Antisocial personality disorder is the most reliably diagnosed condition among the personality disorders, yet treatment efforts are notoriously difficult. Therapeutic hope has not vanished, however, and one study indicated that almost two-thirds of psychiatrists think that "psychopathic disorder" is sometimes a treatable condition (Tennent et al. 1993). A similar finding was reported nearly 40 years ago (Gray and Hutchison 1964). Diagnostic refinement is critical before any treatment efforts are undertaken, especially the determination of the degree of psychopathy in the patient with or without DSM-IV-TR (American Psychiatric Association 2000) antisocial personality disorder.