Current brain scan technology, including fMRI, cannot diagnose psychological disorders because it measures blood flow-not actual neuronal or neurotransmitter activity. "It’s just missing a lot that’s happening," says Dr. Abigail Marsh, professor at Georgetown University.
Psychopathic traits are not fixed. Evidence shows they can be improved. "The pessimism is totally unwarranted," Marsh asserts. Yet, treatment remains largely unattempted.
Individuals with extreme cognitive profiles-whether autistic, highly intelligent, or psychotic-often mask their traits to conform to social norms. "If you’re at the tail, you have to kinda act more like people at the middle," Marsh explains.
Psychotic individuals, particularly those with schizophrenia, struggle with reality monitoring due to widespread neural wiring issues. They cannot prune irrelevant thoughts, leading to delusions often rooted in a desperate sense of mission. "They’re one of the few people who know this information and they can stop it."
The term "psychopath" is scientifically validated; "sociopath" is a media construct. Marsh’s research at NIMH established that fear processing distinguishes psychopaths from extreme altruists-who show heightened sensitivity to fear.
Despite lower well-being metrics, the U.S. ranks among the world’s most altruistic nations-outpacing even the Netherlands and Scandinavia in measurable acts of generosity.