In Cold Blood”: A Profile of the Antisocial Personality Disorder

Mary Anne Gunter
Lyon College

Key Words –Education, Internet, Technology, Society, Teacher, Classroom, Multimedia, Information.


This paper will examine how the 1967 film, “In Cold Blood,” represented the Antisocial Personality Disorder in its cinematic portrayal of the real-life serial killer Richard Hickock. At the time it was an introspective film, filmed in the actual locations surrounding the crime.

Hickock was executed in 1965 for participating in the murders for profit of a family of four in Holcomb, Kansas.


According to the text-revised fourth version of the Diagnostic and Statistical Manual, a personality disorder is an “enduring pattern of experience and behavior that differs greatly from the expectations of the individual’s culture” (Larsen & Buss, 2009, p. 589). This paper will specifically focus on the Antisocial Personality Disorder and explain how Richard Hickock, one of the two protagonists of the film “In Cold Blood,” met the criteria for a DSM-IV –TR diagnosis of Antisocial Personality Disorder.

In November 1959, Richard Hickock and Perry Smith, both recently released from Leavenworth federal prison, conspired together to rob Herbert Clutter, owner of a large and prosperous farm operation in Holcomb, Kansas. Hickock had been assured there was a cash-laden safe at the Clutter home. Upon arrival there, the pair discovered there was neither cash nor safe. Hickock and Smith then systematically separated, tied up, and coolly executed each of the four Clutter family members, two of whom were adolescents, and a third a partial invalid. 

Richard Hickock was the hallmark antisocially-disordered man. He was intelligent, a fast talker, smooth, and organized. He was also glib, shallow, and indifferent to the needs, fears, and boundaries of others. Hickock lacked remorse, was dishonest, manipulative, engaged in petty, as well as major, theft. He engaged in thrill-seeking, risky behaviors, lacked regard for others, including his own family. He lacked regard for the law and society as a whole, and indeed was openly contemptuous of both. He failed to learn consequences from past mistakes and was not rehabilitated from a recent stint in federal prison. He did not honor his parole requirements. He made no effort to change, or improve, his behavior.  An accomplished pathological liar, Hickock was even willing to allow his poverty-stricken, terminally ill elderly father to be held financially responsible for his (Richard’s) hot check crime spree. 

Hickock engaged in shallow, sexually-based relationships with a plethora of females and was divorced after two short-lived, adulterous marriages. He had three little boys, all of whom he was willing to permanently walk away from in his post-crime flight to Mexico. He was violent, edgy, and irritable underneath a façade of suave friendliness. Richard Hickock was criminally versatile, in that his crimes ranged from petty theft, to auto theft, homicide, pathological lying, advance planning of a violent crime for monetary and proprietary benefit, and hot check schemes. Antisocially-disordered persons are often charming, engaging, bright – as well as glib, superficial, and manipulative.  


Larsen and Buss (2009, p. 596) provided a list of diagnostic characteristics of the Antisocial Personality Disorder.  Hickock met virtually all the following facets:

  • “Fails to conform to social norms, e.g. breaks the law
  • Repeatedly lying or conning others for pleasure or profit
  • Impulsivity
  • Irritable and aggressive
  • Reckless disregard for safety of others and self
  • Irresponsible, e.g. truant from school, cannot hold a job
  • Lack of remorse, e.g. indifferent to pain of others, rationalizes having hurt or mistreated others”

Michaud and Hazelwood (1998, p. 89) could well have been observing Richard Hickock when they wrote, “Thinking criminals tend to be extroverted and articulate, use (but do not abuse) alcohol and drugs, and are highly narcissistic. They often take great care with their physical health and appearance and can pass anything but a mirror.”

A diagnosis of Antisocial Personality Disorder, according to the fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual-Text-Revised (2000), is applied to an individual whose “actions regularly disregard and violate the rights of others. These behaviors may be aggressive or destructive and may involve breaking laws or rules, deceit, or theft. 

The diagnostic criteria for 301.7 Antisocial Personality Disorder follows:

A.  There is a pervasive pattern of disregard for and violation of the rights of others . . . 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

B. The individual is at least age 18 years.”

Harenski, Harenski, Shane, and Kiehl (2010, 862-874) conducted functional MRI examinations (fMRI) on seventy-two incarcerated adult males. Their research revealed “a positive association between amygdala activity and severity ratings that was greater in non-psychopaths than psychopaths, and a negative association between posterior temporal activity and severity ratings that was greater in psychopaths than non-psychopaths . . . analysis of brain activity during the evaluation of pictures depicting moral violations in psychopaths versus non-psychopaths showed atypical activity in several regions involved in moral decision-making. This included reduced moral/non-moral picture distinctions in the ventromedial prefrontal cortex and anterior temporal cortex in psychopaths relative to non-psychopaths.”

