Open access peer-reviewed chapter

Successful Psychopaths: A Contemporary Phenomenon

By Floriana Irtelli and Enrico Vincenti

Submitted: June 8th 2017Reviewed: August 29th 2017Published: December 20th 2017

DOI: 10.5772/intechopen.70731

Downloaded: 811

Abstract

The majority of empirical research on psychopathy involves forensic populations; however, researchers have recently turned their attention to the nature and implications of psychopathic features in the workplace, hence shedding light on the notion of “workplace psychopaths.” Nowadays, many studies deal with successful people having a psychopathic outlook in a work environment. This is a contemporary phenomenon, originated during the 1990s. In this period, changing nature of work and business has created a general state of confusion due to increasing instability and competitiveness. In this social context, psychopathic personality aspects, such as the appearance of calm, confidence and other psychopathic tendencies, are mistaken for “leadership qualities.” This contemporary phenomenon is dangerous and connected to psychosocial risks: the social and environmental contexts are affected by this dynamic, which can for instance lead to increasing anxiety in the co-workers and lack of motivation. This affects not only workers, but also companies: results of recent researches show the significant influence of psychopaths on organizational commitment. These dynamics stimulated the interest of researchers in a variety of disciplines: psychiatry, as well as psychology, criminology, and sociology. This chapter aims at reviewing the current knowledge on this phenomenon, and to promote prevention and diagnosis.

Keywords

  • review
  • prevention
  • corporate psychopathy
  • antisocial
  • toxic leaders
  • business
  • contemporary phenomenon
  • psychopathic personality
  • snakes in suits
  • workplace psychopaths
  • executive psychopaths
  • industrial psychopaths
  • organizational psychopaths

