What does Psychopathological mean?

Factual Questions
1

Over the course of 2 yrs, my 24-yr old SIL has been getting into a lot of trouble, not caring about the consequences of her actions, whether she hurts others or herself for that matter and lies, seemingly, uncontrollably. Only recently did she finally agree to therapy and after she consented to allow her therapist to share info with her parents, they were told that their daughter has a “psychopathological disorder,” well this flew right over their heads, to them, it sounded so frightening they didn’t even want to ask for clarification… now they phoned us asking what it might mean, and I really can’t say, and won’t pretend I even have a clue, but thought I’d post here to seek some insight.

thanx in advance!

2

Psychopathology is the study of abnormal psychological processes as pathology is the study of abnormal bodily processes.

Psycopathy is a mostly discredited term which has largely been replaced by a variety of descriptions of Personality Disorder.
Personality Disorders

Antisocial Personality Disorder (impulsive, aggressive, manipulative)
Avoidant Personality Disorder (shy, timid, “inferiority complex”)
Borderline Personality Disorder (impulsive, self-destructive, unstable)
Dependent Personality Disorder (dependent, submissive, clinging)
Histrionic Personality Disorder (emotional, dramatic, theatrical)
Narcissistic Personality Disorder (boastful, egotistical, “superiority complex”)
Obsessive-Compulsive Personality Disorder (perfectionistic, rigid, controlling)
Paranoid Personality Disorder (suspicious, distrustful)
Schizoid Personality Disorder (socially distant, detached)
Schizotypal Personality Disorder (odd, eccentric)
Antisocial Personality Disorder used often to be referred to as Psycopathy or Psycopathic Personality Disorder.
Whether you believe this taxonomy depends on your view of Psychiatry.

3

psychopathy not psycopathy- just woken up!

4

Basically it means what you already know. It’s just a long word validating that these things you mentioned here are real.

5

From a lay-person’s pov, I do have respect for psychiatry. I’m just wondering how a person with a personality disorder [PD] might be treated, clinically… and if someone has a PD, were they born that way? If so, will they always have it? Will they have to be on treatment for the rest of their lives? Well, I hope the therapist she’s seeing can provide the help she needs and understanding her family is seeking, including us.

grazi!

6

What the therapist is most likely saying is that she has Antisocial Personality disorder, and from what you describe, is actually a textbook example.

Psychotpath= sociopath=antisocial. They are all synonyms for the same thing.

Here is a link, but meanwhile, have your parents call the shrink and ask for clarification. Your SIL may be Borderline or something else entirely. The only way to have accurate information about the diagnosis is to ask the therapist involved in the case.

http://www.mentalhealth.com/dis1/p21-pe04.html

7

I don’t know why it ever got classified as a disorder in the first place. It just seems to be a nasty personality trait that is not in the long run more detrimental to the person than other nasty personality traits. Say, being too greedy can lead to a criminal life, as can ‘antisocial personality disorder’. From what I heard from psychologists(don’t really have much contact with psychiatrists) that it’s a pretty untreatable condition. You can torment a person with therapy and possibly medications until you knock the unfavorable behaviors out of them, but you won’t change the way they think. It’s akin to breaking a wild elephant by tying them up. I’m not a doctor though.

8

Not exactly

From what I’ve been able to sort out, psychopaths are born- there is some sort of genetic/congenital deficit in the brain that makes them unable to feel empathy, or indeed, any real emotions except their own needs and desires. Sociopaths, OTOH, are considered to be products of their (really, really bad) environments. It’s a subtle distinction- the psychopath is basically born without a conscience, the sociopath has had his/her conscience removed. Near as I can figure “antisocial personality disorder” is a catch-all term for someone who displays a consistent pattern of criminal behavior from a fairly early age, who may or may not be a psychopath or sociopath.

9

I cannot imagine what it must be like to live with someone who is genetically unable to feel empathy … wouldn’t these type of people be more prone towards dangerous behavior?

10

It isn’t total and absolute. It’s just less than normal amount of empathy. I mean they clearly can grasp the concept of empathy. As far as danger goes, just don’t get in their way and they won’t go out of their way to hurt you.

11

Heh. About 15-20% of my patients are psychopaths. I work in a maximum security prison. So to answer your question, yes! And quite frankly, they tend to be fairly polite, at least to start. Then they get intense about what they want. I need to be very firm with them, explaining that I will take care of their medical needs, not their wants. Also that I will be the one who decides what constitutes a need, not them.

And The Asbestos Mango has described the psychopath nicely, but I tend to use a different definition of sociopath. Usage of these terms is not standard thruout the medical community, but from one common viewpoint, the psychopath has no empathy for any others at all, while the sociopath does not have “normal” empathic ties with his family, nation, etc. but tends to form ties and have empathy with his “gang” or other non-traditional peer group, one which usually exists outside of society’s rules.

Here’s a nice read about psychopathy by an expert in the field: Hare, R. D. (1993). Without Conscience: The Disturbing World of the Psychopaths Among Us. New York, Simon & Schuster.

[quote]
Individuals with this personality disorder are fully aware of the consequences of their actions and know the difference between right and wrong, yet they are terrifyingly self-centered, remorseless, and unable to care about the feelings of others. Perhaps most frightening, they often seem completely normal

I must disagree with Pjen however, about “psychopathy being discredited”. Eventually the DSM will catch up with this diagnosis and stop splitting it into a bunch of different personality disorders! Said personality disorders certainly exist, but so does psychopathy, as a discrete disorder on its own. IMHO.

