About 1 in 7 men will admit to feeling decreased desire when asked. This increases gradually with age. Low desire correlates with daily alcohol intake, poor general health, emotional stresses, fatigue, insufficient sleep, being touched sexually before puberty, same-sex behavior ever, or a partner ever having had an abortion. The accelerating pace of life for many leaves little time for relaxed interaction between partners. This is especially prevalent for families with two working parents and young children. The fatigue that many experience in this context leads to sexual shut-down. Permission and encouragement by physicians to take time to nurture the couple as being a core need for a marriage, rather than an extravagant luxury can be a useful intervention. (How many of us would benefit from the same advice?)

Many illnesses and the drugs used to treat them cause lowered desire.7 Antihypertensive, antiarrhythmic, antineoplastic, anticonvulsant, and antidepressant drugs are common culprits.

Endocrine disturbances commonly have sexual dysfunction associated with them. Hypothyroidism, hypogonadism, and hyperprolactinemia often cause decreased desire.

As men age their testosterone levels gradually decline over decades starting in the 40's. For some men this becomes clinically significant and is variously called Andropause or Androgen Deficiency of the Aging Male ("ADAM").8 Treatment with replacement testosterone is available using pills, injections, patches and (internationally) sub-cutaneous pellets. Similar to hormone replacement for women, testosterone has positive effects on sexual interest, overall mood and general wellbeing, and reduces the risk of osteoporosis. Long-term trials to assess the potential risks of prostate cancer and cardiac disease have not been reported. Prudent management suggests monitoring the prostate with a digital rectal exam, baseline and initially 3 - 6 month follow-up Prostate Specific Antigen testing. Blood pressure, hematocrit, calcium and cholesterol should also be monitored.

Decreased desire is one of the hallmarks of depression. Antidepressants may help mood, but commonly exacerbate hypoactive desire. Addressing these concerns will help medication compliance. Non-SSRI antidepressants, such as bupropion and nefazodone may be relatively more sparing sexually.

Men at risk for lowered desire resulting from a medical condition or use of medication need physicians to raise these issues since without prompting they are unlikely to do so. Routine questioning about sexual concerns can reveal such problems; patients whose diagnoses and/or medications have an effect on sexual desire offer physicians an opportunity to raise and explore these and related sexual health issues.

Frequency dissatisfaction is common in relationships, with the partner with the lower level of interest often being labeled as the identified patient. While stereotypically the woman is labeled as having lower desire, as indicated above, either partner can have the lowered level of desire. Besides looking at possible treatable causes, such as andropause or menopause, it is important to help the couple understand what this situation means for each partner. Does a lack of sex imply a loss of love or attraction? Does it mean that a partner has to feel sexually frustrated due to lack of sexual contact, or can they pleasure themselves?

I use a restaurant analogy with couples around this issue: Both usually agree that they enjoy going out to dinner together, rather than grabbing a bite to eat on their own. I ask them whether each has to eat the same amount of the same food from the menu in order for each of them to feel satisfied and to enjoy the dining encounter. Or can one order steak with all the trimmings, and the other have the pasta? If one partner feels at least neutral about sex, but sees their lover enjoying themselves, can this be enough for them to engage in sex? Can both partners discuss and accept masturbation in the relationship? Helping couples learn to acknowledge each other's levels of sexual desire and frequency as being different and unique to themselves, and aiding them in finding ways to balance these needs is both challenging and helpful. Underlying marital stresses that contribute to decreased desire may need to be addressed.

Some of audience's most loved – and most feared – movies are psychopath movies. It's hard to forget that Hannibal Lecter "ate her liver with fava beans and a nice chianti" no matter how many years it's been since one has seen Silence of the Lambs. But movie psychopaths are not necessarily indicative of real-life psychopaths (psychopath definition), like these famous psychopaths.

