The main signs characteristic of psychopathy were identified. Children are psychopaths

Psychopathy is classified as borderline mental disorders; they occupy a position between personal accentuations (individual characterological deviations, well compensated, leading to behavioral disturbances only during short periods of decompensation associated with mental trauma) and progressive mental illnesses. In our country, when establishing a diagnosis of psychopathy, clinical criteria established by P.B. are used. Gannushkin: stability of personality deformations, the totality of psychopathic personality traits with a violation of the entire mental make-up and the severity of pathological character traits to the extent leading to a violation of social adaptation. According to P.B. Gannushkina, “there is no neurosis without psychopathy,” i.e. neurosis is essentially only a decompensation of psychopathy (for example, there is a decompensation of hysterical psychopathy). But not everyone shares this point of view. For example, V.A. Gilyarovsky believes that under certain (stressful) conditions, neurosis can develop in a mentally stable, healthy person, but in most cases the position of P.B. Gannushkina turns out to be clinically correct.

Classification of psychopathy

Various approaches can be used to classify psychopathy. Nuclear (constitutional) psychopathy includes types caused mainly by hereditary pathology. The marginal ones (O.V. Kerbikov, 1960), which are referred to as pathocharacterological development, include variants of psychopathy that are primarily caused by improper upbringing.

In Russia, for a long time, personality types were described in accordance with the theory of I.P. Pavlov on the relationship between the processes of excitation and inhibition in the cerebral cortex. In accordance with this idea, a circle of excitable and inhibited psychopathy is distinguished. Excitable ones include explosive, epileptoid, hysterical, unstable, hyperthymic psychopaths. To the inhibited - psychasthenic, anankastic, asthenic psychopaths, sensitive schizoids. The most common classifications of psychopathy are based on a clinical description of their types, which may correspond in external manifestations to major mental illnesses. E. Kretschmer (1921) designated characters reminiscent of schizophrenia as schizoid, and those reminiscent of circular psychosis as cycloid. P.B. Gannushkin identified epileptoid and paranoid psychopaths. Thus, Brown's (1790) initial division of all diseases into asthenic and sthenic, in accordance with the presence of asthenia or sthenia, underwent transformation in connection with the clarification of more complex characteristics of personality anomalies.

Nevertheless, in the practice of a psychiatrist, some types of psychopathy are more common, for example, individuals of an asthenic psychopathic type (corresponding to dependent personality disorder according to ICD-10, code F60.7).

Schizoid psychopathy

Schizoid psychopathy is characterized by isolation, a predominance of internal life (autism, according to E. Bleuler). People belonging to this type prefer loneliness, they do not have an active desire for communication, they prefer reading, nature, contemplative life, and lack spontaneity. According to E. Kretschmer, people diagnosed with schizoid psychopathy exhibit a special, psycho-aesthetic proportion in the personality structure with a combination of traits of excessive sensitivity () and emotional coldness (anesthesia). Depending on the predominance of hyperaesthetic or anesthetic elements, two types are distinguished, interconnected by a number of transitional options. Sensitive schizoids are hyperaesthetic with a predominance of asthenic radicals, while expansive schizoids are cold, indifferent to the point of dullness, with a predominance of sthenicity and hyperactivity.

Sensitive schizoids- these are persons with “super-tenderness” (according to E. Kretschmer) internal organization, painfully sensitive, mimosa-like. They experience comments addressed to them for a long time, any, even minor, insult; it is difficult for them to free themselves from the memories of rudeness heard long ago. These are people with a wary attitude towards everything that surrounds them, deeply feeling people, the circle of their affections is quite limited. The “edge” of their experiences is always directed at themselves, which can reach the level of self-torture. Despite their modesty, daydreaming, easy exhaustion, and lack of inclination to violent expression of emotions, they are painfully proud. T.N. Yudin believes that sthenic affect manifests itself in them as a special pride: “I forgive everything to others, but I don’t forgive myself.” They exhibit one-sided depth in their work, extreme conscientiousness and thoroughness, and are more often limited to a narrow range of everyday duties. Under the influence of traumatic circumstances, due to, for example, various ethical conflicts, they easily lose their mental balance, become depressed, lethargic, their isolation from others increases, and unstable sensitive ideas of relationship may arise with an exacerbation of mistrust.

Expansive schizoids they are decisive, not prone to doubts and hesitations, they pay little attention to the views of others, and are dry and formal in their relationships with others. Their demanding adherence to principles in communication is combined with complete indifference to the destinies of people. All this makes their character difficult, even “bad”, with pronounced arrogance, coldness, inability to empathize, heartlessness and even cruelty. At the same time, they are easily vulnerable, skillfully hiding dissatisfaction and self-doubt. Often, expansive schizoids exhibit explosive reactions, outbursts of anger, and impulsive actions as a response to serious life difficulties. In more severe cases, states close to paranoid reactions may appear, while the inherent mistrust is manifested by catothymic delusional experiences. Expansive schizoids, according to S.A. Sukhanov, are very close to the type that he described under the name of “resonating character”. At the same time, there is a tendency to peculiar reasoning at every convenient and inconvenient occasion. Such individuals take little account of the views of others and are self-confident both in actions and in speeches, they like to interfere in other people's affairs, give advice to everyone, their own “I” always comes first. Moral feelings among reasoners are weakly expressed.

The external behavior of schizoids is devoid of emotionality, natural plasticity and flexibility of the psyche, which gives the entire personality pattern a sketchy quality. Persons of the schizoid type do not mix with the environment; an invisible barrier remains between them and the people around them. Their appearance and behavior is often disharmonious and paradoxical, facial expressions and motor skills lack naturalness and ease, which can also be considered characteristic of their mental appearance as a whole.

Asthenic psychopathy.

A distinctive feature of this type is mild exhaustion and irritability, which is reminiscent of the classic J. Beard “irritable weakness.” Patients diagnosed with asthenic psychopathy attract attention with timidity, shyness and extreme impressionability, a tendency to introspection. These qualities manifest themselves most easily in unusual, non-standard situations. The self-awareness of such asthenics is determined by the predominance of dissatisfaction with oneself, a sense of one’s own inferiority, insolvency, pessimistic self-esteem, lack of self-confidence, dependence on others, and fear of upcoming difficulties. They are afraid of responsibility, cannot take initiative and more often take a passive position in life, display humility and subordination, and meekly endure all insults as a matter of course.