Anybody wanna come meet my patients? I’ve got a medical student with me right now, and boy, is she gaining experience!

12

The scary thing is that while they have no empathy, so many of them can fake it so well!!!

But sometimes they will hurt you, even if you don’t get in their way. Because some of them enjoy getting in your way…

13

Given your place of practice, there’s no questioning your case studies! Scarey! I certainly hope my SIL can learn to manage her condition… thru meds? Is lithium one of them?

14

The document you are linking to is 404.

Meanwhile, there are several THEORIES about what makes one anti-social, including terrible childhoods, genes, biology, and/or a combo of these factors, however, like with all the personality disorders, no one can say for certain.

I have yet to see any literature, professional, clinical, or textbookwise that draws the distinction you are making. That being said, I HAVE seen sociology texts say “sociopath” where psych ones say “psychopath,” especially in older editions. They both refer to the exact same thing, and the nomenclature differences between sociology and psychology were enough to make a former professor of mine rant for days about how we needed to all agree because we were confusing people. The cite I have within reach is ye old Synopsis of Psychiatry, a dense pudding of a read often meted out to first year psych grad students, myself among them (back when I was one).

Trust me, they are indeed the same thing- antisocial personality. From whence it comes is somewhat debatable, but a rose is a rose is a rose here.

15

Sorry, I don’t agree.

I do accept the terrible confusion/conflict in the language, with the inconsistent and even contradictory use of “psychopath/sociopath” over the years.

But with the current Psych professionals I work with, the distinction is being kept between psychopathy = “not capable of empathy” and sociopathy = “empathy with antisocial peers”.

And I’ve patients with both disorders. They are not the same, even if many professionals are trying to lump them both into the “antisocial personality disorder” category and call them the same. Frankly, the sociopaths are easier to work with, because there is some empathy to be found in there somewhere. That makes it easier to explain to them why they should behave in a certain way. With psychopaths, one must be extremely concrete about the immediate consequences to themselves of inappropriate actions, or they won’t act any differently.

It’s like trying to lump Type I and Type II diabetes together as one disorder. They have a different pathogenesis, different course, and different treatment. Even if they may manifest quite similarly in other respects.

IMHO, anyway. I generally defer to my psychiatric colleagues in this area. At least I would if they could stop fighting over these things long enough. :smiley:

16

The problem here is that the terms have been sloppily used over the years and now people don’t agree on the exact definitions. The standards following the APA classifications are that psychopathy = sociopathy = Antisocial Personality Disorder. The name just basically changed over the years but those all described the same thing. Dr. Hare was mentioned above, but he’s pretty much going against what the APA classifications are and redefining the word psychopathy to mean what he wants it to mean, because he personally does not like the new DSM crtieria for APD. Some people follow along with Hare and others more closely follow the APA. Since Qadgop is claiming that the DSM needs to “catch up” it’s clear that he’s not following standard APA criteria.

17

That’s it in a nutshell. Fortunately, since I’m neither a psychiatrist, nor do I practice psychiatry, I can sit in the front row and observe the quarrels, and root for whomever I please. Interested Spectator with biases is a fun role! Especially with so many of my day-to-day patients being amoral, remorseless individuals. My task is not to assist them with their mental ills, but rather to get them to take their blood pressure meds reliably. And to stop injuring my other patients.

18

Unfortunately, personality disorders are very difficult to treat. Certainly, the patient needs to be fully cooperative with treatment. While some people with personality disorders are given antidepressants, usually with the goal of making the person better able to participate in therapy, no pill is going to take care of the problem.

Disorders like depression, schizophrenia, and bipolar disorder are grouped together on what is called Axis I. Personality disorders are called Axis II disorders. This is essentially because the person IS the disorder in the case of Axis II disorders. We do not have medications that will change a person’s entire personality.

Is your SIL interested in therapy? Willing to put her full energy into it? Until she is, it is very unlikely that she will get better.

19

unfortunately, she’s in complete denial… claiming instead that others have personality “defects”–not her… but at least she’s talking to someone, I guess you have to start somewhere, right? I think antidepressants were mentioned, though she refused. Progress might be slow.

20

Pace , I’ve been reading this post with interest and haven’t commented since nearly everyone has given you good advice so far. However you may have noticed differences in criteria and definitions. These are explained, for the most part, by the ability of practicing psychiatrists to pretty much make up their own criteria of what comprises a certain diagnosis and what doesn’t. The reasons for this are many but the bottom line is, what is an apple to one is an orange to another. I’ve been dealing with this propensity for years and as a front line worker with this type of patient, I can assure you, it is very frustrating at times.

There is one comment I would like to make and I offer it not to scare you or give you more to worry about than you already have but it is important. There wasn’t a lot of detailed information in your OP and that is fine, we’re not here to cure your SIL. But given what you have said, there could be many choices to be made. If your SIL is, in fact, suffering from personality disorder or one of the many sub-sets thereof, there is one hallmark symptom you should be aware of, that being the tendency toward self-mutilation. Not anything necessarily life-threatening(although sometimes things go wrong) but dangerous nonetheless. If you or your wife or anyone for that matter, observe anything of that nature, do not hesitate in taking strong action, even if it means involving the authorities.

Good luck to you and I wish you all my best. I really do know what you’re going through. And if you or your wife get in a position to be in contact with the psychiatrist, don’t be in awe or overwhelmed by their authority figure status. Question, question, question.