Prison Clinicians' Perceptions of Antisocial Personality Disorder as a Formal Diagnosis

Abstract

The use of the diagnosis antisocial personality disorder among offenders is controversial, largely because the Diagnostic and Statistical Manual of Mental Disorders III and III-R criteria for the diagnosis seem, in essence, to distinguish offenders from nonoffenders. The diagnosis is also the only nomenclature available to clinicians to designate someone as a psychopath as psychopathy is not an official diagnosis. The term psychopathy when applied to offenders has traditionally indicated a particularly serious offender. Therefore, if the diagnosis antisocial personality disorder is used by clinicians to indicate a psychopath, but the criteria for the diagnosis indicate offenders generally, it is important to understand how, when, and why the diagnosis is used. This study attempts to shed some light on these questions by a survey and subsequent interviews with clinicians who work with prison inmates. The results generally indicate that these clinicians use the diagnosis antisocial personality disorder liberally among the inmates they diagnose and that they feel the majority of inmates could be so diagnosed. On the other hand, a large minority of the clinicians report that they do not rely entirely on DSM criteria to diagnose an inmate antisocial personality. These clinicians indicate they often look for characteristics more closely associated with the concept psychopathy. The majority of the clinicians also report that these inmates are more disruptive in prison and more likely to recidivate than other inmates. In addition, they are considered manipulative and difficult to treat. Finally, further research questions are posed.