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standable, that virtually all of the research in these articles comes from incarcerated and offender populations. It rem

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editorial

Expanding Our Understanding of Antisocial Personality Disorder and Psychopathy Jan Fawcett, MD

I

want to personally thank Dr. Stephen H. Dinwiddie for guest editing this issue of Psychiatric Annals as his team of contributors review the current knowledge on Antisocial Personality Disorder (ASPD) and psychopathy. In addition to his lead article, entitled “Psychopathy and Sociopathy: The History of a Concept,” the issue presents a comprehensive review of what is presently known in this field. I personally think this is a great issue. The next article, written by Dr. Michael Brook, details the risk assessment of violence in individuals with ASPD. This is followed by a review of “Childhood Precursors to Psychopathy” by Dr. Julie Sadhu. The next article, “The Neurobiology of Psychopathy,”

Jan Fawcett, MD, is a Professor, Department of Psychiatry, University of New Mexico School of Medicine. He was chairperson of the DSM-5 Mood Disorders Task Force. Address correspondence to Jan Fawcett, MD, via email: [email protected]. doi: 10.3928/00485713-20150401-01

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provides a thorough overview of this aspect of psychiatry. The final article details the “Epidemiology, Comorbidity, and Behavioral Genetics of Antisocial Personality Disorder and Psychopathy.” It is interesting, yet understandable, that virtually all of the

Are there “successful” or functioning sociopaths and psychopaths that we are unable to study? research in these articles comes from incarcerated and offender populations. It reminds me of the night I sat in the Cook County Jail (Chicago, IL) cell of the now deceased John Wayne Gacy, Jr., who was a convicted rapist and serial killer, and experienced one of the few times I could literally feel the hair on the back of my neck stand up. I asked him how he could sexually torture to death 23 young boys, slowly strangling them to death and burying them

under his house. He replied with no emotion: “I don’t see the big deal–I was only getting rid of human trash.” How’s that for callousness? Are our studies limited because we can only observe, for the most part, “unsuccessful” people with ASPD who have been incarcerated? Are there “successful” psychopaths? What about people who commit terrorist acts—would they be diagnosed as having ASPD if evaluated? How about some businessmen who commit unscrupulous acts, such as misusing client retirement funds or inflating health care costs, while making huge amounts of money and being totally insensible to the pain they are causing people who cannot defend themselves? How about corrupt leaders who sell out their constituencies? Are there “successful” or functioning sociopaths and psychopaths that we are unable to study? Perhaps there are, and just maybe they are causing more pain than the incarcerated individuals that we have the opportunity to study.

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