Murphy Carolyn, Vess James
Atascadero State Hospital, Atascadero, California 93423-7001, USA.
Psychiatr Q. 2003 Spring;74(1):11-29. doi: 10.1023/a:1021137521142.
Atascadero State Hospital (ASH) is a maximum-security forensic hospital that houses male patients with a wide range of psychiatric diagnoses. Psychopaths at this institution appear to be a heterogeneous group of individuals who, while sharing core personality characteristics, manifest substantial variability in their behavior. Identifying subtypes within this clinical classification can have implications for patient treatment and management, as well as for the safety of the staff who work with them and for the communities to which they will eventually return. Several means of identifying subtypes have been proposed in the literature, and potential subgroups have been identified. Clinical observations at ASH have suggested 4 possible subtypes of psychopathy: narcissistic, borderline, sadistic, and antisocial. Issues related to the conceptualization of psychopathy are addressed, recognizing that additional data are needed to understand the observed variations in cases of psychopathy.
阿塔斯卡德罗州立医院（ASH）是一家戒备森严的法医医院，收治患有各种精神疾病诊断的男性患者。该机构中的精神病患者似乎是一个异质性的群体，他们虽然具有核心人格特征，但行为表现出很大的变异性。在这一临床分类中识别亚型可能对患者的治疗和管理产生影响，也会影响与他们共事的工作人员的安全以及他们最终回归的社区的安全。文献中已经提出了几种识别亚型的方法，并且已经确定了潜在的亚组。ASH的临床观察表明，精神病态可能有4种亚型：自恋型、边缘型、施虐型和反社会型。文中讨论了与精神病态概念化相关的问题，同时认识到需要更多数据来理解精神病态案例中观察到的差异。
