The DSM-IV prefers the term antisocial personality disorder and states that this is also known as psychopathy. However, recent research indicates that antisocial personality disorder and psychopathy are not the same diagnosis.

Criminality is neither necessary nor sufficient for a diagnosis of psychopathy. On the other hand, antisocial personality disorder is often synonymous with criminality. To illustrate, it is estimated that approximately 80% of male prison inmates meet the criteria for antisocial personality disorder while only around 30% or less meet the criteria for psychopathy. In other words, antisocial personality disorder may be better defined as a behavioural disorder while psychopathy reflects a true disorder of the personality.

I can’t agree with Dave Chadwick’s suggestion that psychiatry is the sole profession capable of reaching this diagnosis. Firstly, Canadian psychologist, Prof. Robert Hare, developed the gold standard of research, assessment tools, and treatment guidelines in the field of psychopathy (see www.hare.org for more information and a comprehensive list of research papers).

Psychopaths are dangerous individuals

Secondly, clinical psychologists are trained to diagnose and treat (non-pharmaceutically) mental illnesses and personality disorders (among other things). Indeed, the NSW Supreme Court recently ruled that the only professions to be accepted by the court as diagnosticians are clinical psychologists and psychiatrists.

However, I do agree with the sentiment of Mr Chadwick’s warnings of the danger of over-use of the terms “psychopath” and “psychopathy”. It seems that psychopathy is the media’s flavour of the month, stimulated by a number of recently published books and by recent visits to Australia by Robert Hare.

The terms are pejorative. There is an implied ethical obligation that their over-use be avoided.

However, psychopaths are dangerous individuals who lack remorse and do not fear the consequences of their actions. Whether they are serial workplace bullies or serial murderers, the impact on those around them can be utterly devastating.

It is not the term “psychopath” that sets them apart from society; it is their shark-like ability to swim invisibly amongst us. Invariably it is only seconds before they strike that their fin breaks the surface and their true colours are known.

Finding a new term to describe these individuals is perhaps less important than giving victims the opportunity to understand what has happened to them, and to provide warning to the potential victims of the future.

Dr Tess Crawley, PhD
Clinical Psychologist