Personality Disorders, Psychopathy, and Deceit

Abstract

The psychiatric assessment of psychopathy and deceit has a complex history. Deceit is at least one constant. But should we think of it as a disease state, a failure of moral development, or the behavioral aggregate of a constellation of biologically determined temperamental traits? Is deception better understood as a means to an end, or as an indication of an underlying deficit in capacity for interpersonal relations? Where does deception of others stop and self-deception begin? Do the failures of perception found in personality disorders generally reflect the activation of “immature defense mechanisms” or some underlying psychological deficits, or are these two ways of saying the same thing? To what extent is deception best understood as a form of aggression? In the final analysis, the conceptualization of personality disorders tends to reflect the presuppositions and cognitive frame of the clinician, rather than the final answer regarding the condition. A single formulation is rarely sufficient. Deceit, however, is almost always a constant.