in 55 graduate students. Results suggest that trauma as a set, as well as being the victim of a violent crime, are significantly related to future violent behavior. However, no other individual predictor variable, including being the victim of childhood physical abuse, significantly predicted future violence. Implications of the findings are discussed.
... Based on case studies, Meloy and Gacono (1993) implied that there is a ''borderline psychopath.'' Although their research has not focused on specific variants of psychopathy, these authors have found that psychopathy , BPD, and narcissistic personality disorder (NPD) are characterized by borderline personality defense mechanisms and immature object relations (Gacono, 1990; Gacono, Meloy, & Berg, 1992). Although their measure of psychopathy was based on the Rorschach (see Wood, Lilienfeld, Garb, & Nezworski, 2000), 11 similar results have been obtained in other research. ...
Although psychopathy typically has been construed as a relatively uniform construct, seminal theories and contemporary research suggest that it may be heterogeneous. In this article, the most promising literature is distilled to distinguish among potential variants of antisocial personality disorder (APD) that can be derived from, and informed by, modern conceptions of psychopathy. This analysis suggests that there are primary and secondary variants of psychopathy, which may be distinguished based on the extent to which they are heritable and are characterized by affective deficits, impulsivity, trait anxiety, and characteristics of borderline and narcissistic personality disorders (NPD). These variants also may differ in their patterns of violence and responsivity to treatment. If variants of psychopathy can be identified reliably and supported empirically, psychopathy may be transformed from a global label to a set of more specific constructs that improve our ability to understand, manage, and treat individuals who have largely been regarded as dangerous and untreatable.
... These dysfunctional early relations seem to replicate themselves in the psychopath's current instable and intense relationships, and their primitive urges and defense. These results are in accordance with empirical studies demonstrating primitive object relations (Gacono, Meloy, & Berg, 1992 ); regulatory deficits; primitive affect (Meloy & Gacono, 1998); and primitive defense (Gacono, 1990; Meloy, 2002 ) in severely psychopathic offenders. The state of continued interpersonal stress described in these cases is a nondiagnostic indication of vulnerability and pain. ...
The character Hannibal "the Cannibal" Lecter, best known from the motion picture The Silence of the Lambs from 1991, has become a cultural icon and model for later portrayals of seriously disturbed offenders. He displays key characteristics of the Psychopathy Checklist-Revised, such as arrogance, manipulation, callousness, and lack of remorse. From a clinical point of view, one of the most fascinating aspects with Lecter is his display of a variety of capacities alternating between cold-blooded predatory behavior, affection toward FBI special agent Starling, and mourning of the loss of his sister Mischa. Many authors have described the ruthless characteristics of the psychopath. Through the lens of object relations theory, this review systematically examines case descriptions of severely psychopathic offenders published between 1980 and March 2009. In contrast to the prevalent opinion, case material ( n = 11) demonstrates that severely psychopathic offenders do suffer from psychological pain.
... Idealization is more sensitive to adaptive rather than defensive operations. The IMP response (Gacono, 1988Gacono, , 1990 Gacono et al., 1990), which Ilolt (1977) discussed as one aspect of explicit symbolism in which both perceptual organization and underlying thought process were suggested, demonstrates the differences in defensive style among groups. Most frequent in the BPDs, this variable may not be specific to the hysterical cognition of the primary psychopath as we earlier thought (Gacono et al., 1990). ...
Rorschach data were used to psychometrically "map" the internal psychological operations of three Cluster B personality disorders, listed in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev. [DSM-III-R]; American Psychiatric Association, 1987), all of which may be organized at a borderline level. Psychopathic antisocial subjects (P-APDs) and narcissistic subjects (NPDs) were highly narcissistic. NPD subjects, however, produced more indices of anxiety and attachment capacity and fewer scores related to borderline object relations and damaged identity. P-APDs and borderline subjects (BPDs) produced similar mean numbers of borderline object relations; however, the BPDs were more anxious, produced more unsublimated aggressive and libidinal drive material, and evidenced greater potential for attachment. BPDs were also less narcissistic than both P-APDs and NPDs. Nonpsychopathic antisocial subjects (NP-APDs) were less borderline than P-APDs and BPDs, less narcissistic in terms of a stable grandiose self-structure than NPD and P-APDs, produced less evidence of attachment capacity than NPDs and BPDs but more than P-APDs, and were similar to BPDs in their proneness to anxiety. The outpatient NPDs and BPDs produced more idealization responses than the incarcerated antisocial personality disorder (APD) groups. We conclude that the behavioral descriptions offered for these three Cluster B personality disorders, when used in conjunction with information such as level of personality organization (Kernberg, 1984), level of psychopathy (Hare, 1980, 1985), and outpatient versus inpatient research settings, may have greater intrapsychic specificity than previously thought.