Some asthenics are distinguished by general lethargy, lack of initiative, indecision, suspiciousness, apathetic or (usually evenly depressed) mood. They are not capable of prolonged effort, work tires them. Fearing all kinds of diseases, they look for any signs of deviation from the norm in their functions. Directing their attention to the smallest sensations of their body, they, against their will, upset their already incorrect functioning autonomic functions, and if unpleasant moments are added to this ( difficult conditions life, troubles at work, etc.), they easily develop real “organ neuroses” (for example, cardioneurosis).

A type of asthenic psychopathy P.B. Gannushkin considers the type described by S.A. Sukhanov as an anxious and suspicious person. Here the main property is a tendency to excessive anxiety and exaggerated suspiciousness. People of this type worry about something that most people are calm or even indifferent to (anxious, avoidant personality disorder).

According to P.B. Gannushkin, a number of psychasthenic patients have a predominant tendency to doubt, extreme indecisiveness in making decisions, determining their own line of behavior, they lack confidence in the correctness of their feelings, judgments, and actions. They lack independence, the ability to stand up for themselves, and decisively refuse. In accordance with the concept of P. Janet, all these properties are the result of a weakening of the tension of mental activity, a general feeling of “incompleteness”, the experience of all mental processes. Although the behavior of psychasthenics and their relationships with people are not always rational, they are rarely accompanied by spontaneous impulses. Direct feeling is inaccessible to a psychasthenic, as P.B. wrote. Gannushkin, and “carefree fun is rarely his lot.” Constant awareness of the insufficient completeness and naturalness of various manifestations of mental activity, constant doubts about the possibility of their implementation contribute to the transformation of such individuals into dependent, dependent, constantly in need of advisers, forced to resort to outside help. E. Kraepelin rightly assessed this as a general property of psychopathy - mental infantilism.

Anxious and suspicious, described by S.A. Sukhanov psychasthenikov T.I. Yudin regards them as sensitive. They are impressionable, prone to getting stuck on negatively colored impressions, fearful, vulnerable, touchy, embarrassed, sometimes their timidity is so great that they cannot act on their own. They are poorly adapted to physical labor, impractical, and awkward in movements. As P. Janet noted, they are carried away by problems that are very far from reality, they are constantly concerned about how not to bother someone, they constantly analyze themselves with their characteristic derogatory self-esteem, exaggerating their own shortcomings.

Usually, psychasthenics are still sufficiently compensated in life; with the right lifestyle, they manage to overcome their doubts. Despite their softness and indecisiveness, psychasthenics can show unexpected firmness if circumstances require it; they often try to do what they have planned as quickly as possible, and do it with special diligence. IN extreme situations such people may completely unexpectedly discover courage that was previously unknown to them.

Anancastic psychopathy is characterized by the formation of obsessions of various contents. Mental obsessions predominate; with decompensation, rituals can be detected.

Hysterical psychopathy.

The features characterizing the specificity of hysterical individuals have been known for a long time. Even T. Sydenham (1688) compared this disease with Proteus in connection with the extreme variability of behavior with it, and he was the first to note that not only women, but also men can suffer from hysteria. T. Sydenham gave a brief, but exact description hysterical: “Everything is full of whims. They love immensely what they soon begin to hate without reason.”

In the psyche of people diagnosed with hysterical psychopathy, emotions and affects with an exaggerated demonstration of their feelings and experiences become sharply predominant. Their internal appearance is determined by the predominance of deep egocentrism, spiritual emptiness with a tendency to external effects, demonstrativeness, which indicates mental immaturity, mental infantilism (a cardinal sign of psychopathy, according to E. Kraepelin). In this regard, the behavior of hysterical psychopaths is dictated not by internal motives, but by the desire to impress others, to constantly play a role, “a thirst for recognition” (K. Schneider). This mental feature makes them look like actors. That is why, for example, in France the terms “histrionicism” and “histrionic personality” were even introduced (from the Latin histrio - a wandering actor, characterized by the desire to please and seduce).

K. Jaspers (1923) saw the main feature of hysterical psychopaths in their desire to appear in the eyes of others “more than they really are.” The tendency to fiction, fantasy, and pseudology is associated precisely with this basic quality of hysterical personalities, with their “thirst for recognition.” Similar properties have been observed in these individuals since childhood, when motor hysterical “stigmas” may also appear - seizures with crying, convulsions, stuttering, phenomena of sudden aphonia, astasia-abasia. Such children and adolescents show a tendency towards extravagant actions, often frivolous, they go on various adventures, are not capable of systematic, purposeful activity, refuse serious work that requires thorough preparation and sustained effort, perseverance, their knowledge is superficial and not deep.

Hysterical psychopaths are attracted to an idle life with entertainment; they like to get nothing but pleasure from life, to admire themselves, to show off in society, to “show off.” They try to emphasize their superiority - beauty, talent, unusualness - with the most different ways: the desire to dress loudly, sometimes even pretentiously, demonstrating a commitment to fashion; exaggeration of their knowledge in such areas as philosophy, art. They are not averse to emphasizing their special place in society, hinting at connections with famous people, they talk about their rich, wide opportunities, which is only a figment of fantasy and a consequence of pseudology. These properties of P.B. Gannushkin explained it by the desire of hysterical psychopaths to be the center of attention. Real world for a person with a hysterical psyche, according to P.B. Gannushkin, the peculiar bizarre outlines, the objective criterion for them is lost, which often gives others a reason to accuse such a person, at best, of lying or pretense. Due to the lack of the ability to objectively perceive the reality of hysteria, some events are assessed as unusually bright and significant, others as pale and inexpressive; hence for them there is no difference between fantasy and reality. The prognosis for hysterical psychopathy is often unfavorable, although under good social and work conditions in adulthood, stable and long-term compensation can be observed. They become somewhat smoother and acquire certain work skills. Cases with the presence of pseudology are less favorable; such psychopaths even stand out as an independent group of liars and deceivers (according to E. Kraepelin, 1915).

