Haltlose personality disorder was a type of personality disorder diagnosis largely used in German-, Russian- and French-speaking countries. The German word haltlos 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. In the early twentieth century, haltlose personality disorder was described by Emil Kraepelin and Gustav Aschaffenburg. In 1905, Kraepelin first used the term to describe individuals possessing psychopathic traits built upon short-sighted selfishness and irresponsible hedonism, combined with an inability to anchor one's identity to a future or past. By 1913, he had characterized the symptomatology as stemming from a lack of inhibition. Haltlose was also characterized as a psychopathy with an "absence of intent or lack of will". The diagnosis was recognized by Karl Jaspers, and by Eugen and Manfred Bleuler, among others. 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". In 1936, it was claimed that – along with other "hyperthymics" – haltlose personalities constituted "the main component of serious crime". Haltlose came to be studied as a type of psychopathy relevant to criminology, as people with the diagnosis were viewed as becoming "very easily involved in criminality" and predisposed to aggression or homicide. Haltlose personality disorder was viewed as difficult to identify due to high levels of conformity. Contrasting traits were noted of pronounced suggestibility and "abnormal rigidity and intransigence and firmness". 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. 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). It is no longer mentioned in DSM-IV, DSM-5, or ICD-11.
Signs and symptoms According to 1968 research, haltlose personality disorder is frequently comorbid with other mental health diagnoses, and rarely appears isolated on its own. Hans Heinze focused on his belief that Haltlose ultimately stemmed from a sense of inferiority, while Kramer held there was a battling inferiority complex and superiority complex. The Haltlose were said to have a dynamic instinctual drive to "cling" to others, to avoid a horrible loneliness they fear – but they will always represent a "lurking danger" because they were unable to actually maintain the necessary relationship and were in a class with the "forever abandoned". According to 1926 research, they view all interaction as a means of winning "indulgence from some people, help from other people". One early study indicated that 7.5% of psychopaths were Haltlose, and Kraepelin estimated that his own practice determined fewer than 20% of psychopaths he saw were Haltlose. However, later studies, after differentiating out newer diagnoses, have suggested that it may be fewer than 1% of psychopaths who are truly Haltlose. Described in 1922 as both "moody" and "passive", they quickly switch from over-confidence in victory to sullen defiance. Their emotional lability means they alternate between projecting an optimistic and competent image claiming they are "destined to do great things", and a more honest cynicism and depression. Research in 1925 indicates they display "great emotional irritability, which may result in violent loss of temper...and interpret every limitation as an undeserved insult" and have a "pronounced lust for argument". The symptoms are considered to worsen if patients are granted greater independence "in the home and in their work". Their self schema only encompasses the immediate present. They are described as "living in a random location and moment". A common pitfall in therapy is that they proved in 1917 to be "very superficial, they easily acquire knowledge but do not apply it in any way and soon forget it".
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