Becoming ever more firmly embedded in the social psyche, conditions such as antisocial personality disorder, psychopathy, dissocial personality disorder and sociopathy have generally been associated with recidivism and dangerousness whilst also used as a criterion to exclude patients from treatment services.

Although currently framed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) there has been criticism that the current definition of antisocial personality disorder, which focuses mainly on observable behaviors, would benefit from an increased focus on the interpersonal and emotional aspects of the disorder, potentially leading to an increase in the number of patients eligible for treatment.

Morton Hesse argues in a commentary for BMC Medicine this week that developments in diagnostics for this controversial field should move away from exclusively focusing on elements such as risk assessment to explore interpersonal and emotional aspects of the disorder, recommendations which could have important implications for the impending revised DSM-V.