Is the label «Psychopath» more a moral denunciation than a clinical diagnosis?

Кошкина Екатерина Николаевна / Koshkina Ekaterina Nikolaevna– MSc (Master of Science) in Criminology and Criminal Psychology (University of Portsmouth, United Kingdom), г. Москва

Аннотация: статья анализирует проблемы диагностики, типирования и исследований, которые приводят к неправильному пониманию того, что такое психопатия и кто может считаться психопатом. Равно как и то, почему психопатия стала хорошо известным и широко использующимся ярлыком с крайне негативным значением.

Abstract: this article analyses diagnostic, subtyping and researches issues that lead to misunderstanding of what psychopathy is and who may be considered a psychopath. As well as why psychopathy has become a well-known label with the extremely negative meaning and widely usage by almost everyone.

Ключевые слова: психопатия, антисоциальное расстройство личности, социопатия, проблемы диагностики.

Keywords: psychopathy, ASPD, sociopathy, diagnostic issues.

Psychopathy “was the first personality disorder to be recognized in psychiatry” [22, p. 28] and, in some ways, may be called one of the most famous psychological disorders together with schizophrenia and bipolar affective disorder. However, if people know of the existence of psychopaths, it does not mean that they understand the nature of this personality disorder very well. All the more so currently there is no such an official diagnosis as psychopathy or psychopathic personality, or psychopathic personality disorder, and even the defined difference between psychopathy and antisocial personality disorder (ASPD) is often blurred. Besides, “psychopathy and ASPD often treated as, but in fact, are not, equivalent diagnoses” [12, p. 22], which means that many persons, especially with history of violence, who are not actually psychopaths, are labelled as psychopaths due to their behaviour fitting in with the basic symptoms of ASPD that are listed in DSM-V. Furthermore, there still is a significant question of clear subtyping psychopathic personalities because not only plenty of individuals with psychopathic traits and behaviours exist, but also “groups of such persons may have little in common with each other” [30, p. 155]. Plus, “if subtypes are found, will all of them be ‘psychopaths’?” [25, p.186]. On condition that some of them, who may be labelled as ‘sociopaths’, are able to adopt social norms and be law-abiding citizens? In addition to not being an easy-diagnosing disorder, psychopathy generally cannot be treated effectively by therapy or somehow else, which makes it kind of a psychiatric nightmare.

So, what is psychopathy? Pinel [24] in some of his work described it as ‘mania without delirium with no cognitive dysfunction’; Henry Maudsley [20] classed it as ‘moral imbecility’ or ‘moral insanity’. According to Hart and Hare [12], it is “a form of chronic mental disorder associated with a specific set of symptoms” as “sense of entitlement, unremorseful, irresponsible, unconscionable, apathetic to others, affectively cold, blameful to others, manipulative, conning, disparate understanding of socially acceptable behaviour, disregardful of social obligations, and nonconforming to social norms” [8, p. 1]. McCord and McCord [21] supposed that the most noticeable trait of psychopathy is “diffusely unpatterned impulsive behaviour”. Hart and Hare [22] later specified that this is “persistent, frequent, and varied asocial and antisocial behaviour, starting at an early age”, and McCord and McCord [21] confirmed it by its own researching that so long as psychopaths are unsocial, their conduct “often brings them into conflict with society”. Maslow [19] wrote that psychopaths “have no love identifications with other human beings and can, therefore, hurt them or even kill them casually, without hate, and without pleasure, precisely as they kill animals who have come to be pets.” Hare [8] described psychopaths as “remorseless predators who use charm, intimidation and, if necessary, highly impulsive and cold-blooded violence to attain their ends”. Thereby, it may be said that psychopaths are mentally ill due to their incapability to feel emotions or control their impulses, but at the same time, they cannot be considered insane due to there is no evidence proving that they cannot be rational and thoughtful, cannot reason, learn and manipulate on purpose.