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Antisocial Personality Disorder. Profiling Psychopathology Dr. Kline FSU-PC Summer 2004. What is a personality Disorder?. Is a long-standing , pervasive , & inflexible pattern of behavior. Usually impairs social & occupational functioning.

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Antisocial personality disorder l.jpg

Antisocial Personality Disorder

Profiling Psychopathology

Dr. Kline

FSU-PC

Summer 2004


What is a personality disorder l.jpg
What is a personality Disorder?

  • Is a long-standing, pervasive, & inflexible pattern of behavior.

  • Usually impairs social & occupational functioning.

  • Personality disorders comprise all disorders in the Axis II of the DSM & these are often comorbid with other Axis I disorders (substance use, depression, etc.)

  • Presence of personality disorders complicate treatment of other Axis I disorders


What is an antisocial personality disorder apd l.jpg
What is an Antisocial Personality Disorder (APD)?

  • Two major criteria:

    1. The presence of a conduct disorder before the age of 15. Symptoms include: truancy; running away from home, theft, compulsive lying, arson, & vandalism.

  • 2. The continuation of this pattern of antisocial behavior into adulthood.


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DSM-IV-TR Diagnostic Criteria for APD:

  • Pervasive pattern of disregard for the rights of others since age 15 & at least 3 of the characteristics 1 through 7 . Eight through 10 must be present for diagnosis.

  • 1. Repeated law-breaking**Core symptom**

  • 2. Deceitfulness; lying

  • 3. Impulsivity

  • 4. Irritableness & aggressiveness

  • 5. Reckless disregard for own safety & that of others.

  • 6. Irresponsibility as seen in unreliable employment history or not meeting financial obligations.

  • 7. Lack of remorse***not necessary for diagnosis***

  • 8. Age at least 18

  • 9. Evidence of conduct disorder before age 15.

  • 10. Antisocial behavior not occurring exclusively during episodes of schizophrenia or mania.


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What % of conduct disordered youth become Antisocial Personality Disorders in adulthood?

  • Roughly 60% of children with conduct disorder develop APD into adulthood (Myers, Stewart, & Brown, 1998).


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What is general profile of person with Antisocial Personality Disorder?

  • Individual:

  • Irresponsible

  • Criminality

  • Displays antisocial behavior (sketchy work history, illegal activities, irritability)

  • Physically aggressive and violent

  • Has financial problems (defaults on debts)

  • Reckless & impulsive behavior

  • May be promiscuous

  • May lack remorse or show little regard for truth


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Prevalence of APD Personality Disorder?

  • Effects 3% of males; 1% of females in U.S.

  • Rates may be higher among younger adults than older adults.

  • Disorder is more common in people of low SES.

  • Comorbidity is high with other personality disorders (e.g., narcissistic PD) as well as other Axis I disorders (substance use).


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What is the difference between APD and psychopathy? Personality Disorder?

  • Major distinction appears to be in symptomatology.

  • “Lack of remorse,” a core symptom of psychopathy, is not required for diagnosis of APD.

  • In one study, 75 to 80% of convicted felons met criteria for APD, but failed to meet criteria for psychopathy.


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Problems with diagnosing APD: Personality Disorder?

  • 1. One major criticism centers around method by which diagnosis is made.

  • An APD diagnosis relies on reports of patient’s past life events. Since these people are often pathological liars, how can we verify their claims???

  • **This is especially problematic—when family members are deceased.***

  • 2. Many psychologists argue that a diagnostic concept in the field of psychopathology shouldn’t be linked with criminality.


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What is Psychopathy? Personality Disorder?

Core features-

  • Psychopaths lack remorse

  • Poverty of emotions (positive & negative)

    Psychopaths are:

    Superficially charming

    Pathological liars & cheaters

    Impulsive; sensations seekers

    Manipulative, will change story to fit facts

    Less responsive to fear/anxiety

    Immoral

    Occurs predominantly in men!!!


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Psychopaths identified by Hare checklist Personality Disorder?

  • Two clusters:

  • 1. Emotional detachment cluster (a selfish remorseless individual with inflated self-esteem who exploits others.)

  • 2. Antisocial lifestyle cluster- marked by impulsivity & irresponsibility.


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Are psychopaths born or made? Personality Disorder?

  • Most likely there are components of both that account for the development of full fledged psychopathy.


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Putative causes of APD & psychopathy? Personality Disorder?

  • 1. Family

  • McCord & McCord (1964) concluded that lack of affection & severe parental rejection may be primary causes of psychopathic behavior.

  • Other suspected family related factors are:

  • Inconsistencies in discipline or no discipline at all, physical abuse, marital discord, & substance use.


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2. Both antisocial personalities & criminal behavior have heritable components.

  • Twin Studies:

  • 1. Higher concordance rate for MZ twins than for DZ twins in APD (Lyons et al., 1995).

  • Adoption Studies:

  • 2. Higher rate of antisocial behavior in adopted children of biological parents with APD.


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3. Father’s behavior heritable components.

  • Fathers of psychopaths are likely to be antisocial personalities themselves!!!!!!


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4. Environmental Factors heritable components.

  • Environment seems to play an important role in APD.

  • It has been shown that environmental factors such as marital problems and substance abuse) are related to the development of APD.

  • Also high levels of conflict & negativity and low levels of parental warmth predict APD.


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What’s likely to be going on? heritable components.

  • Child with diathesis for antisocial behavior may be difficult to deal with & produce environmental changes that result in harsh conditions (treatment) by family members.

  • This may fuel development of full blown antisocial behavior.


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Are psychopaths less prone to anxiety than normal people? heritable components.

  • Yes!!!

  • Lykken (1957) studied the ability of psychopaths & controls to avoid shock.

  • Psychopaths were poorer than controls at avoiding the shocks, suggesting they are low in anxiety compared to controls.


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Do psychopaths show less autonomic arousal to fear eliciting stimuli than controls?

  • Psychopaths show a pattern of autonomic activity that suggests they “tune out” aversive stimuli.

  • Their hearts beat faster than normals when anticipating stress, but their skin conductance levels are lower than controls in response to aversive stimuli.

  • This makes them appear underaroused when they are not.