Dear Barry,

DSM and ICD 10 do not define psychopathic personalities. It defines personality disorders (Axis II DSM IV). Dixon et al. (2011) or Lamont et al. (2009) for example made an review about the prevalence and treatment outcome of individuals with personality disorder. Personality disorders (PD) are considered to be a group causing significant public health burden. The review demonstates that adaptive structerd treatments have improved the outcome rates in the treatment of PD. The main problem in the treatment of PD is that a higher indeces of psychopathological symptoms, high interactional aggressiveness, attachment disorders, such as we find in patients with Axis II disorders are associatedwith lower scores in terms of the "working alliance" or"goaldirected collaboration" and therefore outcome values.

Dixon-Gordon KL, Turner BJ, Chapman AL. Psychotherapy for personality

disorders. Int Rev Psychiatry. 2011 Jun;23(3):282-302. doi:

10.3109/09540261.2011.586992. Review. PubMed PMID: 21923228.

Lamont S, Brunero S. Personality disorder prevalence and treatment outcomes: a

literature review. Issues Ment Health Nurs. 2009 Oct;30(10):631-7. doi:

10.1080/01612840902995288. Review. PubMed PMID: 19742373.

best greetings

Egon

Egon. The ICD refers to asocial and disocial personality disorders which coincide with the definition of psychopathy, indeed on page 227 the word psychopathic is used.

I am interested to know if anyone has had any success in 'curing' or treating traits such as callous unconcern for the feelings of others or gross and persistent attitudes of irresponsibility and disregard for social norms, rules and obligations.

I have met a few of these people professionally and have always found the proneness to blame others/society for their actions or to rationalise their aberrant behaviour to be a major obstacle to communicating.

The DSM has also produced some controversy about appropriate diagnoses for people with strong psychopathic traits. Wikipedia lists several references that discuss the distinction between psychopathy and antisocial personality disorder; these may be of use.

https://en.wikipedia.org/wiki/Psychopathy#DSM

I recently answered a question about self-awareness among psychopaths on Cognitive Sciences Stack Exchange, another Q&A website. There I described elements that psychopathy shares with disorders that are often difficult to treat: it involves externalizing behaviors and is often ego-syntonic. Its relationship with narcissism highlights this tendency in psychopathic self-perception as beyond reproach, which interferes with reception of constructive criticism in a therapeutic context (and any other, I would assume). Similarly, deficient empathy makes self-corrective motivation unlikely to arise in social interaction more generally, and deficit of remorseful emotion makes it unlikely to arise spontaneously.

http://cogsci.stackexchange.com/a/6364/4086

Read Glen O Gabbard's book on psychodynamic psychotherapy. Not sure if it could "cure" but can help in controlled settings.

Dear Barry

I want to give you two empirical researches obout treatment outcome of antisocial PD: The authors (Olver et al. 2009) examined the therapeutic responses of psychopathic sex offenders in terms of treatment dropout and therapeutic change, as well as sexual and violent recidivism over a 10-year follow-up among 156 federally incarcerated sex offenders treated in a high-intensity inpatient sex offender program. Olver et al. (2013) examined the relationships of psychopathy, therapeutic change, and violent recidivism in a sample of 152 high-risk violent offenders treated in a high-intensity violence reduction program. The empirical data from both studies suggest that risk-related treatment can reduce sexual and violent recidivism.

Olver ME, Lewis K, Wong SC. Risk reduction treatment of high-risk psychopathic

offenders: the relationship of psychopathy and treatment change to violent

recidivism. Personal Disord. 2013 Apr;4(2):160-7. doi: 10.1037/a0029769. Epub

2012 Oct 8. PubMed PMID: 23046041.

Olver ME, Wong SC. Therapeutic responses of psychopathic sexual offenders:

treatment attrition, therapeutic change, and long-term recidivism. J Consult Clin

Psychol. 2009 Apr;77(2):328-36. doi: 10.1037/a0015001. PubMed PMID: 19309191.

