05 Dec ANTISOCIAL PERSONALITY VERSUS PSYCHOPATHY

ANTISOCIAL PERSONALITY VERSUS PSYCHOPATHY

 

Antisocial Personality Disorder

· Clinical diagnosis

· 75-80% of criminals

 

Psychopathy

· Legal diagnosis

· 15-25% of felons

 

 

ASPD

 

DSM V Criteria for ASPD Diagnosis

 

A. Significant impairments in personality functioning manifest by:

1. Impairments in self functioning (a or b)

a. Identity: Ego-centrism; self esteem derived from personal gain, power or pleasure

b. Self-direction: Goal-setting based on personal gratification; absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behavior

2. Impairments in interpersonal functioning (a or b)

a. Empathy: Lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or mistreating another.

b. Intimacy: Incapacity for mutually intimate relationships, as exploitation is a primary means of relating to others, including by deceit and coercion; use of dominance or intimidation to control others.

B. Pathological personality traits in the following domains:

1. Antagonism: characterized by manipulativeness, deceitfulness, callousness, and hostility

2. Disinhibition: characterized by irresponsibility, impulsivity, risk taking

C. Impairments are relatively stable across time and situations

D. Impairments are not better understood as normative for developmental stage or cultural environment

E. Impairments are not due to physiological effects of substance (drug use) or medical condition (head trauma)

F. The individual is at least 18 years old

 

 

ASPD Facts

2-3% of the general population

5X as likely in men: 4.9% of males and 0.078% of females

Evidence of genetic influence

Concordance rate for MZ twins: 50%; DZ twins: 20%

Adoptive children mirror outcomes of biological parents

Two life events remit: marriage and military service

 

The Hare Psychopathy Checklist—Revised (PCL-R)

 

The Hare PCL-R uses 20 questions to score psychopathy. The questions are listed below. Each question is scored 0 for no, 1 for maybe, or 2 for yes. Can omit if not enough evidence for an item. 30 is the arbitrary cutoff for psychopathy. If someone scores less than 30 points, they can be written as “many psychopathic traits”, or “mild psychopathic traits”. Traits are relatively stable.

 

1. Glibness/Superficial Charm

2. Grandiose Sense of Self Worth

3. Need for Stimulation/Proneness to Boredom

4. Pathological Lying

5. Conning/Manipulative

6. Lack of Remorse or Guilt

7. Shallow Affect

8. Callous/Lack of Empathy

9. Parasitic Lifestyle

10. Poor Behavioral Controls

11. Promiscuous Sexual Behavior

12. Early Behavior Problems

13. Lack of Realistic Long-term Goals

14. Impulsivity

15. Irresponsibility

16. Failure to Accept Responsibility for Own Actions

17. Many Short-term Marital Relationships

18. Juvenile Delinquency

19. Revocation of Conditional Release

20. Criminal Versatility

 

 

Psychopathy Facts

· Prevalence of psychopathy is 1% in general population

· Prevalence in prison populations is about 15%

· Psychopathic criminals are 3-4X more likely to reoffend

· Psychopaths’ brains respond differently to linguistic and emotional stimuli

· Strong genetic component, but environmental influences are key as well