ABSTRACT
In this chapter, I shall consider a group of individuals who do not fit easily within current delineations of mental disorders and who evoke emotive responses from professionals and laypersons alike. It is also important to indicate at the outset that the definition of psychopathic disorder within current mental health legislation does not necessarily equate with the definitions and descriptions of many aspects of the disorder within clinical texts - as, for example, in The Diagnostic and Statistical Manual of Mental Disorders, DSM IV(R), (APA 1994) or in the International Classification of Diseases (ICD 10) (WHO 1992). Given these discrepancies, it is difficult to be precise as to the condition one is about to describe. At the risk of being criticized, but for the sake of simplification, I shall use the term "psychopathic disorder" to encompass serious anti-social personality disorder (APA 1994), dissocial personality disorder (WHO 1992) and, perhaps somewhat more controversially, the newly "coined" disorder known as "dangerous severe personality disorder". (For a penetrating discussion of
the genesis of this last, see Gunn 2000.) The two opening epigraphs point to several of the key problems in dealing with the concept of psychopathic disorder. The quotation from Richard III suggests the manner in which the so-called psychopath is able to "mask" his persistent criminality behind a facade of charm and normality; to such an extent that Cleckley called his seminal work on the disorder The Mask of Sanity (Cleckley 1976). The second quotation illustrates the long-standing but not very helpful nature versus nurture debate and the psychopath's resistance to punishment or treatment (see later).
