Sinusitis

Classification of psychopathy according to different authors. Psychopathy of character

Etc.), in connection with which Gannushkin uses the expression “constitutional psychopathy,” emphasizing the static and, in his opinion, innate nature of this group of disorders. By the time of the transition to ICD-10, the term “psychopathy” was already firmly assigned to personality disorders.

The classification is based on features of a pathological nature, manifested in a combination of various psychopathic traits, and the type of disorder of higher nervous activity.

The difference between psychopathy and accentuations

General information

Comparative table of classifications of psychopathy:

Groups of psychopathy	E. Kraepelin (1915)	E. Kretschmer (1921)	K. Schneider (1923)	Gannushkin P. B. (1933)	T. Henderson (1947)	Popov E. A. (1957)	Kerbikov O. V. (1968)	ICD-9 with code
Psychopathy with a predominance of emotional disorders	Excitable	Epileptoids	Explosive	Epileptoids	Aggressive	Excitable Explosive	Excitable	Excitable type 301.3
		Cycloids	Hyperthymic Depressed Emotionally labile	Cycloids Constitutionally-excited Constitutionally-depressive Emotionally (reactive)-labile		Thymopathies		Affective type 301.1
	Science Fiction Liars and deceivers		Seeking recognition	Hysterical Pathological liars	Creative	Hysterical	Hysterical	Hysterical type 301.5
Psychopathy with predominant changes in the sphere of thinking			Asthenic	Asthenics		Asthenics	Brakeable	Asthenic type 301.6
			Anancast Unconfident	Psychasthenics		Psychasthenics		Anankastic type 301.4
	Weirdos	Schizoids		Schizoids (dreamers)	Inadequate		Pathologically withdrawn	Schizoid type 301.2
	Grumpy Pathological debaters		Fanatics	Fanatics Paranoid		Paranoid		Paranoid (paranoid) type 301.0
Psychopathy with a predominance of volitional disorders	Unrestrained		Weak-willed Unstable	Unstable		Unstable	Unstable	Unstable type 301.81
Psychopathy with impulse disorders	Obsessed with desires					Sexual perversions	Sexual psychopathy	Sexual perversions 302
Psychopathy with social behavior disorders	Public Enemies		Cold	Antisocial				Emotionally Stupid 301.7
Mixed psychopathy				Constitutionally stupid			Mosaic	Mosaic psychopathy 301.82

Gannushkin's classification of psychopathy

P. B. Gannushkin identified the following types of psychopathic personalities: asthenics, schizoids, paranoids, epileptoids, hysterical characters, cycloids, unstable, antisocial and constitutionally stupid.

Group of asthenics

Asthenic psychopathy

Psychopathic individuals in this circle are characterized since childhood by increased timidity, shyness, indecisiveness, and impressionability. They are especially lost in unfamiliar surroundings and new conditions, while experiencing a feeling of their own inferiority. Increased sensitivity, “mimosis” manifests itself both in relation to mental stimuli and physical activity. Quite often they cannot stand the sight of blood, sudden changes in temperature, and react painfully to rudeness and tactlessness, but their reaction of dissatisfaction can be expressed in silent touchiness or grumbling. They often have various autonomic disorders: headaches, discomfort in the heart, gastrointestinal disorders, sweating, poor sleep. They are quickly exhausted and tend to become fixated on their own well-being.

Psychasthenic psychopathy

Personalities of this type are characterized by pronounced shyness, indecisiveness, self-doubt and a tendency to constant doubts. Psychasthenics are easily vulnerable, shy, timid and at the same time painfully proud. They are characterized by a desire for constant introspection and self-control, a tendency to abstract logical constructs divorced from real life, obsessive doubts, and fears. For psychasthenics, any changes in life, disruption of the usual way of life (change of job, place of residence, etc.) are difficult; this causes them increased uncertainty and anxious fears. At the same time, they are efficient, disciplined, and often pedantic and annoying. They can be good deputies, but can never work in leadership positions. The need to make independent decisions and take initiative is destructive for them. A high level of aspirations and a lack of a sense of reality contribute to the decompensation of such individuals.

Schizoid psychopathy

Personalities of this type are distinguished by isolation, secrecy, isolation from reality, a tendency to internally process their experiences, dryness and coldness in relationships with loved ones. Schizoid psychopaths are characterized by emotional disharmony: a combination of increased sensitivity, vulnerability, impressionability - if the problem is personally significant, and emotional coldness, impenetrability in terms of other people's problems (“wood and glass”). Such a person is detached from reality, his life is aimed at maximum self-satisfaction without the desire for fame and material well-being. His hobbies are unusual, original, “non-standard”. Among them there are many people involved in art, music, and theoretical sciences. In life they are usually called eccentrics, originals. Their judgments about people are categorical, unexpected and even unpredictable. At work, they are often uncontrollable, as they work based on their own ideas about values in life. However, in certain areas where artistic extravagance and talent, unconventional thinking, and symbolism are required, they can achieve a lot. They do not have permanent attachments, family life usually does not work out due to the lack of common interests. However, they are ready to sacrifice themselves for the sake of some abstract concepts, imaginary ideas. Such a person may be absolutely indifferent to his sick mother, but at the same time he will call for assistance to the starving on the other side of the world. Passivity and inactivity in solving everyday problems are combined in schizoid individuals with ingenuity, enterprise and perseverance in achieving goals that are especially significant to them (for example, scientific work, collecting).

It should be noted that such a clinical picture is not always observed. Thus, material well-being and power, as a means of self-satisfaction, can become the main goal of a schizoid. In some cases, a schizoid is able to use his (although sometimes unnoticed by others) unique abilities to influence the world outside him. With regard to the activities of a schizoid in the workplace, it should be noted that the most successful combination is observed when the effectiveness of work brings him satisfaction, and it does not matter what type of activity he is engaged in (naturally, only if it is related to creation or, according to at least with the restoration of something).