Paranoid personality disorder (paranoid psychopathy).

This personality type is closest to schizoids. Readiness for paranoid developments is most typical here. This type of psychopathic personality is characterized by sthenicity, overestimation of one’s “I,” suspicion and a tendency to form overvalued ideas. These are people who are not frank, wayward, irritable, with a predominance of one-sided affects, which often take precedence over logic and reason. They are extremely careful, conscientious, and intolerant of injustice. Their horizons are rather narrow, their interests are, as a rule, limited, their judgments are too straightforward and not always consistent. They often regard the random actions of those around them as hostile and see some special meaning in everything. Extreme egocentrism is a distinctive feature of paranoid psychopaths; this is the basis of their increased self-esteem and heightened sense of self-esteem. They are indifferent to everything that lies outside the sphere of their own “I”. Constantly opposing oneself to others can be combined with a deeply hidden feeling of inner dissatisfaction. In such cases, distrust easily turns into suspicion; the conviction easily arises that they are treated without due respect, that they want to offend, or infringe upon their interests. Any trifle, any indifferent event can be interpreted as a manifestation of bad intentions or a hostile attitude. A complex of such personality anomalies remains persistent and does not change throughout life; a pathological proliferation of one or another trait may even be observed (S.A. Sukhanov, 1912). This determines the readiness for a paranoid reaction. According to P.B. Gannushkin, a specific property of a paranoid person is a tendency to form overvalued ideas that are different in plot (persecution, jealousy, invention) and subjugate the entire personality and determine general behavior.

Expansive paranoid personalities- pathological jealous people, people prone to conflicts, litigators, truth-seekers, “reformers.” According to V.F. Chizha (1902), they are always satisfied with themselves, failures do not bother them, the fight against “personal enemies” tempers them and charges them with energy. Energy and activity combined with elevated background moods. This also includes a group of fanatics who devote themselves to a particular cause with particular obsession and passion (an example is religious fanaticism).

Paranoid sensitive psychopaths can also be encountered (although rarely). During the period of compensation, they reveal similarities with sensitive schizoids. In general, sensitive, asthenic traits in such individuals are combined with sthenic ones (ambition, increased self-esteem). According to E. Kretschmer (1930), especially typical of them is the emergence in connection with various ethical conflicts of long-term sensitive reactions that define “attitude neurosis.” Interpersonal conflicts are most often associated with decompensation phenomena in paranoid psychopathic individuals. The main plot of paranoid development is determined by the content of the provoking situation. At the same time, thinking is characterized by inertia and thoroughness.

(unstable psychopathy).

This type of personality is characterized by immaturity of moral and volitional qualities, their underdevelopment, increased suggestibility, and the absence of positive ethical life attitudes. Already in childhood, such persons are characterized by a lack of strong interests, a lack of their own point of view, and increased suggestibility. They are not inclined to choose any type of useful activity, preferring entertainment, free time, and there are no remorse. If there is a need to put a serious effort of will into something, they immediately give it up, replacing it with something that does not require stress, with something that can be done easily, without effort. Hence the frequent violations of discipline and community rules. When communicating with people, it is easy to notice in such persons the innocence, the ease with which they come into contact. However, at the same time, lasting attachments are not established, even in relationships with close people and relatives.

There are no prohibitions or restrictions for unstable psychopaths. To behave on their own, they often run away from home as teenagers. They live without thinking about the future, one day at a time, take on one thing after another, never finish what they start, prefer easy income to serious responsible work, and tend to live at the expense of others. With constant coercion and strict control by others over their behavior, compensation for the condition occurs for some time. If there is no strict control, they prefer an idle lifestyle, are easily involved in antisocial groups, can commit antisocial acts and petty crimes in company, and easily become addicted to alcohol and drugs. Convicted of unseemly deeds, of committing crimes, such persons shift their blame onto others, without showing any shame or embarrassment, they are prone to pseudology, their lies are rather naive, poorly thought out, implausible, which also does not bother them at all.

Emotionally unstable personality disorder.

The main property of this type is impulsiveness in actions without taking into account possible consequences, lack of self-control. A similar version of personality pathology was described earlier than others (F. Pinel, 1899; J. Pritchard, 1835), and even in England, where the concept of “psychopathy” was not accepted for a long time, for the first time in the manual of J. Henderson (1939) the excitable version of psychopathy was contrasted asthenic. According to E. Kraepelin (1915), excitable psychopathy (impulsive psychopaths) is characterized by unbridled emotions, their indomitability and unpredictability. About increased irritability towards others as a typical feature similar persons wrote V.M. Bekhterev (1891). Any insignificant reason, as he noted, leads excitable psychopaths into strong irritation, so that they “lose their temper” at the slightest contradiction and even without any reason sometimes cannot restrain their impulses. Obvious anger often arises as an impulsive reaction in response to various everyday trifles. V. Magnan (1890) wrote that the brain of these people, at the slightest disturbance, becomes a victim of tension, manifested by extremely lively irritability and violent temper. S. Milea (1970) carefully studied the history of excitable psychopaths and showed that “difficult behavior” has been observed in them since childhood. Such early disorders often do not attract the attention of parents and educators due to their assessment as purely “age-related” characteristics. Demands to adhere to a routine usually lead to obvious manifestations of the disorder, which forces one to seek help. Such children are admitted to the hospital for the first time (60.6%) only in school age. With regard to adulthood, E. Kraepelin showed that psychopathic personalities of the excitable type make up about a third of all psychopaths, in connection with this he designated them with the term “irritable”, who are characterized by violent uncontrollable outbursts of emotions.

E. Kretschmer (1927) considered the explosive reactions of the described psychopaths as a type of reaction in which strong affects are discharged without delay by reflection. In some individuals, such “explosive diathesis” occurs only in a state of pathological intoxication and is detected at the height of its development. The practice of a psychiatrist shows that a narrowing of consciousness can occur at the height of affect in these individuals and outside of intoxication. Here is an episode that took place in the clinical picture of explosive psychopathy in a patient described by T.K. Ushakov (1987).