1. Introduction

Corporate psychopathy is a new emerging concept, therefore the literature about this topic is relatively limited [1] this is why there is the need for a growing research on it. Specifically the concept of “corporate psychopath” represent the merging of the term “corporate,” which relates to the business world, with the term “psychopath,” which is typical of the psychological literature, to denote a person with a psychopathic personality who is active (often times undisturbed) in the organizational area [2]. Corporate psychopaths are subclinical psychopaths within a workplace; as a matter of fact it is necessary to specify that, while psychopaths are over-represented in the prison population, many psychopathic persons are non-violent members of the community [3, 4]. In the 1960s, psychosocial research in the work environment highlighted the impact of some aspects of the workplace on health [5], but in particular during the 1990s, changing nature of business in times of economic uncertainty, has created a general state of confusion, due to increasing instability and competitiveness: the 1990s change became a matter of business necessity and economic survival [6, 7]. In the period of “casino capitalism” [8] managers are reported to be experiencing circumstances like increasing intense work pressures [9, 10], very fast turnover of personnel, the growing problem of time pressure across modern society, increasing pace of business, and relatively shallow appointment procedures [10, 11], which often do not uncover some of their personality flaws [10, 12]. Today it is also essential for companies to maintain high productivity levels, despite the decreasing of economic resources [13] and the proliferation of time constraints, which can often have a brutalizing effect by leading managers to allocate insufficient time for empathic interaction with others: these aspects may have caused vicious cycles between culture individuals and society; in fact some theories have attempted to explain how modern business has facilitated the rise of psychopathic managers, which has in turn influenced capitalism [10, 12, 14, 15]. Research has suggested that psychopathy can even confer benefit on persons seeking rewards within a corporate setting [16], which indicates they can rise to the top of corporations [3, 17] coherently they have also been named as corporate psychopaths, industrial psychopaths, executive psychopaths, to differentiate them from their more commonly known criminal peers [10, 1822]. Research has also suggested that business has promoted psychopathic managers because of their ruthless willingness to “get the job done,” and as they attain senior positions, executive psychopaths have become architects of ruthlessness as they create a “culture of extremes” [10] so corporate psychopathy flourishes perhaps as the most significant threat to ethical corporate behavior. In this contemporary social context, psychopathic personality aspects, like the appearance of confidence, calm, strength, and other psychopathic dispositions, such as the disinclination to express emotions (except to manipulate), are often mistaken for “leadership qualities” [23], also because it is believed that the ability to remain calm and unemotional in pressured circumstances may be factors of success in business [10, 24, 25]. Their characteristics of being ultra-rational financially-oriented managers, with no emotional concern for or empathy with other employees [26], marks them appear as well-sitting in capitalistic context [27] that is profit oriented [10]. The psychopathic individuals’ lack of caring allows them to use any means to achieve their objectives, thereby potentially causing harm to others. Psychopaths have in fact ever-worsening behaviors at a greater pace as they attempt to achieve their goals before anyone else. Psychopathy in these aspects has not necessarily been (superficially) considered an impediment to global corporate advancement because aspects like risk taking, low fear, and lack of concern for consequences are popularly associated with strong leadership styles and ambition [3, 28]. These attitudes are added to their conscience-free approach to life and willingness to lie to present themselves in the best possible light. Using the “mask of sanity” [3], psychopaths are “social chameleons” [29] and adjust their personality depending on the person they are interacting with [6, 7]. Despite these aspects, organizational psychopaths are frequently seen as being charming “organizational stars” deserving of awards by those above them (while they subject those below them to intimidation, bullying, and coercion). Actually successful psychopaths are assumed to have the potential to transform a company’s organizational culture at their pleasing, which others must follow or else exit the company [7, 30], in fact through their attractive interpersonal communication styles, these subclinical psychopaths can influence others by becoming the “leader” [30], and particular significance is the personality of a/the top manager, since his/her personality will most greatly impact the managerial culture [1]. This poses an important ethical problem because it is essential to note that a global influence on the performance of an organization derives from its managerial culture and the common beliefs and expectations that managers have of the people they oversee [1, 31]. Despite the role they can achieve, it is unavoidable that their influence on the organization can be destructive. Babiak and colleagues [28] concluded that corporate psychopathic were able to get promotions and exert influence in business decision-making in spite of their possibly poor performance. There are “red flags” or “common leadership failures” that may be manifestations of corporate psychopathy. These include disparate treatment of staff, difficulty in forming a team, difficulty in sharing ideas and credit with others [7]. In making an actual overview of the phenomenon, we can say that psychopaths represent about 1% of the general population sample as shown in Figure 1 [32]; however, Babiak, et al. [28] reported that the prevalence of psychopathy in a sample of high-level managers was about 4%, which is significantly higher than the prevalence found in general samples [32, 33]; other researches even suggest that one in 10 managers are psychopaths (as shown in Figure 1) [34, 35]. Some authors [36, 37] have also hypothesized that psychopathy is manifested differently in women than in men, with males displaying more of an “antisocial pattern” and females more of a “histrionic pattern” [35], in any event researchers generally concur that men display higher levels of psychopathy than women do. McWilliams asserts that psychopathy is more common in men probably because females experience realistic limitation earlier (for example they are less physically strong and at greater risk of physical abuse) [23]. Finally we can say that corporate psychopaths are thought to gravitate toward organizations where they can gain money, power, and prestige rather than to the less well-remunerated caring professions [10, 26]: they have been found to be more common in some work categories rather than others, including CEOs and lawyers [10, 3840]. This level of incidence results in between 5.75 and 13.5% of employees working with a corporate psychopath, as shown in Figure 2 [10, 41, 42].

Figure 1.

Actual overview of the phenomenon of psychopathy [28, 32, 33].

Figure 2.

Percentage of employees working with a corporate psychopath [10, 41, 42].

Other commentators surprisingly suggest that psychopathy may be beneficial to organizations: these papers and articles should questioned for this viewpoint [10, 25, 43, 44] diverging from the many studies, which we will examine, that verify the importance of preventing these phenomena.