Paranoid psychopathy

The main feature of psychopathic personalities of the paranoid group is the tendency to form extremely valuable ideas, which are formed by the age of 20-25. However, already from childhood they are characterized by such character traits as stubbornness, straightforwardness, one-sided interests and hobbies. They are touchy, vindictive, self-confident and very sensitive to others ignoring their opinions. The constant desire for self-affirmation, categorical judgments and actions, selfishness and extreme self-confidence create the ground for conflicts with others. Personality traits usually increase with age. Getting stuck on certain thoughts and grievances, rigidity, conservatism, “the fight for justice” are the basis for the formation of dominant (overvalued) ideas regarding emotionally significant experiences. Overvalued ideas, unlike delusional ones, are based on real facts and events and are specific in content, but judgments are based on subjective logic, a superficial and one-sided assessment of reality, corresponding to confirmation of one’s own point of view. The content of highly valuable ideas can be invention and reform. Failure to recognize the merits and merits of a paranoid person leads to clashes with others, conflicts, which, in turn, can become a real basis for litigious behavior. The “struggle for justice” in such cases consists of endless complaints, letters to various authorities, and legal proceedings. The patient’s activity and perseverance in this struggle cannot be broken by requests, convictions, or even threats. Ideas of jealousy and hypochondriacal ideas (fixation on one’s own health with constant visits to medical institutions with demands for additional consultations, examinations, the latest treatment methods, which have no real justification) can also be of great value for such individuals.

Epileptoid psychopathy

The leading features of epileptoid personalities are extreme irritability and excitability, explosiveness, leading to attacks of anger, rage, and the reaction does not correspond to the strength of the stimulus. After an outburst of anger or aggressive behavior, patients quickly “move away”, regret what happened, but in appropriate situations they do the same. Such people are usually dissatisfied with many things, look for reasons to find fault, get into arguments over any issue, showing excessive vehemence and trying to outshout their interlocutors. Lack of flexibility, stubbornness, conviction that they are right and the constant struggle for justice, which ultimately boils down to the struggle for their rights and personal selfish interests, lead to their lack of harmony in the team and frequent conflicts in the family and at work. For people with this type of personality, along with viscosity, stuckness, and rancor, they are characterized by such qualities as sweetness, flattery, hypocrisy, and a tendency to use diminutive words in conversation. In addition, excessive pedantry, neatness, authority, selfishness and the predominance of a gloomy mood make them unbearable at home and at work. They are uncompromising - they either love or hate, and those around them, especially close people, usually suffer from both their love and hatred, accompanied by vindictiveness. In some cases, disturbances of impulses come to the fore in the form of alcohol abuse, drug abuse (to relieve tension), and the desire to wander. Among the psychopaths in this circle are gamblers and binge drinkers, sexual perverts and murderers.

Hysterical psychopathy

The most characteristic feature of hysterical individuals is the thirst for recognition, that is, the desire to attract the attention of others at any cost. This is manifested in their demonstrativeness, theatricality, exaggeration and embellishment of their experiences. Their actions are designed for an external effect, just to amaze others, for example, with an unusually bright appearance, a storm of emotions (delight, sobs, wringing of hands), stories about extraordinary adventures, inhuman suffering. Sometimes patients, in order to attract attention to themselves, do not hesitate to lie, self-incriminately, for example, attribute to themselves crimes that they did not commit. These are called pathological liars. Hysterical individuals are characterized by mental infantilism (immaturity), which manifests itself in emotional reactions, judgments, and actions. Their feelings are superficial and unstable. External manifestations of emotional reactions are demonstrative, theatrical, and do not correspond to the reason that caused them. They are characterized by frequent mood swings and rapid changes in likes and dislikes. Hysterical types are characterized by increased suggestibility and self-hypnosis, therefore they constantly play some role and imitate the personality that has struck them. If such a patient is admitted to the hospital, he can copy the symptoms of diseases of other patients who are in the ward with him. Hysterical individuals are characterized by an artistic type of thinking. Their judgments are extremely contradictory and often have no basis in reality. Instead of logical comprehension and sober assessment of facts, their thinking is based on direct impressions and their own inventions and fantasies. Psychopaths of the hysterical circle often achieve success in creative activities or scientific work, as they are helped by an unbridled desire to be in the center of attention, egocentrism.

Cycloid psychopathy

The group of cycloids includes individuals with different, constitutionally determined, levels of mood. Persons with constantly low mood form a group constitutionally depressed psychopaths(hypothymic). These are always gloomy, dull, dissatisfied and uncommunicative people. In their work, they are overly conscientious, careful, and efficient, since they are ready to see complications and failures in everything. They are characterized by a pessimistic assessment of the present and a corresponding view of the future, combined with low self-esteem. They are sensitive to troubles and capable of empathy, but they try to hide their feelings from others. In conversation they are reserved and taciturn, afraid to express their opinion. It seems to them that they are always wrong, looking for their guilt and inadequacy in everything.

Constitutionally excited- these are hyperthymic individuals, and, unlike hypothymic individuals, they are characterized by constantly elevated mood, activity and optimism. These are sociable, lively, talkative people. In their work, they are enterprising, proactive, full of ideas, but their tendency towards adventurism and inconsistency are harmful in achieving their goals. Temporary setbacks do not upset them; they get back to work with tireless energy. Excessive self-confidence, overestimation of their own capabilities, and activities on the edge of the law often complicate their lives. Such individuals are prone to lying and not being obligated to fulfill promises. Due to increased sexual desire, they are promiscuous in making acquaintances and enter into reckless intimate relationships.

Persons with emotional instability, that is, with constant mood swings, belong to the cycloid type. Mood cyclothymics changes from low, sad, to high, joyful. Periods of bad or good mood of varying duration, from several hours to several days, even weeks. Their condition and activity change in accordance with changes in mood.

Emotive-labile (reactive-labile) psychopaths- persons whose state fluctuates extremely often, sometimes right from the day. Their mood goes from one extreme to another without any reason.

Unstable psychopathy

People of this type are characterized by increased subordination to external influences. These are weak-willed, easily suggestible, “spineless” individuals, easily influenced by other people. Their whole life is determined not by goals, but by external, random circumstances. They often fall into bad company, drink too much, become drug addicts, and scammers. At work, such people are unnecessary and undisciplined. On the one hand, they make promises to everyone and try to please, but the slightest external circumstances unsettle them. They constantly need control and authoritative leadership. Under favorable conditions, they can work well and lead a healthy lifestyle.

