Ronson's book is a very quick and entertaining read, but his "research" on psychopathy is so poorly done as to be laughable. Before Ronson's fans respond in defensive outrage, let me be clear: I am a psychologist and a clinical researcher. If you don't want to read evidence of Ronson's many mistaken assumptions, then move now to a more favorable review...
Aside from relying almost entirely on lucky interviews that form a series of entertaining anecdotes, Ronson really provides the reader nothing of substance. Granted, this was not intended to be a scholarly work, and I concede that for sheer entertainment readers could do worse. But what I couldn't get past were his glaring omissions and misunderstandings. First, the DSM is an imperfect instrument and I know no one who would argue that it is infallible. But one saving grace -- a point that Ronson had to notice -- is that every diagnostic category shares a specific criterion (worded variously): EVIDENCE OF IMPAIRMENT. This is the definition of mental illness, and explains why homosexuality was removed from the DSM in 1980. But rather than spend even a brief parenthetical sidestep explaining this to his reader, Ronson leaves this foundational prerequisite completely unmentioned. Psychopathy (antisocial personality disorder) and all the other DSM categories require that the person or those around them experience serious problems, either physically, academically, socially, legally, or vocationally, whether or not the individual themselves recognizes or admits it. By leaving this important caveat out, Ronson allows the lay reader to potentially believe that the Scientologists are correct: All mental disorders are a figment of psychiatrists' and drug manufacturers' self-serving imaginations. Without the impairment criterion, it is also easy to believe that the DSM is just a series of behavioral "checklists," as Ronson says, and that 50% of the public could be easily diagnosed with... well, something. Except for the pesky fact that the vast majority of folks live healthy, productive, and rewarding lives, complete with meaningful interpersonal relationships. Psychiatrists (and psychologists) recognize this, believe it or not, which is why we START with questions of impairment whenever a mental health diagnosis is suspected.
Second, best practices in psychiatry and psychology require that diagnosis is based on a multimodal assessment strategy, meaning that it is highly implausible that "Tony" was held against his will on the basis of the PCL-R alone. Without having access to his file, I can guarantee that in addition to a medical history, interview, etc., he also completed a global personality assessment, which over the years have been amazingly accurate at detecting malingering and lying. Although no single instrument is perfect, the collection of multiple instruments, interviews, histories, etc., ultimately paints a coherent story with time, and unless Tony had specific training or unless the intake clinicians were woefully incompetent, Tony's intentional malingering should have been caught at some point. (BTW, this makes Ronson's ongoing joke of being a qualified psychopathy hunter after his one workshop even more silly than he realizes.) The reason Tony would have received a battery of assessment instruments, ironically, is partly explained later in the book when Ronson retells the story of the Rosenhan experiment. After those researchers were able to fake their way into psychiatric hospitals back in the 1970s, new intake criteria were proposed and now it is actually quite difficult to get hospitalized unless you provide undeniable evidence of imminent harm to self or others. As a result, people who SHOULD be hospitalized are turned away every day. In fact, the pendulum has swung so far the other way that very ill individuals are routinely kicked out into the streets armed only with prescriptions.
But perhaps most disturbing is that Ronson undoubtedly heard everything I just said in his interviews with psychiatrists/psychologists. I'm not saying anything here that every graduate of a Psychology 101 course doesn't already know, so I'm wondering why this information never found its way into the story -- even for a cameo appearance? I think the reason for that is actually provided on page 168 (hardback): "We journalists love writing about eccentrics. We hate writing about impenetrable, boring people. It makes us look bad: the duller the interviewee, the duller the prose." I guess maybe the truth proved too damn boring and Ronson didn't want to wrinkle his readers' foreheads.