Real-Life Psychopaths

Real-life psychopaths are characterized by their inability to feel emotion, a lack of guilt or empathy, manipulativeness, lack of connection to others, narcissism, superficial charm, dishonesty, manipulativeness and reckless risk-taking. While psychopath-types in movies may meet some of these characteristics of the psychopath, they may not meet all of them. Moreover, moviegoers lean towards believing that anyone who is a serial killer is a psychopath, and this is not the case either. (20 Signs of a Psychopath. Are You With One?)

Most Realistic, Best Psychopath Movies

According to psychiatrist, Samuel Leistedt, who has interviewed and diagnosed real psychopaths, some psychopaths in movies are realistic while others aren't. Additionally, Hollywood's portrayals of psychopaths in movies has improved over time. And Leistedt should know, as he and his partner, Paul Linkowski, screened over 400 movies with portrayals of psychopathy, many multiple times, looking for the best examples to use as tools to teach psychiatry students.

Here are a few of the most realistic, best psychopath movies:

• No Country for Old Men (2007) – Anton Chigurh
  In this film, Chigurh is a contract killer and Leistedt says Chigurh is his favorite portrayal of a psychopath on film. Leistedt says, "He does his job and he can sleep without any problems. In my practice, I have met a few people like this." Leistedt would diagnose him as a classic psychopath.
• M (1931) – Hans Beckert
  This character portrayed a man who was normal on the outside and yet was driven to kill. This portrayal was not typical of the time period so this character was far more realistic than most. The researchers would diagnose this character as being a sociopath also suffering from psychosis (Read more about the difference between a psychopath and a sociopath.) .
• Henry: Portrait of a Serial Killer (1991) – Henry
  In this film, Henry likes to find new ways to kill people. The researchers write of this film, "the main, interesting theme is the chaos and instability in the life of the psychopath, Henry's lack of insight, a powerful lack of empathy, emotional poverty, and a well-illustrated failure to plan ahead." Henry's diagnosis would be that of a classic psychopath.

Two Scary But Less Realistic Psychopath Movies

Two movies that many people have seen are Psycho (1960) and Silence of the Lambs (1991), both containing protagonists quite able to give audiences justifiable nightmares. The researchers say these two characters are just not as realistic as some of the other depictions of psychopaths. This is not to suggest that no psychopaths like these two exist but, rather, to say that they are not nearly as common.

In the case of Norman Bates, from Psycho, the researchers feel a general diagnosis of psychosis (being out of touch with reality, the presence of delusions and hallucinations) would be a better fit as Bates appeared to be detached from reality, which is not typical of psychopaths.

Hannibal Lecter from Silence of the Lambs can be thought of as a prototypical "elite" psychopath with almost superhuman intelligence and cunning and this isn't typical of anyone – including psychopaths.

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Are you trying to figure out what makes a marriage work?  Here are some psychological characteristics that people in a good marriage share.

Research on what makes a marriage work shows that people in a good marriage have completed these psychological "tasks":

• Separate emotionally from the family you grew up in; not to the point of estrangement, but enough so that your identity is separate from that of your parents and siblings.
• Build togetherness based on a shared intimacy and identity, while at the same time set boundaries to protect each partner's autonomy.
• Establish a rich and pleasurable sexual relationship and protect it from the intrusions of the workplace and family obligations.
• For couples with children, embrace the daunting roles of parenthood and absorb the impact of a baby's entrance into the marriage. Learn to continue the work of protecting the privacy of you and your spouse as a couple.
• Confront and master the inevitable crises of life.
• Maintain the strength of the marital bond in the face of adversity. The marriage should be a safe haven in which partners are able to express their differences, anger, and conflict.
• Use humor and laughter to keep things in perspective and to avoid boredom and isolation.
• Nurture and comfort each other, satisfying each partnerís needs for dependency and offering continuing encouragement and support.
• Keep alive the early romantic, idealized images of falling in love, while facing the sober realities of the changes wrought by time.