2. General patterns and possible biopsicosocial origins

The variety, number, and intensity of traits differ across persons, hence there can be very significant differences in the behavioral profile of individuals considered to be psychopaths [1]. Independently from the specific traits a general transversal and central dynamic of psychopathic persons is the organizational worry in consciously manipulating or “getting over on” others and the need to exert power that takes precedence over all other aims: the primary defense in psychopathic people is omnipotent control [45, 46]. Psychopathy is generally a clinical construct defined by a cluster of personality traits and characteristics, including shallow emotions, grandiosity, egocentricity, lack of empathy or remorse, deceptiveness, irresponsibility, impulsivity, and a tendency to ignore social norms [47], and thus includes actually a variety of behaviors which reflect violation of societal norms [48]. In the interpersonal domain, the psychopathic person is generally described like grandiose, superficial, and deceitful toward others; in the lifestyle domain, heavy bouts of impulsivity and irresponsibility are frequently reported; in the affective domain this kind of person is conceptualized like without remorse and empathy; and in the antisocial domain, psychopaths generally have a history of exhibiting poor behavioral control and showing antisocial behavior both in adolescence and as an adult [1, 49]. This is a general description but more specifically we can say that there are various psychopathic subtypes that differ for example regarding levels of impulsivity, social cognition, and aggression. Hence they may be more or less successful in society [50, 51], in fact psychopathy is a spectrum rather than a typology, and research using community samples has found individuals to be situated along a “psychopathy continuum” [3, 52]. McWilliams also distinguishes psychopathic thinking to a continuum from psychotic-borderline functioning (defined low level) to a neurotic functioning (defined high level) that is characterized with good-enough ego strength and identity integration, capability to use mature defenses and reality testing [23, 45]: actually variants or subtypes exist, covering a broad range that spans from unsuccessful to very successful. Specifically, corporate psychopaths exhibit subclinical rather than clinical symptoms, with different variations on specific dimensions. Subclinical corporate psychopaths may have some moral emotion deficits, while fully developed psychopaths may instead have more severe moral emotion deficits, and relatively little attachments to others [3], and some senior-ranking managers in “non-criminal” populations have been examined in terms of the construct of “successful psychopathy” [7, 30]; they are said to embody most psychopathic traits, but refrain from serious anti-social behaviors and therefore are infrequently institutionalized [30], in fact although the patterns of dysfunction in their comportment, affect, and cognition are qualitatively the same as conventional conceptualizations of psychopathy, these “subclinical psychopaths” do differ quantitatively in the intensity and pervasiveness of their behavioral disorder [30]. It is not definitively known whether this syndrome derive from physical, biological, or environmental factors [53]; however, patterns of brain dysfunction have been associated with this personality, with particular impairment in the orbital-frontal cortex being evident [5456], for example, physical damage to some area of the brain can result in the onset of psychopathic behavior and causality is implied but not established [10]. Some authors say instead that sociopathic dynamics are correlated to childhood rife with insecurity and chaos (neglect, harsh discipline, and/or overindulgence) [23, 45]. Exposure to habitual expressions of anger and cruel parenting may provide a model of hostile and aggressive behavior, facilitating the internalization of hostile schemas and access to aggressive responses in both benign and threatening circumstances [57, 58]. Some authors suggest that the exposure of minors to violence and abuse are often risk factors for antisocial behavior in adolescence, as well as the presence of antisocial behavior of parents, which has frequently an adverse impact on the mental health of their children [59]. Research has also suggested that there are some complex interactions between factors, for example some environments can lead to antisocial behavior with low genetic risks (for example profit based societies with high levels of competition and inequality between citizens). Therefore, biological explanations encompassing also psychological events should take into account the complex relationship with belief-systems, cultural values, unique life events, and the social environment, as shown in Figure 3 [51].

Figure 3.

Possible biopsicosocial origins of sociopathic personality [10, 23, 45, 51, 54–60].

Given its multifactorial origin, and its manifestation influenced by personal variables (such as gender, age, or personality traits) some attempts have been made to clarify some of these specific underlying mechanisms but much work needs to be done to empirically establish clear links [51] and it is important to specify also that the personal biases of investigators will influence their weighing of the potential contributions of the different factors [1]. Finally we note that a perspective that can help to understand this phenomenon, respecting its complexity, is represented by the General Systems Theory, developed by Von Bertalanffy, which considers a set of events interrelated as a system with specific properties and functions depending on the level at which it is located in comparison to a larger system. The systems theory in fact claims that all levels of an organization are interrelated to each other, so that changing one affects the other (as shown in Figure 3) [60].

