Leistedt S J-J, Braun S, Coumans N, Linkowski P
Laboratoire de Recherches psychiatriques, Service de Psychiatrie, Hôpital Erasme, Bruxelles.
Rev Med Brux. 2009 Nov-Dec;30(6):577-87.
Although psychopathy has traditionally been cited as a disorder of personality, confusion arises as the term is used interchangeably with the terms antisocial personality disorder of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR) or dissocial personality disorder, both of which are largely behaviorally based. This paper aims to provide a clinical and scientific overview of the literature on the topic of psychopathy, which examines this conundrum. This article begins with a wee bit of history about Hervey Cleckley's work, The Mask of Sanity, and then presents the definitions and nosography of psychopathy, focusing on the distinction between the antisocial psychopath and the successful psychopath. The discussion will then lead on the epidemiological aspects and diagnosis, especially psychometric and measurement tools used to assess psychopathy in the individual: Hare's Psychopathy Checklist-Revised (PCL-R), as this is the most frequently used and validated measure of psychopathy. The second section of the article reviews several studies dealing with structural and functional neuroimaging in psychopaths. The final part of this overview considers the treatment and interventions that are available to psychopathic offenders and the implications for future research, especially in terms of prevention. This review demonstrates that studies and further research are still required in psychopathy, particularly using functional neuroimaging techniques, as fMRI and magnetoencephalography, that can describe the functional neuroanatomy of human emotion. Today, cognitive and social neurosciences constitute one of the most promising way to study psychopathy.
尽管传统上精神变态被视为一种人格障碍,但由于该术语与《精神疾病诊断与统计手册》第四版文本修订版(DSM-IV TR)中的反社会人格障碍或社会紊乱型人格障碍这两个术语可互换使用,这就产生了混淆,而后两者很大程度上是基于行为表现的。本文旨在对关于精神变态这一主题的文献进行临床和科学概述,探讨这一难题。本文首先简要介绍一下赫维·克莱克利的著作《理智的面具》的相关历史,然后阐述精神变态的定义和分类学,重点关注反社会精神变态者与成功精神变态者之间的区别。接着讨论将涉及流行病学方面和诊断,尤其是用于评估个体精神变态的心理测量和测量工具:哈雷的《修订版精神变态检查表》(PCL-R),因为这是最常用且经过验证的精神变态测量方法。文章的第二部分回顾了几项关于精神变态者的结构和功能神经影像学研究。本概述的最后一部分考虑了针对患有精神变态的罪犯可采用的治疗和干预措施以及对未来研究的启示,特别是在预防方面。这篇综述表明,在精神变态领域仍需要进行研究及进一步研究,尤其是使用功能性神经影像学技术,如功能磁共振成像(fMRI)和脑磁图,它们能够描述人类情感的功能性神经解剖结构。如今,认知神经科学和社会神经科学构成了研究精神变态最具前景的途径之一。