“Patient S., 47 years old. Over the previous 15 years, states of decompensation of the excitable type have been repeatedly discovered. In the intervals between exacerbations he is sensitive, irritable, and angry. All these years he was constantly irritated by the noise of children playing under his windows. One summer I returned home from work tired, somewhat irritated, and annoyed by work troubles. Children were playing under the window, as usual. Irritability overflowed. I couldn't resist. He ran out into the street. I perceived everything around me “as if in a fog.” I saw a girl playing ball. He ran up to her... One idea was to strangle her. Instantly I realized the horror of the possible action and stopped. Before that, everything was somehow “vague,” “indistinct,” “grayish,” “undefined.” In this state “I almost didn’t remember myself.” He returned to the apartment, sat down on the sofa, and burst into tears. My knees were shaking, I was covered in sweat, and there was aching pain in the heart area.”

Lack of balance of S.S. Korsakov (1893) assessed it as the main feature of the psychopathic constitution. Affects, according to V.P. Serbsky (1912), such psychopaths arise easily; in their strength they are far from corresponding to the cause that caused them. The previously described epileptoid psychopathy largely corresponds to the signs of excitable psychopathy, but here, along with explosiveness, there is viscosity, torpidity of thinking, vindictiveness, thoroughness, pedantry, getting stuck on trifles, and slowness. However, over time, such individuals accumulate irritation, which can suddenly result in a situation that is dangerous for others.

Affective circle psychopathy.

E. Kretschmer contrasted cycloid psychopathy with schizoid, noting the naturalness of affects and all mental life, the “roundness” of the cycloid’s character in contrast to the schematism of schizoids. E. Bleuler (1922) designated the peculiarity of cycloids with the term “syntony”. These people find it easy to communicate with everyone, they are mentally responsive, pleasant, simple and natural in their behavior, and freely express their feelings; They are characterized by kindness, friendliness, good nature, warmth and sincerity. In everyday life, cycloids are realists; they are not prone to fantasies and abstruse constructions, accepting life as it is. Psychopathic personalities of the affective circle are enterprising, flexible, and hardworking. Their main features are emotional lability and mood instability. Joy, a “sunny mood” is easily replaced by sadness, sentimentality is their usual property. Psychogenic and autochthonous phase disorders can occur quite often in them. Such affective instability begins to be detected in such individuals even at school age. G.E. Sukhareva notes that in children, affective lability has periodicity, but the phases are short in time (two to three days), sadness can be replaced by motor restlessness. Throughout life, periodic changes from one state to another are possible, but they are also short-lived.

When considering the dynamics of affective psychopathy, the question arises about the relationship of such cases with an endogenous disease. A number of follow-up studies testify in favor of the independence of psychopathy of the affective type (K. Leongard, 1968, etc.). Depending on the predominant affect, this group is divided into hypothymics and hyperthymics. Hypotimics are born pessimists, they do not understand how people can have fun and enjoy anything, even any kind of luck does not give them hope. They say about themselves: “I don’t know how to rejoice, it’s always hard for me.” Therefore, they notice only the dark and unsightly sides of life, most of the time they are in a gloomy mood, but they can mask it, hide despondency with ostentatious fun. They react to any misfortune more heavily than others, and in case of failure they blame themselves. In a calm, familiar environment, these are quiet, sad, gentle and friendly people. Hyperthymic people, unlike hypothymic people, are indomitable optimists; they are characterized by a good, cheerful state of health, high spirits, and a desire for activity. During school years, they exhibit excessive mobility, increased distractibility, fussiness, and verbosity. Then motor excitement disappears, the predominant characteristic is the desire for leadership and pleasure, which creates a reason for conflicts. In adulthood, they remain optimistically charged, mobile, satisfied with themselves, able to use all the gifts of life, and often become business people who succeed in all endeavors. Despite the increased excitability, as a result of which they show temper, they have enough resources to calm down themselves. N. Petrilovich identifies expansive hyperthymics - selfish, domineering, but shallow by nature. They are prone to strong but short-term affects, almost always impatient and overly decisive. Their activities are most often characterized by a one-sided direction.

Tags: types of psychopathy, classification of psychopathy, schizoid psychopathy, hysterical psychopathy, asthenic psychopathy

Surely you have heard the word “psychopathy” in your life, but not everyone interprets it correctly. This is a special type of antisocial personality disorder, which creates a number of serious obstacles to adaptation in society. Usually they say that such an anomaly is congenital, and it is finally fixed in adolescence and is not able to change throughout all the years of a person’s life.

The main problem of psychopaths is that they completely lack any higher moral feelings and values. That is, such a person does not feel a sense of shame, he has no conscience and compassion for his neighbor. In addition, a psychopath does not love anyone, he does not know how it is to feel affection for anyone. It's sad that psychopaths cannot repent and the concept of honesty is unfamiliar to them.

When diagnosing psychopathy, experts pay attention to how a person behaves in society. If he disdains existing laws, regularly violates them, is hypocritical and deceives solely for his own benefit, behaves irritably, aggressively and extremely emotionally. All this characterizes a psychopath who loves to cause physical and mental harm to people.

A 2008 study in different countries found that more than 10% of the population suffers from psychopathy. The 2% include hysterical, emotionally unstable mental disorder, about 1% of people suffer from narcissism. A direct relationship with gender was also found. For example, very often emotional unstable personality disorder is characteristic of the fairer sex, and everything else is characteristic of men. There may also be a condition in which a person simultaneously combines a number of several symptoms that were characteristic of individual personality disorders.

About the causes of psychopathy

Scientists have found that this type deviations are transmitted genetically. If there were people in the family with psychopathy, then there is a high probability that the next generation will also suffer from the disease. Many doctors are of the opinion that a number of complications that were received during an abnormal course of pregnancy, diseases acquired at an early age, as well as difficult childbirth also play a key role in the development of psychopathy. Physical, sexual and psychological abuse also play a role, as do adverse conditions during a person's childhood. They can increase the risk of developing psychopathy several times, and the symptoms may be different.

