The introduction notes the difficulties and limitations in the diagnosis of child psychopathy, especially as part of an expert approach that requires a thorough study of the patient's entire previous life. The second part of the article is devoted to the available tests, questionnaires and diagnostic scales and the difficulties of their use for children are noted. The third part of the article is devoted to neuropsychological methods for diagnosing psychiatry in children and the difference in the perception of emotionally charged samples in healthy and psychopathic children is noted. The fourth part considers the world's most famous tool for diagnosing psychopathy in children as part of an expert approach – a List of psychopathic traits – a youthful version of R. Hare and K. Kiehl and highlights its shortcomings when it is extended to younger, pre-adolescent age of the subjects. The fifth part is devoted to the PCL-MYV test, which is proposed for the diagnosis of psychopathy in children before any physical signs of puberty appear (6-12 years) as part of an expert approach and the rules for working with it. This tool, as well as the Youthful version of the Psychopathy Checkist, is designed to be completed by specially trained professionals. Скачать в формате PDF
American Scientific Journal № ( 41) / 2020 19

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UDC 15 9.9:616.89 -071


Israel (Vladimir Modestovich) Datskovsky,
Cabinet of Clinical Psychology and Pathopsychology
Rival str. #3, apt. 2 , Beit Shemesh 9908188, State of Israel

Abstract . The introduction notes the difficulties and limitations in the diagnosis of child psychopathy,
especially as part of an expert appro ach that requires a thorough study of the patient's entire pre vious life. The
second part of the article is devoted to the available tests, questionnaires and diagnostic scales and the difficulties
of their use for children are noted. The third part of the article is devoted to neuropsychological methods for
diagnosi ng psychiat ry in children and the difference in the perception of emotionally charged samples in healthy
and psychopathic children is noted. The fourth part considers the world's most famous too l for diagnosing
psychopathy in children as part of an expert approach – a List of psychopathic traits – a youthful version of R.
Hare and K. Kiehl and highlights its shortcomings when it is extended to younger, pre -adolescent age of the
subjects. The fifth part is devoted to the PCL -MYV test, which is proposed for t he diagnosi s of psychopathy in
children before any physical signs of puberty appear (6 -12 years) as part of an expert approach and the rules for
working with it. This tool, as well as the Yo uthful version of the Psychopathy Checkist, is designed to be comp leted
by sp ecially trained professionals.
Keywords: psychopathy, list of psychopathic traits, phenomenological approach, expert approach.

1. Introduction
The field of child psychopathies, desp ite a
sufficient number of printed sources on this topic, is
still a relative ly poorly researched area both as part of
child psychiatry and as part of psychiatry of borderline
states. In our opinion, this situation is primarily
associated with the difficul ty of distinguishing states
related to the field of psychopathie s of childhoo d from
other mental states, especially taking into account the
fact that, as shown in our previous article (Datskovsky
I., 2019 [ B]), the very concept of psychopathy is
ambiguous and there are two significantly different
approaches to diagnosi s, operating with the same name
for the condition – psychopathy.
In addition, it is quite reasonable that in childhood
a diagnosis of psychopathy is not made at all due to the
inseparability of congenital (nuclear) psychopathy,
early brain injury (trauma, intoxication) and the results
of the psycho -traumatic (psychopathic?) influence of
the environment and upbringing at an early age,
although a number of cases described in the l iterature
clearly indicate the diagnosis. This is due to the
uncertainty of the correctness o f such a serious
diagnosis, which lays a heavy imprint on a person's
entire life, since there are many cases of becoming a
normative person growing out of a child who
manifested many symptoms of psychopathy in
childhood. Even the compromise di agnosis of F6 0 in
the ICD -10 ("Specific personality disorders") is
generally not given to children, even as comorbid ones,
and the diagnosis of accentuations of character
accep ted in the Russian literature (A.E. Lichko, 2016),
by definition, describes prec linical condi tions. That is,
on the one hand, there is a well -founded fear of
overdiagnosis of psychopathy. On the other hand, "as
the signs of social distress become more pers istent, we
no longer have the luxury of ignoring psychopathy in
certain children ." (R. Hare, 2007).
In this text, we will continue to call psychopathies
by psychopathies (from ancient Greek ψυχή (psychi
“spirit; soul; consciousness; character” + from
Greek παθος (pathos) “suffering, pain, illness” – a
suffering soul, however, it is not noticed that
psychopaths noticeably suffer from their psychopathy,
from their temper ament, but the environment of
psychopaths suffers from their psychopathy very
significantly), al though in the modern trend of
replacing medical terms that have penetrated into
general speech and carry a negative, sometimes
offensive connotatio n in it, this term is being replaced
by more neutral "personality disorder", (to be
distinguished from person ality changes), although there
is no tendency to return to the old, rather accurate terms
"moral dullness", "emotional underdevelopment".
The main objective of this article is the
development of a test for the diagnosis of child