Sources: Judith S. Wallerstein, PhD, co-author of the book The Good Marriage: How and Why Love Lasts.
The American Psychological Association

Psychopathic behavior is easy to see when a psychopath is a killer, but psychopaths exist in places outside of prison and their behavior goes beyond killing. The most notable psychopathic behaviors are antisocial, often illegal, ones but psychopathic personality traits also create other notable behaviors for psychopaths. Here are some of the places that psychopaths exist and what some of their behaviors typically are.

Psychopathic Behaviors in the Workplace

Lately, some press has taken notice of the fact that psychopaths exist in the workplace, specifically, in management, in greater numbers than elsewhere. In fact, the latest figures suggest that one-in-ten managers are psychopaths.

If your boss is manipulative, intimidating, totally lacking in remorse or guilt, and yet superficially charming, you could be working for a psychopath. An obvious marker of a psychopathic boss is when he or she makes decisions, such as laying off 100 people, and feels no guilt over taking away the livelihood of all those people. (These 20 signs of a psychopath can also help you identify one.)

Psychopath Behaviors of Con Artists

Hollywood movies are full of psychopaths, characters that con others without the slightest bit of remorse. These are behaviors of a psychopath. These psychopaths use their charm to dupe others into trusting them only, in turn, to take advantage of these people.

The movie, Catch Me If You Can, illustrates a quintessential version of this type of psychopathic behavior in its main character, Frank Abagnale, Jr. (played by Leonardo di Caprio). In this film, based on real life events, Abagnale Jr. uses his charisma and other attributes to pass himself off as a commercial pilot, a pediatrician and a prosecutor all before the age of 19. He was also a skilled check forger.

Behaviors of Psychopathic Serial Killers

Of course, this type of psychopath kills, but more subtly, this psychopath typically preys on his victim and uses his charm to lure his victim in. It's not just the killing that denotes a psychopath but rather how they approach the killing and choose and attract his or her victims.

Psychopathic Behaviors of Chronic Offenders

Rather than becoming killers, many psychopaths choose other criminal acts to pursue. In fact, in one estimate 93% of all noninstitutionalized psychopathic males age 18 or over are in the criminal justice system in some way.

One example of a chronic psychopathic offender is offered in the paper, Psychopathic Personality: Bridging the Gap Between Scientific Evidence and Public Policy:

Robert* "has been in trouble with the law since age 10. As a child, he was seriously maltreated both sexually and physically, both at home and later in foster care. Although of average intelligence, he learned little in school and has never successfully held a job. He binges on alcohol and drugs whenever he can; endeavors to manipulate others (but is not particularly adept at it); has never had a stable romantic relationship; and has been convicted of various types of crimes, both violent and nonviolent. He is anxious, easily upset and angered, speaks in a self-centered way about his situation, and appears indifferent to his victims' suffering. When paroled from prison, he is quickly rearrested, more often for trivial than for serious offenses."

For more information on the specific symptoms of psychopathy, please see the article, Does a Psychopath Test Exist? Diagnosing the Psychopath.

* Not his real name

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The definition of sociopath is someone without a conscience who manipulates the world and those in it to benefit himself. Thankfully, there are distinct symptoms of a sociopath to help people recognize one (What is a Sociopathic Person Like?). The symptoms of being a sociopath in men, women, and children are actually a cluster of behaviors and personality traits. These symptoms, these sociopathic traits and behaviors, are seen in how the sociopath interacts with other people.

Symptoms of Being a Sociopath: What a Sociopath Is

When someone first encounters a sociopath, he or she often has a vague feeling that the person is "off" somehow. As seen below, one symptom of a sociopath is dynamic charm, so it can be difficult to determine why this "off" feeling nags at the back of the mind. Knowing the sociopath symptoms can help people more clearly identify a sociopath in their midst.

