1. Antisocial Personality Disorder

2. Personality Traits • characteristic ways of thinking, feeling, and behaving that are stable across time and across situations • considered to be a disorder when • traits are inflexible and maladaptive • cause significant functional impairment and/or distress

3. A Diagnostic Question • Are people with personality disorders qualitatively different from people without? OR • Are people with personality disorders individuals who have extreme versions of otherwise normal personality traits?

4. The Answer • Personality disorders are probably best thought of as extreme positions on one or more personality dimensions

5. Course • thought to originate in childhood and continue into adulthood • believed to be relatively stable, difficult to treat

6. Lack of Research • for many personality disorders, there is relatively little empirical research on the causes and treatments

7. Some Examples • Paranoid personality disorder • pervasive pattern of distrust and suspiciousness of others such that their motives are interpreted as malevolent • Narcissistic personality disorder • pervasive pattern of grandiosity, need for admiration, and lack of empathy

8. Antisocial Personality Disorder • pervasive pattern of disregard for and violation of the rights of others since age 15

9. DSM-IV-TR criteria • at least 3 sx • failure to conform to social norms with respect to lawful behavior (repeated arrests) • deceitfulness (repeated lying, use of aliases, conning) • impulsivity, failure to plan ahead • irritability and aggressiveness (repeated fights) • reckless disregard for safety of others • consistent irresponsibility (no steady employment, doesn’t honor financial obligations) • lack of remorse (indifferent to or rationalizes having hurt, mistreated, or stolen from others)

10. DSM-IV-TR (continued) • must be at least 18 • evidence of conduct disorder prior to age 15 • violation of basic rights of others and major social rules • aggression toward people and/or animals • destruction of property • deceitfulness or theft • serious violation of rules (stays out all night, truant)

11. Prevalence • community samples • males = 3% • females = 1% • clinical settings • 3 - 30%, depending upon characteristics of population sampled • higher prevalence rates are found in substance abuse treatment settings and prison

12. Causes: Biological • genetics • family, adoption, and twin studies show evidence of a genetic link • examples: • offspring of felons raised by adoptive families show higher rates of arrests and antisocial personality disorder than controls • concordance rates for criminality are 55% for MZ twins and 13% for DZ twins

13. But what do they inherit? • underarousal hypothesis • psychopaths have abnormally low levels of cortical arousal • engage in antisocial and risk-taking behaviors to increase level of arousal • evidence • longitudinal study found that future criminals had lower skin conductance activity, lower heart rate, and more slow-frequency brain wave activity

14. fearlessness hypothesis • psychopaths have a higher threshold for experiencing fear than most people • evidence • psychopaths are less likely to develop a classically conditioned fear response

15. Psychological and Social Influences • oversensitivity to reward • will persist in efforts to achieve goal, even when goal is no longer attainable • inconsistent parental discipline • giving in to problem behavior and poor monitoring • other environmental influences • low SES, stress, and degree of mutual trust and solidarity in neighborhood linked to antisocial behaviors

16. Treatment • prognosis for adults is poor • best strategy is to intervene with “high risk” children • teach parents to use behavioral management principles to reduce problem behavior and increase prosocial behavior • research suggests such programs reduce antisocial behavior

17. A Philosophical Debate • Lykken (1982) has argued that the assumptions of the legal system and psychology/psychiatry differ • Legal system • assumes the existence of free will • belief that, with rare exceptions, humans are capable of freely choosing their actions

18. A Philosophical Debate (continued) • Psychiatry/psychology • based on determinism • belief that thoughts, feelings, and behaviors have potentially identifiable causes (such as biological or environmental factors) that can be explained in terms of scientific principles

19. Ramifications for Legal System • Lykken (1982) • legal system wants to know if person should be held responsible for his/her crime • in order to be held responsible, person must have freely chosen the act • it is logically contradictory to ask psychiatry/psychology experts to distinguish individuals who are responsible for their crimes from individuals who are not

20. Lykken (1982) continued • because psychiatry/psychology view all behaviors, thoughts, and feelings as determined, these disciplines cannot provide a meaningful answer as to whether a person should be held responsible