[Psychopathy: from "The Mask of Sanity" to social neurosciences]

Although psychopathy has traditionally been cited as a disorder of personality, confusion arises as the term is used interchangeably with the terms antisocial personality disorder of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV TR) or dissocial personality disorder, both of which are largely behaviorally based. This paper aims to provide a clinical and scientific overview of the literature on the topic of psychopathy, which examines this conundrum. This article begins with a wee bit of history about Hervey Cleckley's work, The Mask of Sanity, and then presents the definitions and nosography of psychopathy, focusing on the distinction between the antisocial psychopath and the successful psychopath. The discussion will then lead on the epidemiological aspects and diagnosis, especially psychometric and measurement tools used to assess psychopathy in the individual: Hare's Psychopathy Checklist-Revised (PCL-R), as this is the most frequently used and validated measure of psychopathy. The second section of the article reviews several studies dealing with structural and functional neuroimaging in psychopaths. The final part of this overview considers the treatment and interventions that are available to psychopathic offenders and the implications for future research, especially in terms of prevention. This review demonstrates that studies and further research are still required in psychopathy, particularly using functional neuroimaging techniques, as fMRI and magnetoencephalography, that can describe the functional neuroanatomy of human emotion. Today, cognitive and social neurosciences constitute one of the most promising way to study psychopathy.