Prototypical analysis of antisocial personality disorder: DSM-IV and beyond.

The diagnostic criteria for antisocial personality disorder (APD) have gone through successive modifications with DSM-II, DSM-III, DSM-III-R, and DSM-IV. We asked 331 forensic psychiatrists to make prototypic ratings of the DSM versions, PCL-R (Hare, 1991), and the ICD-10 dyssocial personality disorder. Four distinct factors emerged that encompassed the following dimensions: (a)unstable self image, unstable relationships and irresponsibility, (b)manipulation and lack of guilt, (c)aggressive behavior, and (d)nonviolent delinquency. These dimensions are discussed in light of an earlier prototypical analysis (Rogers et al., 1992) and raise questions concerning the DSM-IV criteria.