Antisocial psychopathy

A feature of antisocial psychopaths is pronounced moral defects. They suffer from partial emotional dullness and have practically no social emotions: the sense of duty towards society and the feeling of sympathy for others are usually completely absent. They have neither shame nor honor, are indifferent to praise and blame, and are unable to adapt to the rules of society. They often gravitate toward sensual pleasures. Some antisocial psychopaths have been prone to tormenting animals since childhood and have no attachment even to the closest people (even to their mother).

Constitutionally stupid

Psychopaths who are born stupid and limited. A distinctive feature is congenital mental deficiency. These individuals, unlike oligophrenics, study well (not only in secondary school, but even at the university), and they often have a good memory. However, when they enter into life, where they have to put their knowledge into practice and take initiative, nothing works out for them. They do not show any originality and tend to say banal, stereotyped things, which is why their disorder is called “Salon Blödsinn” (German: “salon dementia”). To denote the same concept, Eugen Bleuler used the term “die unklaren” (“unclear”), emphasizing that their main characteristic is more the obscurity of concepts than the poverty of associations. The group of constitutionally stupid also includes “philistines” - people without spiritual (intellectual) needs and requests. However, they can cope well with the simple requirements of a specialty.

Constitutionally stupid psychopaths are suggestible individuals who are ready to obey “public opinion”; they also tend to follow fashion. They are always conservatives, afraid of everything new and holding on, out of a sense of self-defense, to what they are accustomed to and adapted to.

Constitutionally stupid psychopaths can have great self-importance, while with a pompous, solemn air they utter meaningless complex phrases, that is, a set of pompous words that have no content. In literature there is a similar subject in caricature form - Kozma Prutkov.

Kraepelin's classification of psychopathy

Public enemies (German: Gesellschaft feinde), also "anti-social";
Impulsive (German: Triebmenenschen), also “people of desire”;
Excitable (German: Erregbaren);
Unrestrained (German: Haltlosen), also "unstable";
Weirdos (German: Verschrobenenen);
Pathological debaters (German: Streitsüchtigen);
Liars and deceivers (German: Lügner und Schwindler), also "pseudologists".

Schneider's classification of psychopathy

Depressed(German: Depressiven) - pessimists and skeptics who doubt the meaning of life. They have a penchant for refined aestheticism, sophistication and self-torture, which embellishes the inner bleakness. They suffer from more or less prolonged depressed mood, usually perceive everything in a darkened light and see the other side of everything. Some depressed individuals are characterized by arrogance and ridicule of people who are internally “light” and simple. They feel themselves as sufferers, standing above others, as aristocrats.
Hyperthymics(German: Hyperthymischen) - active individuals with a cheerful character, lively sanguine temperament, good-natured optimists, debaters, excitable. Tend to actively interfere in other people's affairs. Negative qualities include uncriticality, inattention, low reliability, and they are also easily influenced by others.
Emotionally labile(German: Stimmungslabilen) - individuals with an unstable mood, prone to unexpected changes.
Seeking recognition(German: Geltungsbedürftigen) - eccentric and vain people who strive to appear more significant than they really are. Eccentricity serves to attract attention to themselves, for this they express the most unusual opinions and perform the most unusual actions.
Explosive(German Explosiblen) - easily excitable, irritable, hot-tempered individuals. They often “boil” over the most insignificant reasons. According to E. Kretschmer, their reactions are primitive reactions. They are offended by any word said in defiance, and before they realize its meaning, a reaction follows in the form of a rapidly violent form of violence or an offensive objection.
Soulless or insensitive(German: Gemütlosen) - individuals who are devoid of a sense of shame, compassion, honor, remorse. They are gloomy and gloomy, and their actions are instinctive and rude.
Weak-willed(German Willenenslosen) - unstable individuals who are subject to both positive and negative influences, they simply do not resist any influence.
Unconfident(German: Selbstunsicheren) - constrained, anxiously insecure and shy individuals. They can hide these traits with an overly daring and bold manner of behavior. Internally indecisive and often slightly depressed.
Fanatical(German Fanatischen) - expansive and active individuals, are captured by overvalued complexes of thoughts of a personal or ideological nature, prone to fighting for their legal or imaginary rights. Sometimes expansive fanatics exhibit paranoid manifestations that go beyond ordinary suspicion. There are also listless fanatics, eccentrics of the “fantasy plane”, detached from reality, with a character less or not at all fighting, like, for example, many sectarians.
Asthenic(German: Asthenenischen) - individuals who are characterized by difficulty concentrating, low performance, poor memory, insomnia, and increased fatigue. They acutely feel mental and mental insufficiency. In the future, some asthenics complain of a feeling of alienation, the unreality of the world and all sensations (states described as reminiscent of derealization). All these conditions are not always, but often, caused by introspection. Asthenics constantly engage in introspection and look inside themselves; they tend to look for any problems in the functioning of the body, and they complain to doctors about the state of their body. It is worth noting that “asthenic psychopathy” has no relation to “asthenic physique,” the so-called leptosomal physique.

Kerbikov's classification of psychopathy

The typology of psychopathy proposed by O. V. Kerbikov was one of the most common in Soviet psychiatry and included the following types:

Unstable type.
Psychasthenic type.
Mosaic (mixed) type.

Triad of criteria for psychopathy by Gannushkin-Kerbikov:

The severity of pathological personality traits to the extent of disruption of social adaptation.
Relative stability of mental character traits, their low reversibility.
The totality of pathological personality traits that determine the entire mental appearance.

Kerbikov O.V. noted that a certain type of upbringing leads to the formation of a certain psychopathy. Thus, with dominant hyperprotection (raising a child with “iron gloves”) an asthenic type is formed, and with indulgent hyperprotection (the child is the “idol of the family”) a personality of a hysterical type is formed, etc.

Genetic taxonomy of psychopathy Kerbikov-Felinskaya

This taxonomy divides psychopathy according to etiology into the following groups:

Nuclear (constitutional, true).
Purchased, which include the following groups:
1. Post-processual (due to a previous mental disorder).
2. Organic (associated with cerebral-organic pathology. For example, the characteropathic version of psychoorganic syndrome).
3. Regional (pathocharacterological, post-reactive and post-neurotic pathological development of personality).

