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“”Some men aren't looking for anything logical, like money. They can't be bought, bullied, reasoned, or negotiated with. Some men just want to watch the world burn.
|—Alfred Pennyworth. The Dark Knight|
The word psychopath is a personality and behavioral label created by an Austrian psychiatrist and later discarded as a medical diagnosis in virtually every country. The label has multiple, sometimes contradictory definitions, which (often, but not always) attempt to describe an individual without any meaningful conscience who engages in self-defeating and criminal behavior. Academic literature acknowledges the term is often used as a pseudoscientific argument tool.
One of the more common, modern usages of the term 'psychopathy' is a redefinition Robert D. Hare made in the 1970s through a diagnostic checklist. This definition is used by forensic psychology to predict the risk of individual criminal recidivism.
'Psychopath' is used as completely interchangeable with the word 'sociopath' and also as only partially interchangeable. Modern pop psychology on psychopathy hyper-focuses on a 'symptom' of many anti-social related diagnoses, specifically a lack of empathy, as there exists evidence in neuroscience for those with a genetic lack of empathy. Using this initial neuroscience as a scientific anchor for a redefinition, modern pop psychology subsequently draws up a long list of (dubious and/or fringe) additional theory and alleged traits of 'monster-from-birth human beings'.
Origin and abandonment of the term in clinical psychiatry
The term 'psychopathy' was coined by the Austrian psychiatrist Baron Ernst von Feuchtersleben in 1847. Feuchtersleben believed there were multiple 'psychopathies', primarily categorized by folly, fixed delusion, mania, and idiocy. He considered hypochondria in men and 'hysteria' in women to be examples of psychopathy. German psychiatrist J.L.A. Koch, who operated in the 1800s, further popularized the term, and used it to refer to all abnormalities, hereditary or acquired, which affect personal life but are not mental illness. At this time, psychopathy was seen as a diverse range of 'moderate' severity conditions, situated between neurosis and psychosis.
Early Australian psychiatry used the term 'psychopath' to refer to individuals who are not mentally deficient or irrational, but who persist in antisocial behavior.
Psychopathy was listed as a clinical diagnosis in a predecessor to the DSM by the American Psychiatric Association (APA). However, the APA ultimately discarded 'psychopathy' as an explicit clinical label. The APA, in their first Diagnostic and Statistical Manual (DSM) of 'mental disorders' replaced the term psychopathy with a similar term called 'sociopathy'. 'Sociopathy' was often written as a theoretical subset of psychopathy for most of its academic history.[note 1] For example, mid-20th century academia would sometimes describe sociopathy as a clinical manifestation of psychopathy.
By the 1960s, academic writing about psychopathy had already peaked in frequency and began to fall out of favor. 'Sociopathy' was again replaced in the DSM as "antisocial personality".
Technical definitions in academic criminal psychology
Technical definitions of psychopathy can be found in academic criminal psychology. They use the Hare Psychopathy Checklist and the Hare Psychopathy Checklist-revised (PCL-R).
This psychopathy checklist has been shown to 'narrow down' a population that is non-identical to those narrowed down by checklists of Antisocial Personality Disorder, (ASPD). Therefore, professionals explicitly recommend against conflating ASPD with academic remnants of the concept of psychopathy.
The PCL-R in full
Canadian psychologist Robert D. Hare has developed a checklist of personality traits which he defined as psychopathy. The Psychopathy Checklist-Revised (PCL-R) is as follows:
- Factor 1 — Personality "Aggressive narcissism"
- Glibness/superficial charm
- Grandiose sense of self-worth
- Pathological lying
- Lack of remorse or guilt
- Emotionally shallow
- Callous/lack of empathy
- Failure to accept responsibility for own actions
- Factor 2 — Case History "Socially Deviant Lifestyle"
- Need for stimulation/proneness to boredom
- Parasitic lifestyle
- Poor behavioral control
- Promiscuous sexual behavior
- Lack of realistic, long-term goals
- Juvenile delinquency
- Early behavioral problems
- Revocation of conditional release
- Traits not correlated with either factor
- Many short-term marital relationships
- Criminal versatility
Surveyors assign number values to the above traits.
- Does not apply = 0
- Somewhat applies = 1
- Fully applies = 2
If a person scores more than 20 points, then yes. It's quite likely that they at least have some psychopathic tendencies.