20 American Scientific Journal № ( 41) / 2020
psychopathicity as part of an expert approach to the
diagnosis of psychopathies (Datskovsky I., 2019 [ B])
in the age group of the school stage of psychophysical
development f rom 6 to 12 y ears old for taking
appropriate adequate measures of both socio -
pedagogical and medical spectra.
2. Psychological tests, questionnaires, scales
Since the end of the 19th century, various
numerous tests and questionnaires, in addition to
differen tly structure d (clinical) interviews, are one of
the main methods of studying the psyche. These
methods have proven themselves very well, the number
of tests is multiplying exponentially, the Internet has
led to an explosive increase in the number of such tests,
howeve r, not all of them are sufficiently well tested (or
not tested at all) and adapted to the tasks they are
designed to solve and to the target population group, for
which they should especially show the properties of
validity and reliability. Th ere are texts both universal,
designed to solve many problems of general and
clinical psychology, and more sp ecific tests that solve
the problems of specific differential diagnosis. Simple
and short screening tests and questionnaires have the
least specifi city.
Nevert heless, in the area under consideration
(child psychopathy), there are numerous sensitive
points in comparison with the ability to make or refute
other diagnoses. “Assessing and predicting which
children will become psychopaths is a difficult task.
Some co nsider that scientists should not even make
such attempts, because if a similar diagnosis is mad e to
children, it can become a stigma for them for life.
Moreover, such stigmatization can be a self -fulfilling
prophecy. According to others, if p arents are to ld that
their child is a psychopath, this may further alienate
them from their child... Scientis ts working in this field
go to all sorts of tricks, just not to use the term
psychopathy when discussing children. Most often they
speak of traits of callousnes s and indifference ." (K.
Kiehl, 2015).
Varieties of questionnaires are used to solve this
problem. Among the universal tests, the first are
questionnaires TAT (Thematic Apperception Test – a
projective psychodiagnostic technique developed i n the
1930s. The purpose of this technique was to study the
driving forces of the personality – internal conflicts,
drives, interests and motives. After the Second World
War, the test became widely used by psychoanalysts
and clinicians to work with disorde rs in the emo tional
sphere of patients) and MMPI ( Minnesota Multiphasic
Personality Inventory – a person ality questionnaire
developed in the late 30s – early 40s at the University
of Minnesota, the most studied and one of the most
popular psychodiagnostic techniques, d esigned to study
individual characteristics and mental states of a person.
MMPI is widely u sed in clinical practice. This
technique was based on a quantitative comparison of
the responses of representatives of the normative group
with typical responses of patients, whose picture of
clinical disorders clearly demonstrated the
predominance of one or another syndromic complex:
hypochondria, depression, hysteria, psychopathy,
psychasthenia, paranoia, schizophrenia, hypomania.
There are Russian -lang uage adaptati ons of MMPI:
MMPI technique modified by F.B. Berezin et al. and
SMIL (standard methodology for the study of
personality) modified by L.N. Sobchik).
However, universal questionnaires are
fundamentally nonspecific, therefore, for a more
accurate diagnosis of child psychopathy, more specific
questionnaires have been developed and continue to be
dev eloped and tested. One of the widespread
questionnaires in Russia for the diagnosis of character
accentuations and psychopathies in adolescence is the
Pathocharacter ological Diagnostic Questionnaire for
adolescents, PDQ, developed by A.E. Lichko (Ivanov
N.Ya., Lichko A.E., 1995).
In Canada and the United States, more recently, a
notable range of questionnaires that are specific to
assessing the traits of callousness a nd indifference in
children have been developed.
The first and most common self -report tool for
assessing callousness and indifference traits in children
is the Childhood Psychopathy Scale (CPS), developed
by Dr. Don Lyman of Purdue University . It includes
questions about the children's relationship with others,
about what is important to them, whether they are very
angry, etc. The University of New Orleans has
developed several scales for assessing the traits of
callousness and indifference fo r parents and teachers,
including the Antisocial Process Screening Device
(APSD). In parallel, Dr. Frick developed the Inventory
of Callous -Unemotional Traits (ICU) with options for
parents, teachers and the child (there are also options
for preschool and primary schoo l children). Hare's
Psychopathy Checklist: Youth Version (PCL: YV);
Youthful Psychopathic T raits Inventory (YPI); Child
Problematic Traits Inventory (CPTI) may also be
Research has even shown that traits of callousness
and indifference in boys aged 7-12 predict their
psychopathic score at age 19 (for example, Burke J. D.,
Loeber R. & Lahe y B. B. Adolescent Conduct Disorder
and Interpersonal Callousness as Predictors
of Psychopathy in Young Adults. [Research Support,
N.I.H., Extramural]. Journal of Clinical Child
Adolescent Psychology, no. 36 (3), 2007, pp. 334 –346
and also Lynam D. R., Cas pi A., Moffit T. E.,
Loeber R. & Stouthamer -Loeber M. Longitudinal
Evidence that Psychopathy Scores in Early
Adolescence Predict Adult Psychopathy. Jour nal
of Abnorm al Psychology, no. 116 (1), 2007, pp. 155 –
However, such questionnaires have their
drawbacks and limitations. Moreover, some drawbacks
are exacerbated when trying to assess the features of
callousness and indifference in young children. T hus,
many chi ldren at risk, whose callousness and
indifferent traits we want to assess, are sim ply unable
to read or listen to questions and answer them on the
CPS, MMPI or other questionnaires.
Another disadvantage of self -reporting in
psychology is that it requires p atient cooperation. It is
very easy to spoil the results if the patient lies
(cons ciously or unconsciously), answers questions at
random, or simply refuses to fill in the questionnaires.