The symptoms of a sociopath paint a clear picture of someone who is a cold, self-centered, manipulative person with no conscience. A sociopath is

• antisocial, caring neither for societal rules, norms, and laws, nor for other people; a sociopath has no empathy.
• conniving, manipulative, deceitful, and dishonest; a symptom of a sociopath is a blatant violation of the rights of others.
• a control freak; a sociopath needs control, has the skills to get it and will stop at nothing to achieve it.
• charming and smooth; for someone who is antisocial, an ironic symptom of a sociopath is someone who has incredible social skills. However, don't let this sociopath symptom fool you, for these social skills are superficial, insincere, and only used by the sociopath to get his or her way.
• a rule-breaker and a risk-taker; for this reason, the sociopath has repeated clashes with the law and commonly has a criminal record.

So, you may be wondering, "Do sociopaths cry or even have feelings?" Read this.

Symptoms of a Sociopath: What a Sociopath Is Not

The symptoms of being a sociopath involve traits and behaviors. These behaviors and personality traits are about how the sociopath interacts with others and who he or she is as a person. Additionally, they are about who the sociopath is not, what he is not like. A sociopath is

• not disoriented or out of touch with reality; the symptoms of a sociopath point to a person who is rational, aware, and calculating, and his or her behavior is a choice.
• not psychotic; a sociopath doesn't have hallucinations or delusions. (It's important to note that the term "psychopath" is often confused with the term "psychotic." To be psychotic means to be out of touch with reality due to hallucinatory sensations and delusional beliefs.)
• incapable of giving or receiving love or of caring about others (Can Sociopaths Love or Even Fall in Love?); a prominent symptom of being a sociopath is a lack of empathy and conscience.
• unable or unwilling to learn from negative consequences; a sociopath is often in and out of jail or prison because rehabilitation is impossible.

Do Men, Women, and Children Show the Same Symptoms of Being a Sociopath?

The above symptoms of being a sociopath apply to everyone who is a sociopath—pretty much, anyway. One can't be officially diagnosed with antisocial personality disorder (a sociopath) until age 18 (Sociopathic Children: How Do They Become That Way?). While there must be a history of behavior problems in adolescents (by age 15, often earlier), a minor isn't considered to be a sociopath. At most, he or she can be diagnosed with conduct disorder.

Once someone reaches adulthood at age 18, he or she can be diagnosed with antisocial personality disorder. At this point, he's a sociopath and displays the symptoms of being a sociopath. According to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5, (2013), only a small percentage of the population has antisocial personality disorder; specifically, between 0.2% and 3.3% of people have the symptoms of being a sociopath. Both genders can have antisocial personality disorder, but males outnumber females by more than three to one (Fallon, 2013).

Sociopath symptoms in men are the same as female sociopath symptoms. To be sure, there are individual differences; after all, while cold and calculating, sociopaths are humans rather than robots.

Despite individual differences among sociopathic people, the core symptoms of a sociopath are the same for all who have antisocial personality disorder. The main issue isn't how sociopaths differ from each other. The biggest concern is what symptoms of being a sociopath set these men and women (and children who will become men and women) apart from the other 99 percent of humanity.

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The idea of a child psychopath is a chilling one for most people. Imagine a sweet, little 12-year-old who could commit heinous acts such as the torture of animals without remorse and then manipulate and charm his way out of any consequences. That might be the image of a child psychopath but do psychopathic children really exist?

What Would a Psychopathic Child Be Like?

Psychopaths are defined by certain personality characteristics and these characteristics can be present in children. It's important to note that only when these psychopathic personality traits exist as a cluster (not just one trait) and/or in the extreme would psychopathy be suspected.

The personality traits of a psychopath include:

• Superficial charm
• Grandiose sense of self-worth
• Manipulativeness
• Shallow emotions
• Lack of empathy
• Lack of remorse or guilt
• Impulsivity
• Failure to accept responsibility for one's own actions

A child need not have all the above traits to be considered having psychopathic tendencies but certainly showing them mildly or singularly may be normal for any given child at a point in his or her development.

