Further, unless the clinician has had experience with forensic populations resulting in a clear understanding of ASPD, he or she would be reticent to diagnose this condition. We must discuss the present criteria for ASPD and the concept of Psychopathic Personality. Instead, they are people who have suffered extreme economic and social deprivation, lived in poverty with little education, and may have become involved in social networks, drugs or gangs leading to forensic histories through committing crimes and being convicted. Because most people with ASPD, and certainly psychopathic personality, do not seek treatment, those studied are the ones arrested and convicted, leading to a disproportion of unsuccessful psychopaths and individuals from lower socioeconomic circumstances in the known population. Hare, an international leader in research on psychopathy, eloquently describes the psychopath as a remorseless predator who uses charm, intimidation, and any means necessary including cold blooded violence to attain his or her goals.
Psychopaths have no remorse, and lack human empathy.
While many may ultimately be arrested, it is unknown how many go through life fairly successfully in many areas of business or other walks of life. They experience interpersonal difficulties, and often need specific instruction in many interpersonal areas, including dating and social relationships. Thus, within this context, clinicians are reticent to diagnose a personality disorder, and have difficulty separating skills affected by developmental delay from problems fitting a pathological framework. Indeed, this is a serious concern, and if the clinician is not totally confident, a diagnosis of any personality disorder should not be given. In the case of ASPD, the diagnostic confusion between ASPD and psychopathic personality is a serious problem.