American Scientific Journal № ( 41) / 2020 21

This greatly limits the usefulness of questionnaires
whe n the patient is hostile or unable to cooperate with
the psychologist. In addition, in the fiel d of research on
psychopathies, especially in childhood and
adolescence, a negative feature of conventional
psychological approaches has been revealed. It lies i n
the fact th at, on the one hand, tests and questionnaires
filled in by children (if the childr en are not angry, agree
to cooperate and know how to read or at least listen and
answer clearly), questionnaires filled in by parents (if
the parents are adequat e in their as sessments and do not
specifically give false answers, for example, when their
chil d is threatened with isolation in special pedagogical
systems) about the same children and, on the other
hand, a professional expert assessment of objective
mate rials and ind ependent assessments about this child
and a focused clinical interview to fill in the Expert
Youth Version of the Psychopathy Checklist (PCL: YV
– R. Hare, 2007) give very different assessments of the
psychopathic properties of the child. Fina lly, and
perh aps the most important flaw in self -report
questionnaires for assessing callousnes s and
indifference is that children with these traits may
simply not be able to talk about their emotional world
in detail. They do not understand themselves, an d this
can pr event the researcher from assessing these traits in
them. Therefore, the main emph asis in the diagnosis of
psychopathy or psychopathic temperament has to be
done precisely on the expert assessment of a specialist.
3. Neuropsychological methods
"In addition to using tests, questionnaires, scales,
and other tools to measure callousness and i ndifference,
psychologists and neuropsychologists have developed
tasks or games to study the brain systems associated
with these symptoms. One such task or game used by
resea rchers is a task of making an emotional lexical
decision . It actually kind of remi nds of spelling
dictation. Chains of letters quickly appear on the
computer screen, and the subject must decide whether
the letters constitute a real word, or it is gibberish or a
word written with a mistake. When letters form an
emotional word (“hate,” “k ill,” “die”), people react
faster than to a neutral word (“chair”, “table”, “hand”).
Emotional word processing employs a brain system
that makes us recognize the m very quickl y. Today, it
has been fairly reliably found that, unlike ordinary
people, psychopa ths do not respond to emotional words
faster than neutral ones. This proved that psychopaths
"know the words, but not the melody." In other words,
psychopaths kn ow the meanin g of the words “love”,
“hate”, “murder”, but they do not feel the affective
influe nce conveyed by these words.” (K. Kiehl, 2015).
After these discoveries, studies have shown that
children and adolescents with traits of callousness and
indiffer ence are wors e at solving emotional vocabulary
and other similar tasks. The use of many studies and
tasks developed in recent years suggests that children
and adolescents with callousness and indifference (as
well as adults with psychopathy in terms of an expert
approa ch) are characterized by deficiencies in the
quality and speed of processing emoti onal stimuli.
However, the methods of neuropsychology, just
like traditional test methods, provide researchers and
doctors with only indirect tools for assessing the
psychopa thic characteristics of children and
adolescents and, when applied, require the ac tive
participation of the subjects.
4. Expert approach
In section 3 "Phenomenological approach" of the
article (Datskovsky I., 2019 [ B]), we have already
indicated that the issu e of child psychopathy was
already raised by P.B. Gannushkin (1933). However, it
remained (and in many respects remains today) within
the framework of an approach based on clinical -
descriptive criteria, which remain both subjective and
eclecti c. Today, the presence of child psychopathy (and
early accentuations of character) is widely re cognized,
the corresponding chapters (within the framework of
the phenomenological approach) are included in many
child psychiatry books (V.V. Kovalev (1979), I. V.
Makarov (2 019), B.V. Voronkov (2017) and many
others), however, we believe that the real bre akthrough
in the diagnosis of child psychopathy is precisely the
expert approach (Datskovsky I., 2019 [ B]) and the
objective diagnostic methods that have been fu rther
brought to clinical use, especially those that do not
require the active participation of the child under study.
At the same time, other characterological deviations in
the state and thinking of a child (and an adult),
considered in the framework of the phenomeno logical
approach to psychopathies, are not denied in any way.
Consider the expert approach to the diagnosis of child
psychopathy proposed by Dr. K. Kiehl (2015) and
propose a modified tool that is more suitable for
younger children (6 -12 years old).
K. Kie hl (2015) provides a corresponding
Psychopathy Checklist for children and adolesce nts,
which is a modification of R. Hare's Psychopathy
Checklist (2007) for adults. The traits and behavior
inherent in this disorder (child psychopathy) are
asse ssed by an ex pert (trained specifically for such an
assessment of the data by a specialist) usi ng this
checklist based on collecting as much information as
possible about the child's previous life (anamnesis
vitae). Just as when using the adult version of the
questionn aire, for each item the expert gives the child a
score from the series 0, 1, 2, an d children who scored
30 or more points are considered psychopathic.
"List of Psychopathic Traits for Children and
1) Introducing oneself in society (e xternal)
2) Exag gerated sense of self -esteem (internal)
3) Desire for arousal
4) Pathological deceit
5) Manipulation for personal gain
6) Lack of remorse
7) Affective flattening
8) Callousness/ lack of empathy
9) Parasitic orientation
10) Anger
11) Impersonal sexual relations
12) Early behav ioral problem s
13) La ck of goals
14) Impulsivity
15) Irresponsibility
16) Failure to ta ke responsibility

