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PSYCHOPATHIC INCLINATION AMONG MEDICAL STUDENTS
1DR. SHER DIL, 2DR. SYEDA FARHANA KAZMI, 3WARDA SADIQ
1Assistant Professor, Department of Psychology Hazara University Mansehra Pakistan
ORCID 0000-0002-5165-5707 sherdilkhanjadoon@gmail.com (Corresponding Author) 2Professor, Department of Psychology Hazara University Mansehra Pakistan s.farhanakazmi@gmail.com 00923459588066 3Department of Psychology, Hazara University Mansehra Pakistan wardasadiqwarda996@gmail.com
Abstract
Psychopathy, as a phenomenon, has been mostly studied forensic concept of the current century. Various studies have linked psychopathy to other concepts such as crimes, aggression, violence, personality. There is another debate around that describe psychopathy as productive for certain profession such as CEOs and Surgeons. Current study aimed to assess the relationship of psychopathy among medical students in Pakistan with reference to demographic characteristics (age, gender). Urdu Psychopathy Scale (Dil & Kazmi, 2016) was used to assess the psychopathy. male and female medical students were approached using convenient sampling. Results revealed that age is not related to psychopathy. Significant gender differences exist with respect to psychopathy, and 4.68% of medical students score 262 or higher. The study provided a way to look into the phenomenon of psychopathy among medical students.
Key Words: Psychopathy, Medical Students, Gender Differences, Age
INTRODUCTION
The word psychopathy has gained much attention in recent years in Pakistan. There is great concern over the nature of crime committed by psychopaths. Psychopaths often get into trouble with the law due to impulsiveness. Psychopaths frequently commit fraud, forgery and theft as well as violent crimes such as murders (Daniel, 2010). Psychopathic inclinations are found in every profession apart from criminals. Unlicensed practitioners, sexual offenders, serial killers, political leaders, child abuser may suffer from psychopathy (Copley, 2008).
There is also a need to understand the practices by medical professionals having psychopathic tendencies (AFP, 2014; Ashraf, 2017; Gadit, 2011; Kaleem, 2019). There is ongoing debate that Pakistanis are turning into a Psychopathic nation (Hasan, 2019). The medical history has witnessed many practitioner, such as Dr. Fata, sentenced for 175 years for false cancer diagnoses of 553 patients, Dr. Panos, guilty of performing hundreds of unnecessary operations. Tang, Lai, and Aravinthan (2019) reported the arrest of a fake doctor who had performed 70000 operations and medical procedures before being caught. Pakistan is one of the countries that frequently witnesses medical malpractices, fraudulent claims by doctors, ethical violations and violations of human rights. Such psychopathic traits may contribute to successful high-functioning professionals, e.g., CEOs, lawyers, anchorpersons even salesperson, also called functional psychopaths (Dutton, 2012; Hoffman, 2015). Psychopaths may excel in certain profession fields that are fertile for them. It is argued that having psychopathic traits in certain fields serves as an advantage for the psychopaths (Ronson, 2012). Psychopathy is characterized by coldness, irresponsibility, impulsivity and reckless behaviors (Babiak, Neumann, & Hare, 2010). Psychopathy is also characterized by interpersonal and affective deficits. They show disrespectful behavior for societal laws (Neumann & Hare, 2008). Psychopathy is expressed in three core characteristics: emotional, interpersonal and behavioral (Wynn, Hoiseth, & Pettersen (2012). According to Nioche et al. (2010) psychopathy is a personality disorder that is characterized by lack of emotions, cruelty, callousness, deceitfulness. Individuals having high level of psychopathy are stimulation-seeking and impulsive, lacks remorse and guilt (Mullin as cited in Fazel, Langstrom, Hjern, Grann, & Lichtenstien, 2009).
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Earlier studies of psychopathy were based on the forensic samples, individuals who have antisocial personality disorders and distinct personality features such as criminality. There is a debate that psychopathic tendencies also found within normal population (Edens, Marcus, Lilienfeld, &Poythress, 2006). It is also argued that psychopathic traits exist on a continuum when studied within normal population. There is positive association between immoral behavior is psychopathy within normal population (Ishikawa, Raine, Lencz, Bihrle, and Lacasse, 2001). Similarly, Skeem, Polaschek, Patrick, and Lilienfeld (2011) argued about presence of psychopathic tendencies in forensic as well as normal population. According to Neumann and Hare (2008) psychopathic traits exist across a range of population from forensic to normal population.