Inaccurate conflation of ASPD traits with PCL-R traits
With each revision in the DSM, the definition of 'psychopath'-related words change. And since the 1960s, even the definition of Anti-social Personality Disorder (ASPD) has changed with each DSM revision. The frequency with which the DSM ASPD definition has changed has made the ASPD definition less intelligible than the old psychopathy literature. This has led clinicians to opportunistically and inaccurately reach into psychopathy academia to inform their ASPD-related practice. They will often inaccurately assume those diagnosed with ASPD will exhibit traits present in literature on psychopathy.
According to a member of the DSM-V working group, the closest diagnosis to year 2022 popular notions of "psychopathy" in DSM-V, is F91.1 or F91.2. These are youth conduct disorders with "callous unemotional traits" and "limited prosocial emotions" subtype. These diagnoses are not a subtype of ASPD, or F60.2.
Only the second subtype of Robert Hare's PCL-R has a close relationships with ASPD, whereas the first subtype of Hare's PCL-R does not. Lack of empathy, arrogance and excessive vanity are PCL-R characteristics but not ASPD characteristics. Therefore, not every person who meets Robert Hare's definition of a 'psychopath' necessarily meets ASPD criteria.
Psychiatric survivor groups have regularly criticized the idea of an incurable mental disease, with which modern attempts at resurrecting psychopathy are arguably another attempt to do.
Even though academic writing on psychopathy was winding down and falling out of favor during the 1970s, there was still academia and legal structures taking it seriously. During the 1970s, the London Mental Patients Union, called for
The abolition of the concept of ‘psychopath’ as a legal or medical category.—London Mental Patients Union, 1973
- Episode #304 (9 May 2011) of the Skeptics Guide to the Universe contains an interview with Jon Ronson, author of The Men Who Stare at Goats and The Psychopath Test
- In recent years, there have been attempts to redefine sociopathy as adjacent to, rather than as a subset of psychopathy. The word 'psychopathy' is redefined by pop psychology to exclude nurture causes, and is contrasted against 'sociopathy' which is defined as due to nurture.
- Dinwiddie, Stephen. (2015). Psychopathy and Sociopathy: The History of a Concept. Psychiatric Annals. 45. 169-174. 10.3928/00485713-20150401-04.
- Shapland, Susanna (2019) Defining the elephant : a history of psychopathy, 1891-1959. Doctoral thesis, Birkbeck, University of London.
- DeMatteo, D., Edens, J. F., Galloway, M., Cox, J., Smith, S. T., Koller, J. P., & Bersoff, B. (2014). Investigating the role of the Psychopathy Checklist–Revised in United States case law. Psychology, Public Policy, and Law, 20(1), 96–107. https://doi.org/10.1037/a0035452
- Nadelhoffer, Thomas, and Walter P. Sinnott-Armstrong, 'Is Psychopathy a Mental Disease?', in Nicole A. Vincent (ed.), Neuroscience and Legal Responsibility, Oxford Series in Neuroscience, Law, and Philosophy (New York, 2013; online edn, Oxford Academic, 23 May 2013), https://doi.org/10.1093/acprof:oso/9780199925605.003.0010, accessed 4 Nov. 2022.
- Narcissist, Psychopath, or Sociopath: How to Spot the Differences. Dr. Ramani Durvasula
- The Psychopath Whisperer: The Science of Those Without Conscience, by Kent A. Kiehl 'It was if my lab had discovered a new disorder, but we didn't have a cure' -Kiehl
- Whitlock, F. A. (1967). Prichard and the Concept of Moral Insanity. Australian & New Zealand Journal of Psychiatry, 1(2), 72–79. doi:10.3109/00048676709159168
- A Forgotten Psychiatrist, Baron Ernst von Feuchtersleben, M.D., 1833 By CHARLES L. C. BURNS, M.R.C.S., L.R.C.P., D.P.M.
- Adler HM. Psychiatry and the Criminal. Cal West Med. 1932 Mar;36(3):170-5. PMID: 18742067; PMCID: PMC1658159.
- Whitlock FA. Prichard and the Concept of Moral Insanity. Australian & New Zealand Journal of Psychiatry. 1967;1(2):72-79. doi:10.3109/00048676709159168
- Ogloff, J. R. P. (2006). Psychopathy/Antisocial Personality Disorder Conundrum. Australian & New Zealand Journal of Psychiatry, 40(6-7), 519–528. doi:10.1080/j.1440-1614.2006.01834.x
- See the Wikipedia article on Hare Psychopathy Checklist.
- Abdalla-Filho E, Völlm B. Does every psychopath have an antisocial personality disorder? Braz J Psychiatry. 2020;42(3):241-242. doi: 10.1590/1516-4446-2019-0762. PMID: 32074231; PMCID: PMC7236162.