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Antisocial Personality Disorder and Psychopathy

Antisocial Personality Disorder and Psychopathy. DSM-IV Criteria for ASPD. Must be at least 18 years old Three or more of the following: Conduct disorder before the age of 15 Disregard for the rights of others Impulsive, irresponsible behavior Deceitfulness Irritability and aggressiveness

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Antisocial Personality Disorder and Psychopathy

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  1. Antisocial Personality Disorder and Psychopathy

  2. DSM-IV Criteria for ASPD • Must be at least 18 years old • Three or more of the following: • Conduct disorder before the age of 15 • Disregard for the rights of others • Impulsive, irresponsible behavior • Deceitfulness • Irritability and aggressiveness • Reckless disregard for the safety of others • Lack of remorse • Low tolerance for frustration and boredom

  3. Prevalence of ASPD • 3.6% in general population • 5.5% in men • 1.9% in women

  4. Negative Outcomes • Criminality • Domestic partner violence • Suicidality • Substance Use Disorders • Most common comorbid disorder • Greater severity of impairment • Poor treatment outcomes • Higher levels of needle drug use

  5. ASPD and Psychopathy • Psychopathy • Factor 1: affective interpersonal component • Factor 2: antisocial component • Farrington Chapter • Cambridge Study: The two factors related differentially to convictions and ASPD criteria • Predictors of psychopathy similar to that of ASPD

  6. Psychopathy • DSM-IV equates psychopathy and ASPD • ASPD research has focused on behavioral features • Psychopathy research has focused on emotional features

  7. Family Factors • Childrearing • Abuse • Parental conflict/disrupted families • Large family size • Criminal or antisocial parents or siblings • Other characteristics of parents • Young age • Substance abuse • Stress or depression • SES factors

  8. Environemental Factors • Delinquent peers • Schools • Those with high rates of delinquency • Inconsistent rule enforcement • Lack of commitment by staff, teachers • Neighborhoods

  9. Other Risk Factors • Predictors of psychopathy at age 48 • Low non-verbal IQ • Low verbal IQ • High risk-taking • Poor concentration or restlessness • High impulsivity on psychomotor tests

  10. Biopsychosocial Interactions and Protective Factors • Multiple risk factors often exist for any individual and have multiplicative interaction effects • However sometimes protective effects may offset this

  11. Lahey, 2005 • Background • Childhood CD behaviors are significant predictors of adulthood ASPD • However many boys with CD do not develop ASPD • Purpose: Determine greater specificity of risk for development of ASPD • Hypothesis: Childhood CD is an independent predictor of adult APD in males, but childhood ADHD does not predict later APD when controlling for CD and ODD.

  12. Results (Lahey, 2005) • Childhood Characteristics predicting adult ASPD • Race • Total family income • Maternal education • SES • CD Symptoms • ODD Symptoms • Maternal ASPD, not Paternal • Regression analyses • CD and low SES • Engagement in covert behaviors • CD and ADHD did not predict later ASPD • Most boys with CD had ADHD • However not all boys with ADHD had CD

  13. Psychopathy Research • Consistent finding of lack of emotionality in response to aversive events • Startle-elicited blink response • Aversive noise blast paradigms • Callous and unemotional traits responsible for these findings

  14. ASPD and Psychopathy • Most psychopaths would qualify as having ASPD, but not all individuals with ASPD are psychopaths • All serial killers would probably qualify as psychopaths, but not all psychopaths are serial killers

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