Individuals with high level of psychopaths are responsible for more than half of all serious crime. They commit a variety of crimes ranging from physical harm to financial harm and also cause psychological and emotional damage (Bailey, 2010). Psychopaths have criminal tendencies and commit huge number of serious crimes including violent, physical and financial crimes (Halty & Prieto-Ursua, 2015). Psychopaths exhibit poor behavioral controls, short-temperament, and behave more aggressively (Stafford & Cornell, 2003). Psychopaths cover only approximately 1% of the global population, however the prevalence rate is higher among criminals approximately 25%. Among professionals reported prevalence rate is comparatively higher such as corporate CEOs the prevalence rate is 4% (Ronson, 2011). However, no studies have been conducted on medical students and medical professionals.
There exist gender differences in psychopathic tendencies among male and female however, there is difference in expression of aggressive behavior (Bailey, 2010; Carroll et al., 2010; Jackson, Rogers, Neumann, & Lambert, 2002). Female psychopaths exhibit social and verbal aggression compared to male expression of physical aggression (Carroll et al.; Lehmann & Ittel, 2012), female show self-injurious behavior more (Sevecke, Lehmkuhl, & Krischer, 2009).
Assessment of psychopathic characteristics among medical professional is gaining importance. Current study is first of its kind to assess the level among Pakistani medical students. Since psychopathy is associated to criminal behavior, there is a need to assess the phenomenon among medical professionals. There are many cases fraudulent practices by doctors, or quackery by some medical professional for misusing their licenses (Case against fake doctors, 2019; Shabbir, 2019; Tang et al., 2019). Shabbir reported that about 70000 to 80000 unqualified medical practitioners including pharmacist, homeopathists are working in Punjab only the largest province of Pakistan. The hiring of the puppet doctors reflects the lack of moral obligations among Pakistani doctors. One possible explanation can be psychopathy inclination among them.
METHOD
Objectives
The study is based on following objectives.
1. The study aimed to assess levels of psychopathy among medical students
2. The study also focused on assessing demographic differences (age, gender) with respect to psychopathy.
Hypotheses
To fulfil the objectives of the current study following hypotheses were formulated.
1. Gender differences exists with respect to psychopathy among medical students.
2. Age is negatively related to psychopathy among medical students. Sample
The study was conducted on medical students from Abbottabad. A sample of 555 male and female
students from three medical colleges of Abbottabad that are Women Medical College, Ayub Medical
College and Frontier Medical College was selected through convenient sampling technique (M = 21.52,
SD = 1.78); male (M = 21.81, SD = 1.80) and female (M = 21.23, SD = 1.72).
Inclusion Criteria. Both male and female medical students were included.
Exclusion Criteria. Any medical student who have completed the formal degree.
Definition of Variable
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Psychopathy. Psychopathy is characterized by pathological lying, lack of remorse, responsibility and empathy, seeking sensation, manipulating other, poor anger control, behavioral problems even at younger age, unbalanced social relationship and criminal resourcefulness (Hare, 2003). High scores obtained on psychopathy scale (Dil & Kazmi, 2016) reflect higher levels of psychopathy. Instruments
Urdu Psychopathy Scale. Urdu Psychopathy Scale (Dil & Kazmi, 2016) is used to measure psychopathy. It is a 70 items scale having five response categories. The reversed coded items are 7, 9, 12, 16, 17, 25, 36, 37, 39, 42, 52, 55 and 59. Research Design
In current study, correlational research design was used to collect data through cross-sectional
survey.
Procedure
The data were collected from three medical colleges of Abbottabad. Both male and female medical students were approached individually using convenient sampling. Total 555 students were approached. They were briefed about the nature of the research and were asked for their voluntary participation. They were asked to filled the questionnaire honestly and return the same to researcher. They were also told that they should answer every question being asked. The participants were informed that no such question was asked that could identify the participants. Therefore, there is no such issue of confidentiality and privacy of the data. The study did not involve any harmful procedures. The filled questionnaires were collected at spot and participants were thanked for their valuable contribution. Results
Table 1. Summary of Inter-correlation between Psychopathy and age among medical students (N=555)
Measure 1 2 M SD
1. PS - .011 202.66 32.09
2. Age - 21.52 1.78
Note. PS = Psychopathy Scale p > .05.
