Is psychopathy a syndrome? Commentary on Marcus, Fulton, and Edens

Comments on the original article by Marcus, Fulton, and Edens (see record 2011-23134-001). The term "syndrome" derives from the Greek, meaning to "run together." Accordingly, in organic medicine, syndromes are traditionally conceptualized as conditions marked by constellations of signs (observable indicators) and symptoms (subjective indicators) that covary across individuals (Kazdin, 1983; Lilienfeld, Waldman, & Israel, 1994). For example, panic disorder is a classical syndrome because it consists of signs (e.g., sweating and difficulty breathing) and symptoms (e.g., intense fear and fears of dying or losing control) that are positively correlated. In rare cases, syndromes also comprise constellations of largely uncorrelated traits that point to an underlying pathology. For example, Gerstmann's syndrome in neurology is marked by four indicators: dysgraphia/ agraphia, dyscalculia/acalculia, left-right disorientation, and finger agnosia (Benton, 1992). Across the general population, these four indicators are essentially uncorrelated. Nevertheless, when observed together, this constellation of four signs generally indicates a lesion in the left hemisphere near the angular gyrus.