In most cases, the etiology of psychopathy is mixed.

Often the label is “hung” on people with almost any type of mental personality disorder; sometimes a psychopath is identified with a sociopath. However, due to the classification of personality disorders developed by Ganushkin, psychopathy began to be attributed to the accentuation of character and temperament, i.e. to acquired pronounced neurotic character traits and congenital disorders of higher nervous activity of a person.

With such a character disorder as psychopathy, a person is characterized by inadequacy of emotional and psychological experiences and a tendency to depression and obsessions - these are the main distinguishing features of psychopaths.

Signs of psychopathy - types and types

The main signs of psychopathy are classified into several types, types of character accentuation: neurasthenic, psychasthenic, schizoid, paranoid, excitable, hysterical, affective and unstable.

Let us consider in more detail each individual type (type) of character psychopathy, their signs and characteristics.

Neurasthenic (asthenic) type of psychopathy:
In psychopaths of the neurasthenic type, usually from childhood such “weak” character traits as timidity and shyness, indecisiveness, and most importantly, high impressionability are revealed.
Asthenic psychopaths usually feel like inferior individuals: they often get lost in new and difficult situations. Their excessive sensitivity causes them to lose mental energy sometimes even with the most ordinary mental and physical stimuli. People with neurasthenic psychopathy quickly deplete their nervous system. They are sometimes so impressionable that they react very negatively to rudeness and tactlessness, temperature changes, and are afraid of the sight of blood... Psychopathy in neurasthenics can also manifest itself in physical and psychological ailments: insomnia, headaches, disturbances in cardiac activity, in the gastrointestinal tract...can sweat for no reason...

Psychasthenic psychopathy
Psychopaths of the psychasthenic type constantly doubt everything, they are indecisive, often shy, timid and unsure of themselves. They are too proud and this makes them vulnerable individuals.
With psychasthenic type psychopathy, people often engage in self-examination (introspection), try to control themselves in everything, like to think abstractly and come up with obsessions and fears.

Any sudden changes in life cause increased anxiety and nervous unrest in psychasthenic psychopaths. However, they are very diligent, disciplined and often precise to the point of pedantry, which they sometimes insistently demand from others.

Schizoid psychopathy
Schizoid psychopaths are distinguished by isolation, secrecy, withdrawal into themselves, and emotional coldness in relationships with loved ones. They like to think to themselves and not take their experiences outside.
Schizoid psychopathy is characterized by emotional and psychological disharmony within the psychopath’s personality: they combine emotional coldness towards other people’s problems and high sensitivity to their own personal ones.

They have their own ideas about life values, so schizoid psychopaths can be unpredictable and poorly managed at work. However, they can be quite creative individuals: they are often involved in art, music, and science. In life, they may be perceived as “originals” or “eccentrics.”

Schizoids can be passive and inactive in everyday life, but at the same time very active and active in activities that are meaningful only to them.

Their family life often does not work out due to the lack of permanent attachments and failure to find common interests.
Their favorite activities are those where they can create something... Schizoid psychopaths can be both inglorious disinterested people, so passionate about business and wealth...

Paranoid psychopathy
In addition to the fact that with paranoid psychopathy, a person comes up with “supervaluable ideas” for himself, these psychopaths are characterized by such character traits as stubbornness, directness, one-sided interests and hobbies - these traits often manifest themselves in childhood.
Paranoid psychopaths are very touchy, vindictive, self-confident and very receptive and sensitive to having their opinions ignored. They often create conflict situations due to categorical judgments, views and selfish actions.

Paranoid psychopaths often get stuck on their thoughts and grievances, they are characterized by rigidity of thinking, conservative views on life, their “favorite pastime” is “the fight for truth and justice.”
Their “overvalued ideas” are not the same as delusional ones - they are based on reality, but have a too subjective point of view, often a one-sided and superficial assessment of reality...

Excitable psychopathy
Excitable psychopaths are characterized by irritability, excitability, and “explosiveness” that are inappropriate to the situation, with attacks of anger and aggression. Typically, these people are quick to respond and may feel guilty and repent for their aggressive behavior, but in such situations their excitability will arise again.

With excitable psychopathy, people are prone to arguing for the sake of arguing, they like to find fault with others with or without reason, they are “always” dissatisfied with something, during a discussion they want to shout down their opponent, proving that they are right. These psychopaths are very quarrelsome in the family and at work, because... a heightened sense of being right pushes them into quarrels, squabbles and conflicts.

Excitable people, or as they are also called epileptoid psychopaths, cannot reach compromises, much less cooperation in relationships. They are categorical in their judgments, they either love or hate... very vindictive and sometimes insidious.
This type of psychopathy can include binge alcoholics, drug addicts, gamblers, perverts and murderers...

Hysterical psychopathy
A hysterical psychopath places recognition of his personality by others at the forefront - ignoring him is unthinkable. Hysterical psychopathy is expressed in theatrical, staged, feigned behavior of a person... in demonstrating oneself through emotional effects: flashes of joy and laughter, sadness and sobbing; eccentric gestures and extravagant clothing and appearance - all this is just for “showing off”, in order to be in sight, in the spotlight.

In addition, hysterics are highly suggestible and can imitate another personality that has struck them. Hysterical personalities, due to their egoism (egocentrism) - the desire to be in the center of attention and artistic type of thinking - can achieve success in creative, theatrical work...

Affective psychopathy
Affective psychopathy can be divided into three types: hypothymic psychopath, hyperthymic and cycloid.

Hypothymic characterized by “eternally” low mood: these are unsociable, sad and gloomy people with a tendency to depression. They always see possible failures and mistakes in everything, so they work very diligently, accurately and conscientiously.

A pessimistic outlook on life and constantly low self-esteem do not allow hypothymic psychopaths to grow and develop personally and adequately build their future. They always feel they are wrong and therefore are afraid to express their opinion. They often engage in self-accusation and self-flagellation.

Hyperthymic psychopath, on the contrary, is distinguished by an “eternally” high spirits, high self-esteem and optimistic outlook on life. They are very sociable and talkative, they have a predominant spirit of initiative and enterprise - they are prone to adventure.

