Psychopathy/Antisocial Personality Disorder: Diagnostic Confusion
Regarding: something published and apparently ignored since February 1, 1996
Psychiatric Times. Vol. 13 No. 2: http://www.psychiatrictimes.com/display/article/10168/54831
"Written by Robert D. Hare, Ph.D. Dr. Hare, who has researched psychopathy for more than 25 years, is a professor of psychology at the University of British Columbia, and was scientific director of a 1995 NATO Advanced Study Institute on Psychopathic Behavior."
i wanted to introduce the topic of Sociopathy vs. Psychopathy into the materials present in Dr. Robert Hare's writing (both his articles found on the web, such as http://www.psychiatrictimes.com/p960239.html and his own website and writings in print).
"The distinction between psychopathy and ASPD is of considerable significance to the mental health and criminal justice systems. Unfortunately, it is a distinction that is often blurred, not only in the minds of many clinicians but in the latest edition of DSM-IV."
His article at http://www.psychiatrictimes.com/p960239.html is near excellent in defining some very vital reasoning on why confusion of ASPD and Psychopathy is a terrible problem.
Yet, i see a terrible problem in the lack of mention of Sociopathy.
The DSM not only lumps ASPD with Psychopathy, but also does the same with Sociopathy. Sociopathy and Psychopathy ARE Anti Social Personality Disorders. More so, they DIFFER in perceptually small yet effectively VAST ways.
i was very excited to find the book "The Sociopath Next Door" by Dr. Martha Stout. i was confused when a friend read the book and found it lacking my own personal differentiation between sociopathy and psychopathy. i examined the parts she cited and felt she was indeed correct. i had lead her to a book that does not go where i thought it did and where i have been going very frequently in my attempts to educate others.
i have since located some web-based material called "The Psychopath Next Door" which is reportedly Martha Stout's website (which looks outdated and does not indicate her name). The information on this page seems VERY similar to her book. It occurred to me that the process of formalizing her writing on the topic had forced her to change from the subject of Psychopathy to Sociopathy because the people she was writing about were not murderers, cult leaders or other such common psychopathic actions. It is fortunate that she changed terms before publishing the book, but unfortunate that it does not do near as well a job as my own talks with people to define the difference between the two labels.
Most importantly, i think it is VITAL that all of this information be brought back into public discussion, form part of whatever processes involved in producing the next (unfortunately biblically followed) DSM edition, and CLARIFIED to eliminate the confusion that is growing more and more rampant.
i have a personal motivator here. i was harassed, intimidated and abused by several sociopaths. To my knowledge, they are not psychopaths. Their ASPD stops at the point where they attempt to preserve their social status and maintain their adherence to the majority of laws and social rules that would have them filtered out of society, should they break those rules and laws. i have no interest in "protecting" these people in any way (i would love to see sociopaths filtered out of society just as psychopaths tend to filter themselves out after committing crimes), but i DO see a neurological connection to two neurological/psychiatric items that do NOT deserve to be lumped into the same category as psychopaths:
- Borderline Personality Disorder. This is largely a defensive mechanism of the human mind in response to extensive and intolerable amounts of mental (and often physical) abuse. Most typically observed in females from teenage to about 35, is the claim of much material on BPD. Noted is the "mysterious growing out of it" effect that i have read about in several published materials on BPD. i find this irresponsible and i "see" what is likely happening: BPD leads to sociopathy, if not treated, cared for or otherwise halted in its tracks.
- BPD appears to be a VERY common comorbidity of autistic neurology in the later years (between teens and mid 30s).
You see the process i am illustrating?
High Functioning Autistic neurology leads to much social (and often physical abuse) through the "growth years" and the comorbid condition of BPD establishes a strong hold to preserve the mental integrity of the individual. A worst case scenario leads to the terminal point of BPD transitioning into Sociopathy.
In case you cannot predetermine my personal bias here, i am autistic.
My autism spectrum label would most likely be Asperger's Syndrome, but the longer i continue to combat "the system" as an individual, and combat sociopaths and "professionals," the more i am forced to wonder if i am something slightly higher functioning than the high functioning AS individual. My self awareness and intelligence has made me feel rather alienated by those AS persons i have encountered in AS communities and the "professionals" refuse to recognize me as BEING on the autism spectrum (because apparently they do not grasp that austistic children eventually GROW UP with or without a diagnosis). i did not have a diagnosis of anything until about a year ago when i pursued the diagnosis of AS through independent research and a rough time locating professionals who could see beyond their traditionally myopic perspective of only working with children.
AS, and autism in general, has many features that are similar to the criteria for ASPDs and many are perceived to BE antisocial. Worse, it seems to me, from my own personal research and experience, autistic neurology is a potential catalyst for becoming an antisocial person, a "Borderliner," Sociopath or psychopath. The determining factors seem to be nurture (positive or negative) and self awareness (though that lucidity of self awareness is questionable in terms of how it comes about and whether it can be taught or learned).
My point: Sociopaths are more dangerous than psychopaths. They do not get filtered out of society because, as many have stated, the "dog eat dog" aspects of "modern society" seem to encourage it and getting "ahead" in society seems to be enabled by the traits of sociopathy. Also, i know MANY persons with AS and BPD. None of them deserve the mistaken presumption or sloppy and incorrect diagnosis of Sociopathy or Psychopathy.
The DSM needs to be moved drastically into a "spectral" format instead of solid on and off bipolar determination. i am hoping that interaction from people such as myself with people such as the professionals "in the business" (especially those who are authoring books and being read by other professionals and students of the topics he presents) will eventually lead to a healthier DSM and better diagnostic results from the "professionals" who use the DSM as the end-all be-all bible of "mental health."
The mind is the brain. The brain is the mind. Knowing how it works, and why it works in the ways it does, is the best route to a healthier human species and human societies.
Thank you for reading this rather long message. i would like to send a copy to Dr. Robert Hare, but the website indicates a postal address only for personal correspondence. i hope that this message is a little of both; please do forward this message to him if that is possible. Otherwise, i will have to use the postal service.
dysamoria dot com