Haltlose personality disorder

Haltlose personality disorder was a type of personality disorder diagnosis largely used in German-, Russian- and French-speaking countries. The German word haltlose refers to being "unstable" (literally: "without footing"), and in English-speaking countries the diagnosis was sometimes referred to as "the unstable psychopath" (although it was little known even among experts in psychiatry).^[9][10]

In the early twentieth century, haltlose personality disorder was described by Emil Kraepelin and Gustav Aschaffenburg.^[11][12] In 1905, Kraepelin first used the term to describe individuals possessing psychopathic traits built upon short-sighted selfishness^[13] and irresponsible hedonism, combined with an inability to anchor one's identity to a future or past.^[9][14] By 1913, he had characterized the symptomatology as stemming from a lack of inhibition.^[15][16] Haltlose was also characterized as a psychopathy with an "absence of intent or lack of will".^[3] The diagnosis was recognized by Karl Jaspers, and by Eugen and Manfred Bleuler, among others.^[3]

In 1933, it was argued that significant social restraints needed to be imposed on the lives of people diagnosed with haltlose personality disorder, including "constant guardianship in an organized environment under the pressure of a harsh lifestyle, or in the hands of a person with a strong will who does not let him out of his sight".^[17] In 1936, it was claimed that – along with other "hyperthymics" – haltlose personalities constituted "the main component of serious crime".^[18] Haltlose came to be studied as a type of psychopathy relevant to criminology,^[19][20][21] as people with the diagnosis were viewed as becoming "very easily involved in criminality"^[22] and predisposed to aggression^[4][23] or homicide.^[24]

Haltlose personality disorder was viewed as difficult to identify due to high levels of conformity.^[25] Contrasting traits were noted of pronounced suggestibility and "abnormal rigidity and intransigence and firmness".^[26] As recently as 1978, a claim was made that a diagnosis of haltlose personality disorder carried one of the most unfavorable prognoses among the different types of psychopathies recognized at the time.^[27]

Regarding recent medical classifications, the term "haltlose personality disorder" was mentioned in ICD-10 under "other specific personality disorders", and in DSM-III under "other personality disorders", but the term was not described or discussed in either classification (separately, it was claimed that the diagnosis describes a combination of frontal lobe syndrome, sociopathic and histrionic personality traits^[9]). It is no longer mentioned in DSM-4, DSM-5 or ICD-11.