22 American Scientific Journal № ( 41) / 2020
17) Unstable interpersonal relationships
18) Major infraction s
19) Serious violations of the conditions of release
20) Variety of criminal activities ".
Since in this paper we are dis cussing child ren
between the ages of 6 and 12, a number of features cited
by Dr. K. Kiehl is irrelevant or requires a change in the
wording for this age group (and often for a group of
older children). We have marked these cha racteristics
in Dr. K. Kiehl 's Checklist in underlined italics .
However, among these signs there are two, which,
although infrequently, appear in the examined children
and very clearly (obligatory) indicate the presence of
psychopathy. We marked these feat ures in highlighted
underlined italics , and in the proposed test, we
highlighted them in a separate group of features (table
5. Psychopathy Checklist – Modified Youth
Version (PCL -MYV)
Often, the problems of psychopathic development
of the child's charact er become noticeable to parent s
and educato rs, as a rule, from 3 -4 years old (and
sometimes even earlier), but it is obvious that it is
impossible to diagnose such a difficult diagnosis based
on only recently noticed problems. And a child of
primary school age (from 6 -7 years old) is a lready a
fair ly mature personality with clearly distinguishable
character traits that can already be diagnostically
analyzed, although the actual diagnosis of psychopathy
cannot be made even before any physical signs of
pubert y appear , or even until late a dolescence (f or
avoidance of labeling, when the diagnosis can greatly
interfere with the child's socialization and thereby turn
out to be a self -fulfilling prophecy). However, even the
diagnosis "established" by the points sco red in the pre -
pubertal age sh ould be recor ded only in documents that
are closed from outsiders (except for a professional -
specialist) and explained to parents in Aesopian
language, with euphemisms in the form of
recommendations for correctional, education al and, if
this is indicated, for medical m easures.
For the needs of early diagnosis of child
psychopathy (in terms of an expert approach), we have
clarified the Psychopathy Checklist for children and
adolescents (in fact, by proposing PCL -MYV –
Psychopathy Checklist – Modified Youth V ersion),
remo ving irre levant items and adding items that are
absent in the original Checklist, but important from our
point of view, or changing the wording of some items
from the Checklist of R. Hare – K. Kiehl .
In addition, we have made the scoring a lit tle more
diff icult. Although this list is in no way a test or a
questionnaire for a small patient and it is also not a
questionnaire for the environment of the child being
checked (parents, educators, teachers, ne ighbors, etc.),
but is a professional tool of a trained professional
psychologist or psychiatrist, nevertheless, if you use the
method of R. Hare – K. Kiehl, to give a score of 2
points, you need to have a very vivid picture of this
deviation, which is oft en very difficult to collect, given
the lim ited material s on the characteristics of the
behavior of a small patient, and a score of 1 point is
often does not give a sufficiently adequate
characterization of the child. Therefore, we mitigated
the difficulty of assessing a particular characteristic o f
a child by introducing not a three -position (0 -1-2), but
a four -position assessment (0 (absent) – 1 (present in a
mild form) – 2 (present in a highly developed form) –
3 (striking feature of the child's personal ity)). We
understand that in most cases it will not be e asy to give
a score of 3 for most characteristics (as well as a score
of 2 in the R. Hare – K. Kiehl approach), therefore, we
left the main scoring at the level of the third column
(the characteristic is in a very developed form), giving
the r elatively rar e characteristics that received a point
in the fourth column to slightly increase the total score
and thereby slightly strengthening the validity of the
psychopathic diagnosis.
It was also noted that some characteristics from
the modified chil dren's list o f psychic traits are almost
always found in children with psychopathic problems
and characterize their personality much more clearly
than other characteristics. Moreover, such
characteristics are abse nt or poorly expressed in non -
psychopathic children. To account for this
phenomenon, we introduced the concept of important
characteristics (some semblance of obligate symptoms
in psychiatry) and ordinary characteristics (some
semblance of facultative symp toms in psychiatry),
provided that importan t characteris tics received a
double number of points (scale 0 -2-4-6).
Moreover, there is a third group of characteristics,
which includes only two characteristics (in a modified
formulation), marked by us in the l ist of K. Kiehl in
highlighted underlined i talics . These characteristics
(highlighted in Table 2) receive points in the same way
as the characteristics in Table 1, but these
characteristics were NOT entirely included in the total
score when setting the bou ndary values of points (like
the points in the fourth co lumn), but were included in
the score points given to this child. This leads to the fact
that scores other than zero in this table noticeably shift
the result towards the diagnosis of psychopathy.
We do not consider parabolic or more complex
scales of incr easing points within one PCL -MYV item
(for example, instead of a scale of 0 -1-2-3 points,
introducing a scale of 0 -1-3-6 points with an increase
in the difference in points when moving up the scale),
as to substantiate such an approach, we nee d a fairly
large statistical sample WITH TRACED
CATAMNESIS at least up to the upper limit of
adolescence (18 years), which we do not have.
We also refrained from highlighting some
characteristics that do not stron gly affect the child's
image into the fourt h, one -half, less significant scale
with score values of 0 -0.5 – 1-1.5 in order not to
multiply entities (Occam's razor) without a sufficiently
long and massive statistical study on numerous children
with psychopa thic problems.
Since the collection of full -fledged, com plete
information about a fairly short life of a young patient
is very difficult, we tried to compensate for this
problem with more detailed, consisting of a larger
number of characteristics than in t he original. This also
mitigates the influe nce of each g iven score on the final
diagnostic result.

