deceit and manipulation are central features heavy use of
rationalization; may blame their victims for being stupid, weak
looking out for #1 more likely to die prematurely
Slide 3
Criteria for Antisocial P D A.A pervasive pattern of disregard
for and violation of the rights of others since the age of 15 as
indicated by 3 or more: Repeated unlawful acts (lying, using
aliases, conning others) Impulsivity or failure to plan ahead
Irritability and aggressiveness Reckless disregard for the safety
of self or others Irresponsibility in work or finances Lack of
remorse B. At least 18 years old C.Evidence of Conduct Disorder
before the age of 15 D.Antisocial behavior does not occur
exclusively in schizophrenic or manic episode
Slide 4
Antisocial Personality Disorder Prevalence: 2.5% of general
population (but see Lenzenweger et al, 2007) Much more common in
males 3% of population, 1% of women Comorbidity with Axis I:
Substance abuse disorders (esp. alcohol), Anxiety, Depression,
somatization, pathological gambling, impulse control disorders Axis
II: overlap with BPD, HistrionicPD, Narcissistic PD differential:
BPD manipulates for attention; ASPD for personal gain NPD not
impulsive
Slide 5
begins early in life and abates in midlife. starts in early
childhood for boys, but in adolescence for girls. 40% of Conduct
Disordered males become ASPD. rates of conviction decline steeply
after 40 for ASPDs (psychopathic burnout) Course
Slide 6
Hare, McPherson, & Forth (1988) JCCP Rate of Prison Time
for Psychopaths (Group P) And Non-psychopaths (Group NP)
Slide 7
Risk Factors low SES in urban setting male parent with ASPD
combination of Conduct Disorder and ADHD (The Fledgling Psychopath
(Lynman, 1996) childhood abuse or neglect unstable or erratic
parenting individualist society
Slide 8
Protective Factors High ANS reactivity (Kagan) high IQ (Kandel
et al, 1988) may lead to rewards in school that help child to
orient to conventional social order higher SES less disturbed
parent sibling barricade (Reiss et al, 1995)
Slide 9
Hares Psychopathy Checklist - R (1985) based on Cleckleys
(1941, 1976) description Mask of Sanity Interpersonal &
Affective Traits Unstable & Antisocial Lifestyle 1.
Glibness/superficial charm 9. Parasitic lifestyle 2. Grandiose
sense of self-worth 10. Poor behavioral controls 3. Need for
stimulation 11. Promiscuous sexual behavior 4. Pathological lying
12. Early behavioral problems 5. Cunning/manipulative 13. Lack of
realistic long-term goals 6. Lack of remorse or guilt 14.
Impulsivity 7. Shallow affect 15. Irresponsibility 8. Callous/lack
of empathy 16. Doesnt accept respons. actions 17. Many short-term
relationships 18. Juvenile delinquency
Slide 10
Subtypes of Psychopathy Primary (based on personality and
emotion) cold, remorseless, lack of empathy, but charming seems to
lack emotion and anxiety predator mentality may be more intelligent
than secondary may have larger genetic component Secondary (based
on behavior and lifestyle) impulsive, irresponsible, aggressive,
life of crime poor emotional control may be less intelligent than
primary more environmental component
Etiology Environmental Factors Childhood abuse Harsh or erratic
parenting Chaotic family life Mother who has been convicted of
crime Farrington (2006)
Slide 13
Gene-Environment Interaction in Anti-Social Behavior Caspi et
al (2002) Science
Slide 14
Treatment Insight oriented treatment generally not effective
Empathy training may increase ability to manipulate others SSRIs
for impulsiveness and aggressiveness Early treatment may be best
bet at treatment (Caldwell et al, 2006) group setting may help to
learn interdependence with others Vaillant (1975): sometimes the
introspection of enforced incarceration is the best therapy.
Conclusion: As of now, therapy is not effective. Prevention appears
to be a better option.
Slide 15
Rates of Violent Recidivism for Psychopaths and Nonpsychopaths
Who Were Treated in the Therapeutic Community or Who Went to Prison
Rice (1997 ) American Psychologist
Slide 16
Question of the Week There is a clear biological element to
psychopathy, and we have seen evidence that children as young as
seven may display genetically- based psychopathic traits. Yet
psychopathy and ASPD are not considered to be mitigating factors in
criminal acts whereas psychotic disorders such as schizophrenia
are. Should courts take psychopathy into account when sentencing
criminals? Why or why not? Movie of the Week: The Dark Knight
Starring: Christian Bale Heath Ledger
