Mental health articles

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antisocial personality disorder sociopath

The terms antisocial personality and psychopathy are often used interchangeably. Indeed, the DSM-IV-TR category of antisocial personality disorder was intended to combine diagnoses of antisocial personality and psychopathy, which DSM-III did not. Critics of DSM-IV-TR have argued that it has not succeeded in this attempt, and that the two conditions are not synonymous. They have different characteristics and long-term outcomes. According to Hare et al., DSM-IV-TR still describes an individual who is criminally antisocial. By contrast, psychopathy refers to an individual who not only has these characteristics, but also experiences a poverty of both positive and negative emotions, and is motivated by thrill-seeking as much as by any other gain. Antisocial behaviour tends to reduce with age; psychopathic behaviour does not. DSM-IV-TR defi nes antisocial personality as a pervasive pattern of disregard for, and violation of, the rights of others occurring from the age of 15 years. Its core characteristics include:

repeatedly performing acts that could lead to arrest repeated lying, use of aliases, or conning others for personal profi t or pleasure impulsivity or failure to plan ahead reckless disregard for the safety of self or others consistent irresponsibility: repeated failure to sustain work or honour fi nancial obligations lack of remorse for others.

Without specifi c DSM diagnos ic criteria, those who distinguish between antisocial beha viour and psychopathy generally use Hare’s Psychopathy Checklist (PCL) to diagnose psychopathy. This identifi es two sets of factors associated with psychopathy: emotional detachment and an antisocial lifestyle. Emotional detachment involves a lack of capacity to process emotional information, and a consequent lack of understanding and disregard for the emotions of others. It is Hare’s defi ning characteristic of psychopathy. Using the PCL to diagnose psychopathology, Hare found that up to 80 per cent of criminals could be categorized as having antisocial personality disorder: only 20 per cent met the criteria for psychopathy, a fi nding supporting his argument of clinical differences between the two conditions.

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