Psychopath criteria: DSM-5 conduct disorder and ASPD checklist

Key takeaways

DSM-5 has no diagnosis called psychopathy, so clinicians document the behavior as conduct disorder in under-18s and antisocial personality disorder in adults.

Conduct disorder criterion A needs three of 15 behaviors in the past 12 months, with at least one in the past six months.

The limited prosocial emotions specifier is the closest DSM-5 comes to callous and unemotional traits, requiring two of four characteristics for 12 months.

Antisocial personality disorder needs three of seven criterion A features since age 15, plus an age of 18 and childhood conduct disorder.

The Hare PCL-R is a separate forensic instrument, not a DSM-5 diagnosis, and it is not what this checklist covers.

If you are looking for psychopath criteria in DSM-5, you will not find them under that name. Instead, the manual splits that presentation by age. Conduct disorder covers the years before 18, and antisocial personality disorder covers adulthood from there.

The patient’s age and childhood history decide which set you score, not how the presentation feels in the room. That matters, because either diagnosis follows a patient into school records, child protection referrals, and court. You get both criteria sets in full below, along with the specifiers and the three age thresholds that link them. The last sections cover how the checklist works in a session, and where it usually goes wrong.

Why DSM-5 has no psychopathy diagnosis

DSM-5 contains no diagnosis called psychopathy. The manual covers the same territory with two disorders split by age. Conduct disorder describes the pattern in children and adolescents, and antisocial personality disorder describes it from age 18 onward.

Section III of the manual adds an alternative model of personality disorders. That model lets a clinician record antisocial personality disorder with psychopathic features, marking low anxiety and a bold, dominant interpersonal style. It sits in the section reserved for models that need further research, so it is not the everyday coding route.

The practical answer for a clinical record is the one the downloadable checklist reflects. You document observed behaviors against the conduct disorder or antisocial criteria, then note the specifiers that capture callousness. Practices running mental health EMR software can hold those criteria as a structured form rather than free text.

Criteria A to C decide a conduct disorder diagnosis

Conduct disorder is diagnosed when a repetitive, persistent pattern of behavior violates the basic rights of others or major age-appropriate norms and rules. You have to satisfy three criteria. Criterion A sets the behavior count, criterion B sets the impairment test, and criterion C sets the age boundary.

Criterion A: three of 15 behaviors in four groups

Criterion A requires at least three of 15 behaviors in the past 12 months, with at least one present in the past six months. The behaviors fall into four groups, and the three can be drawn from any combination of them.

Aggression to people and animals (seven behaviors)

• Often bullies, threatens, or intimidates others
• Often initiates physical fights
• Has used a weapon that can cause serious physical harm to others
• Has been physically cruel to people
• Has been physically cruel to animals
• Has stolen while confronting a victim
• Has forced someone into sexual activity

Destruction of property (two behaviors)

• Has deliberately set a fire with the intention of causing serious damage
• Has deliberately destroyed other people’s property by other means

Deceitfulness or theft (three behaviors)

• Has broken into someone else’s house, building, or car
• Often lies to obtain goods or favors, or to avoid obligations
• Has stolen items of nontrivial value without confronting a victim

Serious violations of rules (three behaviors)

• Often stays out at night despite parental prohibitions, beginning before age 13
• Has run away from home overnight at least twice, or once without returning for a lengthy period
• Is often truant from school, beginning before age 13

Two of those items carry their own age qualifier. Staying out at night and truancy only count toward criterion A if the behavior began before age 13.

Criterion B: the behavior has to cause impairment

Criterion B asks whether the behavior causes clinically significant impairment in social, academic, or occupational functioning. Behavior that meets the count in criterion A but leaves school, work, and relationships intact does not satisfy this criterion. Record the impairment, not just the incidents.

Criterion C: what changes once the patient turns 18

Criterion C states that if the individual is 18 or older, the criteria for antisocial personality disorder must not be met. Conduct disorder can still be diagnosed in an adult, but only where the adult criteria fall short. This is where the two sets of criteria meet.