That said, it is believed that psychopathic traits are fairly stable over the course of a person's life, including development at some point during childhood. Indeed, most of the traits will be noticeable before a child turns 16. (Psychopathic Personality and How It Develops)

Adolescents with psychopathic traits will also:

• Seek stimulation
• Be more reactive to reward than punishment
• Be more likely to exhibit behavior outside the norms of society and engage in antisocial behavior
• Show more premeditated aggression compared to other youths with behavioral problems

Diagnosing a Child Psychopath

Children are not actually diagnosed as psychopaths until they turn 18, rather, children are said to have psychopathic traits or psychopathic tendencies. These traits, or tendencies, can be assessed by a professional using the 50-item Psychopathy Checklist-Revised Youth version by Hare. This way of assessing psychopathy in youths is time-consuming, however, so other methods have been developed such as the Youth Psychopathic Traits Inventory and the Antisocial Process Screening Device – Self Report each designed to assess psychopathic traits among 13-18-year-olds in the community.

Is My Child a Psychopath?

Only a professional, such as a psychiatrist who specializes in psychopathy, can answer the question as to whether your child is a psychopath. Nevertheless, if your child shows the above traits, professional help should be sought as psychopaths not only cause great harm to the community, but they also tend to end up incarcerated. One should also be warned that, in rare cases, psychopaths have killed others before adulthood.

What To Do With A Psychopathic Child

If a child is found to have psychopathic tendencies, not all hope is lost. While treatment of adult psychopaths has been virtually fruitless, the same cannot be said of the treatment of young psychopaths. A relatively new therapy called decompression treatment has been used with positive results.

Keep in mind that psychopathic traits in children are also highly correlated with other mental illnesses and drug use. Psychopathic youth also tend to drop out of psychiatric treatment and be noncompliant on a more regular basis than others.

For more information on the treatment of psychopathy, please see: Treatment for Psychopaths: Can the Psychopath Be Cured?

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The word sociopath is a familiar one, yet it can be difficult to define sociopath. A simple definition of sociopath is someone who possesses the sociopathic characteristics of having no conscience and is tremendously antisocial. While indeed accurate, that definition falls a bit short. Perhaps that's because sociopath is a word that touches people on not just an intellectual level but an emotional one too, often evoking dark feelings and making people shudder (Signs of a Sociopath are Big-Time Scary). To define a sociopath, a complex human being who doesn't fit the norms of society - of humanity - it's necessary to consider that the true sociopath definition is actually a cluster of behaviors and personality traits.

To Define Sociopath Using Other Terms

Not only is the definition of sociopath complex, but the very word itself is complicated. Scientists and lay people alike use different words for this disorder.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is the authority on mental illnesses published by the American PsychiatricAssociation. The DSM-5's diagnostic term for sociopathy is antisocial personality disorder. Other terms used for this condition are psychopathy (psychopath) and dissocial personality disorder (Psychopath vs. Sociopath: What’s the Difference?). The definition of sociopath applies to these other terms as well.

What is the Definition of a Sociopath?

The DSM-5 defines antisocial personality disorder as "[a] pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following:

1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another."

It's important to note that sociopathic children do not exist as a person cannot be diagnosed as a sociopath until age 18. While the patterns of behavior and personality traits exist prior to adulthood, until then, a child may be diagnosed with conduct disorder, but he can't be defined as a sociopath.

To Define Sociopath, Consider These Four Categories

The above definition of sociopath is easiest to grasp when it's organized to fit people rather than paper. In The Psychopath Inside, James Fallon breaks down the definition of a sociopath into four categories.

1. Interpersonal: This category involves interaction with other people. In this area, someone who is a sociopath is superficial and incapable of deep, meaningful relationships and connections. It might seem at first that this person is very attached and caring, but that's just an act. A sociopath is antisocial; he (or sometimes she) is capable of lies and deception in order to get his or her way, but he cares nothing about forming real friendships and partnerships.
2. Affective: This area deals with emotions and feelings. When it comes to the affective part of being human, the definition of a sociopath is someone who completely lacks empathy. He simply can't take the perspective of others or understand (or care) how someone else feels. When a sociopath is hurtful, he feels no remorse. If it's good for him, he doesn't care who's hurt in the process. A sociopath has no conscience.
3. Behavioral: Someone who is a sociopath is impulsive and unreliable. As a result of these traits, the sociopath also lacks the ability to set long-term goals. Further, he can't, or won't, accept responsibility for his actions.
4. Antisocial: The definition of a sociopath centers on this concept. This person stands apart from the rest of society; he exists for himself and only for himself. He cares nothing for the norms, rules, and laws of society. Accordingly, a sociopath has a history of juvenile delinquency and likely has a criminal record in adulthood.

