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ANTISOCIAL PERSONALITY DISORDER AND PSYCHOPATHY – DISTINGUISHING THE TERMS
In 1968, the American Psychiatric Association changed the label sociopath to personality disorder, antisocial. The DSM-III (APA, 1980), DSMIII-R (APA, 1987), and DSM-IV (APA, 1994, p . 645) continued to use the term antisocial personality disorder to refer specifically to an individual who exhibits “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood .” In other words, antisocial personality disorder is closely allied with persistent criminality.
Antisocial personality disorder is not the same as psychopathy, despite the fact that its description in the most recent editions of the DSM (DSM-IV and DSM-IV TR) very closely parallels definitions of psychopathy.
Psychologist Robert Hare (1970), one of the world’s leading experts on psychopathy, proposed a useful scheme to outline three categories of psychopaths: the primary, the secondary or neurotic, and the dyssocial . Only the primary psychopath is a “true” psychopath .
The primary or “true” psychopath has certain identifiable psychological, emotional, cognitive, and biological differences that distinguish him or her from the general or criminal population.
The other two categories meld a heterogeneous group of antisocial individuals who comprise a large segment of the criminal population .
Secondary psychopaths commit antisocial or violent acts because of severe emotional problems or inner conflicts. They are sometimes called acting-out neurotics, neurotic delinquents, symptomatic psychopaths, or simply emotionally disturbed offenders. The popular entertainment media often refer to these persons as “psychopathic killers” or use some other attention-getting terminology designed to conjure bloodthirsty disturbed persons indiscriminately killing everyone they meet.
The third group, dyssocial psychopaths, displays aggressive, antisocial behavior they have learned from their subculture, like their gangs or families.
In both cases, the label psychopath is misleading, because the behaviors and backgrounds have little if any similarity to those of primary psychopaths. Yet both secondary and dyssocial psychopaths are often incorrectly called psychopaths because of their high recidivism rates. As noted above, the term antisocial personality disorder describes a pervasive pattern of disregarding the rights of others. Antisocial personalities are further described as those persons who “fail to conform to social norms with respect to lawful behaviors. They may repeatedly perform acts that are grounds for arrest, such as destroying property, harassing others, stealing or pursuing illegal occupations” (American Psychiatric Association, 1994, p. 646). Also, as noted above, the descriptions of the psychiatric term antisocial personality disorder follow very closely the descriptions of the psychological term psychopathy. However, the definition of antisocial personality disorder is more narrow than that of primary psychopathy because it restricts its definition to behavioral indicators. Hare’s definition of primary psychopathy includes both emotional and cognitive aspects. Nevertheless, with each new publication of the DSM, the characteristics used to describe the antisocial personality are increasingly similar to Hare’s primary psychopathy in behavioral terms. It is easy to understand why clinicians often confuse the terms. Hare’s scheme of “primary psychopath” is often considered an empirically and clinically useful designation. It is distinguished from secondary or neurotic psychopath in its behavioral, cognitive, and neurophysiological features .
(From: Criminal Behaviour: A Psychosocial Approach; Bartol)