Didn't the DSM used to separate out ASPD Type I and II, with the latter being an acquired impairment in self-regulation (affecting eg planning) and low-level introspection / stimulus-response (affecting affective empathy and reaction to pain, as the most commonly measured effects), and the former being an inborn instance of very similar symptoms? Sounds a lot like the colloquial definitions of sociopathy and psychopathy.
I'm more a cognitive scientist than a practicing psychiatrist, but as I understand the merger and restructuring of the diagnostic criteria was purely due to clinical irrelevance, rather than any evidence that ASPD I and II were fundamentally not coherent clusters of response-patterns.
(edits to clarify given the context of the last few pages of the thread)
I'll probably regret posting this but I'll give it my best shot to break down my thoughts here...
Psychopathy is an extremely fraught topic in modern psychology, in large part because the guy who wrote the books and thus makes all the money off 'criminal psychopathy', Robert Hare, is actively litigious about peers trying to dispute his findings or methodology. It was an entire thing, look up 'forensic psychopathy lawsuit' if you're curious.
Now, while I think Hare is absolutely full of shit, applying the sharpshooter's fallacy, and is simply a symptom of how young and underdeveloped psychology is as a field, I don't have the appropriate degree, let alone doctorate to actually dispute him, beyond noting that his so-called PCL-R has never made it into the DSM or the ICD (I assume this keeps him up at night).
So I'll instead look at the background of it — because the cultural concept of the psychopath predates anything close to modern psychopathology (the study and categorisation of mental disorders, for onlookers). Indeed, one could argue that the cultural concept of the psychopath is what prompted psychopathology to be studied! Which is perhaps why it's been such a persistent bugbear.
Early ideas analogous to the cultural idea of the sociopath or psychopathy, I would say, start with the 19th century Italian idea of the 'born criminal' or Maudsley's (19th-20th century English psychiatrist) concept of the 'moral imbecile' — someone who, while otherwise rational and possessed of their faculties, is not 'enlightened to the higher order of moral intelligence' (paraphrased but he
would say it like that).
It is perhaps worth noting that some of the earliest uses of psychopath as a diagnosis were to diagnose 'constitutional psychopathic interiority' —which is to say, you were some kind of societal deviant, such as a homosexual — and autistic children, who were called 'psychopathic children' and Aspergers' Syndrome was originally known as 'autistic psychopathy'. At the time, psychopathy was meant to cover a much broader range of behaviours than is currently assumed, but it has always been more or less targeted at 'undesirable behaviour'. While this does at times include dangerous behaviour, more commonly it was used as a tool to control deviants, delinquents and defiant women.
I'm getting a bit far afield but to summarise...
There was, during the 20th century, a very strong inclination towards pathologising crime as a disease and criminals as sick. No 'right-minded' person would commit crimes, or be a delinquent or any kind of social deviant. This legacy is something psychopathology still struggles to grapple with today and it's that legacy that the pop cultural concept of the sociopath and/or the psychopath comes from, the idea of people who are fundamentally Born Different about relating to people.
That does exist, but it's called autism (among, admittedly, other diagnoses, but that's the most common one). Not ASPD, which by my understanding has a low heritability rate and is highly correlated with 'abusive' or 'broken' homes which is presumed to teach the child faulty risk/reward calculations.
While we're much more open minded today and are more likely to attribute things to environmental factors or free will rather than the pathologisation of morals... people still don't like thinking that people who can do terrible things without remorse are sane. And most serial killers
are sane. The labels 'psychopath' and 'sociopath' (they are entirely interchangeable these days colloquially) are, in my eyes, more or less an attempt to 'other' those who do terrible things, to reassure the speaker of the term and the listener who hears it that they, upright, moral folk aren't like
them.
I just don't think that's at all true. It's pure cope.
