The Confusion Over Psychopathy (I): Historical Considerations

Published date01 June 2001
Date01 June 2001
DOI10.1177/0306624X01453005
Subject MatterJournal Article
International Journal of Offender Therapy and Comparative Criminology
The Confusion Over Psychopathy
The Confusion Over Psychopathy (I):
Historical Considerations
Bruce A. Arrigo
Stacey Shipley
Abstract: This article is the first in a two-part series on psychopathy.Psychopathy is an elu-
sive and perplexing psychological construct. Problems posed by this mental disorder are
linked to changing historical interpretationsimpacting the current clinical community’s gen-
eral understanding of it, especially in relation to Antisocial Personality Disorder (ASPD).
Accordingly, the researchers provide a thorough analytical review of the major transitions
associated with psychopathy’s historical development. This assessment demonstrates where
and how the nomenclature, meaning, degreeof social condemnation, and prognosis for this
mental disorder have changed. Ultimately,this article clarifies much of the uncertainty sur-
rounding this misunderstood psychological construct.
This article is the first in a two-part series on psychopathy published in the Inter-
national Journal of Offender Therapyand Comparative Criminology. This article
focuses on the history of psychopathy, mindful of its confusing and complicated
evolution. The second article addresses the current and practical implications of
the construct’s development, especially in relation to assessment matters, diag-
nostics and treatment, and expert testimony.
As an identified mental disorder and evolving label, psychopathy has a long
history, dating back many centuries. Indeed, researchers havefound reference to
psychopathic individuals in biblical, classical, and medievaltexts (e.g., Cleckley,
1976; Hare, 1996; McCord & McCord, 1964). Notwithstanding its extensiveheri-
tage, psychopathy has been plagued by changing and uncertain diagnostic
nomenclature. For example, a great deal of confusion currently exists regarding
the relationship between Antisocial Personality Disorder (ASPD), as identified
by the Diagnostic and Statistical Manual of Mental Disorders (4th ed.)
(DSM–IV), and the modern construct of psychopathy as explained by Cleckley
(1941) and further refined and empirically validated by Hare (1985, 1991).
Although contemporary research supporting the diagnosis of psychopathy is at its
strongest, mental health professionals remain perplexed when diagnosing, treat-
ing, or making recommendations to the court system about these individuals (e.g.,
Gacono & Hutton, 1994; Hare, 1996; Stevens, 1993).
Given the ongoing forensic practice problems that ostensibly pervade the psy-
chopathy construct, understanding how it has been defined and redefined
throughout history may be warranted. In general, we note that the psychopathic
International Journal of Offender Therapy and Comparative Criminology, 45(3), 2001 325-344
2001 Sage Publications
325
label (i.e., explanation) has changed from the morally neutral view of Pinel
(1801/1962) to the more truculent and disparaging characterization described by
Kraepelin (1915). In addition, the designation itself has evolvedfrom the unpopu-
lar term insanity, to the controversial expression moral, to the present moniker
psychopathic (Hare, 1996; Millon, Simonsen, & Birket-Smith, 1998).
The elusiveness of the psychopathic construct and its meaning is further con-
founded by the theoretical basis out of which social scientists approach and inves-
tigate this mental disorder (Martens, 2000). Indeed, some researchers invoke
descriptors for psychopathy, implying that the individual experiences morality
problems that are solely personality based (e.g., Craft, 1966; Dinges, Atlis, & Vin-
cent, 1998; Millon et al., 1998), exclusively congenitally or biologically derived
(Ellard, 1988; Schneider, 1958; Smith, 1978), or principally behaviorally
grounded (American Psychiatric Association, 1994). Moreover,notwithstanding
these interpretations, Hare’s (1996) empirical and qualitative findings consis-
tently demonstrate that the psychopath has distinctive affective, interpersonal,
and behavioral attributes.
Relatedly,the clinical construct of psychopathy remains inexplicable and puz-
zling not only in name and definition but also in consequence. In short, neither the
mental health nor the criminal justice systems have been successful in rehabilitat-
ing the psychopath. Psychopathic individuals historically and at present are
almost uniformly considered difficult, if not impossible, to treat. Indeed, as Hare
(1993) notes, the psychopath is a “self-centered, callous, and remorseless person
profoundly lacking in empathy and the ability to form warm emotional relation-
ships with others, a person who functions without the restraint of a conscience”
(pp. 2-3). Moreover,the designation carries with it the message that the individual
is untreatable and cannot be rehabilitated (e.g., Coid, 1998; Ogloff, Wong, &
Greenwood, 1990; Rice, Harris, & Cormier, 1992). As one researcher concludes,
psychopaths are “psychiatrically damaged” (Gunn, 1998, p. 34). Given these
institutional limits and professional practice concerns, establishing any form of
ongoing, efficacious interventioncan, at best, be described as unrealistic and mis-
guided (e.g., Meloy, 1996; Rice, 1997; Simon, 1998; Stevens, 1994).
We submit that the diagnostic confusion surrounding psychopathy (i.e., the
label and its meaning) and the adverse consequences persons in the mental health
and criminal justice systems (potentially) experience in the wake of such a deter-
mination, warrant closer scrutiny.To better appreciate these matters, it is first nec-
essary to explore psychopathy’s long and convolutedhistory, commencing in the
early 1800s (i.e., the insights of Pinel) and extending to the present day (i.e., the
contributions of Hare). This historical assessment of psychopathy will illustrate
the varied philosophical and scientific perspectives expressed by researchers on
such matters as (a) general nomenclature, (b) form of social condemnation,
(c) cause of mental illness, and (d) amenability to treatment.
Although clearly not exhaustive,this overview will provide an important back-
drop, making it possible to assess provisionally how psychopathy evolvedinto a
mental disorder and a pejorative label. In addition, the development of the con-
326 International Journal of Offender Therapy and Comparative Criminology

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