Types of Psychopaths

There are several types of psychopathy:

• asthenic type. A person gets irritated very quickly, he behaves aggressively;
• excitable type. The individual experiences various, inexplicable emotional reactions that are typical in such a state;
• hysterical type. Such people are very impressionable, they are suggestible and sometimes too focused on themselves;
• paranoid type. A person looks down on everyone, he tends to repeat the same thing several times, trying to establish his point of view.

Only a qualified specialist, based on a person’s behavior, can determine the type of psychopathy from which he suffers.

The main characteristics of each type of psychopathic disorder:

• Asthenic psychopathy is also called dependent personality disorder. The main symptoms: vulnerability, increased sensitivity and the expression of care on the part of loved ones. Such people are very afraid of everything new, they get lost in an unfamiliar environment and very quickly become attached to other people. A person does not consciously strive to demonstrate responsibility; it is very difficult for him to make independent decisions; in addition, a number of autonomic disorders are observed.
• Excitable psychopathy is characterized by an increased level of irritability. People suffering from this type of disorder are always tense, they feel that they urgently need to get rid of their negative emotions. Such people evaluate those around them as critically as possible and make a number of exaggerated demands. They are suspicious, jealous and self-centered. They are characterized by being in constant dysphoria, that is, angry melancholy. In the process of contacting other people, such persons show aggression, can brutally beat a person for no particular reason and will not stop at anything.
• Hysterical type - it is typical for such a person great amount emotions that are often in abundance. They strive to always be in the center of everyone's attention, and position themselves as a cheerful and friendly person. Quite often, this is just a mask and the emotions of such psychopaths are superficial, they are unstable and often exaggerated. Such patients attract attention to their person with the help of sexuality, believing that it can be safely considered as a key tool for manipulating others. There is excessive egocentrism, as well as extremely superficial judgments, and a person never evaluates the situation completely, only from the point of view of its individual fragments. The diagnosis can be made by a specialist based on three or more stable signs that are characteristic of this type of disorder. This illness can be cured with the help of psychoanalytic therapy.
• Paranoid psychopathy is a special type of mental disorder, which is usually characterized by an increased level of resentment, suspicion and an acute reaction to everything that happens around. Such people tend to distort the actions of other people and everything that happens around them; they perceive events completely differently and usually see them in a negative way. Those suffering from this disease are very often dissatisfied with their lives, they are irritated by people, etc. Paranoid psychopaths cannot forgive a person for a banal mistake; they tend to consider evil intent everywhere and in everything and make plans and actions to eradicate it. Extremely jealous, emotionally unbalanced people who cannot control their actions. They tend to deny that they are sick and react very sharply to everything that happens, blaming other people for all sorts of troubles.

In addition to the four main types of psychopathy listed above, there are also other types.

Other types of psychopaths

Psychasthenic psychopathy, for example, is characterized by a so-called increased level of anxiety. A person is very unsure of himself, he is very sensitive to many things and makes strange and sometimes completely inexplicable plans for a normal person. It is very difficult for persons divorced from reality to settle in society and find mutual language with other people. People with this type of disorder suffer from obsessions that seem to haunt them. Schizoid psychopathy - such persons are very vulnerable, sensitive and prone to being despotic. On the contrary, it is not typical for them to show any emotions, and all because they are very hostile to everything that happens and do not strive to make friends. However, they show pedantry and some autism in communicating with other people. Schizoids are not given the ability to empathize with anyone.

Narcissistic disorder is characterized by a person’s belief in his own irresistibility and uniqueness. Such people want to be constantly complimented, admired and helped in everything. The patient is firmly convinced that he is not one of the so-called “gray masses”, he is special and very talented person, which should be admired by everyone around. The patient constantly focuses on the fact that everyone around him is jealous, although he is also not averse to noting that someone has something better.

Anxious personality disorder is a special type of psychopathy in which a person constantly feels worse than others. It seems to him that no one loves him, and no one pays attention to him. Such persons are very sensitive to criticism addressed to them, and they are also very afraid and worried about disapproval from other people. When meeting strangers they experience a special discomfort that cannot be described in words. The patient sincerely believes that someone is superior to him and is quite often afraid of being rejected by another person, so he does not strive to get to know anyone.

With passive-aggressive personality disorder, the patient experiences constant resistance to any type of activity. A person does not strive to do anything, he behaves passively and does not like anything. Such patients do not like having rules dictated to them; they quite often conflict with other people and believe that this is completely normal and completely logical behavior. Someone’s life is much better than that of such people - this is what it seems to people who suffer from this type of disorder. It’s easier for them to remain in the state of the “eternal sufferer,” who constantly manages to exaggerate everything that happens in his life. Psychotherapy will help cure this type of disorder, and usually the technique should be chosen based only on a number of features of this type of disorder. Jung's deep therapy helps to understand this. what happens, study modifications and combinations of these methods.

Does psychopathy need to be treated?

You will be extremely surprised, but this type of psychological disorder does not always require treatment. It is enough just to pay special attention to preventive measures, monitor how the child is raised at school, how he is socially adapted to the events around him, whether he is satisfied with his job, etc. It is very important that the level of a person’s mental makeup corresponds to the level of intelligence. Usually, only a specialist can diagnose psychopathy and, therefore, only he has the right to prescribe medication if it is really necessary.

These can be various psychotropic drugs, which are selected very carefully and only based on the personal characteristics of the patient. Antidepressants may be prescribed, usually in response to a hysterical reaction to events around you. Any pronounced deviations require special intervention and, depending on exactly what emotions and feelings a person displays, preventive medications will be prescribed. Remember that only a psychiatrist has the right to select medications, but you should not self-medicate and diagnose a number of mental disorders in yourself and your family, which will then need to be urgently treated.

Classifications of psychopathy are very diverse. There have been attempts to reduce all types of psychopathy to two - excitable and inhibited; there were descriptions including more than a dozen types. The following types are included in ICD-10.

