---
title: "History of psychopathy"
chunk: 4/6
source: "https://en.wikipedia.org/wiki/History_of_psychopathy"
category: "reference"
tags: "science, encyclopedia"
date_saved: "2026-05-05T04:00:22.648437+00:00"
instance: "kb-cron"
---

== Mid-20th century ==
The Mask of Sanity by American psychiatrist Hervey M. Cleckley, first published in 1941 and with revised editions for several decades, is considered a seminal work which provided a vivid series of case studies of individuals described as psychopaths. Cleckley proposed 16 characteristics of psychopathy, derived mainly from his work with male psychiatric patients in a locked institution. The title refers to the "mask" of normal functioning that Cleckley thought concealed the disorganization, amorality and disorder of the psychopathic personality. This marked the start in America of the current clinical and popularist conception of psychopathy as a particular type of antisocial, emotionless and criminal character. Cleckley would produce five editions of the book over subsequent decades, including a substantial revision in 1950, expanding his case studies and theories to more non-prisoners and non-criminals.
In Nazi Germany, especially during World War II, psychiatrists and others in programmes such as Action T4 and Action 14f13 systematically deported, sterilised, interned and euthanised patients and prisoners who could be classed as mentally ill, feebleminded, psychopathic, criminally insane or just asocial. In the aftermath of the war, therefore, concepts of antisocial psychopathic personalities fell out of favour in Europe to some extent. At the same time, however, in America and other countries the concept became increasingly prominent, used to categorise allied soldiers as fit or unfit for duty or on return to society, or, conversely, in the more specific sinister sense of the term, as a way to explain the actions of Nazis.
The first version of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1952 did not use the term psychopathy as a diagnosis, but "sociopathic personality disturbance". Individuals to be placed in this category were said to be "...ill primarily in terms of society and of conformity with the prevailing milieu, and not only in terms of personal discomfort and relations with other individuals". There were four subtypes (called 'reactions' after Adolf Meyer): antisocial, dyssocial, sexual and addiction. The antisocial reaction was said to include "individuals who are chronically in trouble and do not seem to change as a result of experience or punishment, with no loyalties to anyone", as well as being frequently callous and lacking responsibility, with an ability to 'rationalize' their behaviour. The dyssocial reaction was for "individuals who disregard societal rules, although they are capable of strong loyalties to others or groups." Although the sociopathy category was very broad by today's definitions, the DSM-I itself pointed out that it was more specific and limited than the then current notions of 'constitutional psychopathic state' or 'psychopathic personality'.
Meanwhile, other subtypes of psychopathy were sometimes proposed, notably by psychoanalyst Benjamin Karpman from the 1940s. He described psychopathy due to psychological problems (e.g. psychotic, hysterical or neurotic conditions) and idiopathic psychopathy where there was no obvious psychological cause, concluding that the former could not be attributed to a psychopathic personality and that the latter appeared so absent of any redeeming features that it couldn't be seen as a personality issue either but must be a constitutional "anethopathy" (amorality or antipathy). Various theories of distinctions between primary and secondary psychopathy remain to this day.
Cleckley's concept of psychopathy as expanded on in new editions of his book, particularly the sense of a conscience-less man beneath a mask of normality, caught the public imagination around this time. It also became increasingly influential in psychiatric circles. It later fell out of favor for some time, however, such that when he died in 1984 he was better remembered for a vivid case study of a female patient published in 1956, turned into a movie The Three Faces of Eve in 1957, which had (re)popularized in America another controversial diagnosis, multiple personality disorder.
A sociologist reviewing the field in 1958 wrote that "Without exception, on every point regarding psychopathic personality, psychiatrists present varying or contradictory views."
Nevertheless, criminologist sociologists William and Joan McCord were influential in narrowing the definition of psychopathy in some quarters to mean an antisocial lack of guilt accompanied by reactive aggression. From another direction, sociologist Lee Robins was also an influential figure in sociopathy research, stemming largely from her research-based 1966 book 'Deviant Children Grown Up: a sociological and psychiatric study of sociopathic personality', based on operational criteria provided by Eli Robins, which would shape the later diagnosis of Antisocial Personality Disorder.
In the Mental Health Act in England, a new category of 'Psychopathic Personality' was added in 1959, renamed Psychopathic Disorder in 1983 (then in 2007 removed entirely). This was a legal subcategory in addition to 'mental illness' which did not equate to any one psychiatric diagnosis but covered anyone with "a persistent disorder or disability of mind which results in abnormally aggressive or seriously irresponsible conduct."
On the other hand, various analysts began to identify "successful" psychopaths in society, some even suggesting it was but an adaption to the social or economic mores of the age, others noting they could be hard to spot either because they were so good at hiding their lack of conscience, or because many people showed the traits to some degree.