2.1. Specific dynamics in workplace

Individuals considered corporate/organizational/executive psychopaths [1, 2, 7, 61, 62] are also referred to as “snakes in suits” by Babiak and Hare [7], because of their capacity of rising through the ranks to leadership positions, achieving wealth and fame (in some cases) [35]; they have been named “successful” due to their ability to avoid confrontation with legal authorities. In any event, in corporations the term “corporate psychopath” has been adopted as the common term for such people [10, 19, 63, 64]. On the other hand Edwin Sutherland is regarded as the scholar that first (a long time ago) brought the term “white-collar crime” into common usage, describing specific financial crimes committed by some people in the upper socioeconomic position of society [65, 66]. Lykken [67] suggested that there may be some professional advantages to possessing psychopathic inclinations. These professional advantages may be particularly relevant in business, as several of the personality characteristics which speak to the presence of psychopathy are beneficial in finance, including: low anxiety, aggressiveness, self-confidence, charm, dominance, willingness to take risks, and the ability to influence others [7, 68, 69]; in fact through case studies and empirical research, it has been proven that some people with psychopathic traits are capable of excelling in corporate organizations and may be drawn to careers in finance [18, 20, 28, 70, 71]. They may be particularly attracted to the financial power and status gains which are available in senior positions, and can cause considerable damage in such roles by giving course to a manipulative interpersonal style to large-scale fraud [3]: their core ways of acting and thinking show an antisocial sensibility ruthless, even if snakes in suits are apparently well adapted in the higher ranges of organizations, controlling everything and every person in the environment. The concept of corporate psychopathy has been used as a means of understanding unethical behavior in organizations and has often times been associated with bullying, but it is actually quite different from just bullying. Workplace bullying is defined as the repeated unethical and unfavorable treatment of an individual by another in the workplace. This includes behavior aimed ad belittling others through humiliation, threats, sarcasm, overworking a colleague, and rudeness [42, 72, 73]. Bullying can also take the form of applying undue work pressure, sexual harassment and making the victim a “scapegoat” [74]. This behavior is reportedly undertaken to maintain power and control over people [72]. Psychopathic individuals also often brag outright about their power and conquests if they think the listener can be thereby impressed, as a matter of fact one of the most significant characteristic is the possession of a high level of manipulation skills, and the only way they can get other people to understand what they are feeling is to evoke that feeling in them [75, 76]. In the workplace they open appear friendly and pleasant in order to further their goals and provide some measure of emotional reward; they may take pride from having the ability to trick others [1, 7]. Another specific dynamic is the tendency to be high in third-party-directed negative emotions and low in self-directed negative emotions. In other words, they may be frequently giving signals to others to change their behavior but rarely change their own behavior [3]. Other frequent aspects of psychopathic dynamics are: imprudence being this referred to the corporate psychopath’s excessive and myopic risk-taking, corruption, capability to conceal risky and often very short-sighted personal agendas which undermine the long term interests of the corporations [77, 78]. However, the corporate psychopath’s capacity for concealment also has a crucial weakness: often psychopathic achieve apparent success in their careers, despite negative performance ratings and behaviors potentially harmful to the corporation and its personnel, as a matter of fact some have found psychopathy to be positively related to unethical decision-making: a recurring theme in the business world during the past few years [79, 80].

