Antisocial Personality Disorder and Psychopathy: Understanding the Differences

The term Antisocial Personality Disorder (ASPD) was first introduced in 1980 when personality disorders entered the DSM (in DSM-III). However, prior to that time, clinicians and researchers had been interested in a syndrome that was initially called sociopathic personality but is now usually referred to as psychopathy.

Psychopathy was first identified in the nineteenth century when terms such as manie sans delire (insanity without delirium), moral weakness, or moral insanity were used to describe it. The most comprehensive early description of psychopathy was made by Cleckley in the 1940s. In his book, The Mask of Sanity, Cleckley provided detailed case studies of people he identified as psychopaths and outlined 21 core traits of psychopathy, which were later revised and reduced to 16 traits.

The prevalence of psychopathy is unknown because no epidemiological studies have assessed this. However, for males in North America, the prevalence is estimated to be about 1 to 2 percent. Rates for women are estimated to be much lower (well under 1 percent).

It is important to note that the features of DSM-5 ASPD do not fully map onto the construct of psychopathy as originally described. This was done deliberately in an attempt to increase the reliability of the ASPD diagnosis. However, many researchers expressed concern that reliability was being emphasized at the expense of validity and that many key features of psychopathy were not included in the diagnostic criteria. This has raised questions about whether the ASPD construct is the same as psychopathy. It is generally accepted that there is a good deal of overlap, although the diagnosis of ASPD is more inclusive and reflects a lot of criminality, whereas the diagnosis of psychopathy is more narrow and much more focused on personality structure.

References

Hooley, J. M., Nock, M. K., & Butcher, J. N. (2019). Abnormal Psychology (18th ed.). Pearson Education (US). https://bookshelf.vitalsource.com/books/9780135191033