Dissocial personality disorder is one of several psychopathic
personality disorderPersonality disorders, formerly referred to as character disorders, are a class of personality types which deviate from the contemporary expectations of a society....
s, each of which has different
operational definitionAn operational definition is a demonstration of a process – such as a variable, term, or object – in terms of the specific process or set of validation tests used to determine its presence and quantity. The term was coined by Percy Williams Bridgman...
s and
terminologiesTerminology is the study of terms and their use. Terms are words and compound words that are used in specific contexts. Not to be confused with "terms" in colloquial usages, the shortened form of technical terms which are defined within a discipline or speciality field...
depending on the system of
classification of mental disordersThe classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
used.
PsychopathyPsychopathy is a psychological construct that describes chronic disregard for ethical principles and antisocial behavior.The term is often used interchangeably with sociopathy. This is a commonly made mistake. Sociopathy is no longer a correct term to use, and when it is used it actually refers to...
is a general
constructSocial constructionism and social constructivism are sociological theories of knowledge that consider how social phenomena develop in social contexts...
that differs from the specific diagnoses of
antisocialAntisocial personality disorder is defined by the American Psychiatric Association's Diagnostic and Statistical Manual as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." The individual...
, psychopathic, dissocial, and sociopathic personality disorders, the various
diagnostic classificationsThe classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
for psychopathy.
Dissocial personality disorder is the diagnostic category established for psychopathy in the
ICD-10The International Statistical Classification of Diseases and Related Health Problems10th Revision is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization...
diagnostic criteria developed by the
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health...
(WHO).
Dissocial personality disorder is one of several psychopathic
personality disorderPersonality disorders, formerly referred to as character disorders, are a class of personality types which deviate from the contemporary expectations of a society....
s, each of which has different
operational definitionAn operational definition is a demonstration of a process – such as a variable, term, or object – in terms of the specific process or set of validation tests used to determine its presence and quantity. The term was coined by Percy Williams Bridgman...
s and
terminologiesTerminology is the study of terms and their use. Terms are words and compound words that are used in specific contexts. Not to be confused with "terms" in colloquial usages, the shortened form of technical terms which are defined within a discipline or speciality field...
depending on the system of
classification of mental disordersThe classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
used.
PsychopathyPsychopathy is a psychological construct that describes chronic disregard for ethical principles and antisocial behavior.The term is often used interchangeably with sociopathy. This is a commonly made mistake. Sociopathy is no longer a correct term to use, and when it is used it actually refers to...
is a general
constructSocial constructionism and social constructivism are sociological theories of knowledge that consider how social phenomena develop in social contexts...
that differs from the specific diagnoses of
antisocialAntisocial personality disorder is defined by the American Psychiatric Association's Diagnostic and Statistical Manual as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." The individual...
, psychopathic, dissocial, and sociopathic personality disorders, the various
diagnostic classificationsThe classification of mental disorders, also known as psychiatric nosology or taxonomy, is a key aspect of psychiatry and other mental health professions and an important issue for consumers and providers of mental health services...
for psychopathy.
Dissocial personality disorder is the diagnostic category established for psychopathy in the
ICD-10The International Statistical Classification of Diseases and Related Health Problems10th Revision is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization...
diagnostic criteria developed by the
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health...
(WHO). It is conceptually similar to the DSM-IV-TR diagnostic criteria for
Antisocial personality disorderAntisocial personality disorder is defined by the American Psychiatric Association's Diagnostic and Statistical Manual as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." The individual...
.
ICD-10 Criteria for Dissocial Personality Disorder
Specifically, the dissocial personality disorder is described by the
World Health OrganizationThe World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health...
by the following criteria:
- Callous unconcern for the feelings of others and lack of the capacity for empathy
Empathy, which literally translates as 'in feeling', is the capability to share and understand another's emotions and feelings. It is often characterized as the ability to "put oneself into another's shoes".-Etymology:...
.
- Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
- Incapacity to maintain enduring relationships, though having no difficulty in establishing them.
- Very low tolerance to frustration
Frustration is a common emotional response to opposition. Related to anger and disappointment, it arises from the perceived resistance to the fulfillment of individual will. The greater the obstruction, and the greater the will, the more the frustration is likely to be. Causes of frustration may be...
and a low threshold for discharge of aggressionIn psychology, as well as other social and behavioral sciences, aggression refers to behavior between members of the same species that is intended to cause pain or harm. Predatory or defensive behavior between members of different species is not normally considered "aggression." Aggression takes a...
, including violenceViolence is the expression of physical or verbal force against self or other, compelling action against one's will on pain of being hurt. Variant uses of the term refer to the destruction of non-living objects . Worldwide, violence is used as a tool of manipulation and also is an area of concern...
.
- Incapacity to experience guilt
Guilt is a cognitive or an emotional experience that occurs when a person realizes or believes - whether justified or not - that he or she has violated a moral standard, and is responsible for that violation...
and to profit from experience, particularly punishmentPunishment is the practice of imposing something unpleasant or aversive on a person or animal, usually in response to disobedience, defiance, or behavior deemed morally wrong by individual, governmental, or religious principles.-Etymology:...
.
