New research highlights the health dangers associated with an antisocial lifestyle. A study of psychopathic female offenders revealed a mortality risk that was 12 times higher compared to the general population. The findings were published in the journal Frontiers in Psychiatry.
Antisocial personality disorder (ASPD) is a condition defined by antisocial behavior, aggression and impulsivity, and a lack of concern for others. People with ASPD are often involved in criminal activity and tend to experience difficulty forming long-term relationships. In its extreme form, ASPD is often referred to as psychopathy.
A body of past research has revealed high rates of premature death among people with ASPD, presumably due to the dangerous lifestyle associated with the disorder. Research in men has additionally found that the degree of psychopathy matters — as psychopathy increases, life expectancy decreases.
Study author Olli Vaurio and colleagues conducted a study to investigate whether mortality risk may differ between men and women with psychopathy. The researchers note that psychopathy manifests differently in men and women, which could lead to gender differences in mortality risk. For example, psychopathic women are less likely to display physical aggression and more likely to show relational or verbal aggression compared to psychopathic men.
To study the risk of mortality in psychopathic women, the researchers obtained data from a sample of female criminal offenders and compared this to national mortality rates. The sample included 57 Finnish women who had undergone forensic psychiatric evaluation for having committed severe crimes. For the current analysis, participants were excluded if they met criteria for a major mental illness like schizophrenia or delusional disorder.
Based on their scores on the Psychopathy Checklist-Revised (PCL-R), the women were categorized into one of two groups: low psychopathy (41 women) and high psychopathy (16 women). The women were followed for between 17 and 25 years, and during the follow-up period, 6 deaths occurred in the high psychopathy group, and 16 deaths occurred in the low psychopathy group. The average age at the time of death was 52.7 years old.
The researchers obtained mortality data collected from Statistics Finland, for the years 1984–2013. They then calculated the ratio of observed to expected number of deaths for both the low and high psychopathy groups. It was found that both groups had higher mortality compared to the general Finnish population.
Mortality was especially high in the high psychopathy group, where it was twelve times higher than in the general population. For the low psychopathy group, mortality was more than six times higher than in the general population. In line with previous research conducted among psychopathic men, mortality risk increased with higher PCL-R scores.
Death by natural causes was more common than death by unnatural causes. For the high psychopathy group, this included cancer (2 cases), cerebrovascular disease (1 case), and liver disease (1 case).
The authors discuss how some of these fatalities may relate to an antisocial lifestyle. For example, psychopathy involves an impulsivity and recklessness which may influence health behaviors. This may lead to higher rates of cigarette smoking and alcohol consumption, which can lead to lung and liver disease. More generally, a volatile lifestyle may lead to fewer healthcare visits.
“Although effective treatment options for adult antisocial psychopaths are scarce, many of those suffering from its consequences could benefit from information about common health issues and targeted measures to alleviate them,” Vaurio and colleagues say. “There is also some evidence that early interventions, such as parent management training (PMT) or adequate treatment of conduct disorder, may be beneficial in preventing the possible later life complications in children and young people (CYP) at risk of psychopathy.”
Overall, the findings support past evidence that antisocial personality is tied to increased mortality. Notably, the sample size of the study was small, with only 16 psychopathic women. Future studies with larger samples may help unearth differences in mortality risk between men and women with psychopathy.
The study, “Female Psychopathy and Mortality”, was authored by Olli Vaurio, Markku Lähteenvuo, Hannu Kautiainen, Eila Repo-Tiihonen, and Jari Tiihonen.
