La diagnosi differenziale nella valutazione della psicopatia e del comportamento violento

Abstract: psychopathy is a personality disorder entailing traits and behaviors that have a negative impact on individuals and society. These include egocentricity, superficial charm, grandiose sense of self-worth, need for stimulation, pathological lying, manipulative approach to relationships, lack of remorse and guilt, callousness, lack of empathy, impulsivity, irresponsibility, inclination toward criminal behaviors. The term psychopathy has a long history in psychiatry and has been widely discussed; nonetheless, the lack of a specific diagnostic category for assessing psychopathy in the most important psychiatric manuals, and the overlapping of the diagnostic criteria for psychopathy withother disorders – e.g., the Antisocial Personality Disorder, or the Narcissistic Personality Disorder in its overt-malignant expression – led to a confusion in the use of the term. In this article, the main features of psychopathy are critically examined, in order to identify those psychological and behavioral characteristics of the psychopathic personality that allow a differential diagnosis with other disorders sharing some diagnostic criteria with psychopathy. It is indeed necessary to draw a clear distinction between the psychopathic personality disorder and the other disorders, given that the assessment and the eventual treatment of the psychopaths raise complex clinical issues. Furthermore, the clinical and social issues concerning the psychopatic personality are very different from the ones concerning other disorders.