However, it is precisely excessive self-confidence, adventurism and overestimation of one’s strengths and capabilities that often leads a psychopath to enormous difficulties in life.

Cycloid type of psychopathy is expressed in constant changes, cycles of mood, from hypothymic to hyperthymic and back. Such cycles can last from several hours to several days.

Unstable psychopathy
Unstable psychopaths tend to submit to external influences. They are regarded as “spineless”, weak-willed, weak-willed individuals who can easily be influenced by other people, instill in them anything and

The classification is based on features of a pathological nature, manifested in a combination of various psychopathic traits, and the type of disorder of higher nervous activity.

The difference between psychopathy and accentuations

General information

Comparative table of classifications of psychopathy:

Groups of psychopathy	E. Kraepelin (1915)	E. Kretschmer (1921)	K. Schneider (1923)	Gannushkin P. B. (1933)	T. Henderson (1947)	Popov E. A. (1957)	Kerbikov O. V. (1968)	ICD-9 with code
Psychopathy with a predominance of emotional disorders	Excitable	Epileptoids	Explosive	Epileptoids	Aggressive	Excitable Explosive	Excitable	Excitable type 301.3
		Cycloids	Hyperthymic Depressed Emotionally labile	Cycloids Constitutionally-excited Constitutionally-depressive Emotionally (reactive)-labile		Thymopathies		Affective type 301.1
	Science Fiction Liars and deceivers		Seeking recognition	Hysterical Pathological liars	Creative	Hysterical	Hysterical	Hysterical type 301.5
Psychopathy with predominant changes in the sphere of thinking			Asthenic	Asthenics		Asthenics	Brakeable	Asthenic type 301.6
			Anancast Unconfident	Psychasthenics		Psychasthenics		Anankastic type 301.4
	Weirdos	Schizoids		Schizoids (dreamers)	Inadequate		Pathologically withdrawn	Schizoid type 301.2
	Grumpy Pathological debaters		Fanatics	Fanatics Paranoid		Paranoid		Paranoid (paranoid) type 301.0
Psychopathy with a predominance of volitional disorders	Unrestrained		Weak-willed Unstable	Unstable		Unstable	Unstable	Unstable type 301.81
Psychopathy with impulse disorders	Obsessed with desires					Sexual perversions	Sexual psychopathy	Sexual perversions 302
Psychopathy with social behavior disorders	Public Enemies		Cold	Antisocial				Emotionally Stupid 301.7
Mixed psychopathy				Constitutionally stupid			Mosaic	Mosaic psychopathy 301.82

Gannushkin's classification of psychopathy

Group of asthenics

Asthenic psychopathy

Psychasthenic psychopathy

Schizoid psychopathy

Paranoid psychopathy

Epileptoid psychopathy

Hysterical psychopathy

Cycloid psychopathy

Emotive-labile (reactive-labile) psychopaths- persons whose state fluctuates extremely often, sometimes right from the day. Their mood goes from one extreme to another without any reason.

Unstable psychopathy

Antisocial psychopathy

A feature of antisocial psychopaths is pronounced moral defects. They suffer from partial emotional dullness and have practically no social emotions: the sense of duty towards society and the feeling of sympathy for others are usually completely absent. They have neither shame nor honor, are indifferent to praise and blame, and are unable to adapt to the rules of society. They often gravitate towards sensual pleasures. Some antisocial psychopaths have been prone to tormenting animals since childhood and have no attachment even to the closest people (even to their mother).

Constitutionally stupid

Kraepelin's classification of psychopathy

Public enemies (German: Gesellschaft feinde), also "anti-social";
Impulsive (German: Triebmenenschen), also “people of desire”;
Excitable (German: Erregbaren);
Unrestrained (German: Haltlosen), also "unstable";
Weirdos (German: Verschrobenenen);
Pathological debaters (German: Streitsüchtigen);
Liars and deceivers (German: Lügner und Schwindler), also "pseudologists".

Schneider's classification of psychopathy

Depressed(German: Depressiven) - pessimists and skeptics who doubt the meaning of life. They have a penchant for refined aestheticism, sophistication and self-torture, which embellishes the inner bleakness. They suffer from more or less prolonged depressed mood, usually perceive everything in a darkened light and see the other side of everything. Some depressed individuals are characterized by arrogance and ridicule of people who are internally “light” and simple. They feel themselves as sufferers, standing above others, as aristocrats.
Hyperthymics(German: Hyperthymischen) - active individuals with a cheerful character, lively sanguine temperament, good-natured optimists, debaters, excitable. Tend to actively interfere in other people's affairs. Negative qualities include uncriticality, inattention, low reliability, and they are also easily influenced by others.
Emotionally labile(German: Stimmungslabilen) - individuals with an unstable mood, prone to unexpected changes.
Seeking recognition(German: Geltungsbedürftigen) - eccentric and vain people who strive to appear more significant than they really are. Eccentricity serves to attract attention to themselves, for this they express the most unusual opinions and perform the most unusual actions.
Explosive(German Explosiblen) - easily excitable, irritable, hot-tempered individuals. They often “boil” over the most insignificant reasons. According to E. Kretschmer, their reactions are primitive reactions. They are offended by any word said in defiance, and before they realize its meaning, a reaction follows in the form of a rapidly violent form of violence or an offensive objection.
Soulless or insensitive(German: Gemütlosen) - individuals who are devoid of a sense of shame, compassion, honor, remorse. They are gloomy and gloomy, and their actions are instinctive and rude.
Weak-willed(German Willenenslosen) - unstable individuals who are subject to both positive and negative influences, they simply do not resist any influence.
Unconfident(German: Selbstunsicheren) - constrained, anxiously insecure and shy individuals. They can hide these traits with an overly daring and bold manner of behavior. Internally indecisive and often slightly depressed.
Fanatical(German Fanatischen) - expansive and active individuals, are captured by overvalued complexes of thoughts of a personal or ideological nature, prone to fighting for their legal or imaginary rights. Sometimes expansive fanatics exhibit paranoid manifestations that go beyond ordinary suspicion. There are also listless fanatics, eccentrics of the “fantasy plane”, detached from reality, with a character less or not at all fighting, like, for example, many sectarians.
Asthenic(German: Asthenenischen) - individuals who are characterized by difficulty concentrating, low performance, poor memory, insomnia, and increased fatigue. They acutely feel mental and mental insufficiency. In the future, some asthenics complain of a feeling of alienation, the unreality of the world and all sensations (states described as reminiscent of derealization). All these conditions are not always, but often, caused by introspection. Asthenics constantly engage in introspection and look inside themselves; they tend to look for any problems in the functioning of the body, and they complain to doctors about the state of their body. It is worth noting that “asthenic psychopathy” has no relation to “asthenic physique,” the so-called leptosomal physique.