American Scientific Journal № ( 41) / 2020 23

We shall note that adult psychopaths usually have
a history of late (after the age of 5 years) enuresis.
However, it is impossible at this stage of diagnosis to
accept this symptom as a predictor of p sychopathy –
according to modern concepts, enuresis can be caused
by abnormalities in one of the four neural pathways, but
it seems that only one of them, passing through the
amygdala, to some extent indicates psy chopathic
development. Apparently, those su ffering from
enuresis due to the pathology or underdevelopment of
other neural pathways do not become psychopaths, and
they often even have late enuresis spontaneously or
with some treatment, although later than m ost children.
We also note that in psychopa thy, deviatin g
personality traits should be total, that is, be manifested
everywhere and always, in any situation and
circumstances. "They should be present almost
everywhere – at home, at work, at school, in
comm unication with family, friends and neighbor s."
(K. Kiehl , 2015). "A teenager with psychopathy
discovers his/her type of character in the family and
school, with peers and with elders, in school and on
vacation, in work and play, in the ordinary and familia r,
as well as in the most emergency situati ons." (A.E.
Lichko, 2016). But the opposite is also true: "A tyrant
at home and an exemplary student at school, a quiet
child under harsh authority and an unbridled bully in an
atmosphere of connivance, a fugitive from a home
where an oppressive atmosphere reigns or a family is
torn apart by contradictions, who can get along well in
a good boarding school – they all should not be counted
to psychopaths, even if adolescence passes under the
sign of impaired adaptati on." (A.E. Lichko, 2016).
The test was cons tructed accor ding to a scheme
similar to the scheme of the Modified Detailed
Infantilism Test – DIT -M, previously published
(Datskovsky I., 2019 [A]).
The proposed revised list of PCL -MYV
(Psychopathy Checklist – Modified Youth Version )
consists of three t ables (scales ) and looks as follows:
1. Important characteristics
No. Characteristic

0 points
Present in
mild form

2 points
Present in a
4 points
trait of a
6 points
1 Early behavioral probl ems
2 Aff ective flattening
3 Lack of empathy
4 Lack of remorse
5 Callousness
6 Indifference
7 Pathological deceit
8 Aggressiveness
9 Conflict, numerous fights, often on their
own initiative without sufficient reason
System atic cruelty to animals, insects and
even children and adults that does not pass
even after many explanations and
punishments. Unexplained disappearances
and deaths of a nimals

11 Intriguery
12 Seeking arousal to perform inappropriat e
actions / su sceptibility to boredom
13 Lack of fear
14 Apparent ineffectiveness of punishments
Column scores
Total score for important

24 American Scientific Journal № ( 41) / 2020
2. Rarely found important characteristics
No. Characteristic

0 points
Present in
mild form

3 points
Present in a
3 points
trait of a
9 points
1 Active sexual behavior beyond age (up to
the normal age of puberty)
2 Major infractions, often with violent
Column sco res
Total score for rarely found important

