A patient with Antisocial Personality Disorder (ASPD) is distinct from someone with 'psychopathy' (as measured by the Hare Psychopathy Checklist). The key difference is that ASPD focuses on which domain, while psychopathy adds which interpersonal-affective dimension?

• A ASPD focuses on criminal behavior; psychopathy adds Factor 1 traits (grandiosity, shallow affect, lack of empathy, callousness) ✓
• B ASPD is based on neuroimaging; psychopathy is clinical
• C ASPD requires a history of conduct disorder; psychopathy does not
• D Psychopathy and ASPD are identical constructs

Explanation

ASPD (DSM-5) is primarily defined by behavioral criteria — persistent antisocial, irresponsible, deceitful behaviors starting in childhood (conduct disorder before 15). Psychopathy (Hare PCL-R) adds interpersonal-affective traits (Factor 1: glibness, grandiosity, shallow affect, callousness, lack of remorse, lack of empathy) beyond behavioral antisociality. ASPD is over-diagnosed in forensic/prison populations (~25-80%); true psychopathy is rarer (~15-25% of ASPD individuals). Psychopathy predicts violence and recidivism better than ASPD.

Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.

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Written and medically reviewed by the StethoPrep medical team.