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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Antisocial personality disorder | 5/9 | https://en.wikipedia.org/wiki/Antisocial_personality_disorder | reference | science, encyclopedia | 2026-05-05T15:21:37.098549+00:00 | kb-cron |
==== DSM-5 ==== In the main section (section II) of the DSM-5, a categorical classification with ten specific categories of personality disorder was retained from the DSM-IV. Among these, antisocial personality disorder is defined as being characterized by at least three of seven traits. In order to be diagnosed with antisocial personality disorder under the DSM-5, one must be at least 18 years old, show evidence of onset of conduct disorder before age 15, and antisocial behavior cannot be explained by schizophrenia or bipolar disorder. This categorical system has faced criticism for problems such as excessive comorbidity among personality disorders, heterogeneity within categories, and the use of the often most correct but uninformative personality disorder-not otherwise specified (PD-NOS) diagnosis. In response to problems associated with the categorical system, the DSM-5 Personality and Personality Disorders Work Group devised the AMPD. This model bases diagnosis on the level of personality functioning (criterion A) as well as presence of pathological personality traits (criterion B) in a patient, with specific personality disorders being characterized by certain combinations of these. Personality functioning comprises self functioning (identity and self-direction) and interpersonal functioning (empathy and intimacy); for example, in the case of ASPD, characteristic impairment in the identity domain is described as follows: "Egocentrism; self-esteem derived from personal gain, power, or pleasure". Serving to characterize the pathological aspects of the personality giving rise to the impairment in personality functioning, criterion B requires that at least six out of seven pathological traits be present in order for a diagnosis to be made. In the case of ASPD, the aforementioned traits belong to the domains of antagonism and disinhibition. The AMPD diagnosis can be further specified using a "with psychopathic traits" specifier modelled after the Fearless Dominance scale of the Psychopathic Personality Inventory, defined by low Anxiousness and Withdrawal and high Attention-Seeking. Researchers have also proposed the inclusion of Grandiosity and Restricted Affectivity to better capture psychopathy. Moreover, the individual must be at least 18 years old, and meet the AMPD's additional criteria (C–G), such as differentiation from other conditions.
==== ICD-11 ====
The World Health Organization's ICD-11 has replaced the categorical classification of personality disorders in the ICD-10 with a dimensional model containing a unified personality disorder (6D10) with severity specifiers, along with specifiers for prominent personality traits or patterns (6D11). Severity is assessed based on the pervasiveness of impairment in several areas of functioning, as well as on the level of distress and harm caused by the disorder, while trait and pattern specifiers are used for recording the manner in which the disturbance is manifested. Dissocial personality disorder has been found to be consistently associated with the ICD-11 trait domains Dissociality (6D11.2) and Disinhibition (6D11.3), reflecting core features such as callousness, lack of remorse, impulsivity, and risk-taking. Some evidence also points to a negative association with Negative Affectivity (6D11.0), consistent with traits like fearlessness and boldness. In the categorical classification of the ICD-10, dissocial personality disorder (F60.2) was a distinct personality disorder diagnosis.
=== Psychopathy ===
Psychopathy is commonly defined as a personality construct characterized partly by antisocial behavior, a diminished capacity for empathy and remorse, and poor behavioral controls. Psychopathic traits are assessed using various measurement tools, including Canadian researcher Robert D. Hare's Psychopathy Checklist, Revised (PCL-R). "Psychopathy" is not the official title of any diagnosis in the DSM or ICD; nor is it an official title used by any other major psychiatric organizations. The DSM and ICD, however, state that their antisocial diagnoses are at times referred to (or include what is referred to) as psychopathy or sociopathy. American psychiatrist Hervey Cleckley's work on psychopathy formed the basis of the diagnostic criteria for ASPD, and the DSM states ASPD is often referred to as psychopathy. However, critics argue ASPD is not synonymous with psychopathy as the diagnostic criteria are not the same, since criteria relating to personality traits are emphasized relatively less in the former. These differences exist in part because it was believed such traits were difficult to measure reliably and it was "easier to agree on the behaviors that typify a disorder than on the reasons why they occur". Although the diagnosis of ASPD covers two to three times as many prisoners as the diagnosis of psychopathy, Robert Hare believes the PCL-R is better able to predict future criminality, violence, and recidivism than a diagnosis of ASPD. He suggests there are differences between PCL-R-diagnosed psychopaths and non-psychopaths on "processing and use of linguistic and emotional information", while such differences are potentially smaller between those diagnosed with ASPD and without. Additionally, Hare argued that confusion regarding how to diagnose ASPD, confusion regarding the difference between ASPD and psychopathy, as well as the differing future prognoses regarding recidivism and treatability, may have serious consequences in settings such as court cases where psychopathy is often seen as aggravating the crime. Nonetheless, psychopathy has been proposed as a specifier under an alternative model for ASPD. In the DSM-5, under "Alternative DSM-5 Model for Personality Disorders", ASPD with psychopathic features is described as characterized by "a lack of anxiety or fear and by a bold interpersonal style that may mask maladaptive behaviors (e.g., fraudulence)". Low levels of withdrawal and high levels of attention-seeking combined with low anxiety are associated with "social potency" and "stress immunity" in psychopathy. Under the specifier, affective and interpersonal characteristics are comparatively emphasized over behavioral components. Research suggests that, even without the "with psychopathic traits" specifier, these Section III criteria accurately capture the affective-interpersonal features of psychopathy, though the specifier increases coverage of the Interpersonal and Lifestyle facets of the PCL-R.
=== Millon's subtypes === Theodore Millon suggested 5 subtypes of ASPD. However, these constructs are not recognized in the DSM or ICD.
Elsewhere, Millon differentiates ten subtypes (partially overlapping with the above) – covetous, risk-taking, malevolent, tyrannical, malignant, disingenuous, explosive, and abrasive – but specifically stresses that "the number 10 is by no means special ... Taxonomies may be put forward at levels that are more coarse or more fine-grained."