Antisocial Personality Disorder

1. Antisocial Personality Disorder

2. Antisocial Behaviour • Antisocial Behaviour • criminal, aggressive behaviour that might come to clinical attention • less inflexible, maladaptive, persistent, distressing, and impairing than APD

3. Antisocial Personality Disorder • Pervasive disregard for, and violation of, the rights of others that begins before the age of 15 and continues into adulthood • 1% of females and 4-6% of males

4. Antisocial Personality Disorder • Defining features: • Antisocial behaviour present before age 15 • Irresponsible • Irritable/Aggressive • Impulsive/Reckless • Deceitfulness

5. Psychopathy • Late 19th century: “Psychopath” • 20th century: “Sociopath” • DSM-IV: “Antisocial Personality Disorder” • not all antisocial behaviour is evidence of a “disorder” • but fails to include emotional and interpersonal characteristics associated with psychopathy

6. APD vs. Psychopathy • Impulsive, but motivated vs. unmotivated • Irritable, angry vs. shallow emotions - no empathy or anxiety • Normal learning vs. poor passive avoidance learning • Constantly in conflict with society vs. pleasant exterior & deceptive • reactive aggression vs. instrumental aggression

7. Considerable overlap and debate • Clinically antisocial • Simply a criminal • Psychopath

8. Antisocial Behaviour and Age • By definition APD individuals demonstrated antisocial behaviour during adolescence • Homicide rates among boys are much higher in the USA than anywhere else • Violence has been increasing among children in the USA

9. Antisocial Behaviour and Age • Two DSM-IV categories for childhood antisocial behaviour: • Conduct Disorder • Oppositional Defiant Disorder

10. Antisocial Behaviour and Age • Antisocial behaviour in childhood is a good predictor of adult antisocial behaviour • Protective factors • high levels of physiological arousal • strong orienting response

11. Sociocultural Approach • Next to gender, poverty is the single greatest risk factor for violent behaviour • Injustices in society contribute to the development of criminal behaviour • need and inability to succeed in a socially sanctioned manner • Socialization into groups that encourage antisocial behaviour

12. Behavioural Approach • Focus on the individuals immediate environment (family) • Modeling • media, family examples • Poor reinforcement of pro-social behaviour • Inconsistent and harsh punishments • Do not perceive connection between positive behaviour and treatment they receive (luck)

13. Cognitive Approach • Poor social problem solving and ability to read social situations • See hostility where none was intended

14. Biological Approach • Identical twins are more likely than fraternal twins to be concordant in criminal activity • Adopted twins separated at birth are more likely to be concordant with each other than with adopted siblings

15. Biological Approach • APD shows high comorbidity with addictions • General vulnerability to toward antisocial behaviour, not violence • EEG abnormality in left frontal lobes

16. Biological Approach • Limited capacity for fear • Poor fear conditioning • Underaroused stimulus-seekers • heart rates at age 3 predict aggression at age 11

17. Anderson, Bechara, Damasio, Tranel and Damasio (1999) Impairment of social and moral behaviour related to early damage in human prefrontal cortex • impaired social behaviour, insensitivity to consequences of decisions, defective autonomic responses to punishment • defective social and moral reasoning (but normal intelligence)

18. Raine, Lencz, Bihrle, LaCasse, and Colletti (2000) Reduced prefrontalgray matter volume and reduced autonomic activity in antisocial personality disorder • people with APD who do not have discernable brain trauma nevertheless have subtle prefrontal deficits • this my explain low arousal, poor fear conditioning, lack of conscience, and decision-making deficits

19. Psychodynamic Approach • Traditional psychoanalytic approaches • poor SuperEgo development