Avi: I was referring to narcissistic personality disorder, not psychopathology. I don’t know anything about antisocial personality disorder, or whether it is in fact the universally accepted description of a psychopath (as Midwest2 posted), or whether the Rambam’s definition of a sheid does in fact refer to a psychopath.
I was Thinking out loud about what might be a window of bechira for someone who has narcissistic personality disorder, which I acknowledged I know very little about!