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Abstract
Taking a social constructionist approach, this article critically examines antisocial personality disorder (ASPD) to investigate how a mental illness with vague diagnostic criteria and a lack of solid empirical backing continues to persevere within the mental health system. It explores the sociohistorical roots of ASPD in the nineteenth century, emerging with psychiatry's interest in the moral transgressions of criminals as signs of mental disorder. This analysis then discusses the evolution of the ASPD label through the various iterations of the American Psychiatric Association's Diagnostic and statistical manual of mental disorders in the twentieth century, to the contemporary moment where the current classification lists criteria that can be potentially applied to almost all of those who encounter the criminal justice system. Rather than being a legitimate mental disorder, it is concluded that the ASPD classification serves as a way for psychiatry to expand their expertise and influence beyond the psychiatric institution and further into the criminal justice system.
Keywords: antisocial personality disorder; criminal justice system; DSM; medicalisation; psychopathy
Introduction
Antisocial personality disorder (ASPD) is a widely accepted personality disorder within psychiatry which is frequently used in both forensic settings (that is, places that detain those with mental disorders who have criminally offended or are 'at risk' of offending) and within the criminal justice system (CJS) (McCallum, 2001, p. 7). While this classification was once reserved for those who were judged to have committed the most serious of crimes (such as rape or murder), it can now be applied to any individual who is encapsulated within the CJS and associated with notions of danger and criminality, eliciting fear within society through the linkage of ASPD to ideas of psychopathy (Soares, 2010, p. 854). While there is no solid definition for the latter term, Hare (1993, p. xi), a renowned expert in the field, describes 'psychopaths' as charming, manipulative predators, lacking in conscience and feelings for others. They are understood to violate social norms and expectations and do so without feelings of remorse or regret. However, while it is believed that every psychopath has ASPD, not every person with ASPD is seen to be a psychopath. Thus, while the two diagnoses are similar in many respects, and often overlapping in terms of traits and symptomologies, they...