There is a public perception that the numbers of MDO’s are very high, especially when considering violent crimes. In reality, MDOs only account for a very small percentage of criminal acts, even including violent offences. MDO’s are not usually what people typically think – like a schizophrenic – but are rather people who experience personality disorders and substance abuse disorders. Antisocial personality is the major predictor from clinical perspectives for criminal behaviour. Predictors for MDO’s are similar to those for general offenders. As well, compared to general offenders, MDOs are less likely to recidivate.
Psychopathy has a role in criminal behaviour as well. Psychopathology is defined as the manifestation of mental disorders and involves a deviance and distress. A mental disorder is a behaviour or psychological syndrome or pattern that occurs in an individual and that is associated with a painful symptom (distress) or problems is functioning (disability). Psychopathy on the other hand is a specific form of psychopathology, a specific disorder. It is a disorder of the personality but should not be confused with antisocial personality disorder. Antisocial personality disorder is a disorder that falls under the broader category of personality disorders. The concept of psychopathy originated in the early 1800’s as an attempt to describe individuals who habitually exhibit asocial and antisocial actions, but did not exhibit signs of mental illness as it was then understood.
A term that was also used was “moral imbecility” which reflected a diminished capacity for morality or lower moral intelligence. This definition was further refined to suggest 16 different characteristics of psychopaths. The 16 characteristics include manipulation, superficial charm, above average intelligence, the absence of psychotic symptoms (i.e., delusions and hallucinations), the absence of anxiety, a lack of remorse, failure to learn from experience, egocentrism, a lack of emotional depth, a trivial sex life, unreliability and irresponsibility, a failure to follow a life plan, untruthfulness, impulsiveness, and antisocial behaviour. Psychopaths have all the outward appearances of normality as they lack the psychotic symptoms and there is absences of any feeling of anxiety or distress on their part. They appear to be unresponsive to social control and continue to get into trouble despite repeated punishment from the people around them and society. It should be noted however that criminal behaviour is not as essential characteristic of psychopathy, and not all criminals are psychopaths. When measuring psychopathy various scales and checklists are used. Those criminal who score high on psychopathy checklists show a significantly higher level of recidivism. This is the case with violent recidivism as well.
Treatment of psychopathic offenders is difficult as they lack anxiety, guilt and remorse about their behaviours and are therefore unresponsive to treatment, and has even been seen to increase it.