Criminal behaviour,personality disorder,and mental illness: the origins of confusion

The statutory concept of psychopathic disorder has only limited correspondence with clinical concepts of psychopathic personality, and obscures the heterogeneity of personality disorder among the antisocial. This is partly reflected in problems in assessing the treatability of ‘psychopaths’. Admission of ‘psychopaths’ for treatment may be justified when their socially deviant behaviour is a function of an identifiable personality disorder. This requires specification of treatment targets. It is proposed that personality disorder can be conceptualised as inflexible interpersonal styles supported by expectations of others which are self-fulfilling prophecies, and that these cut across the medicolegal categories of mental illness and psychopathic disorder. Data are presented from a special hospital sample which support the model, and which have implications for clinical intervention.