SOCIOPATHIC PERSONALITY DISTURBANCE

A group of personality or character disorders marked primarily by failure to adapt to prevailing ethical and social standards and by lack of social responsibility. The Diagnostic and Statistical Manual of the American Psychiatric Association (1952) applies this category to individuals who are “ill primarily in terms of society and of conformity within the prevailing cultural milieu, and not only in terms of personal discomfort and relations with other individuals. However, sociopathic reactions are very often symptomatic of severe underlying personality disorder, neurosis or psychosis, or occur as the result of organic brain injury or disease.”Four types of disorder are classified under this heading. First, antisocial reaction, comprising individuals who are constantly in trouble, do not profit from experience or punishment, tend to have no genuine loyalties, and are usually callous, egocentric, emotionally immature and irresponsible, yet rationalize their behavior so that it appears reasonable and justified. Second, dyssocial reaction, comprising individuals who disregard or come into direct conflict with social codes, who—though often capable of strong loyalties—live all their lives in an abnormal moral environment, and who usually adhere to a criminal code, but without showing any other significant personality deviation. Third, sexual deviation, comprising persons who exhibit such deviations as homosexuality, transvestism, pedophilia, fetishism, and sexual sadism (rape, sexual assault, mutilation, etc.), when these practices are not symptomatic of more extensive syndromes such as schizophrenic or obsessional reactions. Fourth, addiction, including well-established addiction to alcohol or narcotic drugs without a recognized underlying disorder such as organic brain syndrome, psychosis, or psychoneurosis.These disturbances are grouped together for several reasons. First, they are all forms of social pathology, since the behavior of sociopaths is in basic conflict with the laws, norms, and customs of society. Second, sociopathic individuals have certain general personality characteristics in common; notably, lack of restraint and control over behavior, a weak or distorted conscience (superego), absence of a normal sense of guilt, and disturbed relationships with other people. Third, they are rarely neurotic, since they are not tom by unconscious emotional conflicts and their behavior is not basically a defense against anxiety. Fourth, they seldom become psychotic, since they are in good contact with reality and their personalities are generally well integrated. Fifth, they generally accept their reactions and behavior patterns as a fixed way of life which they see little reason or possibility to change. For this reason they tend to be highly resistant to the usual types of therapy.The classification and distinctions given above need qualification. The four categories cannot be strictly separated, since many individuals are mixed types, such as antisocial sexual deviants and dyssocial alcoholics. Although many sociopaths adopt one type of unacceptable behavior, others engage in many kinds: rape, theft, drug addiction, etc. Moreover, a sizable minority—particularly certain sexual deviants, alcoholics, and drug addicts—have been found to be neurotic, and some extreme sociopaths are psychotic.In general, sociopathic individuals constitute a high percentage of our criminal and delinquent population, including confidence men, unscrupulous businessmen, impostors, embezzlers, racketeers, child molesters, prostitutes, burglars, and murderers. A study of ten thousand inmates of Sing Sing indicated that 66 per cent could be classified as antisocial or dyssocial, and many of the remaining 34 per cent were sociopathic alcoholics and sexual deviants (Gaeta- niello, 1963). These men were all gross offenders against society.On the other hand, a great many sociopaths are of a milder type, constituting the huge number of highly self- centered, unreliable, uninhibited, amoral, untruthful individuals who live as they please in careless disregard of the rights of others and their own responsibilities to society. (The four types of sociopaths, as well as various subcategories, are discussed under separate topic headings.)