Personality Disorders in Children: Problems in Diagnosis and Definition

Abstract

For the past 20 years there has been a perceptible trend in general psychiatry and, especially, in child psychiatry toward narrowing the concept of psychopathy, or even toward doing away with the term entirely. Its ambiguity and imprecision are evident in the multiplicity and vagueness of the diagnostic criteria, the variety of definitions, and the difficulties encountered in fitting the conditions to which it refers into a single, standard, classificatory system. Kurt Schneider's (1942) definition, according to which a psychopath is a person whose deviance causes trouble for himself and those around him, is much too general and is, moreover, equally applicable to other psychopathological states. Furthermore, the diagnosis of psychopathy is sometimes considered inappropriate in child psychiatry even by those who still use the term for adults. Tramer (1949) and Destunis (1961) suggest that the term prepsychopathy rather than psychopathy be used for children, since the psychopathic signs evident in children do not necessarily persist into adulthood. Gollnitz (1974) cautions against premature labeling of a child, maintaining that during a child's development various traits and modes of behavior that appear to be quite typically psychopathic may emerge for a time only to vanish completely a little while later. A child's personality is shaped gradually as he develops, through constant interplay with his environment.