The current study was designed to show the differentiation of narrative styles in individuals with high scores in Psychopathic deviate (Pd) scale and develop a method enabling identification of psychopathic personality traits based on linguistic indicators. 600 spontaneous narrations related to emotional topics have been examined for grammar, syntactic, and lexical indicators. The indicators have been selected based on a review related to language of psychopaths. The narrations were written by 200 persons who were also tested for psychopathic deviate and intelligence level, including prisoners diagnosed with antisocial personality disorder. Independent judges identified the linguistic indicators which were then counted for each person with the use of computer software. The configuration profiles of the linguistic indicators/narrative styles were established using k-mean clustering method. Then, ANOVA was performed to show which clusters differentiate the levels of psychopathic deviate. The findings show there are two configurations of language features (important: single features were not examined) associated with high levels of psychopathic deviate patterns. Two narrative styles were identified, labelled demonstrative-digressive-egocentric-emotional-dogmatic and reserved-focused on the topic-repetitive, which indicate high psychopathic deviate traits. The ROC curves were applied to establish the prediction of the narrative styles for high psychopathic deviate scores.
Forensic psychiatric patients exhibit complex clinical issues that are neither readily understood by staff nor necessarily responsive to traditional psychotherapy or treatment milieu approaches. Individualized treatment planning identifies treatment needs and matches them to treatment services, thereby increasing the opportunity for a positive therapeutic out-come. The nature of the Rorschach, particularly that it bypasses volitional resources, enables observation and quantification of personality processes, making the Rorschach uniquely suited for treatment planning in forensic settings. In this article, the authors review relevant Rorschach literature, address the importance of incorporating Rorschach data into the assessment process, and discuss how Rorschach data fit into a thorough assessment that includes historical, clinical, dispositional, and contextual information. The authors offer two case examples to illustrate how Rorschach data are integrated in forensic treatment planning.
Since its inception, the concept of ?secondary psychopathy? has been contrasted with primary psychopathy on the grounds of neuroticism, affect instability, and anxiety. Nonetheless, while the etiology of primary psychopathy, and its various possible expressions, has received ample attention, secondary psychopathy has been largely neglected and only discussed in cluster-analytic studies. This paper seeks to fill that caveat by delineating the continuum on which secondary psychopathic individuals may be set apart and exploring potential sources of within group homogeneity and heterogeneity. While secondary psychopathic individuals share a number of etiological antecedents (attachment problems, childhood maltreatment, neurobiological dysfunctions) they can vary on different temperamental predispositions and specific types of maltreatment experienced in childhood (neglect/abuse vs. trauma/abuse, low vs. high prefrontal catecholaminergic activity), thus creating the heterogeneity observed in this group. Secondary psychopathic individuals may be situated on a continuum that spans from attentional hyposensitivity and cognitive distractibility on the far left side, associated with deficient prefrontal catecholamine activity and childhood neglect/abuse, ultimately culminating in more detached expressions of secondary psychopathy (callousness, hedonism, and low worrying), to attentional hypersensitivity and cognitive rigidity on the far right side, associated with non-optimally high levels of catecholamine activity and childhood relational trauma/abuse leading to more unstable expressions of secondary psychopathy (hostility, neuroticism, instability, and worrying).