Kerbikov's classification of psychopathy

The typology of psychopathy proposed by O. V. Kerbikov was one of the most common in Soviet psychiatry and included the following types:

Unstable type.
Psychasthenic type.
Mosaic (mixed) type.

Triad of criteria for psychopathy by Gannushkin-Kerbikov:

The severity of pathological personality traits to the extent of disruption of social adaptation.
Relative stability of mental character traits, their low reversibility.
The totality of pathological personality traits that determine the entire mental appearance.

Genetic taxonomy of psychopathy Kerbikov-Felinskaya

This taxonomy divides psychopathy according to etiology into the following groups:

Nuclear (constitutional, true).
Purchased, which include the following groups:
1. Post-processual (due to a previous mental disorder).
2. Organic (associated with cerebral-organic pathology. For example, the characteropathic version of psychoorganic syndrome).
3. Regional (pathocharacterological, post-reactive and post-neurotic pathological development of personality).

In most cases, the etiology of psychopathy is mixed.

(constitutional psychopathy, personality disorders) - mental disorders in which there is a persistent disturbance of character and behavioral tendencies, affecting several areas of the personality. Arises from birth or early childhood and persists throughout life. Accompanied by social and personal maladaptation of varying degrees of severity. Psychopathy is a multifactorial disease, the significance of various factors can vary significantly. The diagnosis is made taking into account the history and clinical symptoms. Treatment – assistance in adaptation, psychotherapy, drug therapy.

General information

mental disorders observed throughout the patient's life. They are characterized by persistent disturbances of character and behavior, leading to deterioration of social and personal adaptation. According to statistics obtained in 2008 as a result of large-scale international studies, more than 10% of the population suffers from psychopathy (including mild forms). At the same time, the prevalence of emotionally unstable, schizotypal, histrionic and dissocial personality disorder is approximately 2% for each disorder, and the frequency of anxiety and narcissistic disorder ranges from 0.5 to 1%.

A connection with gender is revealed. Asthenic, hysterical and emotionally unstable personality disorder are more often diagnosed in women, other psychopathy - in men. Some patients experience a combination of symptoms characteristic of several personality disorders. Due to its widespread prevalence, the diagnosis and treatment of psychopathy is becoming a problem of high medical and social significance. Treatment of this pathology is carried out by specialists in the field of psychiatry, psychotherapy and clinical psychology.

Causes of psychopathy

The significance of certain factors in the development of psychopathy has not yet been reliably clarified, which is due to the difficulty of studying the circumstances influencing the formation of this group of mental disorders. The undoubted importance of the genetic factor has been established - relatives of patients with psychopathy are more likely to have similar disorders than the population average. Often representatives of two or more generations of the same family, for example, father and son or mother and daughter, suffer from psychopathy. At the same time, one cannot ignore the influence of a vicious system of relationships in the family of a psychopath and a large number of pathological beliefs and patterns of behavior acquired by a child who, from the first days of life until reaching adulthood, communicates with a patient with psychopathy.

Many experts believe that complicated pregnancy, difficult childbirth, and early childhood illnesses may play a certain role in the development of psychopathy. There is a connection with physical, psychological and sexual abuse suffered in childhood. Researchers believe that unfavorable living conditions during childhood aggravate genetically determined character traits and personality traits and increase the risk of developing psychopathy.

Classification of psychopathy

The traditional Gannushkin classification, used by Soviet and Russian psychiatrists, included seven types of psychopathy: asthenic, psychasthenic, schizoid, paranoid, excitable, hysterical, affective and unstable. Since 1997, after the transition to the ICD-10 classification of diseases, psychopathy began to be called personality disorders. The ICD-10 identifies the following types of personality disorders:

Schizoid disorder (corresponding to schizoid psychopathy)
Paranoid disorder (corresponding to paranoid psychopathy)
Schizotypal disorder
Antisocial disorder
Emotionally unstable disorder (corresponding to excitable psychopathy)
Histrionic disorder (corresponding to hysterical psychopathy)
Narcissistic disorder
Obsessive-compulsive disorder (corresponds to psychasthenic psychopathy)
Avoidant disorder
Dependent disorder (corresponds to asthenic psychopathy)
Passive-aggressive disorder.

It should be noted that, despite the adoption of ICD-10, there is still no absolute unity among psychiatrists on the issue of classification of psychopathy, which is due to the complexity and significant polymorphism of the clinical picture of this mental disorder.

Forms of psychopathy

Schizoid psychopathy (schizoid personality disorder)

The main signs of schizoid psychopathy are a lack of need for close relationships, a persistent desire to minimize social contacts, some disregard for social norms, emotional coldness and detachment from one’s own feelings, combined with theorizing and withdrawal into fantasy. Patients suffering from schizoid psychopathy are unable to express any strong feelings - both positive (joy, tenderness, delight) and negative (rage, anger).

Such patients have little interest in sexual contacts, friendships and creating a family. They prefer to lead a solitary lifestyle. People suffering from schizoid psychopathy find it difficult to work in a team, so they choose professions that require individual activity. They either enjoy a small number of activities or do not enjoy them at all. They are indifferent to both condemnation and approval, they care little about accepted social norms.

Psychoanalysts believe that the reason for the development of schizoid psychopathy is the duality of parental messages and the need for intimacy, combined with the fear of absorption, which forces one to maintain a distance in communicating with people. Intellectualization becomes the main mental defense. There is a pronounced tendency to sublimation. The diagnosis of schizoid psychopathy is made in the presence of four or more of the listed symptoms at the age of 18 years or older, their manifestation in different contexts and persistence throughout life. Treatment – social adaptation, long-term psychoanalytic therapy.