Specifiers record onset, severity, and callousness

Three specifiers sit under the conduct disorder criteria, and the checklist gives each one a row of checkboxes. Onset and severity are recorded on every diagnosis. The third is the one that matters most to a question about psychopathic traits.

Limited prosocial emotions is the callousness specifier

This specifier requires at least two of four characteristics, shown persistently over at least 12 months and across multiple relationships and settings. The four are:

• Lack of remorse or guilt: no bad feeling about wrongdoing, beyond regret at being caught or punished
• Callousness, or lack of empathy: disregard for and indifference to how other people feel
• Unconcerned about performance: no concern about poor results at school or work, even where expectations are clear
• Shallow or deficient affect: emotions that read as absent, insincere, or switched on for effect

The two-of-four rule and the 12-month window separate this specifier from a single callous remark in a session. It is also the closest DSM-5 comes to the callous and unemotional traits described in psychopathy research.

Antisocial personality disorder adds a fourth criterion

Antisocial personality disorder is the adult diagnosis, and it carries four criteria rather than three. Criterion A lists seven features and requires three of them. Criteria B, C, and D then set the age, the developmental history, and one exclusion.

Criterion A: three of seven features since age 15

Criterion A describes a pervasive pattern of disregard for and violation of the rights of others, present since age 15. You have to document three or more of the following seven features:

• Failure to conform to social norms: repeated acts that are grounds for arrest
• Deceitfulness: repeated lying, use of aliases, or conning other people
• Impulsivity: acting without planning ahead
• Irritability and aggressiveness: repeated physical fights or assaults
• Reckless disregard for safety: putting their own safety, or other people’s, at risk
• Consistent irresponsibility: repeated failure to hold down work or honor financial obligations
• Lack of remorse: indifference to, or rationalizing, having hurt or stolen from someone

Criteria B, C, and D are gates, not counts

The remaining three criteria set conditions rather than symptom counts.

• Criterion B: the individual is at least 18 years old.
• Criterion C: there is evidence of conduct disorder with onset before age 15.
• Criterion D: the antisocial behavior does not occur exclusively during schizophrenia or bipolar disorder.

Criterion C is where adult assessments stall. Without a documented history of conduct disorder before age 15, the antisocial criteria are not met, however clear the adult pattern looks.

That history usually comes from collateral sources. School records, family accounts, and earlier clinical notes carry the most weight here. A note that names its source is worth more than one that does not.

Side by side, the two sets differ on more than the age they apply to.

Three ages decide which diagnosis you can record

The two criteria sets are not alternatives to pick between. They form a sequence, and three age thresholds govern it. Each one decides something different about the diagnosis you can record.

Working forward, this is why a conduct disorder diagnosis at 16 is not a forecast of antisocial personality disorder at 25. DSM-5 notes that most people diagnosed with conduct disorder show remission of symptoms by adulthood. Working backward, it is why an adult assessment cannot skip the childhood history.

The specifiers are what carry prognostic weight in between. Childhood onset and the limited prosocial emotions specifier both mark a more persistent course. That is why the checklist asks for each one explicitly, rather than leaving it to the narrative.

The Hare PCL-R is an instrument, not a diagnosis

The Hare Psychopathy Checklist-Revised is a separate forensic instrument, not part of DSM-5. It is a 20-item rating scale used mainly in forensic risk assessment, and scoring it requires instrument-specific training. This template does not contain it.

If a court report or a formal risk assessment calls for the PCL-R, that is a referral to someone trained to score it. For a diagnosis in a clinical record, the DSM-5 criteria on this checklist are the relevant ones.

How the checklist works alongside the interview

Work the checklist as a documentation aid, not as a script to read out. The behaviors are historical facts, so most boxes get filled from collateral sources rather than the patient’s own account.

