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Pinel's (1801) labeling of behavior that was violent but not psychotic, mania sans delire, was perhaps the first recognition that certain antisocial behaviors emanate from deep character pathology. Later, Prichard (1835) described moral insanity in connection with a loose group of socially marginal, odd, and delinquent characters. Lombroso's (1876) renowned treatise on criminality also delineated a character type called the born criminal. However, these concepts remained ill-assimilated in medicine until Koch (1891) renamed the condition constitutional psychopathic inferiority. Further credence was added to the disorder's nosological status when the great British psychiatrist, Maudsley (1896) recognized it. Twelve years later, Freud's (1908) observations regarding criminal tendencies illuminated dynamic and structural issues in this realm. He stated that:
our civilization is built upon the suppression of instincts … Each individual has surrendered … some part of the sense of omnipotence or of the aggressive or vindictive inclinations in his personality … The man who, in consequence of his unyielding constitution, can not fall in with this suppression of instinct, becomes a ‘criminal’, an ‘outlaw’ in the face of society, unless his social position or his exceptional capacities enable him to impose on it as a great man, a ‘hero’.” (p. 187)
Freud (1914) later elaborated the connection between excessive narcissism and sociopathy and suggested (1916) that all crimes are muted or disguised versions of two fundamental human transgressions namely, incest and parricide. He also differentiated between those who were “criminal from a sense of guilt” and those “who commit crimes without any sense of guilt” (1916, p. 333). Still later, Freud (1925) stated that tendencies towards ruthlessness and criminality usually emanate from the lack of “certain psychical structures” (p. 275).
From these early writings, through the contributions of Aichhorn, Eissler, and Kernberg, to today's DSM