Defense mechanisms are regarded as means by which the ego protects itself against such unpleasurable experiences as anxiety, depression, guilt, and shame (e.g., Fenichel, 1945; A. Freud, 1936/1959; S. Freud, 1972b). A symptom is seen as the result of the failure of a defense against instinctual drive derivatives (Freud, 1972b). Various constellations of defense mechanisms are regarded as more or less specific to the different types of neurosis (A. Freud, 1936/1959; S. Freud, 1972b). However, defense mechanisms are not regarded as pathogenic per se, but only when used in exaggeration (Freud, 1972a, 1972c) or in a rigid or overgeneralized way (Loewenstein, 1967). The adaptive functions of defense mechanisms were stressed by Anna Freud (1936/1959), Hartmann (1939), and others. According to A. Freud, each person chooses a limited number of defense mechanisms to protect oneself against unpleasurable experiences. The constellation of defense mechanisms habitually used contributes to what is called a person’s “character” (A. Freud, 1936/1959; Hoffmann, 1984; Reich, 1933). According to Millon (1984, p. 460), a systematic assessment of defense mechanisms “is central to a comprehensive personality assessment.”
To many observers, reactive violence can present as a puzzling phenomenon. Offenders often report experiencing cognitive distortions during the event. Offenders may have no history of violence, yet crime scenes are often described as “horrific.” When violence manifests, the motive often seems vastly disproportionate to any precipitating factor. Reactive violence is fueled by intense emotions, although they may not be evident before or during the event. How best to reconcile these findings and provide a parsimonious and coherent explanation? Psychoanalytic theory can illuminate the psychological processes that may underlie reactive violence. In particular, how narcissistic injury can generate impulsive aggression in vulnerable individuals. I draw upon Stanley Kubrick's film The Shining to study the phenomenon. While The Shining is a fictional horror film in which a family is tormented by supernatural forces, I argue that the horror does not emanate from paranormal sources; rather, it is found within human psychology. Copyright
The Psychopathy Checklist (PCL; Hare, 1980) and its revision (PCL-R; Hare, 1985a, in press) are clinical rating scales that provide researchers and clinicians with reliable and valid assessments of psychopathy. Their development was spurred largely by dissatisfactions with the ways in which other assessment procedures defined and measured psychopathy (Hare, 1980, 1985b).
Female psychopathy has been conceived as a malignant form of hysteria organized at the borderline level of personality function. In this study, the PCL-R was used to assess psychopathy, and the Rorschach Comprehensive System, Extended Aggression Scores, Rorschach Defense Scales, Rorschach Oral Dependency, Trauma Content Index, and Primitive Modes of Relating scoring systems were used to examine psychodynamic variables in female psychopaths. Our findings support the conceptualization of female psychopathy as a malignant form of hysteria and lead us to suggest the need for modifying several PCL-R items with female offenders.
Two words describe the status of the Rorschach in the United States as we move into the 1990s. They are integration and elaboration. The integration is between structural and theoretically informed approaches to the test. The elaboration comes as researchers provide more and more data about various populations and clinical syndromes. This paper provides a survey of these trends over the past 5 years, surely among the most productive in American Rorschach history. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
As mental health resources dwindle, efficient use of available services becomes an economic and ethical necessity. Integral to this process are screening, assessment, and treatment planning. Treatment planning is especially critical in correctional settings where change-resistant Antisocial Personality Disordered (ASPD) individuals compose a disproportionate percentage of the population. Not a homogeneous group, some ASPDs are treatable, some are not. The Hare Psychopathy Checklist-Revised (PCL-R) and Rorschach Test aid the clinician in formulating diagnoses, assessing treatment amenability, targeting areas for intervention, and, with the Rorschach, monitoring treatment progress. This article discusses the PCL-R's and Rorschach's role in treating ASPD patients. Two low-Lambda, introversive, T = 1, ASPD Rorschach protocols highlight treatment planning and treatment progress assessment.