 Discover "What is a Sociopathic Person Like?" or take the "Sociopath Test: Am I A Sociopath?"

Understanding the Meaning of Sociopath

The above concepts define sociopath. What, though, is the meaning of sociopath? 

At their essence, sociopaths are social predators. Hallmark traits of sociopathy are a lack of empathy and a disregard for societal norms, the rules both written and unwritten that help keep the world safe and fair for all. The sociopath can be defined as someone who cares only for himself and lacks the ability to treat other people as human beings.

What is a sociopath? A definition of sociopath is someone who, because he is antisocial with no conscience, ignores reality to make his own uncaring and selfish life.

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While the idea of a psychopathic child may seem like it's out of a movie, a small number of psychopathic children do exist. In fact, psychopaths tend to develop their psychopathic traits before the age of 16. But what is a psychopathic tendency in a child and how can you spot psychopathic behavior in children?

Psychopathic Children

Children (those under the age of 18) are not, technically, psychopaths, even if they meet every criterion as psychopathy is only officially diagnosed in adults. However, when psychopathic adults are studied, it's clear that their psychopathic personality and tendencies developed as children and young adults. Some psychopaths even kill before their 18th birthday.

Psychopathic Behavior in Children

Several checklists have been developed to help identify children with psychopathic tendencies. These include Hare's Psychopathy Checklist-Revised; Youth version, the Youth Psychopathic Traits Inventory (YPI) and the Antisocial Process Screening Device – Self Report (APSD-SR). These three screening devices help to pinpoint the behaviors of psychopathic children.

The following are examples of psychopathic behaviors in children as identified by the APSD-SR:

• Has shallow emotions
• Brags about accomplishments
• Uses or cons others
• Teases other people
• Is charming in insincere ways
• Becomes angry when corrected
• Thinks he or she is more important than others
• Blames others for mistakes
• Gets bored easily
• Acts without thinking
• Engages in risky and dangerous behavior
• Does not plan ahead
• Does not show emotions
• Breaks promises
• Doesn't feel bad or guilty
• Is not concerned about the feelings of others
• Doesn't keep the same friends
• Isn't concerned about schoolwork
• Lies easily and skillfully
• Engages in illegal activities

It's important to remember that no, single psychopathic behavior indicates that a child is a psychopath but, rather, it's a constellation of traits that indicate psychopathy.

Also keep in mind that some of the psychopathy is genetic and if a child has psychopathic parents or parents with psychopathic tendencies, the child will have a greater chance of becoming a psychopath him or herself.

If You Suspect Your Child Has Psychopathic Tendencies

If you spot psychopathic tendencies in your child and are concerned, you should get help immediately from someone such as a psychologist or psychiatrist who specializes in psychopathy (treatment of psychopaths).

While studies have shown that no treatment has helped change the behavior of adult psychopaths, the same has not been true of children with psychopathic tendencies. A therapy known as decompression treatment has shown positive results in helping children with psychopathic behavior. Some specialized institutions offer this treatment but the treatment tends to last a year or more and does not work for everyone.

The psychopathic brain has been an interest of study for decades due to the fact that psychopaths represent such a small segment of society and yet commit a highly disproportionate amount of criminal acts (like these famous psychopaths and psychopath killers). And with more-and-more psychopaths having magnetic resonance imaging (MRI) scans or functional MRI (fMRI) scans, some correlates have been found. In short, the brain of a psychopath is different than a normal brain.

