Abigail Marsh: Current brain scan technology fails to diagnose psychological disorders, psychopathic traits can be improved, and societal norms challenge cognitive diversity | Jordan Harbinger

Psychopathy's treatability is underestimated, with societal attitudes often hindering effective treatment approaches.

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Add us on Google by Editorial Team Mar. 25, 2026

Key takeaways

• Current brain scan technology, like fMRI, has limitations in diagnosing psychological disorders.
• Psychopathic traits are not fixed and can be improved over time.
• There is a common but unwarranted pessimism regarding the treatability of psychopathy.
• Effective treatment for psychopathy is possible but often not pursued.
• People with unique cognitive abilities often mask their traits to fit societal norms.
• Psychotic individuals have widespread wiring issues that affect their reality-checking abilities.
• Those with psychotic tendencies struggle to maintain coherent reasoning due to irrelevant thoughts.
• People with extreme beliefs often genuinely feel they are saving the world.
• The term “psychopath” is scientifically accepted, unlike “sociopath,” which is colloquial.
• The US ranks high in altruistic behaviors compared to other countries.
• Technological limitations hinder the accurate measurement of neuronal activity.
• Societal attitudes toward mental health often hinder effective treatment approaches.
• Cognitive diversity requires individuals to adapt to social norms.
• Neurological differences significantly impact the cognitive processes of psychotic individuals.
• Altruism in the US is notable despite not being the highest in well-being metrics.

Guest intro

Abigail Marsh is a Professor in the Department of Psychology and the Interdisciplinary Neuroscience Program at Georgetown University, where she directs the Laboratory on Social and Affective Neuroscience. She conducted some of the first research on the neurodevelopment of psychopathy at the National Institute of Mental Health from 2004 to 2008. Her work reveals that fear processing distinguishes extreme altruists, who are hypersensitive to it, from psychopaths, who show reduced responses.

The limitations of current brain scan technology

• Current brain scans cannot accurately diagnose psychological disorders due to their limitations in measuring actual neuronal activity.

• The problem is an MRI is just showing you where blood flow is changing in the brain it’s not measuring actual activity in neurons

  — Abigail Marsh

• Brain scans like fMRI miss a lot of what’s happening in neurotransmitter systems.

• It’s not measuring activity in neurotransmitter systems like is this dopamine is it serotonin

  — Abigail Marsh

• Understanding these limitations is crucial for advancing neuroscience and psychological diagnosis.
• The technology does not provide a complete picture of brain activity, affecting diagnosis accuracy.

• It’s just missing a lot that’s happening

  — Abigail Marsh

• Improvements in technology are needed to better understand psychological conditions.

Treatability of psychopathic traits

• Psychopathic traits are not immutable and can be treated or improved over time.

• The evidence is they can be changed they can be improved

  — Abigail Marsh

• There is unwarranted pessimism about the treatability of psychological disorders.

• The pessimism is totally unwarranted

  — Abigail Marsh

• Effective treatment for psychopathy is possible but often not pursued.

• Right now we’re not even really trying to treat psychopathy

  — Abigail Marsh

• Challenging misconceptions about psychopathy is important for encouraging treatment efforts.

• If we try to treat it, it turns out it actually works

  — Abigail Marsh

Cognitive diversity and societal norms

• People with unique cognitive abilities often have to mask their traits to fit in with societal norms.

• If you’re at the tail you have to kinda act more like people at the middle

  — Abigail Marsh

• This masking is common among individuals with autism and high intelligence.

• People with all kinds of brains that are at the tails

  — Abigail Marsh

• Understanding cognitive diversity is important for fostering inclusive social environments.
• The need to adapt to social norms can be challenging for those with atypical cognitive traits.

• You have to mask

  — Abigail Marsh

• Social interactions often require individuals to conform to the majority’s expectations.

Neurological differences in psychotic individuals

• Psychotic individuals often lack the ability to perform reality checks due to widespread wiring problems in their brains.

• There seems to be sort of widespread wiring problems in the brains of people who are psychotic

  — Abigail Marsh

• These wiring issues are especially prevalent in individuals with schizophrenia.

• Especially people who have schizophrenia

  — Abigail Marsh

• Psychotic individuals struggle to prune irrelevant thoughts, affecting their reasoning.

• They can’t sort of prune away the irrelevant thoughts

  — Abigail Marsh

• Understanding these cognitive challenges is crucial for improving mental health treatment.

• They just don’t have those good reality monitoring mechanisms

  — Abigail Marsh

The psychology of extreme beliefs

• People who believe they are being watched or targeted often genuinely think they are trying to save the world.

• It’s really tragic if you think about it

  — Abigail Marsh

• These individuals may believe in conspiracy theories and feel they are among the few who know the truth.

• They’re so sure that government officials have actually been abducted by pod people

  — Abigail Marsh

• Understanding the psychological aspects of these beliefs can help in addressing them.

• They’re one of the few people who know this information and they can stop it

  — Abigail Marsh

• The complexity of human psychology plays a significant role in the formation of extreme beliefs.

Scientific terminology in psychology

• The term “psychopath” is scientifically accepted and has established measures for assessment.

• I will say that the term psychopath or psychopathic is the sort of accepted scientific term now

  — Abigail Marsh

• In contrast, “sociopath” is largely a colloquial term used by media.

• The same is not true for sociopathy that’s basically a term now that is mostly just used by movie makers and authors

  — Abigail Marsh

• Understanding the distinction between these terms is important for accurate discussions in psychology.
• The scientific consensus favors the use of “psychopath” over “sociopath.”

Altruism in the United States

• America is one of the most altruistic countries, particularly in terms of measurable altruistic behaviors.

• If you look at altruistic behavior… you see happen at very high levels in the US

  — Abigail Marsh

• The US ranks high in altruism compared to countries like the Netherlands and Scandinavia.

• Places like the Netherlands and the Scandinavian countries

  — Abigail Marsh

• Despite not being the highest in well-being metrics, the US shows significant altruistic behavior.

• The US is not as high as we could be in terms of well-being but we’re pretty high in the scheme of things

  — Abigail Marsh

Disclosure: This article was edited by Editorial Team. For more information on how we create and review content, see our Editorial Policy.