3. Ordinary characteristics
No. Characteristic

0 points
Present in
mild form

1 point
Present in a
2 points
trait of a child
3 poin ts
1 Pompous introducing of oneself in society
for both adults and children (external)
2 Exaggerated sense of self -esteem
Loquacity / superficial charm (ability to
speak convincingly, fluently, interesting,
streamline d)

4 Manip ulation for personal gain
5 Envy
6 Anger even for minor reasons, or even for
no apparent reason
7 Impulsiveness
8 Lack of goals even in normal activities
(play, study, etc.)
9 Lack of idea even about the immediate
results of their own actions
Lack of idea about the feasibility and
reality of the goal of the performed
actions (even without taking into account
possible obstacles in achieving the goal)

11 Lack of both close and more distant plans
12 Uns table interpers onal relationships (both
with adults and in the children's team)
13 Irresponsibility
14 Failure to take responsibility
15 Inability to study regularly, even with
good intelligence
Inability to control expenses, excessi ve
and unnecess ary spending, debts that are
not even planned to be paid

17 Cheating in games, during tests
18 Inappropriate behavior against the
background of their age group
Non -participation in collective actions
(games and other action s), striving fo r
individual activity

Lack of cooperation (separation of
functions in collective actions) and lack of
understanding of the need to share in
games and other actions

21 Pyromania

American Scientific Journal № ( 41) / 2020 25

Difficulties with abstract concepts:
abstra ct description of objects in
mathematics, metaphors, proverbs, fables
in the humanities

Impaired learning ability (not school, but
life), even from their own experience (not
to mention the experience of children
from their age group or gleaned from
literary or fo lklore sources)

Imperviousness to moral ideas and rules
(including inferences from literary or
folklore sources)

Nasty things (verbal (name -calling,
curses) and actions), often in an
underhand way, without witnesses

Col umn scores
Total score for ordinary characteristics
Total score for the test

The total score for the third column (the
characteristic is present in a highly developed form) for
both tables – scales (tables 1 and 3) is 106 points
(without points for table 2). Following Dr. R. Hare and
K. Kiehl , we will establish the conclusion about the
presence of psychopathy at the level of overcoming
75% of the mark, that is, 80 points and above. However,
for a more differential diagnosis, we wi ll introduce two
more scoring ranges :
• 54 -79 points (51 -75%) – psychopathic
character formation;
• 36 -53 po ints (36 -50%) – suspected
psychopathic character formation ;
• 35 or less points – no psychopathic tendencies.
We shall notice that, since we have proposed the
calculation of the sums of points according to the sum
of points in the third column, it is theoret ically possible
that some especially pronounced psychopaths who
scored points in the fourth column for several
characteristics or received points other than zero
accord ing to Table 2 will exceed 106 points. The
theoretical maximum is 159 points (167 points taking
into account the points in Table 2).
6. Conclusion
Therefore, in this article we have proposed the
PCL -MYV test (Psychopathy Checklist – Modified
Youth Version), which is a sufficiently distant relative
of the Psychopathy Checklist (PCL) for children and
adolescents, proposed by R. Hare (2007) and K. Kiehl
(2015), but, like it, drawn up in the framework of an
expert approach. The proposed test has a completely
diff erent, more complex and branched structure in
relation to the Psychopathy Checkl ist (PCL) for
children and adolescents and is more focused on
children aged 6 -12 years (pre -pubertal age).
An attempt is made to introduce the boundaries of
var ious preclinical stages of psychopathy, separating
them from the indicators of healthy children,
determined by the same test.
Although it is clear to us that the expert and
phenomenological approaches to the diagnosis of
psychopathies and preclinical psych opathic states a re
not very compatible with each other, nevertheless, an
attempt has been made t o draw some analogies in
assessing the severity of a psychopathic state between
these approaches.
In addition, the traits of the character and behavior
of child ren are consider ed, which at a certain stage of
ontogenesis may be similar to some psychopathic traits,
but require careful attention to themselves in order to
avoid unreasonable overdiagnosis of psychopathic