The results of inter-correlation between age and psychopathy revealed that age is not related to psychopathy in medical students (r = .011, p > .05). Table 2. Gender differences in Psychopathy among medical students (N = 553)
Male Female
(n=281) (n=274) 95% CI Cohen's
Variable M SD M SD t(553) P LL UL d
PS 206.74 33.52 198.46 30.06 3.06 .002 2.96 13.59 .26
Note. PS = Psychopathy Scale.
The results in above table show that males significantly scored higher compared to females on psychopathy scale (t(553) = 3.06, p < .01).
DISCUSSION
The current study was aimed to assessed the psychopathic inclination among medical students of Hazara Division. The study was aimed at finding prevalence of psychopathic tendencies in medical students as well as gender differences among them. It was also aimed at finding relationship between age and psychopathy. Both male and female medical students were approached for the study. The alpha reliability of the Urdu psychopathy scale was .89 for current study.
The overall psychopathy scores revealed that only 17.5% of the medical students scored less than half of total psychopathy scores that is 175. It was also observed that more than 50% of the medical students scored higher than 200 (M = 225.16, SD = 24.17). That indicated the level of psychopathy was higher among medical students compared normal population reported in earlier studies (Dil & Kazmi, 2016). For a cut off score of 262 (75% of total score; Putkonen et al., 2010), 26 individuals or
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4.68% among medical students scored higher than cut off score. Most studies on psychopathy have reported 75% of the total scores as cut off scores for psychopathy (Carroll et al., 2010; Hare, 2003; Thomson et al., 2015). Whereas a lower threshold for psychopath was reported for some Scandinavian countries (Putkonen et al., 2010; Thomson et al., 2015).
It was postulated that gender differences would exist with respect to psychopathy and males would score high on psychopathy scale. The results revealed significant gender difference in level of psychopathy (t = 3.06, p < .01). Males scored higher on the psychopathy scale compared to females. Numerous studies have reported that males have higher levels of psychopathy compared to females (Rogstad & Rogers, 2008; Warren, Burnette, & South, 2003). Dotterer, (2014) reported that there are significant gender differences in level of psychopathy and male show higher levels of psychopathy. In the current study it was also postulated that there would be negative relationship between age and psychopathy. However, the results revealed that there is non-significant positive relationship between age and psychopathy among medical students. Previous studies have reported a negative relationship between psychopathy and age of the participants (Harris, Rice, Hilton, Lalumiere, & Quinsey, 2007; Ishikawa, Raine, Lencz, Bihrle, & LaCasse, 2001). Conclusion
Current study was aimed at finding psychopathic inclination among medical students and relationship between psychopathy and age. The study also assessed the gender differences with respect to psychopathy. Results revealed the males scored higher compared to females and psychopathy did not relate to the age of the participants. The prevalence rate for psychopathy was 4.68% among medical students.
Implications of Study
The recent interest in explaining psychopathy with reference to normal population has gained momentum. The importance of psychopathy in identifying criminal offender, quack and immoral practitioner cannot be denied. The assessment of psychopathic tendencies among medical students provide an insight that how medical professionals are involved in ethical malpractices as well as act as an agent of drug mafia. There is also a need to provide a treatment base for the psychopathy for Pakistani individuals. The current study provides an insight to clinicians and educationists about the psychopathic construct and its usefulness in criminal justice system. The psychoeducation programs can be initiated to reduce the impact of psychopaths as well as the screening out of psychopaths among medical professional will increase the level of trust between medical professionals and patients.
Limitation and Suggestions
As in the case of social science researches, present study has following limitations
1. Self-report measures were used in current study, that may have effect on social desirability. Other techniques such as criminal records, projective techniques should be used to assess the variables.
2. Due to financial limitations and time limits, population was taken from Abbottabad only. Including other areas will have more insight into the factors.
3. The present study was conducted on medical students only. Future studies should include Doctors and other professionals to get better understanding of the distribution of the sample.
4. Due to limited access to criminal population, the criminals were not studied. Future study should be conducted on normal as well as incarcerated individuals to compare both.
5. Present study studied limited number of demographic variable and other intervening variables. Future research should include other possible intervening variables.
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