With changes in the structure of the Menninger Foundation and its relocation from Topeka, Kansas, to Houston, Texas, and the greater opportunity for psychologists to obtain full psychoanalytic training, interest among psychologists/psychoanalysts in psychological testing has waned. This, in my judgment, is unfortunate, because it raises the possibility that fewer psychoanalytically oriented psychologists will be aware of the work of Rapaport and his contributions to testing. Based on the conviction that Rapaport's legacy is worth preserving, especially at a time when several are calling for a firming up of the scientific basis of psychoanalysis, in this article I review Rapaport's contributions to psychological testing, those of his students and colleagues, and discuss the work of current writers within this tradition.
The Role of Substance Use in Criminal BehaviorThe Economic Cost of Psychopathic Disorders and Substance AbusePublic Policy and the Economics of Substance AbuseCurrent Efforts to Interrupt the Cycle of Substance Abuse-Related OffendingRelationships among Psychopathic Disorders, Substance Abuse and CriminalityThe Significance of Spirituality in Substance Abuse Treatment, and Regulatory Barriers to Nonconventional ModalitiesPublic Policy Responses to Substance Abuse and CrimeReferences
Generally, these patients are diagnosed based on ‘antisocial personality’ criteria. However, these are insufficient to evaluate the degree of severity. Hare has established a list of psychopathic symptoms on a scale of 1 to 3. Subjects who obtain 30 out of 40 are considered to have ‘antisocial personalities with severe psychopathy’. Criminal psychopaths are not receptive to treatment and some treatment can even increase their chances of recidivism. The therapeutic setting must have a certain capacity and indispensable security measures to insure a treatment without risk to the personnel. These patients feel little anguish or attachment. They systematically degrade others and find a sadistic pleasure in making others suffer, physically or psychologically. The have internalised few moral values. The clinician must critically study the various reactions that the psychopath triggers in the therapist. Among the various possible therapies, medication can reduce aggressiveness and violence. Family therapies or those involving the patient's environment are to be discussed on a case-by-case basis. Psychodynamical conceptions are very useful in helping the clinician understand the role of the unconscious factors at play. In conclusion, rules of caution, a patient and respectful clinic, cooperation with the family, mastery of counter-transference, a prolonged treatment and a very active supervision of therapeutic relationships allow the improvement of the prognostic and the reduction of relapses and recidivism.
University Microfilms order no. UMI00359150. Thesis (Ph. D.)--University of British Columbia, 1991. Includes bibliographical references.
We propose the addition of four aggressive indices for Rorschach scoring: aggressive content, aggressive potential, aggressive past, and sado-masochism scores. Interrater agreement is presented and ranges from 92-100%. Nomothetic comparisons are made between groups with higher base rates for violence with mixed results, although the sado-masochism frequency was significantly higher in severe psychopaths than in moderate psychopaths. Idiographic use of the aggression indices is emphasized, with a particular focus upon inferring the quality, intensity, and directionality of intrapsychic aggression in relation to self and object representations.
The inter-situational, inter-rater and temporal reliability of a schedule for rating personality disorders is described. In an initial study with a simplified form of the schedule in patients from different wards of a psychiatric hospital inter-situational reliability between raters was higher for patients with personality disorders than with no personality disorder. Using the full schedule, inter-rater reliability, using audiotaped and separate interviews, and temporal reliability at interviews conducted a mean of 12.5 months apart all reached a satisfactory level, suggesting that the schedule may be a useful instrument for measuring deviant personality traits. The interview may be used with a subject or an informant but agreement between ratings made with informants and psychiatric patients during illness was low, and the schedule is not recommended for use with patients alone during acute episodes of illness.
The author distinguished three broad personality groupings. The borderline group has as its central task the prevention of fragmentation and disintegration. The narcissistic group has reunion as the central task. The central task of the complementary group is the resolution of the Oedipus complex. The three groups are on a continuum which is derived from the development of self-object differentiation and the firmness of the sense of self. Within the narcissistic group, he distinguished four personality types: the craving, the paranoid, the manipulative and the phallic narcissistic personalities. These types represent a progression both in terms of the instinctual stages predominantly represented in the execution of the narcissistic central task (reunion) and in the degree of separation and individuation. The values held by each of these types represent parental values which have dovetailed with the particular stage of libidinal emphasis and degree of separation and individuation. He discusses some of the theoretical implications of this progression.