Cleckley (1976), as cited in Hare (2008), designed an original list of features of the Antisocial Personality Disorder; again Hickock met nearly all of them:

  1. “Superficial charm and good ‘intelligence’
  2. Absence of delusions and other signs of irrational thinking
  3. Absence of ‘nervousness’ or psychoneurotic manifestations
  4. Unreliability
  5. Untruthfulness and insincerity
  6. Lack of remorse or shame
  7. Inadequately motivated antisocial behavior
  8. Poor judgment and failure to learn by experience
  9. Pathologic egocentricity and incapacity for love
  10. General poverty in major affective reactions
  11. Specific loss of insight
  12. Unresponsiveness in general interpersonal relations
  13. Fantastic behavior with drink and sometimes without
  14. Suicide rarely carried out
  15. Sex life impersonal, trivial, and poorly integrated
  16. Failure to follow any life plan”


Lenzenweger, Lane, Loranger, and Kessler (2007) reported that the prevalence for any type of personality disorder is 9.1%, and, more specifically, the prevalence rate for the Antisocial Personality Disorder is 0.6%. Baker (2007), in a study of a large sample of nine to ten-year-old twins, discovered that a common antisocial behavioral factor (including child psychopathy traits, aggression, and delinquency) was highly heritable.  Viding (2007), as cited in Hare (2008), further located a common genetic similarity in callous-unemotional traits, and antisocial tendencies, in children. 

Khan, Jacobson, Gardner, Prescott, and Kendler (2005) documented that males diagnosed with antisocial personality disorder (3.9%, or 154/3947) vastly outnumbered females with the disorder (0.4%, or 12/2776). Khan et al. further determined that externalizing disorders, such as alcohol and substance dependence, antisocial personality disorder, and conduct disorder were observed more often in males, as opposed to internalizing disorders (major depression, generalized anxiety, panic disorder, phobias), which were observed more often in females.

Howard, Huband, Duggan, and Mannion (2008) found in their research of two hundred twenty-four subjects that those diagnosed with Antisocial Personality Disorder were quite likely to have been convicted of a violent crime. Howard et al. found they were more likely to possess higher levels of anger and impulsivity, with a history of aggression as well.

Woodworth and Porter (2002) studied a sampling of one hundred twenty-five incarcerated Canadian offenders, hypothesizing a correlation between homicides committed by psychopathic offenders and those committed by non-psychopathic offenders. Homicides committed by psychopathic offenders were instrumental (including premeditation, goal-oriented, lacking affective reaction, and described as “cold-blooded”). In juxtaposition to this, homicides committed by non-psychopathic offenders were more often crimes of passion, which included elements of emotionality and impulsivity. An overwhelming percentage (93.3%) of psychopathic homicides were instrumental, compared to the 48.4 percent of homicides committed by non-psychopaths. This finding reiterates that the antisocial personality-disordered person operates in a shrewd and goal-oriented fashion in order to achieve exactly what he/she wants, indifferent to the resulting damage to property and/or human beings.

Raine, Lencz, Bihrle, LaCasse, and Colletti (2000) discovered that subjects diagnosed with Antisocial Personality Disorder demonstrated an 11.0 percent reduction in prefrontal gray matter volume. Additionally, Raine et al. found an absence of brain lesions and reduced autonomic activity. The authors hypothesized that this prefrontal deficit may help explain lowered arousal, poor fear conditioning, a lack of conscience, and deficits in decision-making, all of which point toward antisocial behavior.

Hart, Kropp, and Hare (1988) studied a sample of two hundred thirty-one federal offenders and were able to predict post-release behavior, utilizing the Hare Psychopathy Checklist. Harris, Rice, and Cormier (2002), in their study of a sample of one hundred sixty-nine male forensic subjects, found that the violent recidivism rate was 77 percent for psychopaths.  This high percentage was nearly four times that of non-psychopaths (21%). This finding helps explain why Richard Hickock immediately began planning the Clutter robbery, even while still in prison for a previous crime. Hare and McPherson (1984) discovered that psychopaths were substantially more likely to engage in violence and aggressive behavior, which included verbal abuse, threats, intimidation, both inside and outside of prison, than other criminals.