Greetings

Egon

Here are some more hints from the literature:

Veit R, Lotze M, Sewing S, Missenhardt H, Gaber T, Birbaumer N. Aberrant

social and cerebral responding in a competitive reaction time paradigm in

criminal psychopaths. Neuroimage. 2010 Feb 15;49(4):3365-72. doi:

10.1016/j.neuroimage.2009.11.040.

Birbaumer N, Veit R, Lotze M, Erb M, Hermann C, Grodd W, Flor H. Deficient

fear conditioning in psychopathy: a functional magnetic resonance imaging study.

Arch Gen Psychiatry. 2005 Jul;62(7):799-805.

Veit R, Flor H, Erb M, Hermann C, Lotze M, Grodd W, Birbaumer N. Brain

circuits involved in emotional learning in antisocial behavior and social phobia

in humans. Neurosci Lett. 2002 Aug 16;328(3):233-6.

Flor H, Birbaumer N, Hermann C, Ziegler S, Patrick CJ. Aversive Pavlovian

conditioning in psychopaths: peripheral and central correlates. Psychophysiology.

2002 Jul;39(4):505-18.

Dear Barry

The psychopath (antisocial personality disorder) is seductive, engaging, sympathetic even get someone's trust, however in reality it is a cold, calculating, deceitful, manipulative, impulsive, irresponsible and transgressor of social rules.

In Brazil the total prison population, approximately 20% suffer from this problem

To many experts, psychopaths are born with the disorder and at some point in life the disease can be triggered to a greater or lesser degree.

This type of disorder has no cure, since psychopaths do not repent or suffer the consequences of their actions. Dealing with a psychopath is an uphill struggle, because there is no way to change the way you see and feel the world. Psychopathy is a way of being

Dear Elias, and all colleagues,

I aggreee to most of your comments. But in geeral you are too pessimistic. A psychopath cannot be cured but he can improve in controlling his deficites in affectregulation (for example aggression: empirical research to this see above my last comment).

In all the studies and meta-analyses that examine the general influencing factors of psychotherapy the central importance is attached to the working alliance. This is why a “goal-directed, collaborative working alliance” is thus considered a causal factor for outcome. Polaschek et al. (2010) demonstrated this: Violent psychopathic prisoners with an “improving alliance” reached the highest ES.

Polaschek, D. L., & Ross, E. C. (2010). Do early therapeutic alliance, motivation, and stages of change predict therapy change for high-risk, psychopathic violent prisoners? Crim Behav Ment Health, 20(2), 100-111. doi: 10.1002/cbm.759

greetings

Egon

Forgive the intrusion, this is not an area I have any real knowledge of, but your thread raises some questions for me.

If you mean to 'cure' a psychopath, are you discussing deviant rather than functional psychopaths?

Does 'cure' imply finding a way to help someone who is characterised by a lack of empathy, with some ability to 'feel' how others feel?

If that is what is regarded as unattainable, does the cure involve CBT to teach new ways of thinking and acting with more socially acceptable outcomes?

Would this add to manipulative skills that alter an end result but do not cure a major component of what I understand to be psychopathy?

First of all, I do not agree that the concept of ASPD/DPD and psychopathy do coincide. In my view, diagnoses of ASPD can include psychopathy, but ASPD can also be non-psychopathic.Unfortunately, psychopathy per se is not conceptualized in the ICD and DSM. On the other hand, psychopathy also goes beyond clinical diagnostic systems as it refers to a dimensional personality construct. 

Regarding (the possibility of) treatment, I want to draw your attention also to neurobiologically-based forms of treatment, e.g., neurofeedback, which seems to work in some domains, for instance: 

Konicar L, Veit R, Eisenbarth H, Barth B, Tonin P, Strehl U, et al. Brain self-regulation in criminal psychopaths. Sci. Rep. 2015;5:9426.

Dear Barry

The psychopath has no cure. The psychopath takes pleasure in committing evil in achieving  what he wants. When the damage is done it is free of any guilt, regret or remorse for what he did wrong