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May 13, 2012

Can you diagnose someone as a psychopath at age 9?

Can You Call a 9-Year-Old a Psychopath? - NYTimes.com
By the time he turned 5, Michael had developed an uncanny ability to switch from full-blown anger to moments of pure rationality or calculated charm — a facility that Anne describes as deeply unsettling. “You never know when you’re going to see a proper emotion,” she said. She recalled one argument, over a homework assignment, when Michael shrieked and wept as she tried to reason with him. “I said: ‘Michael, remember the brainstorming we did yesterday? All you have to do is take your thoughts from that and turn them into sentences, and you’re done!’ He’s still screaming bloody murder, so I say, ‘Michael, I thought we brainstormed so we could avoid all this drama today.’ He stopped dead, in the middle of the screaming, turned to me and said in this flat, adult voice, ‘Well, you didn’t think that through very clearly then, did you?’ ” . . . For the past 10 years, Waschbusch has been studying “callous-unemotional” children — those who exhibit a distinctive lack of affect, remorse or empathy — and who are considered at risk of becoming psychopaths as adults. To evaluate Michael, Waschbusch used a combination of psychological exams and teacher- and family-rating scales, including the Inventory of Callous-Unemotional Traits, the Child Psychopathy Scale and a modified version of the Antisocial Process Screening Device — all tools designed to measure the cold, predatory conduct most closely associated with adult psychopathy. (The terms “sociopath” and “psychopath” are essentially identical.) A research assistant interviewed Michael’s parents and teachers about his behavior at home and in school. When all the exams and reports were tabulated, Michael was almost two standard deviations outside the normal range for callous-unemotional behavior, which placed him on the severe end of the spectrum. Currently, there is no standard test for psychopathy in children, but a growing number of psychologists believe that psychopathy, like autism, is a distinct neurological condition — one that can be identified in children as young as 5. Crucial to this diagnosis are callous-unemotional traits, which most researchers now believe distinguish “fledgling psychopaths” from children with ordinary conduct disorder, who are also impulsive and hard to control and exhibit hostile or violent behavior. According to some studies, roughly one-third of children with severe behavioral problems — like the aggressive disobedience that Michael displays — also test above normal on callous-unemotional traits. (Narcissism and impulsivity, which are part of the adult diagnostic criteria, are difficult to apply to children, who are narcissistic and impulsive by nature.) . . .

There is no such thing as sex addiction, but internet gaming addiction totally exists

According to the scientists behind the new edition of the DSM. Medical News: DSM-5: What's In, What's Out - in Meeting Coverage, APA from MedPage Today
Not everything that was initially considered for DSM-5 ended up in the near-final draft reviewed at the APA meeting. Some proposals left by the wayside include the following. Other addictions. Despite substantial pressure both within and outside psychiatry, the relevant workgroup rejected proposals to recognize addictions to sex, food, the Internet, and caffeine as diagnosable disorders. O'Brien said the group recognized that, anecdotally, many people meet most of the criteria for addiction to these behaviors. But the DSM-5 emphasis on scientific justification precluded listing them. Said O'Brien, "We looked at sex addiction, but there was no science at all. None." However, Internet gaming addiction will be listed in DSM-5's Section III, the equivalent of the DSM-IV appendix, indicating that more research is needed and wanted. The word "addiction." In fact, it is not used in any DSM-5 names. Instead, they are labeled "use disorders," as in "opioid use disorder." O'Brien said this choice was made over his objection. "They're addictions," he said. "That's the word people are going to use." But others in his group thought the word "disorder" was less pejorative and stigmatizing.