Five habits keep the completed form defensible months later:

• Date the window. Note which behaviors fall in the past 12 months, and which fall in the past six.
• Name the source. Record whether each behavior came from the patient, a parent, a school report, or a prior note.
• Record the impairment. Criterion B needs a stated effect on social, academic, or occupational functioning.
• Check the age gates. Confirm onset before 10 for the childhood-onset specifier, and before 15 for antisocial criterion C.
• Complete the clinician block. The last page carries your name, license number, phone, email, and practice name.

Paper copies work for a single session, but they leave the criteria outside the record. Digital intake forms in practice management software like Pabau let a clinician fill it in on a tablet. The checklist then files against the client’s record the moment you save.

Where completed checklists usually go wrong

The criteria themselves are not hard to read. The qualifiers attached to them are what get dropped. Each mistake below costs the diagnosis its footing.

• Undated behaviors. A checked box with no date cannot prove the 12-month window, or the one behavior needed in the past six months.
• The before-13 rule ignored. Staying out at night and truancy count toward criterion A only if they started before age 13.
• Behaviors without impairment. Criterion B needs a stated effect on school, work, or relationships, not a longer list of incidents.
• Callousness read from one remark. The limited prosocial emotions specifier needs two of four characteristics, held for 12 months in more than one setting.
• No childhood history. Without conduct disorder documented before age 15, criterion C is unmet, so the adult diagnosis cannot be recorded.

Each of these is easier to catch on a structured form than in a narrative note. That is the practical case for filling the checklist in as you go, rather than writing it up afterward.

Who can use this, and what it is not for

This is a documentation aid for qualified clinicians, and it is not a self-diagnosis tool. The PDF says as much on its final page, and the reason is practical. A conduct disorder or antisocial personality disorder diagnosis carries legal, educational, and child protection consequences.

Two more points belong in the note. Diagnose only within your own scope of practice and licensure. When you assess a minor, record who gave consent and who was present in the room.

These records also sit at the sensitive end of the scale, so storage matters. Compliance management software that logs who opened a file, and when, keeps an audit trail behind a diagnosis this consequential.

How Pabau keeps DSM-5 criteria in the client record

Plenty of practices run this checklist on paper or in a PDF, then type a summary into the note. The checked boxes stay outside the record, so the next clinician sees a conclusion with no evidence behind it.

Pabau holds the checklist as a custom clinical form instead. Each criterion becomes its own field, and the completed form attaches to the client’s file. The specifiers stay searchable rather than buried in free text.

That matters for the age gates. When the intake form, past notes, and correspondence sit in one file, the onset question has an answer you can cite. Automated reminders then chase the review appointment and the collateral information you are still waiting on.

Because the form sits inside software for therapy practices, the assessment lives beside the calendar and the billing. There is no second tool to keep in step.

Keep the DSM-5 criteria inside the client record

Pabau turns the conduct disorder and antisocial checklists into custom clinical forms that file against the client record. Onset dates, specifiers, and impairment notes stay searchable for the next assessment.

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Conclusion

Score the set the patient’s age points to, and date every behavior you check. That is the part that survives a second reading, whether the reader is a colleague, a school, or a court.

The trade-off worth remembering is that these criteria describe conduct, not character. A completed checklist tells you what a person has done, and when. It does not forecast what they will do next. DSM-5 is clear that most conduct disorder symptoms remit by adulthood.

Download the checklist, and keep the completed copy where the rest of the assessment lives. Book a demo to see how Pabau files DSM-5 criteria against the client record and keeps the audit trail intact.

Continue your research

Assessing an adult rather than a minor? The antisocial personality disorder test works through the adult criteria on their own.

Need the structured interview behind the diagnosis? The SCID-5 assessment template covers the interview clinicians use to confirm a DSM-5 diagnosis.

Documenting the wider psychiatric picture? The psychiatric evaluation template gives you the assessment structure this checklist slots into.

Is impulsivity the dominant feature? The UPPS impulsive behavior scale breaks impulsivity into five subscales you can score.

Frequently asked questions