Associated with does not mean presence/absence can be used as a singular, reliable diagnostic test. On the deprecation, I’m no psychologist, merely an interested layman but I don’t understand the reasoning the APA used to justify getting rid of the psychopathy diagnosis. It seems to be quite a distinct subgroup within ASPD. At the extreme, using the old labels, no matter how lovely, caring etc. they are raised psychopaths are bad news, persons with similar dispositions towards psychopathic behaviour but different childhood environments can either express (act like psychopaths) or not, and then there are APSD, who can have traits that would disqualify them from either diagnosis, e.g. feeling sincere guilt even momentarily, or having relationships that are not purely instrumental.
I don’t understand the reasoning the APA used to justify getting rid of the psychopathy diagnosis. It seems to be quite a distinct subgroup within ASPD.
If that were the case, the solution would be easy: recognize psychopathy as a subgroup. They could call it Antisocial Personality Disorder, malignant variety, perhaps.
But the classic Cleckley psychopath often isn’t an anti-social personality. Antisocial personality is based on concrete diagnostic criteria that high-functioning, intelligent psychopaths don’t necessarily manifest; they may be political leaders, attorneys, judges, businessmen, anywhere arbitrary power can be found. I think they are probably better conceived as a subset of Narcissistic Personality Disorder. But the psychiatrists who pioneered in applying that diagnosis, the psychoanalyst Kohut and colleagues, have a more romantic understanding of their narcissistic patients. Politics figure large in the diagnostic manual’s catalog.
Associated with does not mean presence/absence can be used as a singular, reliable diagnostic test. On the deprecation, I’m no psychologist, merely an interested layman but I don’t understand the reasoning the APA used to justify getting rid of the psychopathy diagnosis. It seems to be quite a distinct subgroup within ASPD. At the extreme, using the old labels, no matter how lovely, caring etc. they are raised psychopaths are bad news, persons with similar dispositions towards psychopathic behaviour but different childhood environments can either express (act like psychopaths) or not, and then there are APSD, who can have traits that would disqualify them from either diagnosis, e.g. feeling sincere guilt even momentarily, or having relationships that are not purely instrumental.
If that were the case, the solution would be easy: recognize psychopathy as a subgroup. They could call it Antisocial Personality Disorder, malignant variety, perhaps.
But the classic Cleckley psychopath often isn’t an anti-social personality. Antisocial personality is based on concrete diagnostic criteria that high-functioning, intelligent psychopaths don’t necessarily manifest; they may be political leaders, attorneys, judges, businessmen, anywhere arbitrary power can be found. I think they are probably better conceived as a subset of Narcissistic Personality Disorder. But the psychiatrists who pioneered in applying that diagnosis, the psychoanalyst Kohut and colleagues, have a more romantic understanding of their narcissistic patients. Politics figure large in the diagnostic manual’s catalog.