The Mask of Sanity is the seminal work in which Herve M. Cleckley introduced the forensic community to his clinical description of psychopathy. His concept was later quantified by Robert Hare's Psychopathy Checklist‐Revised (PCL‐R) and other PCL variants that are widely used in forensic mental health. A more recent contribution to the psychopathy literature is Handbook of Psychopathy. The book, which is a compilation of analytical and theoretical perspectives about psychopathy, is edited by psychologist Christopher J. Patrick.
Handbook of Psychopathy has 54 contributing authors and its 31 chapters are divided into five main sections: “Theoretical and Empirical Foundations,” “Issues in Conceptualization and Assessment,” “Etiological Mechanisms,” “Psychopathy in Specific Subpopulations,” and “Clinical and Applied Issues.” The sixth section contains only the concluding chapter.
Each topical section contains chapters that are organized like literature reviews. The chapters are written to stand alone, and so there is inevitable repetition of some material. The final chapter of each section offers a concise summary of the material in the section.
Researchers studying psychopathy often find it useful to divide the PCL‐R into two components or factors: Factor 1 (affective‐interpersonal or “core” features) and Factor 2 (impulsive‐antisocial behaviors). Many of the hypotheses presented in Handbook of Psychopathy cite this two‐factor model of psychopathy. Of note, Robert Hare has coauthored a chapter detailing a revised categorization of psychopathy according to a four‐factor model.
Besides the chapter written by Hare, the book's chapters have been authored by many other recognizable names in forensic psychology and clinical psychology. The only physician‐authored chapter deals with the neurochemical and pharmacological aspects of psychopathy.
The book focuses on the search for a discrete categorization of psychopathy. This approach is in contrast to the general psychiatric conceptualization of psychopathology as lying on a continuum (i.e., a categorical versus dimensional perspective).
The book substantially delves into personality theory and technical concepts. Its content may occupy the attention of meticulous psychology researchers, but appears to be of less functional value for psychiatrists, who are more likely to be interested in the pragmatic clinical aspects of psychopathy.
Fortunately, from the standpoint of forensic clinical applications, most research on psychopathy has involved forensic populations. Arguably, the more clinically stimulating chapters include discussions of psychopathy and persons who are not routinely represented in the psychopathy literature. For example, one chapter introduces “successful” or “noncriminal” psychopaths. These “subclinical” psychopaths have often been overlooked in favor of the high‐PCL‐R‐scoring individuals who occupy the most urgent forensic attention.
The chapters on the biology of psychopathy, ethnic and cultural variations in psychopathy, psychopathy in women, and psychopathy in children and adolescents are also of particular interest because of their relevance to contemporary forensic psychiatry. They heighten our awareness of the utilitarian value and potential limitations of the psychopathy concept.
Forensic psychiatrists may also be interested in the chapters that address psychopathy and substance use, sexual coercion against women, criminal recidivism, treatment, and legal and ethics‐related conundrums.
Each chapter of this comprehensive book contains an extensive reference list. However, the book's value for a forensic psychiatrist is questionable. If one wants to have access to historical and recent professional literature and current hypotheses regarding psychopathy, then Handbook of Psychopathy is a must. For those with more interest in the practical clinical applications, the book may be of less value, but possibly of sufficient interest to add to a psychiatry reference library. A paperback edition of Handbook of Psychopathy is now available.
- American Academy of Psychiatry and the Law
