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Class 3: Antisocial PD and Psychopathy
Classification of Antisocial Personality Disorder and
Psychopathy
Coid – Antisocial Personality Disorder is on a Continuum with
Psychopathy.
Background: Antisocial personality disorder (ASPD) and psychopathy are
different diagnostic constructs. It is unclear whether they are separate clinical
syndromes or whether psychopathy is a severe form of ASPD.
Methods: A representative sample of 496 prisoners in England and Wales was
interviewed in the second phase of a survey carried out in 1997 using the
Schedules for Clinical Assessment in Neuropsychiatry, the Structured Clinical
Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition Axis II personality disorders, and the Psychopathy Checklist–Revised.
Results: Among those 18 years and older (n = 470), 211 (44.9%) received a
diagnosis of ASPD, of whom 67 (31.8%) were classified as psychopaths, indicated
by Psychopathy Checklist–Revised scores of 25 and above. Symptoms of
ASPD and psychopathy both demonstrated low diagnostic contrast
when comparing subgroups of ASPD above and below the cutoff for
psychopathy. There were no differences in demography, Axis I
comorbidity, and treatment-seeking behavior. Psychopathic individuals
with ASPD demonstrated comorbid schizoid and narcissistic personality
disorder, more severe conduct disorder and adult antisocial symptoms, and
more violent convictions.
Conclusions: Psychopathy and ASPD are not separate diagnostic
entities, but psychopathic ASPD is a more severe form than ASPD
alone with greater risk of violence. Dimensional scores of Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition personality disorders
(other than ASPD) may be helpful in identifying this specific subgroup.
Introduction
Psychopathy has traditionally been considered as a disorder of
personality, particularly the component of affective deficiency
o Contemporary conceptualizations cover the interpersonal, affective,
and impulsive personality domains of psychopathy, but
emphasize the additional relevance of criminal behaviors.
In contrast, the criteria for antisocial personality disorder (ASPD) in
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-
IV) and its predecessors are predominantly behaviorally based.
o This results in over-diagnosis in forensic settings, although it has
been emphasized that less than half of persons with ASPD
demonstrated a significant arrest record and that diagnosis of ASPD
was strongly related to violent acts
Class 3: Antisocial PD and Psychopathy
Classification of Antisocial Personality Disorder and
Psychopathy
Coid – Antisocial Personality Disorder is on a Continuum with
Psychopathy.
Background: Antisocial personality disorder (ASPD) and psychopathy are
different diagnostic constructs. It is unclear whether they are separate clinical
syndromes or whether psychopathy is a severe form of ASPD.
Methods: A representative sample of 496 prisoners in England and Wales was
interviewed in the second phase of a survey carried out in 1997 using the
Schedules for Clinical Assessment in Neuropsychiatry, the Structured Clinical
Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth
Edition Axis II personality disorders, and the Psychopathy Checklist–Revised.
Results: Among those 18 years and older (n = 470), 211 (44.9%) received a
diagnosis of ASPD, of whom 67 (31.8%) were classified as psychopaths, indicated
by Psychopathy Checklist–Revised scores of 25 and above. Symptoms of
ASPD and psychopathy both demonstrated low diagnostic contrast
when comparing subgroups of ASPD above and below the cutoff for
psychopathy. There were no differences in demography, Axis I
comorbidity, and treatment-seeking behavior. Psychopathic individuals
with ASPD demonstrated comorbid schizoid and narcissistic personality
disorder, more severe conduct disorder and adult antisocial symptoms, and
more violent convictions.
Conclusions: Psychopathy and ASPD are not separate diagnostic
entities, but psychopathic ASPD is a more severe form than ASPD
alone with greater risk of violence. Dimensional scores of Diagnostic and
Statistical Manual of Mental Disorders, Fourth Edition personality disorders
(other than ASPD) may be helpful in identifying this specific subgroup.
Introduction
Psychopathy has traditionally been considered as a disorder of
personality, particularly the component of affective deficiency
o Contemporary conceptualizations cover the interpersonal, affective,
and impulsive personality domains of psychopathy, but
emphasize the additional relevance of criminal behaviors.
In contrast, the criteria for antisocial personality disorder (ASPD) in
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-
IV) and its predecessors are predominantly behaviorally based.
o This results in over-diagnosis in forensic settings, although it has
been emphasized that less than half of persons with ASPD
demonstrated a significant arrest record and that diagnosis of ASPD
was strongly related to violent acts