Schizoid personality disorder(schizoid psychopathy) according to ICD-10 is characterized by the following character traits: inability to experience pleasure (anhedonia); emotional coldness and inability to express warm or hostile feelings towards others; weak reaction to praise and blame; little interest in sexual intercourse with others; a tendency to fantasize to oneself (autistic fantasy) and introspection (immersion in the inner world); lack of close, trusting contacts with others; difficulty in understanding and assimilating generally accepted norms of behavior, which is manifested by eccentric actions.

The most striking character trait is isolation and unsociability (from childhood they preferred to play alone). They often live by their unusual interests and hobbies, in which they can achieve success (unique information in a narrow field, deep interest in philosophical and religious issues, unusual collections, etc.). Hobbies and fantasies fill the inner world, almost always closed to others. Fantasies are intended for oneself and can be ambitious or erotic (with outward asexuality). Emotional restraint looks like coldness, although inner feelings can be strong and deep. It is difficult to establish informal emotional contacts. Lack of intuition is manifested by the inability to understand other people's desires, fears, and experiences. They are prone to nonconformism - they do not like to act “like everyone else.” Situations where it is necessary to quickly and indiscriminately establish informal contacts, as well as the violent invasion of strangers into one’s inner world, are difficult to bear.

Dissociative identity disorder(psychopathy of an unstable type, antisocial personality disorder) according to ICD-10 is recognized by the following characteristics: neglect of the feelings of others and lack of empathy - the ability to penetrate into their experiences; irresponsibility and disregard for social norms, rules and responsibilities; inability to maintain stable relationships with others; low tolerance to frustration (inability to get what you want); ease of aggressive outbursts, including violence; lack of guilt and inability to learn from the past, especially from punishment; tendency to blame others for everything and complain about failures; constant irritability.

The main feature is constant thirst light entertainment and pleasures, an idle lifestyle with evasion of all work, study, and fulfillment of any duties, both social and family. Since adolescence, they have been drawn to antisocial companies, alcohol, and drugs. Sexual life serves only as a source of pleasure. They are unable to fall in love or become attached to loved ones and friends. They are indifferent to their future - they live in the present. They are weak-willed and cowardly, they try to run away from any difficulties and troubles. They do not tolerate loneliness well - they are unable to occupy themselves with anything. The situation of neglect, lack of guardianship and strict control is detrimental.

Emotionally unstable personality disorder(emotionally labile type of psychopathy, explosive, affective, impulsive, excitable, epileptoid psychopathy) according to ICD-10 represents a combined group with various disorders of the emotional sphere. In Russian psychiatry, it is customary to distinguish between two close, but not identical, types.

Explosive (affectively labile) psychopathy characterized by emotional outbursts at the slightest provocation, but anger is easily replaced by tears, swearing and throwing things - by moaning, aggression towards others - by self-harm, attempted suicide. The mood often changes, which leads to restlessness, lack of composure, and distractibility. They are completely uncontrollable, boil over at the slightest comments or opposition, and react extremely painfully to emotional rejection and any stress.

Epileptoid psychopathy differs in that, in addition to explosiveness (a tendency to uncontrollable affective reactions with aggression and auto-aggression), states of dysphoria periodically arise - a dark and angry mood, during which patients are looking for something to vent their accumulated evil on. Dysphoria lasts from several hours to several days. Violent affective reactions are usually preceded by a gradual boiling of initially suppressed irritation. In the heat of the moment, during fights, they become wild and are capable of inflicting heavy damage. Sometimes disturbances of impulses are revealed, most often sadistic-masochistic tendencies. They take pleasure in tormenting, sophisticatedly mocking or brutally beating the weak, defenseless, dependent on them, unable to fight back. Often, from childhood, they love to torture and kill animals. But they can receive sensual pleasure by causing pain to themselves with cuts and burns from burning cigarettes. Alcohol intoxication is more often of the dysphoric type. They like to get drunk to the point of insensibility. Suicidal attempts can be either demonstrative with the aim of blackmailing someone, or during dysphoria with the actual intention of committing suicide.

Histrionic personality disorder(hysterical psychopathy), according to ICD-10, can be diagnosed in the presence of a tendency to self-dramatization, theatrical behavior, and exaggerated expression of emotions; suggestibility, easy susceptibility to the influence of others; superficial and labile effectiveness; self-centeredness with the desire to forgive oneself everything and not take into account the interests of others; constant desire to be appreciated and slight vulnerability; thirst for situations where you can be the center of attention; manipulative behavior (any kind of manipulation) in order to achieve their goals.

Among the listed character traits, the most striking is the constant desire to be in the center of attention of others, demonstrativeness, and pretentiousness. For this purpose, they even resort to performances depicting suicide attempts. Suggestibility, often highly emphasized, is in fact very selective: one can only suggest that which does not contradict egocentric aspirations. But the level of aspirations is high: they claim much more than their abilities and capabilities allow. Under the influence of severe mental trauma, hysterical psychoses can occur - twilight states, pseudodementia, etc.

Anancastic (obsessive-compulsive) personality disorder(psychasthenic psychopathy) according to ICD-10 is characterized by indecision, constant doubts; excessive precautions regarding a possibly dangerous or unpleasant course of events; perfectionism (i.e. the desire to always achieve the highest results, to do everything in the best way, regardless of the unimportance of the matter); the need to re-check what has been done; extreme preoccupation with detail in trivial matters and loss of broad perspective; extreme conscientiousness, scrupulousness, concern, preventing one from experiencing pleasure; pedantry and adherence to conventions with limited ability to express warm feelings; rigidity and stubbornness, insistence that others obey the order they have established; the appearance of unwanted thoughts and impulses, which, however, do not reach the level of severe obsession; the need to plan all activities in advance in the most insignificant details.

Obsessive thoughts, movements, rituals, fears, self-invented “signs” and “prohibitions” are observed almost constantly, sometimes intensifying and sometimes weakening (for example, for important occasions, always wear the same clothes, walk only one route, do not touch anything). why black, etc.). Pedantry, the desire to foresee everything in advance and plan it in the smallest detail, and minute adherence to rules serve as compensation for constant fear for the future - one’s own and that of one’s loved ones. Other compensatory mechanisms may turn out to be exaggerated: indecision when a decision has already been made turns into impatience, shyness into unexpected and unnecessary categoricalness. This type of psychopathy usually manifests itself with school years, but it intensifies when they begin to live independently and need to be responsible for both themselves and others.