- Markedly prone to blame others or to offer plausible rationalization
In psychology and logic, rationalization is the process of constructing a logical justification for a belief, decision, action or lack thereof that was originally arrived at through a different mental process...
s for the behavior bringing the subject into conflict.
- Persistent irritability
Irritability is an excessive response to stimuli. The term is used for both the physiological reaction to stimuli and for the pathological, abnormal or excessive sensitivity to stimuli....
.
The criteria specifically rule out
conduct disorderConduct disorder is a psychiatric category marked by a pattern of repetitive behavior wherein the rights of others or social norms are violated....
s. Dissocial personality disorder criteria differ from those for antisocial and sociopathic personality disorders.
Confusion in terminology
Although conceptually the antisocial, dissocial, and sociopathic personality disorders are synonymous with psychopathy, operationally the diagnostic criteria for these disorders are definitely distinct. They are not equivalent disorders. The largest difference is the emphasis on
delinquentA delinquent is one who fails to do that which is required by law or by duty when such failure is minor in nature.The term is often used to refer to a juvenile who commits a minor criminal act—juvenile delinquents....
and
criminal behaviorCrime is the breach of one or more rules or laws for which some governing authority, via mechanisms such as police power, may ultimately prescribe a conviction...
s found in the DSM-IV-TR's version, the
antisocial personality disorderAntisocial personality disorder is defined by the American Psychiatric Association's Diagnostic and Statistical Manual as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." The individual...
. The dissocial personality disorder pays more attention to the affective, interpersonal and behavioral components not present in DSM-IV-R's criteria.
The criteria for antisocial personality disorder are largely based on observable behaviors while the ICD criteria for dissocial personality disorder focus more on the affective and interpersonal deficits. However, the ICD criteria do not represent the broad personality and behavioral factors of psychopathy.
The blurring of distinctions between these diagnostic categories and psychopathy have caused diagnosis confusion. For the mental health and criminal justice system, the distinction between psychopathy and antisocial personality disorder is of considerable importance.
Research findings
Much research into psychopathy, as operationalized by the Hare Psychopathy Checklist Revised (PCL-R), has been conducted. The checklist assesses both interpersonal and affective components as well as
lifestyleLifestyle was originally coined by Austrian psychologist Alfred Adler in 1929. The current broader sense of the word dates from 1961.In sociology, a lifestyle is the way a person lives. A lifestyle is a characteristic bundle of behaviors that makes sense to both others and oneself in a given time...
and antisocial deficits. However, the research results cannot be easily extrapolated to the clinical diagnoses of dissocial personality disorder or antisocial personality disorder.
A sample research finding is that between 50% and 80% of prisoners in England and Wales meet the diagnostic criteria of dissocial personality disorder, but only 15% would be predicted to be psychopathic as measured by the PCL-R. Therefore, the findings drawn from psychopathy research have not yet been shown to be relevant as an aid to the diagnosis and treatment of dissocial or antisocial personality disorders.
Attempts to correlate dissocial personality disorder have had
methodologicalMethodology can be defined as:# "the analysis of the principles of methods, rules, and postulates employed by a discipline";# "the systematic study of methods that are, can be, or have been applied within a discipline"; or...
problems. Although a high percentage of prisoners in England and Wales were shown in one survey to fulfill the criteria for a dissocial personality, since the diagnosis of dissocial personality includes a disregard for social rules and norms, it is not surprising that the same individuals commit crimes.
Research has been done attempting to assess the co-morbidity of dissocial personality disorder with other conditions. However, the few studies that have been done use too many different
methodologiesMethodology can be defined as:# "the analysis of the principles of methods, rules, and postulates employed by a discipline";# "the systematic study of methods that are, can be, or have been applied within a discipline"; or...
to enable forming solid conclusions, although it seems that there is a low prevalence of antisocial personality disorder/dissocial personality disorder in psychiatric hospitals.
Treatment
In practice, mental health professionals rarely treat dissocial personality disorders as they are considered untreatable and no interventions have proven to be effective. In
EnglandEngland is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west and the North Sea to the east, with the English Channel to the south separating it from continental...
and
WalesWales is a country that is part of the United Kingdom, bordered by England to its east, and the Atlantic Ocean and Irish Sea to its west. It is also an elective region of the European Union...
the diagnosis is grounds for
detentionDetention generally refers to a state or government holding a person in a particular area , either for interrogation, as punishment for a crime , or as a precautionary measure while that person is suspected of posing a potential threat.The term can also be used in reference to the holding of...
in secure
psychiatric hospitalA psychiatric hospital, sometimes known as an asylum, is a hospital specializing in the treatment of serious mental illness, usually for relatively long-term inpatients....
s under the
Mental Health ActThe Mental Health Act 1983 is an Act of the Parliament of the United Kingdom but applies only to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...
if individuals with that diagnosis have committed serious crimes, but since such individuals are disruptive for other patients and not responsive to treatment this alternative to
prisonA prison is a place in which people are physically confined and, usually, deprived of a range of personal freedoms. Other terms are penitentiary, correctional facility, and jail , although in the United States "jail" and "prison" refer to different subtypes of correctional facility...
is not often used.
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