2.2. Psychosocial aspects and consequences

The workplace can be taken as a model of a complex system, involving psychological, biological and social aspects, so it is necessary to rely on a biopsychosocial approach to deal effectively with any issue concerning individuals and teams. These three dimensions are interlinked, in fact effective management of health and safety in the workplace is important and recommended to individuals and society alike [13], and psychosocial risks should be taken into account when managing the social and environmental contexts that may lead to damages to psychological health [5]. Coherently with these premises, since the end of the 1990s considerable attention and research have been focused on the field of corporate social responsibility worldwide [81]. Psychopathic traits are a potent underlying factor for many of the deviant interpersonal behaviors displayed by some kind of leaders, and a cause of high psychological distress in their colleagues [7]. Bullying in organizations can also lead to a variety of dysfunctional and negative outcomes for the organization as well as for individuals within those organizations [42, 74]: each level of the organization is interconnected with others. Bullying is widespread, inherently unfair to its victims, and is a key ethical problem in modern workplaces [42, 82]. It should also be considered that more often than not there is a link between the actions of toxic managers and its subordinates’ deviant conduct [1], on the other hand reciprocal altruism is often beneficial for most of the population because cooperation can increase “survival rates” in the long term even if it reduces opportunities in the short term [3]. While aspects of a psychopathic personality can yield individual success, they may also promote unfavorable emotional reactions in those interacting with psychopaths in the same workplace, resulting in higher psychological distress of other employees [30, 83] and colleagues to be significantly more likely to withdraw in terms of leaving work early and taking longer breaks [10], leading to a decline in global productivity and hence an economic damage to the organization, dynamics that we will deal with. Corporate psychopaths in leadership positions therefore have the potential to adversely influence the lives of many individuals [3] and specifically some psychopathic managers have been assumed to be responsible for their subordinates’ reduced job satisfaction, lowered affective engagement, and increased family—work conflict [30, 84, 85]. In addition, Leslie and Van Velsor [86] noted that corporate psychopaths consistently take responsibility for positive outcomes, yet deny responsibility for failure, attributing such results to bad luck or others [30], so they can have a negative impact on employees’ moods, psychological well-being, job performances [84], distress [87, 88] and job satisfaction [89, 90]. They prioritize self-interest, which can include destructive consequences such as disruptions to the functioning of a group [3]. Psychopaths have also been described as “homo economicus” [91] because often times they are solely focused on gaining rewards and unconcerned with social consequences; while others may use aggression as an emotional reaction, psychopaths are more likely to use aggression proactively and without emotion: aggressiveness is simply a means to ensure that psychopaths get what they want [3, 92]. These dynamics are counterproductive for the organizations’ financial well-being [93], and to be more precise they are associated with a lowering of colleagues’ creativity [94], an increase in colleagues’ organizational deviance [95] and lowered employee performance [96, 97]. When colleagues are treated unjustly they are more likely to show behaviors that harm the organization or its members [98, 99]. Outcomes also included a marked organizational decline in terms of revenue, employee commitment, inventiveness and organizational innovativeness [10]. Several authors have highlighted a global reduced productivity and increased workplace absenteeism [100]: these deviant workplace behaviors cause losses of billions of dollars across all business organizations, and much of this behavior could possibly stem from corporate psychopaths in positions of leadership [1]; psychopath’s behaviors can also affect a company’s reputation in the eyes of its customers and employees [6, 7]. In some extreme cases also the surprisingly high number of suicides within organizations could suggest a distorted psychological and managerial environment [1]. We specify also that much of how individuals deal with situations depends on personal coping skills and resources; in fact from the 1960s, there has been a growing awareness on how these aspects make the difference in the outcomes of the adaptation process [101, 102]. The specific features involved in the modulation of the stress-response strategies are called “coping skills,” and the whole process of reaction and coping with stress is referred to as “coping” [101, 103]. Prolonged stress situations can be hard tests for such coping skills and it is much more difficult to predict the subjective reactions to them, as well as the possible “burn out.” The “burn out” syndrome consists in a dynamic of progressive loss of motivation, idealism, and decreased perception of the social utility of one’s own work. The “burn out” condition does not coincide with stress but it induces stress in a work environment when the balance between the following three important factors is lost: (a) required level of performance, (b) control over one’s own work, (c) reward and gratification. In some situations, which we just mentioned, it is easier for this balance to be lost [5].