Course and Prognosis

Simonoff, Elander, Holmshaw, Pickles, Murray, and Rutter (2004) found in their study of two hundred twenty-five twins that hyperactivity and conduct disorder in childhood both helped predict later Antisocial Personality Disorder, as well as criminal behavior, in adults.  Simonoff et al. also documented a relation between lowered IQ scores and reading difficulties with this diagnosis. 

Larsson et al. (2007), as cited in Hare (2008), discovered that previous (ages 13-14) tendencies towards antisocial behavior were clearly related to later (ages 16-17) interpersonal, affective, and impulsive psychopathic traits. Larsson et al. concluded there was satisfactory documentation of the stability of psychopathic traits from childhood and adolescence, onwards into adulthood. Vitacco, et al. (2002) discovered a degree of predictability, in that callous and impulsive traits can indicate a predisposition towards antisocial behavior in the future.

Black, Baumgard, and Bell (1995) studied seventy-one males diagnosed with Antisocial Personality Disorder, who had been formerly housed in a psychiatric hospital. Remissions accounted for 26.6 percent, 31.1 percent showed improvement but had not remitted, and 42.2 percent were not improved. They concluded that Antisocial Personality Disorder is a chronic disorder, associated with continuing psychiatric, medical, and social problems, usually lacking a good prognosis. Dolan and Coid (1993) found a generally poor prognosis, as well as a poor treatment response for the person diagnosed with Antisocial Personality Disorder.

Ogloff, Wong, and Greenwood  (1990) found that, by utilizing the PCL-R (Psychopathy Checklist-Revised) they were able to accurately document that psychopaths remain in a community program designed for personality-disordered criminals for a shorter period of time, invest less effort, and exhibit less improvement. 

Overall, the prognosis for the Antisocial Personality Disorder is not positive. The person with this diagnosis exhibits chronic behavior, does not seem to learn from punishment or getting caught. They are not motivated to seek help. However, they are motivated to lie and manipulate. Further, there is no distinct pharmacological regimen, nor is there a well-established psychological treatment program that has proven effective for the person diagnosed with Antisocial Personality Disorder. The disorder, however, does seem to taper off on its own accord towards mid-life.

Diagnostic Considerations

Glenn, Raine, Venables, and Mednick (2007) documented a possible predictable connection between children’s temperament and psychophysiology, with later adult psychopathic personality features, upon testing a group of three hundred thirty-five three year-olds, and later administered follow-up testing at age twenty-eight. Those subjects who received higher scores on the measures were found to be less fearful and inhibited, and exhibited more sociability. Khan et al. (2005) found a connection between neuroticism and psychopathology, and that neuroticism made a significant contribution to lifetime comorbidity of common psychiatric disorders. 

It may then appear deceptively straightforward and easy to predict future Antisocial Personality Disorder. Lahey, Loeber, Burke, and Applegate (2005) warned that the reliance on a childhood diagnosis of conduct disorder alone, in attempting to diagnosis Antisocial Personality Disorder later, led to a significant number of false-positive predictions. 

In several cinematic scenes, Hickock riskily consumed quantities of alcohol, invariably while behind the wheel on the highway driving across multiple states. Although details of Hickock’s childhood, any propensity for conduct disorder, violence, or pre-antisocial behaviors are unknown, Trull, Sher, Minks-Brown, Durbin, and Burr (as cited in Tragesser et al, 2008) reported that, due to impulsivity traits, there may exist a relation between alcohol consumption and Cluster B personality disorders, which includes the Antisocial Personality Disorder.

Although Hickock did not appear to exhibit classic symptomatology of depression, he may have been experiencing some level of depression and used alcohol as a means to self-medicate. Hickock would have had ample justification for experiencing depression (recent federal imprisonment, terminally ill father, separation from his three children, unemployment, two recent divorces).


Dolan and Park (2002) found impairments in visual memory tasks, and tasks involving DLPFC (dorsolateral prefrontal) and VMPFC (ventromedial prefrontal) functioning in test subjects with Antisocial Personality Disorder. Unfortunately, there exists no information available on Hickock’s childhood, i.e., any possible medical issues suffered, or any possible abuse. Indeed, as a jocular and athletic young man, his friends and family prior to the commission of the 1959 Clutter killings often called him “the All-American Boy”. While Hickock seemed to meet almost all of the criteria for a diagnosis of Antisocial Personality Disorder, one is hard-pressed to find any specific pointer from childhood that may have contributed to this diagnosis.