Paranoid psychopathy (paranoid personality disorder)

The hallmarks of paranoid psychopathy are resentment, suspicion, overreactions to rejection or the inability to satisfy needs, as well as a distorted perception of the environment with a tendency to distort facts, take everything personally, interpret the actions of other people in a negative way and suspect them of bad intentions. Patients suffering from paranoid psychopathy are constantly dissatisfied with someone or something. It is difficult for them to forgive the mistakes of others; behind any accident they see malicious intent, build conspiracy theories, are sensitive to issues of individual rights, and consider neutral or positive words and actions of other people as an attack on their own reputation. A characteristic feature of this psychopathy is constant excessive jealousy.

The main defense mechanisms of the psyche are projection, denial and reactive formation. Patients suffering from paranoid psychopathy experience many pronounced negative emotions (anger, envy, resentment, desire for revenge, anger, fear, guilt, shame), but they deny their feelings and project them onto others. The diagnosis is made when three or more of the above signs of psychopathy are identified. A prerequisite is the constancy of these signs and their influence on several aspects of the patient’s life. Treatment includes social adaptation measures and long-term psychotherapy.

Excitable psychopathy (emotionally unstable personality disorder)

There are two types of excitable psychopathy: impulsive personality disorder and borderline personality disorder. Both pathologies are characterized by impulsiveness, a tendency to violent, bright, uncontrollable expression of emotions, often inconsistent with the significance of real circumstances. The distinctive features of psychopathy are instability of the self-image, serious problems in building social relationships, high tension in personal relationships, fluctuations from idealization to devaluation of the partner.

Patients suffering from excitable psychopathy experience a pronounced fear of loneliness, but due to beliefs that arose in childhood, they cannot build stable relationships. On the one hand, people with excitable psychopathy doubt their own worth and significance, consider their feelings and interests unimportant and try to hide them, on the other hand, they assume that others can use them and suspect others of selfish interests. High emotional stress “splashes out” in the form of uncontrollable outbursts of rage and anger, often incomprehensible to others. This psychopathy is characterized by periods of anxiety and irritability, self-aggressive behavior and sexual promiscuity.

Many patients attempt suicide and abuse substances. The impulsive version of excitable psychopathy differs from borderline disorder by more pronounced aggressiveness, cruelty and emotional instability and a lower level of control over one’s own behavior. The diagnosis of psychopathy is made in the presence of severe impulsivity, a significant decrease in the ability to plan and uncontrollable outbursts of anger. Treatment is long-term psychotherapy aimed at correcting pathological beliefs and stabilizing the image of one’s own “I”, in combination with measures for social adaptation.

Histrionic psychopathy (hysterical personality disorder)

Characterized by excessive emotionality combined with the need to remain in the center of attention of others in any way. Emotions are superficial, unstable, and often overly exaggerated (theatrical). To attract attention, patients suffering from hysterical psychopathy actively use their own sexuality and view their appearance as a tool for manipulating others.

There is egocentrism, superficiality of judgment, lack of need for a full analysis of situations, and high suggestibility. Patients with hysterical psychopathy easily fall under the influence of others. The diagnosis is made in the presence of three or more stable signs characteristic of this disorder. Treatment – assistance in social adaptation, long-term psychotherapy. Psychoanalytic therapy is considered the most effective technique.

Other psychopathy

Psychasthenic psychopathy(obsessive-compulsive personality disorder) is characterized by indecisiveness, stubbornness, excessive attention to detail, perfectionism, neatness, and the need to control the environment. Patients with psychasthenic psychopathy constantly plan something aimlessly, trying to take into account the smallest details. It is difficult for them to relax; they constantly strive to find some “useful activity” for themselves, preferring unnecessary work to relaxation and communication with friends.

Asthenic psychopathy(dependent personality disorder) is manifested by vulnerability, high sensitivity and an excessive need for the care of others. Patients suffering from this psychopathy are afraid of imaginary separation, get lost in unusual surroundings, become overly attached to other people and are afraid of loneliness. They tend to take the position of a follower, avoid responsibility, and have difficulty making any decisions. Concomitant autonomic disorders and increased exhaustion are observed.

Schizotypal psychopathy(schizotypal personality disorder) is characterized by an inability to form close relationships, unusual behavior, and mystical thinking. Patients believe that they have some kind of extraordinary, usually extrasensory, abilities: they read the future, see and understand something hidden from the eyes of other people, have telepathy, etc. They are characterized by unusual behavior and speech rich in metaphors.

Antisocial psychopathy(dissocial personality disorder) is accompanied by a gross disregard for generally accepted social norms and disregard for the rules of behavior in society. Patients show indifference to the feelings of others, are prone to risk, aggression and impulsive behavior. If desired, patients suffering from antisocial psychopathy can easily get along with other people, but have an extremely limited ability to form attachments. They do not feel guilty, they tend to blame other people for everything and find plausible explanations for any of their own actions.

Narcissistic personality disorder– psychopathy, in which there is a belief in one’s own uniqueness, a need for admiration and a lack of empathy. Patients are convinced that they are different from the “gray mass”, that their talents and achievements are of particular significance. They believe that they should be loved, admired and obeyed. At the same time, the “empty” inner “I” of a person suffering from psychopathy requires constant external confirmation of its own significance and uniqueness. The patient experiences envy of others and believes that other people envy him.

Avoidant personality disorder(anxiety disorder) is a psychopathy in which patients constantly suffer from feelings of inferiority. They are extremely sensitive to criticism, fear the displeasure and disapproval of other people, restrain emotions when communicating with strangers, and avoid new activities. They believe in the superiority of others. They are so afraid of being rejected that they maintain a distance that prevents other people from getting close enough for approval or rejection.

Passive-aggressive personality disorder– psychopathy, in which there is constant passive resistance to any type of activity. Patients fluctuate from protest to repentance, easily enter into conflicts with other people, complain and criticize others, and envy other people's successes. They tend to take the position of an “eternal sufferer,” exaggerating their own troubles.