2.3. The importance of prevention: future directions and limits

Based on these findings we underline the importance of primary prevention, the purpose of which is to decrease the incidence of the arisal of the negative phenomenon; primary prevention consists in an attempt to prevent the development of a discomfort in a population at risk [5]. One basic question, which is highly relevant from a practical perspective, is whether there are any instruments that could prevent corporate psychopaths from entering organizations or, when this is not possible, to stop them from climbing the corporate ladder; just because psychopaths are experts at hiding their personality traits, a simple screening procedure during the job interview will probably not detect organizational psychopaths; besides, one has to be experienced and specially trained [53] so it is helpful to build a team of interviewers to tackle hiring procedures; the different perspectives of the team of interviewers can help ensure the decision to be unbiased, and there also should be a sufficient probation period to evaluate performance to prevent any further damage [6, 7]. Specific measures of adult psychopathy are, for example, the Psychopathy Checklist-Revised (PCL-R) [104, 105] and its derivative, the Psychopathy Checklist: Screening Version [106]. For clinical and applied purposes their administration is restricted to those with appropriate professional qualifications (making them unsuitable for use by many human resources personnel). Test administrators need to have high levels of education in psychology or psychology-related fields as well as undergo a comprehensive amount of training given by Hare and his delegates to be considered qualified to administer and interpret results along the appropriate personality dimensions/factors [76]. PCL-R [104, 105], defines psychopathy as a multifaceted construct made up of four dimensions that underpin the superordinate construct of psychopathy [80]: Interpersonal, Affective, Lifestyle, and Antisocial [97]. The proper test typically requires 90–120 minto administer. It consists of different parts: an interview with the subject and a review of the subject’s file records and history [49]. It is the person administrating the test who answers a 20-item list. Babiak and Hare developed also the Business-Scan 360 (B-Scan 360). The B-Scan 360 was modeled on a structural model of the PCL-R [104, 105]. In order to make the screening procedure more complete and reach the most straightforward method to offset the limitations inherent in the current standard in detecting psychopathy, a combined approach is recommended, whereby the usage of the tests is complemented with: electroencephalography, measurement of galvanic skin responses, and electromyography [76]. Specifically, it may be useful to observe the correlation between PCL-R scores along with recordings of electroencephalography, galvanic skin responses, and electromyography. To promote secondary and tertiary prevention some authors propose guidelines for how to identify and mitigate the effects of corporate psychopathy [76] already present in the company. The adoption of a program to educate employees in general could be useful [12, 76] for secondary prevention (which tends to reduce the prevalence of morbidity through the curtailment of the period, the spreading of stress) and also tertiary prevention (which tends to mitigate the effects of negative factors on those affected) [5]. It is important to develop proper systems of performance evaluation, based on known criteria (preferably shared), on a transparent communication and on constructive feedback from the management, and also to encourage introspection among employees, so that they can become aware of their own weaknesses (for example predisposition to acquiescence toward stronger personalities) which may be exploited by manipulative corporate psychopaths [76]. The timing of the intervention with the onset of symptoms is, therefore, the discriminating factor between these three levels of prevention [5]. The earlier the preventive intervention takes place, the more effectiveness it has in preventing potential damages. It is also important to discuss the circumstances under which a screening for psychopathy would be morally justified, because only a small percentage of organizational staff will consist of corporate psychopaths: the question is how to avoid a culture of mutual mistrust, where suspicion instead of confidence and collegiality prevails. The suggestion of integrating physiological methods of detection, as well as urging pro-active education of all employees as the symptoms and effects of corporate psychopathy [76] has important practical outcomes, such as identifying job applicants who would be disastrous employees.

3. Conclusions

It is very important to discuss about the specific dynamics, such as manipulation, aggression and cheating behavior, that allow sociopaths to reach leading positions, and on how psychiatry and clinical psychology aim to identify psychopaths in work environments based on these behaviors. The present chapter brings together diverse and growing scientific researches on significant impacts of “business psychopathy” on counterproductive work behavior and ethical decision-making in the corporate world. All the intervention models mentioned could be effective examples of institutional responses to corporate psychopathy dynamics, and this chapter suggests also a framework that may help to identify some risk factors which may be considered in order to safeguard against the potentially damaging behavior of executive psychopaths in organizations. We can also say that the best way to prevent this dynamic is to try the identification before executive psychopaths enter the corporation: once they are established, it will be more difficult to address these dynamics. We specify also that diagnosis is a highly complex issue that needs to be done by mental health professionals. Through appropriate interventions corporations will be able to offer preventive measures with specific educational programs (for example anti-bullying training programs) to promote a certain degree of safety, a team-oriented culture, a culture of prevention and overall increase of the employees’ job satisfaction; these preventive measures will promote a degree of immunity to such dangerous dynamics because employees can acquire the tools to identify and deal with executive sociopaths. It is also essential to create a friendly atmosphere of trust for colleagues such that employees can feel comfortable and safe reporting potential behavioral problems. These aspects are particularly important for ethical reasons and also for the economic benefit of corporations: lower employees’ turnover and higher employees’ job satisfaction will be helpful for productivity and global corporate profit. A boundary that should be noted, and that has already been pointed out by other research [35] is that public policy efforts, such as those directed toward risk assessment, or the pre-employment screening of individuals with marked psychopathic traits, will need to come to grips with the heterogeneity of psychopathy, factor that can make the issue more complicated and difficult to manage. A systematic study of these behaviors will hopefully lead to a higher awareness of society toward the existence of this phenomenon and to a better control of the workplace and social environment.

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Floriana Irtelli and Enrico Vincenti (December 20th 2017). Successful Psychopaths: A Contemporary Phenomenon, Psychopathy - New Updates on an Old Phenomenon, Federico Durbano, IntechOpen, DOI: 10.5772/intechopen.70731. Available from:

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