Gatzke and Raine (2000) reported that, because often treatment strategies for Antisocial Personality Disorder-afflicted patients are unsuccessful, and the chronic, harmful behaviors of these patients often negatively impact individuals and society, the extrication of them from the community into incarceration is the only viable alternative. Persons diagnosed with this disorder are not easily treated; there is no “magic pill” or psychological treatment regimen that has proven effective long-term in alleviating the symptomatology of this highly dangerous disorder. Further, they are supremely self-absorbed and narcissistic. Not only are they not motivated to change, but they often glean negative reinforcement for their antisociality, not to mention the perverse thrill they sometimes gain from risk-taking behaviors. 

Across a ten-year study Rice, Harris, and Cormier (1992) found a fascinating yet ominous outcome in treatment for those diagnosed with Antisocial Personality Disorder. Not only did the subjects not significantly improve but those receiving treatment in a prison community milieu bizarrely demonstrated an actual increase in recurrences of violent offenses over and above those who were untreated. Ostensibly, while other inmates were learning better and healthier life strategies, the antisocially-disordered members were essentially honing their craft.

Multiaxial Diagnosis of Richard Hickock

Axis I:      V71.01 Adult Antisocial Behavior
Axis II:     301.7 Antisocial Personality Disorder
Axis III:    None
Axis IV:    Recent commission of violent crimes, including multiple homicides and robbery, recent federal imprisonment, unemployed, recent second divorce, separated from three children, father terminally ill
Axis V:     GAF:   18 (Current)


Author Truman Capote penned his classic book, “In Cold Blood,” which was published in 1965. The subsequent film “In Cold Blood” was released in 1967. Due to its grittiness, realism, and being filmed in the actual locations (including the original Clutter home in Holcomb, Kansas), coupled with edgy, frenetic music, and filmed in an avant-garde black and white, introspective film noir style, “In Cold Blood” was nominated for an Academy Award.

The film received the technical support of Dr. Joseph Satten and the Menninger Institute for Psychiatry, assuring accuracy in representing this complex psychological disorder (still relatively “new” and unknown at that time) to the lay public. “In Cold Blood” excelled in its portrayal of not only the major aspects of the Antisocial Personality Disorder, such as homicide, lack of remorse, and criminal versatility, but the lesser-known aspects, such as petty theft simply for the thrill of it, as when Hickock steals a small, inexpensive package of razor blades that he could easily afford. It also demonstrated Hickock’s shallow sexual relationships, such as his having sex in a dank Mexican hotel room with a strange woman he had never met before, in the presence of his partner Perry. He was glib and disrespectful of women, calling them “blonde chickens.”

The element of criminal versatility of the Antisocial Personality Disorder was the primary theme in the film. Hickock was seen engaging in theft, methodically planning and executing a hot check scheme for cash, refusing to follow his parole requirements after his release from federal prison, robbery, multiple homicides, and completely disregarding rules, mores, and conventions of society and family. 

“In Cold Blood” provided examples where Hickock lacked remorse, was glib, superficial, shallow, blamed others, seemed to feel slighted by life and a “victim.” He failed to heed consequences (recent federal imprisonment, strict rules of parole, and high risk of returning to prison). He repeatedly engaged in alcohol consumption while driving, carefully devised a plan to kill an innocent good Samaritan while hitchhiking, simply for his car and money (an instrumental crime). He was masterfully manipulative in his deceit of the Kansas clothing store employee. He employed instrumental flattery and wit to his supreme advantage. 

Ever the quintessential con man and opportunist, Hickock even boasted of his ability to deceive and manipulate. He was impulsive and assumed great risk by returning from Mexico back to the United States, heaping one crime and risk upon another by gambling with essentially stolen money, at a scene arrived at in a stolen vehicle, after he was already homeless, having spent all his ill-gotten earnings already, at a time when there was a national manhunt for him.

Hickock was extroverted, persuasive, and calm in social situations. Yet waiting just beneath the surface was a quick trigger of anger and irritability that could explode at the slightest provocation. Yet he actually was able to carry on a brief social conversation with the teenage Clutter boy while tying him up, mere moments before helping to kill him. He also was seductive with the teenage Clutter girl, again only moments before helping to kill her.  He exhibited complete indifference to the tearful pleadings of their invalid mother for her husband and children’s safety, while tying her up just before helping to kill her as well.

Hickock lacked regard for others, as evidenced by his violence towards the Clutter family, and lacked regard for his own family as well. In spite of early on in the film having a tender moment with his father, nevertheless Hickock allowed his terminally ill father to “face the music” of his hot check scheme. He exhibited total lack of regard for his two former wives and three small children. He was acutely aware his innocent family members would suffer and perhaps be indirectly blamed for his criminality, but laughed it off. Even before his 1965 imminent execution Hickock still remained glib and jocular, without apology or remorse, neither to his own family or the surviving members of the Clutter family. 


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