APD is more closely correlated with Factor 2 of the PCL-R than Factor 1. While most individuals with APD d0 not meet the diagnostic criteria for psychopathy, psychopaths are almost invariably diagnosed with APD (Harpur,1994). APD is defined in the DSM-V as a having a pervasive disregard for and willingness to violate the rights of others (DSM-V, 2013). The term sociopathy is not used in modern academic circles anymore.įigure 3: Cover of The Mask of Sanity by Hervey Cleckley.Ī closely related construct to psychopathy, is anti-social personality disorder (APD). Psychopathy and sociopathy generally refer to the same set of symptoms, but sociopathy connotes social origins, whereas psychopathy is agnostic to etiology, meaning social and biological reasons are equally plausible.
Unfortunately, the term sociopathy has been used in colloquial settings interchangeably with psychopathy ever since. Literally every criminal met the criteria for sociopathy as it was defined. One of the immediate problems with the diagnosis of sociopathy was that it, like many of its predecessors, was too broad and encompassed far too many individuals. Rather, he felt that most antisocial acts emanate from the operation of societal forces that make the more acceptable forms of behavior difficult to learn (Birnbaum, 1909). Birnbaum believed that antisocial behavior rarely stemmed from constitutional flaws in character. In 1909, Birnbaum suggested that sociopathic might be a better term than psychopathic to describe individuals with this particular constellation of symptoms. This overly encompassing definition lost sight of the moral disability that is central to what is today known as psychopathy.īy the 1920s psychiatry was using the word psychopath to include people who were depressed, weak-willed, and excessively shy and insecure-in other words, it became a placeholder for abnormal psychology. Psychopastiche constituted people who hurt themselves (i.e., suicide attempts) as well as others. Koch’s strategy is generalizable to assessing all personality traits and was included in the 8th edition of Emil Kraepelin’s classic textbook on clinical psychiatry (Feuchtersleben, 1845).Įven though Koch’s psychopastiche construct was more focused than the concept “moral insanity,” it was still sufficiently broad to encompass personality disorders generally. This gestalt view is necessary to accurately characterize psychopathic traits in an individual. Koch recognized that assessing psychopathic traits requires a holistic appraisal of the patient’s life history. Constitutional psychopathy became a popular disorder in the literature of the early 1900s. Koch claimed that psychopathy arose from a flaw in one’s constitution at birth. Koch (1841-1908) (Figure 2), coined the term psychopastiche, or psychopath, in 1888. Indeed, it was the absence of psychotic symptoms that originally differentiated individuals with psychopathy from other patient groups.įigure 2: Julius Koch (1841-1908) was a German psychiatrist who coined the term psychopath. Psychotic symptoms are not typically observed in individuals with psychopathy. Psychosis presents itself in disorders like schizophrenia, bipolar disorder, and major depression.
Psychosis is a loss of contact with reality that leads to symptoms like hallucinations, delusions, and disordered thoughts. Importantly, psychosis and psychopathy are not the same. Pinel described a type of “moral insanity” that occurred in the absence of confusion in mind and intellect, differentiating these cases from patients with psychotic behaviors. The term was used to describe individuals who had no intellectual problems but a profound deficit in behavior typified by marked cruelty, antisocial acts, alcohol and drug use, irresponsibility, and immorality. It was Philippe Pinel (1745-1826) (Figure 1), the founding father of modern psychiatry, who first described a group of patients afflicted with mania sans délire (insanity without delirium)(Pinel, 1801). Figure 1: Philippe Pinel (1745-1826) was first to describe patients with psychopathic traits.
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