Think for a minute about high school acquaintances whose personalities made them stand out—not necessarily in a good way. Was there an odd person who did not seem to make sense, wore strange outfits, sometimes would not respond in conversation—or would respond by bringing up weird things like astrology or mind reading? Or perhaps a drama queen, someone whose theatrics and exaggerated emotions turned everything into a big deal? And do not forget the neat freak, the perfectionist obsessed with control, who had the perfectly organized locker, precisely arranged hair, and sweater with zero lint balls. One way to describe such people is to say they simply have personalities, the unique patterns of traits we explored in the Personality chapter. But sometimes personality traits can become so rigid and confining that they blend into mental disorders. Personality disorders are enduring patterns of thinking, feeling, or relating to others or controlling impulses that deviate from cultural expectations and cause distress or impaired functioning. Personality disorders begin in adolescence or early adulthood and are relatively stable over time. Let us look at the types of personality disorders and then take a closer look at one that sometimes lands people in jail: antisocial personality disorder.

The DSM–5 lists 10 specific personality disorders (see TABLE 15.3). They fall into three clusters: (a) odd/eccentric, (b) dramatic/erratic, and (c) anxious/inhibited. The strange high school person, for example, could have schizotypal personality disorder (odd/eccentric cluster); the drama queen could have histrionic personality disorder (dramatic/erratic cluster); the neat freak could have obsessive-compulsive personality disorder (anxious/inhibited cluster). In fact, browsing through the list may awaken other high school memories. Do not rush to judgment, however. Most of those kids were probably quite healthy and fell far short of qualifying for a diagnosis; after all, high school can be a rocky time for everyone, which is why personality disorders are not diagnosed in children or adolescents. The DSM–5 even notes that early personality problems often do not persist into adulthood. Still, the array of personality disorders suggests that there are multiple ways an individual’s gift of a unique personality could become a problem.

Personality disorders have been a bit controversial for several reasons. First, critics question whether having a problematic personality is really a disorder. Canadian data are lacking, but estimates of the prevalence of personality disorders in the population range from about 1 in 16 to about 1 in 11 (Public Health Agency of Canada, 2002b), which makes it pretty common. Perhaps it might be better just to admit that a lot of people are difficult and leave it at that. Another question is whether personality problems correspond to “disorders” in that there are distinct types or whether such problems might be better understood as extreme values on trait dimensions such as the Big Five traits discussed in the Personality chapter (Trull & Durrett, 2005). In DSM–IV, personality disorders appeared as a separate type of disorder from all of the other disorders described above (specifically, those major disorders were all in a category called Axis I and personality disorders were in Axis II. However, in DSM–5 personality disorders have earned equal footing as full-fledged disorders. One of the most well studied of all the personality disorders is antisocial personality disorder.

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Henri Desiré Landru began using personal advertisements to attract a woman “interested in matrimony” in Paris in 1914, and he succeeded in seducing 10 of them. He bilked them of their savings, poisoned them, and cremated them in his stove, also disposing of a boy and two dogs along the way. He recorded his murders in a notebook and maintained a marriage and a mistress all the while. The gruesome actions of serial killers such as Landru leave us frightened and wondering; however, bullies, compulsive liars, and even drivers who regularly speed through a school zone share the same shocking blindness to human pain. The DSM–5 includes the category of antisocial personality disorder (APD) and defines it as a pervasive pattern of disregard for and violation of the rights of others that begins in childhood or early adolescence and continues into adulthood.

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Adults with an APD diagnosis typically have a history of conduct disorder before the age of 15. In adulthood, a diagnosis of APD is given to individuals who show 3 or more of a set of 7 diagnostic signs: illegal behaviour, deception, impulsivity, physical aggression, recklessness, irresponsibility, and a lack of remorse for wrongdoing. About 3.6 percent of the general population has APD, and the rate of occurrence in men is 3 times the rate in women (Grant et al., 2004).

The terms sociopath and psychopath describe people with APD who are especially coldhearted, manipulative, and ruthless—yet may be glib and charming (Cleckley, 1976; Hare, 1998). Although psychologists usually try to explain the development of abnormal behaviour as a product of childhood experiences or difficult life circumstances, those who work with APD seem less forgiving, often noting the sheer dangerousness of people with this disorder. Many people with APD do commit crimes, and many are caught because of the frequency and flagrancy of their infractions. Among 22 790 prisoners in one study, 47 percent of the men and 21 percent of the women were diagnosed with APD (Fazel & Danesh, 2002). Statistics such as these support the notion of a “criminal personality.”

Both the early onset of conduct problems and the lack of success in treatment suggest that career criminality often has an internal cause (Lykken, 1995). Evidence of brain abnormalities in people with APD is also accumulating (Blair, Peschardt, & Mitchell, 2005). One line of investigation has looked at sensitivity to fear in psychopaths and individuals who show no such psychopathology. For example, criminal psychopaths who are shown negative emotional words such as hate or corpse exhibit less activity in the amygdala and hippocampus than do noncriminals (Kiehl et al., 2001). The two brain areas are involved in the process of fear conditioning (Patrick, Cuthbert, & Lang, 1994), so their relative inactivity in such studies suggests that psychopaths are less sensitive to fear than are other people. Violent psychopaths can target their aggression toward the self as well as others, often behaving in reckless ways that lead to violent ends. It might seem peaceful to go through life “without fear,” but perhaps fear is useful in keeping people from the extremes of antisocial behaviour.

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