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Am J Psychiatry 1942;99:330-337.
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Director Habit Clinic for Child Guidance. Research Consultant for Massachusetts Department of Mental Health.

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1. The constitutional psychopath or the psychopathic personality represents the most difficult group of all the mentally sick individuals with which the medical and legal professions have to deal. Particularly baffling are those psychopaths who show evidences of perversions in relation to their sexual drives.2. The psychiatrist is in a position to recognize in many instances during the preadolescence years definite tendencies for these unstable children to incorporate into the framework of their disintegrated personalities sexual anomalies which are significant and have grave implications.We recognize that such individuals are not governed by the same inhibiting forces as the normal individual. They are impulsive, cunning, and unpredictable. They have no regrets, remorse, or sense of guilt about their asocial activities. They do not profit from experience, they are not restrained by punishment, and up to the present time they do not improve under treatment.3. The case presented is an example of the personality type which is in need of serious consideration from both the medical and legal professions.4. There seem to be two vitally important points which have not, as yet, been given sufficient consideration by those interested in psychiatry and criminology.(a) A statute should be enacted which would permit or require the court to have those suspected of sexual psychopathy submitted to psychiatric examination by two qualified psychiatrists in order to determine their responsibility. If the evidence of this examination is of such a nature as to convince the court of their irresponsibility because of sexual psychopathy they should be sent to an institution providing care for this type of individual.(b) The fact that no such institution exists at the present time brings up the need of providing an institution so organized that a thorough study might be made from every possible angle, medical, psychological, psychiatric. Let us turn our battery of tests on these individuals, study their behavior under strict supervision or modified supervision, but always supervision, until we have some assurance that they will not return to society only to repeat more serious offenses.

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