Anxious (“avoidant”) personality disorder(sensitive psychopathy) according to ICD-10 criteria can be recognized by constant feeling internal tension and anxiety; shyness and feelings of inferiority, self-doubt; constantly trying to please and be accepted by others; increased sensitivity to criticism from others; by tendency to refuse to enter into relationships with others until they are sure that they will not be criticized; a very limited circle of personal attachments; tendencies to exaggerate potential danger and the risk of everyday situations, avoiding some of them, which, however, does not reach persistent phobias (obsessive fears); according to a limited lifestyle that allows you to feel safe.

Great impressionability and a sense of inferiority are two main traits. They see many shortcomings in themselves and are afraid of being ridiculed and condemned. Their isolation is purely external - a consequence of being fenced off from strangers and unfamiliar situations. They are quite sociable with those they are used to and trust. The situation in which they become the subject of unkind attention from others, when a shadow falls on their reputation or they are subjected to unfair accusations, becomes intolerable. Prone to depressive reactions, during which they can gradually and secretly prepare for suicide or are capable of unexpected desperate acts leading to grave consequences (up to and including causing serious injury or killing the offenders).

According to ICD-10 criteria, dependent personality disorder corresponds to one of the types of asthenic psychopathy. It is characterized by a tendency to shift responsibility for oneself onto others and to completely submit to the interests of the one on whom one depends, neglecting one’s own desires. They evaluate themselves as helpless, incompetent and unbearable. They have a fear of abandonment and a constant need for reassurance in this regard. They cannot stand loneliness and feel empty and helpless when ties with those on whom they depend are severed. Responsibility for misfortunes is transferred to others.

Mixed types of personality disorder are diagnosed when it is difficult to identify a separate type due to the fact that the traits of different types are represented relatively evenly. However, completely “pure” types of psychopathy are relatively rare - the type should be determined by the predominant features. Just as with character accentuations, mixed types can be intermediate (mainly hereditarily determined, for example, schizoid-epileptoid psychopathy), or amalgam (the endogenous core of one type is superimposed with the traits of another due to long-term adverse influence environment, for example, histrionic, i.e. hysterical, traits are superimposed on the constitutional traits of emotional lability when raised in childhood as a “family idol”.

Organic psychopathy is most often mixed, representing various combinations of emotionally labile, histrionic and dissociative traits (i.e. explosive, hysterical and unstable psychopathy). Diagnosis of organic psychopathy is based on following signs. There is a history of intrauterine, birth and early postnatal (first 2-3 years of life) traumatic brain injuries, brain infections and neurointoxication. Residual neurological “microsymptoms” are revealed: asymmetry of facial innervation, mild oculomotor disturbances, uneven tendon and skin reflexes, mild diencephalic disorders. An X-ray of the skull shows abnormalities of ossification and signs of increased intracranial pressure; the EEG usually shows pronounced diffuse changes. A pathopsychological examination reveals attention deficits and fatigue when repeating tasks.

Other classifications of psychopathy. Many classifications have been proposed. Some of them are descriptive - types are distinguished according to the most striking character traits, others are based on a certain principle. In Russian psychiatry, an example of the first is the taxonomy of P. B. Gannushkin (1933), and the second - his student O. V. Kerbikov (1968), as well as B. V. Shostakovich (1988) and A. E. Lichko (1977) .

P.B. Gannushkin described several groups of psychopathy.

The group of cycloids (constitutional-depressive, constitutionally-excited, cyclothymic, emotive-labile) are distinguished by the characteristics of the dominant mood - constantly depressed, elevated, periodically or frequently changing. The group of asthenics (neurasthenics, “overly impressionable”, psychasthenics) was united by a tendency to easy exhaustion and “irritable weakness”. In addition, groups of schizoids, paranoids, epileptoids, hysterical and unstable psychopaths, etc. were identified, most of which are included in ICD-10 under the same or different names. O. V. Kerbikov took the types of higher education for classification nervous activity I. P. Pavlova and first of all divided psychopathy into excitable (explosive, epileptoids) and inhibited (asthenics, psychasthenics). But especially outside the chosen principle were “pathologically closed” (i.e. schizoid), hysterical, unstable, sexual and mosaic (i.e. mixed) psychopathy. B.V. Shostakovich used the psychological principle for taxonomy: the predominance of changes in the sphere of thinking (schizoids, psychasthenics, paranoid), in the sphere of affective disorders (epileptoids, excitables, cycloids, hysterical) or in the sphere volitional violations(unstable, sexy). A.E. Lichko combined the taxonomy of psychopathy and character accentuations, describing the same types, which are either variants of the norm (accentuation) or reaching a pathological level of deviation (psychopathy).

The content of the article

Classification and clinic of psychopathy

Paranoid psychopathy

Affective type psychopathy

Schizoid psychopathy

Excitable type psychopathy

Psychasthenic psychopathy (personality disorders of the anaicastic type)

Hysterical psychopathy (personality disorders of the hysterical type)

Asthenic psychopathy (personality disorders of the asthenic type)

Emotionally Stupid Personality Disorders (Heboid Psychopathy, Emotionally Stupid Personality)

Psychopathy of unstable type

Etiology, pathogenesis and differential diagnosis of psychopathy

Prevention of psychopathy, treatment and social and labor rehabilitation of patients

Psychopathy(from the Greek psyche - soul and pathos - suffering) - a congenital or developed in the early years a personality anomaly, an anomaly of higher nervous activity, causing mental inferiority.

Personal behavior is modified depending on the form of psychopathy, becoming abnormal for certain groups of stimuli. In the development and course of psychopathy, there are different stages of exacerbation of psychopathic traits and phases of decompensation.

Causes of psychopathy

Psychopathic personality type arises on the basis of the interaction of congenital or early acquired biological inferiority of the nervous system with acutely negative environmental conditions. A characteristic feature of a psychopathic personality is the disharmony of its emotional-volitional sphere with the relative preservation of intelligence. Psychopathic personality traits complicate social adaptation, and under traumatic circumstances lead to maladaptive behavioral acts.