There are three main parts of the brain which psychopath brain scans show significant differences in. They are in the regions of the amygdala, the prefrontal cortex, and the extended paralimbic structures. Light is shed on these regions in the paper, The Psychopath Magnetized: Insights from Brain Imaging, by Anderson and Kiehl. The effects on these regions of the brain may be what produces psychopathic symptoms and what is termed the psychopathic personality.

The Brain of a Psychopath: The Amygdala

The amygdala in critical in the acquisition of information around us that reinforces learning. Learning, for example, is what teaches us what societal norms are and without that, we may be more prone to antisocial behavior like a psychopath. The amygdala also allows for the recognition of emotionally important information, such as the presence of threats.

In recent studies, psychopathic brains showed less activation in the amygdala when viewing pictures depicting moral violations and fearful faces; suggesting these things simply affect a psychopathic brain less. The greater the level of psychopathy, as measured on the Hare Psychopathic Checklist (psychopath test), the less the activation seen in the amygdala.

The Brain of a Psychopath: The Prefrontal Cortex

Areas of the prefrontal cortex are important in monitoring our behavior, estimating consequences and incorporating emotional learning into our future decision-making process. If this area is deficient, this could mean that, for psychopaths, whatever they would learn through emotions would not affect future decisions and they may underestimate the consequences of their actions.

A section of the prefrontal cortex – the orbitofrontal cortex – shows reduced grey matter in volume and thickness. Again, the more severe the psychopathy, the greater this deficiency seems to be. The activation in this region during specific tasks mirrors this finding as when psychopaths decide to cooperate, they show less activation here and when they observe an opponent being punished, this area activates more than in the normal brain (which correlates with antisocial behavior and impulsivity traits).

The Brain of a Psychopath: Extended Paralimbic Structures

Recent research has shown that the dysfunction in a psychopathic brain goes beyond the mere limbic system as above and into the areas around the limbic system as well. This may indicate broader cognitive impairments in general.

In these other regions of the brain, volume reduction has also be found and these reductions have been linked to impairments in episodic memory and in self-referential experiences perhaps meaning that psychopaths view their own memories differently than do others and perhaps see their roles in those memories differently (perhaps as more grandiose). The deficits in emotions seen in psychopaths have also been linked to decreased grey matter volume in parts of the brain.

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You're having problems in your marriage or relationship, but who do you turn to for help? Here's what to look for in a marriage counselor.

How do you choose a marriage counselor?

Take care when choosing a marriage counselor or therapist. Not all are licensed or certified, or have specialized training in couples counseling.

Look for a marriage counselor who is a licensed mental health professional. Many marriage counselors are specifically designated as licensed marriage and family therapists (L.M.F.T.s). Licensing and credentialing requirements can vary by state. But most states require advanced training, including a master's or doctoral degree, graduate training in marriage and family therapy, and training under the supervision of other experts. Many marriage and family therapists choose to become credentialed by the American Association for Marriage and Family Therapy (AAMFT), which sets specific eligibility criteria.

Most marriage counselors work in private practice. They may also work in clinics, mental health centers, hospitals and government agencies. Ask your health care provider for a referral to a marriage counselor. Family and friends also may give you recommendations based on their experiences. Your health insurer, employee assistance program, clergy, or state or local agencies also may offer recommendations. You can also look up marriage counselors in your phone book.

What questions should you ask when choosing a marriage counselor?

Before choosing a new marriage counselor, you can ask lots of questions to see if he or she is the right fit for you. Consider asking questions like these:

• Are you a clinical member of the AAMFT or licensed by the state, or both?
• What is your educational and training background?
• What is your experience with my type of problem?
• How much do you charge?
• Are your services covered by my health insurance?
• Where is your office, and what are your hours?
• How long is each session?
• How often are sessions scheduled?
• How many sessions should I expect to have?
• What is your policy on canceled sessions?
• How can I contact you if I have an emergency?

Making the decision to go to marriage counseling can be tough. But marriage counseling can help you cope better with a troubled relationship — rather than trying to ignore it or hoping it gets better on its own.