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Кононков Валерий Васильевич
DOI: 10.31618/asj.2707 -9864.2020.3.41.31
Абстракт . Общая анестезия является методом выбора у пациентов подвергающихся обширным
оперативным вмешательствам. Иногда данная анестезия может комбинироваться с эпидуральной
анестезией. Однако комбинирование обоих методик имеет множество ограничений и побо чных эффектов.
Здесь мы предоставл яем случай пациентки, у которой была выполнена срединная лапар отомия по
поводу острого холецистита осложненного холедохолитиазом и синдромом билиарной гипертензии.
Сопутствующая патология: ишемическая болезнь сердца, пости нфарктный и атеросклеротический
кардиосклероз, атеросклероз аорты и коронарных артерий, Н2А, пос ледствия перенесенного ОНМК.
Короновирусная двухсторонняя полисегментарная пневмония, тяжелое течение ДН2.
Интра - и послеоперационное ведение данной пациентки т ребовало адекватного обезболивания с
минимальным коли чеством наркотических анальгетиков. Адекват ная анестезия была достигнута путем
комбинирования общей анестезии и интратекального введения низких доз тяжелого бупивакаина и
морфина. Данная комбинация позво лила снизить количество введенных опиоидов и миорелаксантов во
время операции и отказаться то ис пользования наркотических анальгетиков в послеоперационном
периоде, что позволило быстрее активизировать пациентку в раннем послеоперационном периоде и
избежать осложнений характ ерных для пациентов с данным коморбидным фоном.

Общая анестезия – ме тод анестезии который
наиболее часто применяется у пациентов
подвергающихся лапаратомным вмешательствам.
Однако у пациентов с сопутствующей кардиальной
патологи ей, последствиями перенесенного ОНМК
и короновирусной пневмонией желательно
применение Fast truc k методик и использование
меньшего количества опиоидных анальгетиков в
послеоперационном периоде. Рутинная
комбинация комбинированной анестезии с
применением эп идурального обезболивания
сопровождается гемодинамическим дисбалансом и
требует жесткого контрол я показателей
свертывании крови при стоянии эпидурального
катетера, так при лечении COVID пневмонии
требуется введение терапевтических доз
Учитывая з аболевание пациентки,
сопутствующую патологию, ограничение ресурсов
в условии эпидемии COVID 19 была выбрана
комбинированная анестезия с использованием
интратекального введения низких доз бупивакаина
и морфина в виде единичного введения. Используя
этот мет од мы добились хорошего уровня интра - и
послеоперационного обезболивания с
минимальным количеств ом опиоидов, ранней
экстубации и активации, возможность раннего
перевода в общесоматическое от деление с
последующей выпиской из стационара.
Презентация случая
Мы проводили анестезию пациентке, у
которой был диагностирован острый калькулезный
холецистит, х оледохолитиаз, синдром билиарной
гипертензии. Пациентке оказывалась помощь в
специализированном стационаре т.к. у неу была
диагностирована двухсторонняя полисег ментарная
короновирус ная пневмония. Исходное состояние
оценивалось как тяжелое ЧД – 28 SpO 2 95 с
подачей увлажненного кислорода через носовые
канюли со скоростью потока, 7л/мин. Содержание
кислорода в артериальной крови составило 67
mmHg . Респираторный инд екс 250 Среднее АД
было несколько выше нормы и колебалось в
пределах 95 -100 мм рт ст . По данным РКТ грудной
клетки от с обеих сторон более выражено слева, по
всем легочным полям, больше в нижних отделах
перибронхиально и субплеврально определяются
участки снижения пневматизации по типу матового
стекла. С участками утолщения интерстиция.
Сопутсвующа я патология включала
ишемическую болезнь сердца, постинфарктный и
атеросклеротический кардиосклероз, атеросклероз
аорты и коронарных артерий, Н2А, последствия
перенесенного ОНМК.
Пациентке была выполнена операция:
лапаротомия, холецистэктомия. Реконструкти вная
операция на желчевыводящих путях,
трансдуоденальная папиллосфинктеропластика,
дренирование холедоха по Холстеду.
В качестве анестезиологического пособия мы
выбрали комбинированную анестезию с
испол ьзованием интратекального введения низких
доз бупивака ина и морфина в виде единичного
введения в комбинации с тотальной внутривенной
анестезией с ИВЛ.