Psychopaths do not have irreversible personality defects. Under favorable environmental conditions, their mental anomalies are smoothed out. However, in all mentally difficult conditions for them, a breakdown reaction and behavioral disadaptation are inevitable. Among persons who commit violent crimes, psychopaths occupy a leading place. Psychopaths are characterized by mental immaturity, manifested in increased suggestibility, a tendency to exaggerate, and unfounded suspiciousness.

The leading factor in the psychopathization of a personality in some cases is congenital constitutional characteristics (the so-called nuclear psychopathy), in others it is the psychogenic influence of the environment (“pathocharacteristic development of the individual”).

Long-term exposure to unfavorable social factors may be the main cause of psychopathic personality development, its distorted mental formation.

Personality, emerging in conditions constant gross suppression, humiliation, begins to show timidity, depression, uncertainty or, conversely, increased excitability, aggressiveness, confrontation. An environment of universal adoration and admiration, unquestioning fulfillment of all the child’s whims can lead to the formation of a hysterical personality type, the development of egocentrism, narcissism (narcissism). Along with this, traits of explosiveness (explosiveness, impulsiveness) develop. In continued conditions of excessive guardianship, asthenicity, lack of initiative, helplessness, and external behavioral orientation (blaming one’s failures on external circumstances) are formed. Since the pathocharacteristic development of personality is predominantly determined by the social factor, it is possible to stop this process under favorable social conditions.

Classification of psychopathy

The classification of psychopathy is still controversial.

Basic types of psychopathy:

• psychasthenic;
• excitable (explosive);
• hysterical;
• paranoid;
• schizoid psychopathy.

Psychoasthenic psychopathy

Psychasthenic psychopaths They are characterized by an increased level of anxiety, fearfulness, lack of self-confidence, extremely increased sensitivity to traumatic circumstances, and maladjustment in mentally stressful situations. Their intellectual constructs and life plans are divorced from the real conditions of life, they are prone to morbid philosophizing (“intellectual chewing gum”), stagnant soul-searching (they like to “saw sawdust”), obsessions. Psychasthenics are characterized by a functional predominance of the second signaling system and weakness of the subcortical systems, which is manifested in the general energetic weakening of their higher nervous activity, the weakness of the most fragile inhibitory process. Their motivational sphere is characterized by stagnant, obsessive impulses.

Excitable psychopathy

Excitable (explosive) psychopaths characterized by increased irritability, constant state of mental stress, explosive emotional reactivity, reaching the point of inappropriate attacks of rage. They are characterized by increased demands on others, extreme egoism and selfishness, distrust and suspicion. They often fall into a state dysphoria- evil melancholy. They are stubborn, quarrelsome, conflict-ridden, petty-picky and domineering. They are rude, and when angry they are extremely aggressive, capable of inflicting severe beatings, and do not even hesitate to kill. Their affective behavior occurs against the background of a narrowed consciousness. In some cases, malice and explosiveness (explosiveness) will be mixed in the direction of stagnant drives (drunkenness, vagrancy, gambling, sexual excesses and perversions).

Istic psychopathy

Hysterical psychopaths They differ mainly in their thirst for recognition. They strive for external manifestation of their significance, demonstration of their superiority, and are prone to theatricality and panache, posing and external showiness. Their desire for exaggeration often borders on deceit, and delights and disappointments are manifested violently and expressively (theatrical gestures, wringing of hands, loud, prolonged laughter and sobs, enthusiastic hugs and grievances “for life”). Their life strategy is to be the center of attention by any means necessary: ​​unbridled fantasizing, constant lies (pathological liars and mythomaniacs). In pursuit of recognition, they do not even stop at self-incrimination. The psyche of these people is immature and infantile. In neurophysiological terms, they are dominated by the first signaling system, the activity of the right hemisphere. Their immediate impressions are so vivid that they suppress criticism.

Paranoid psychopathy

Paranoid psychopaths (paranoids) are characterized by an increased propensity for “overvalued ideas.” This is due to the extreme narrowness of their thinking, unidirectional interests, increased self-esteem, egocentrism, and suspicion of other people. Low plasticity of the psyche makes their behavior conflicting; they are constantly in a fight with imaginary enemies. Their main focus is “invention” and “reformism”. Non-recognition of their merits leads to constant clashes with the environment, litigiousness, anonymous denunciations, etc.

Schizoid psychopathy

Schizoid psychopaths highly sensitive, vulnerable, but emotionally limited (“cold aristocrats”), despotic, prone to reasoning. Their psychomotor skills are defective - clumsy. They are pedantic and autistic—alienated. Their social identification is severely impaired - hostility to the social environment. Psychopaths of the schizoid type lack emotional resonance to the experiences of other people. Their social contacts are difficult. They are cold, cruel and unceremonious; their internal motivations are poorly understood and are often determined by orientations that are extremely valuable to them.

Psychopathic individuals are extremely sensitive to certain psycho-traumatic influences, touchy and suspicious. Their mood is subject to periodic disorders - dysphoria. Tides of angry melancholy, fear, and depression cause them to become increasingly picky about others.

Psychopathic personality traits

Psychopathic personality traits are formed due to extremes in educational methods - oppression, suppression, belittlement form a depressed, inhibitory personality type. Systematic rudeness and violence contribute to the formation of an aggressive personality type. The hysterical personality type is formed in an atmosphere of full adoration and admiration, fulfillment of all the whims and whims of a psychopathic individual.

Psychopaths of the excitable and hysterical type are especially prone to sexual perversions - homosexuality(sexual attraction to people of the same sex), gerontophilia(for elderly people), pedophilia(to children). Other behavioral perversions of an erotic nature are also possible - scopophilia(secretly spying on other people's intimate acts), erotic fetishism(transfer of erotic feelings to things), transvestism(the desire to experience sexual satisfaction when dressing in clothes of the opposite sex), exhibitionism(sexual satisfaction when exposing your body in the presence of people of the other sex), sadism(erotic tyranny), masochism(autosadism).

All sexual perversions are signs of mental disorders.