Psychopathy and Lack of Guilt

Psychopathy is among the more widely discussed personality disorders. Psychopathy is intriguing for many reasons, one of which is that many of the most famous and heinous villains, real or imagined, are psychopathic. Understanding how a person could be so evil is clearly a very important, fundamental social concern. Yet, there remains no consensus as to even an authoritative description of the disorder (Crego & Widiger, 2015; Lilienfeld, Watts, Francis Berg, & Latzman, 2015). It is our impression, perhaps incorrectly, that Justman (2021) is arguing for a central importance of lack of guilt.

We begin by noting that it is only the rare person who has all of the features of a respective personality disorder (Widiger & Trull, 2007). Diagnostic criterion sets describe the prototypic case. Actual cases vary in the extent to which they have the respective features. One of the principle reasons for the current shift toward dimensional models of classification is precisely because most cases will not be prototypic cases, and individual cases are best described by a profile of traits specific to the respective person rather than a diagnostic category that will imply features that are not present and fail to recognize all of the features that are present.

Currently, there is no single criterion that is or should be considered pathognomic (i.e., present in all cases and not present in any other persons). We would agree with Lynam and Miller (2019) that traits of antagonism (callousness, lack of guilt, ruthlessness, exploitation, arrogance, manipulation) provide the primary or fundamental features of psychopathy. We suggest that other traits, such as fearlessness and glib charm (from personality domain of low neuroticism), excitement-seeking (from extraversion), and disinhibition (laxness, irresponsibility, and impulsivity) from low conscientiousness are not as central. One can readily imagine a person who is exploitative, remorseless, manipulative, deceptive, cruel, demeaning, arrogant, and ruthless as being psychopathic, even if this person is not fearless, excitement-seeking, or impulsive. In contrast, it is perhaps difficult to imagine a person who is just fearless, excitementseeking, and impulsive as being a psychopath. In addition, given that the traits of antagonism are highly correlated, it would be unusual to find a person who is exploitative, manipulative, deceptive, cruel, arrogant, demeaning and ruthless who is not also remorseless; and perhaps comparably uncommon to find a person who is remorseless but not exploitative, manipulative, or deceptive. However, such persons will occur and therefore we would suggest that no single trait is likely to be a cardinal or pathognomic trait.

We agree that lack of guilt was not included within Diagnostic and Statistical Manual of Mental Disorders (DSM)-III due largely to the influential research of Robins (1966). Justman (2021) appears to question the impact of Robins' research. However, Robins had included lack of guilt in her empirical study and simply found that it was not assessed sufficiently reliably nor frequently enough to justify its retention. Reaching a decision on the basis of empirical research would appear to be justifiable. As acknowledged by Justman, interviewees can readily deny an absence of guilt and pretend to feel remorseful.

Justman (2021) suggests that lack of guilt vanished with DSM-III. Robins' (1966) was indeed quite influential in the development of the 1980 DSM-III that did not include guilt, but lack of guilt returned in the subsequent 1987 edition, DSMIII-R, the construction of which was informed by further research subsequent to Robins. The 1966 Robins study is no longer so influential (Crego & Widiger, 2015; Lilienfeld et al., 2015). In any case, lack of guilt (or lack of remorse) has been present within the DSM criterion sets since 1987.

Most models and measures of psychopathy also include guiltlessness. An historically influential model of psychopathy is the Psychopathy Checklist-Revised (Hare, 2003), which includes an item for lack of remorse. More recently developed measures and models of psychopathy, such as the Elemental Psychopathy Assessment (Lynam et al., 2011) and the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2012) do not include a scale explicitly for guiltlessness, but they do include scales for callousness, a trait that incorporates...