Psychopathy, Sociopathy, and Antisocial Personality Disorder: Confused

[CKYMargera00]

My husband was diagnosed with ASPD and NP. And even though that is all that he was diagnosed with, sometimes it feels like I can see cross overs from other Cluster B personality disorders.
Is that common?? Are there any other issues, such as mental health or other personality disorders, that are commonly seen??

Another question is, I have been told that psychopaths are not diagnosable, meaning that there isn't a clear diagnosis in the Mental health field. Is that true or is a psychopath the same as a sociopath??

Thanks..

 

[Into The Light]

Re: Confused

what are ASPD and NP?

i'm afraid i don't have the answers to your questions but maybe someone else here knows a bit more.

 

[CKYMargera00]

Re: Confused

ASPD is Antisocial personality disorder or sociopath. NP is Narcissistic personality disorder. Both are Cluster B personality disorders.

Thanks I hope someone might!

 

[Lana]

Re: Confused

I am going to guess and say that it wouldn't be too unusual for diagnoses in the same cluster to overlap in some areas. But, there are always finer distinctions so that they can be individually identified.

I wasn't aware that psychopathy is not diagnosable. However, I do know that psychopathy is extremely difficult to treat, if not impossible. Same for narcissistic personality disorder. Reason is that such people never seek help because they don't think they need it.

 

[David Baxter PhD]

Re: Confused

Psychopath and sociopath are simply two different terms for the same "syndrome".

I don;t think the problem is that psychopathy can't be diagnosed - believe me, when you see the real thing, you know what it is - there's no doubt.

The problem from the DSM standpoint is that it was difficult to get agreement on the defining characteristics of psychopathy, in part because of personal agendas of people on the revisions board, in my opinion.

The best description, clinically or otherwise, of psychopathy is Cleckley's The Mask of Sanity. The worst definition, in my opinion, is Hare's Psychopathy Checklist, which measures criminality and antisocial personality, not psychopathy.

 

[CKYMargera00]

Re: Confused

I was wondering than, is sociopath the same as someone with anti-social personality??

 

[David Baxter PhD]

Re: Confused

No. Almost anyone with a criminal record can meet the criteria for antisocial personality disorder but not all of them are sociopaths/psychopaths.

Sociopath is just another term for psychopath, not really used any more.

Psychopathy should be considered a subset or extreme of antisocial personality disorder.

 

[CKYMargera00]

Re: Confused

So basically, when my husband was diagnosed with ASPD as well as being a psychopath...they are different diagnoses?

 

[David Baxter PhD]

Re: Confused

At present, there is no official diagnosis for psychopathy. Thus, someone with psychopathic personality would have to be diagnosed as Antisocial Personality Disorder, which is a very broad diagnostic category as I've said:

Diagnostic criteria for 301.7 Antisocial Personality Disorder

A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:

(1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
(2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
(3) impulsivity or failure to plan ahead
(4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
(5) reckless disregard for safety of self or others
(6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
(7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

B. The individual is at least age 18 years.

C. There is evidence of Conduct Disorder with onset before age 15 years.

D. The occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode.

 

[CKYMargera00]

Re: Confused

How frustrating. I've attempted to do as much research as I can and it seems to leave me frustrated and annoyed. Every book that I seem to read from The Sociopath Next Door to A Mask of Sanity, basically clump antisocial, psychopathy and sociopathy as one.

How are the three exactly different?

How would you exactly explain the three? Are they basically the same with slight differences??

 

[David Baxter PhD]

Re: Confused

There is no difference at all between sociopathy and psychopathy. For a while, the preferred term was sociopath because it was believed to be primarily the result of inadequate or otherwise abnormal socialization processes. Later research determined that there were some basic physiological differences that more strongly suggested a genetic basis and the term psychopath returned to favor. (The original term back in the 1800s was "moral imbecility" and various synonyms, to reflect the evident lack of a sense of morality and remorse.)

The difference between psychopathy and antisocial personality disorder is partly one of degree and partly the presence or absence of the emotional-cognitive parts of Cleckley's criteria (he was the author of The Mask of Sanity).

This is from a handout for a course I taught a few years ago:

• the concept of psychopathy originated in the early 1800s as attempts to describe individuals who ?habitually exhibited asocial and antisocial actions (not necessarily criminal) but did not exhibit signs of mental illness as it was then understood? (Bartol, 1999)
• in France, Pinel coined the term ?manie sans delire? (mania without delirium/frenzy) to describe such individuals
• in England, Pritchard (1839) renamed this disorder ?moral insanity? ? i.e., mental illness based on absence of morality rather than other psychopathology, manifested as a ?derangement? characterized by ?failure to abide by society?s expectations of religious, ethical, and cultural conduct? (Bartol, 1999)
• another view used the term ?moral imbecility? for this disorder ? i.e., reflecting a diminished capacity for morality or ?low moral intelligence?
• later, in Germany, Koch (1888) suggested that the term ?moral insanity? had ?unwarranted negative connotations? and proposed the term ?psychopathic inferiority? as a substitute ? encompassing a large list of characteristic traits and behaviors
• in the early 1900s, the concept of ?psychopathic inferiority? was both refined and expanded ? e.g., Kraepelin (1913) suggested 7 types of psychopath and Kahn (1931) suggested 16 types
• Partridge (1930), arguing that ?psychopathy? was a social rather than mental disorder, proposed the term sociopath as a substitute ? his suggestion was adopted by the American Psychiatric Association (APA) for their Diagnsotic and Statistical Manual (DSM) in 1952 as the diagnostic category ?sociopathic personality disturbance, antisocial reaction?
• in 1968, APA changed the diagnostic label to ?personality disorder, antisocial? for DSM-II and continued this through DSM-III (1980), DSM-III-R (1987), and DSM-IV (1994)
• probably the best known description of the psychopath comes from the work of Hervey Cleckley (1976), published as The Mask of Sanity and representing an attempt to delineate the characteristics of the ?full-fledged? psychopath

Cleckley?s 16 Characteristics of the Psychopath
(from Andrews & Bonta, 1998)

Key Features

• manipulative
• superficial charm
• above-average intelligence
• absence of psychotic symptoms (delusions, hallucinations, etc.)
• absence of anxiety
• lack of remorse
• failure to learn from experience
• egocentric
• lacking emotional depth (?emotional flatness?)

Other Characteristics

• trivial sex life (many casual partners)
• unreliable - irresponsible
• failure to follow a life plan
• untruthful
• impulsive
• antisocial behavior
• if any suicide attempts, rarely genuine

Notes:

1. Psychopaths have all the outward appearances of normality (hence ?Mask of Sanity?) ? absence of psychotic symptoms, absence of debilitating anxiety or guilt
2. Psychopaths appear to be unresponsive to social control ? continue to get into trouble despite repeated punishment from people around them and society at large
3. Criminal behavior is NOT an essential characteristic of psychopathy! Not all criminals are psychopaths, and not all psychopaths are criminals.