The basis of treatment for all of these psychopathies is long-term psychotherapy. The technique is chosen taking into account the characteristics of the disorder. In most cases, the most effective are classical psychoanalysis, Jung's depth psychoanalytic therapy, and various combinations and modifications of these methods. If necessary, tranquilizers and antidepressants are prescribed for psychopathy. Purposeful social adaptation in adolescence and youth plays an important role: support when joining a team, help in choosing a profession, etc.

When meeting an unusual, unpleasant or frighteningly strange person, people are surprised or indignant, explaining the behavior of the interlocutor with poor upbringing, bad character or the whims of an egoist. The impressions from such meetings will be so different that it is impossible to assume anything in common in the manifestations of the characters of completely different people. And yet there is a unifying principle for these situations. Its name is psychopathy. Communication with a person suffering from such a personality disorder is not always unpleasant. Sometimes such people even evoke admiration and genuine interest. But life next to such an individual cannot be called calm and balanced. It is always an existence “on the edge”. And on the verge of what - depends on the type of psychopathic disorder inherent in this or that problem person.

Biological and social causes of psychopathy

So what is psychopathy? Disease? Caprice? Bad character or the consequences of poor upbringing and environmental influences? There is some truth in all assumptions. But there is still debate about this type of “sickness of the soul” (this is how the term is translated from Greek). There is no consensus yet on the causes of this condition and its varieties. Even the term “psychopathy” itself is not entirely unambiguous, which is not very good for trying to give an accurate definition of the phenomenon. This expression is quite often used to refer to various mental illnesses. But other sources define psychopathy as a dissocial personality disorder.

Psychopathy can be classified as a so-called borderline condition. This may also be a characterological deviation that interferes with the normal functioning of the individual in society, making a person’s behavior sometimes “strange” and sometimes simply unacceptable. But close to this “border” are also progressive mental illnesses, such as Alzheimer's disease. Although there are no signs of organic brain damage in psychopaths. They often display extremely high intelligence.

Maybe these are simply the consequences of the negative influence of external circumstances? Or was it his irresponsible and short-sighted upbringing that made him this way? One can partly agree with such statements. Important factors for the development of psychopathy are indeed the negative (psychogenic) influence of the environment in which the individual developed and is located. In addition, there are no irreversible personality defects in people suffering from psychopathy. If environmental conditions change to more favorable ones, their mental anomalies are smoothed out.

But there are certain characteristics of the body that make it possible for the development of psychopathy.

There are three reasons for the occurrence of this pathological condition:

In the presence of hereditary characteristics (biological factor), the emergence of nuclear or constitutional psychopathy can be assumed.
Acquired organic deficiency can cause a condition called organic psychopathy (mosaic psychopathy). Life circumstances still play a significant role in this case.
In the case when biological factors play a very small role in the formation of a personality disorder, we can say that marginal psychopathy occurs. The occurrence of psychopathy depends on the characteristics of the general life situation and psychogenic factors.

Is it possible to raise a psychopath?

Psychopathy is observed in every hundredth child

In young children, you can observe signs that portend the possibility of diagnosing psychopathy:

Frequent quarrels and fights;
Stealing or damaging things that belong to other people;
The desire for constant “violation of prohibitions”, sometimes running away from home;
Lack of guilt;
Indifference to people's feelings and suffering;
Spectacular display of emotions for the purpose of manipulation;
Irresponsibility;
Pathological desire for risk;
Indifference to punishment;
Extremely active desire for pleasure.

It will be difficult for such a child, and subsequently for an adult, to adapt to society. And here a lot depends on upbringing and the conditions surrounding a person. If life circumstances traumatize a growing person, this can lead to antisocial behavior in the person in the future.

A characteristic feature of psychopathy is the imbalance of the emotional and volitional spheres with complete intellectual integrity. If favorable living conditions are created for a person with a similar illness, then his behavior will normalize. However, changes in behavior will not be the final “recovery.” A person with such a state of mental health is always “on the edge.” At the slightest destabilizing situation, a breakdown is always possible.

What unites and what distinguishes manifestations of psychopathy

Individuals suffering from a psychopathic disorder, despite very obvious differences in behavior and character, exhibit common symptoms of this condition:

Disharmonious behavior that is noticeable in all areas of life and relationships;
Problems arise in childhood and then become fixed;
Personality disorder causes deterioration in social and professional productivity;
Conduct disorder causes distinct adjustment disorders and personal distress.

The final classification of conditions that are various manifestations of this “disease of the soul” has not yet been established.

Most sources identify the following main types of psychopathy:

psychasthenic;
asthenic;
excitable (explosive);
hysterical;
paranoid;
schizoid;
epileptoid.

Psychasthenic psychopathy characterized by a high level of anxiety, timidity and self-doubt, sensitivity to traumatic situations.

Asthenic psychopathy manifests itself as increased timidity and shyness. Such people are extremely impressionable. They experience particular confusion when the environment changes, while acutely feeling their own inferiority.

Excitable psychopathy(explosive psychopathy) causes a person to show a very high degree of irritability, powerful outbursts of emotions, uncontrollable anger and rage. The personality experiences constant mental stress.

Hysterical psychopathy(hysterical psychopathy) is always an excessive demonstration of significance and superiority over others. Such people constantly act, they love external effects. This type of personality disorder sometimes makes a person prone to sexual perversion (sexual psychopathy).

Paranoid psychopathy. The main sign of this state is the desire to form “extra-valuable ideas.” Such people have rather narrow interests and thinking. They are self-centered, suspicious and jealous. The passive-aggressive version of this disorder is manifested by a tendency to quarrelsomeness, intensified by the “struggle for the truth.” This is a milder manifestation of paranoid psychopathy: psychopathy with a tendency to litigiousness.

Schizoid psychopathy makes people consider themselves very sensitive and vulnerable. This does not prevent them from being emotionally limited despots, somewhat autistic and very pedantic.

Epileptoid psychopathy. The manifestations of this condition are similar to the features of personality changes in epilepsy. A person is dominated by a melancholy and angry mood, explosiveness along with inertia of thinking. Irritation is constantly present in behavior.

You can read about the treatment of psychopathy and its manifestations in our next article. If you have any questions, ask them in the comments.

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