Conduct Disorder, Antisocial Personality Disorder, and Psychopathy

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Conduct Disorder, Antisocial Personality
Disorder, and Psychopathy
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What is conduct disorder?

• A repetitive persistent pattern of seriously
  antisocial behavior, usually criminal (illegal)
  in nature marked by extreme callousness.
• Diagnosis is made in individuals under age 18.
• Behaviors may include (but not limited to)
• Cruelty toward animals and/or people
• Vandalism
• Lying
• Theft
• Physical aggressiveness

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Conduct Disorder comorbidity

• Attention Deficit Hyperactivity Disorder
• Substance use disorders (alcohol, marijuana)
• Anxiety
• Depression (15-45)

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What is prevalence of conduct disorder?

• Offord colleagues (1987) conducted a study of
  more than 2,500 children in Ontario, Canada.
• They found that 8 of boys 3 of girls aged
  4-16 met the DSM criteria for conduct disorder.
• Rates may climb to 16 in boys during
  adolescence.
• Violent crimes, such as rape aggravated assault
  are largely crimes produced by adolescents.
  Activity peaks by age 17 then drops off.

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Do kids with conduct disorder become antisocial
adults?

• More than half of children diagnosed with conduct
  disorder do not become antisocial personalities
  in adulthood (Loeber, 1991 Zoccolillo et al.,
  1992).
• Males with conduct disorder who had fathers with
  antisocial behavior poor verbal intelligence,
  more likely to develop APD.

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Moffitts theory Two courses of conduct
disorder

• 1. Life-course persistent pattern of
  antisocial behavior, beginning with problems by
  age 3 continuing into adulthood.
• 2. Adolescent-limited normal childhood with
  high levels of antisocial behavior during
  adolescence that does not continue into adulthood.

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What are Personality Disorders (Axis II)?

• These are long-standing, pervasive, inflexible
  patterns of behavior.
• Usually impair social occupational functioning.
• Are often comorbid with Axis I disorders (e.g.,
  substance use, depression)
•  
• Make treating an Axis I disorder more difficult.
  

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What is an Antisocial Personality Disorder (APD)?

• DSM diagnosis
• 1. The presence of a conduct disorder before
  the age of 15
• Truancy running away from home
• Theft compulsive lying
• Arson vandalism
• 2. The continuation of this pattern of behavior
  into adulthood.

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APD features

• Irresponsible antisocial behavior
• Criminality (breaking laws)core feature
• Irritability
• Physical aggressiveness
• Defaulting on debts
• Impulsivity
• Pathological lying
• Lack of remorse Not necessary for diagnosis
• Prevalence 3 of males 1 of females in U.S.

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What is Psychopathy?

• 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
• Usually men

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Psychopaths identified by Hare checklist

• 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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What is the difference between APD and
psychopathy?

• 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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Are psychopaths born or made?

• 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?

• 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. Fathers behavior

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

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Whats likely to be going on?

• 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?

• 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 under-aroused when they
  are not.

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Startle Blink studies

• The startle blink response is a good non-verbal
  indicator of emotional state.
• Magnitude of the startle blink changes with
  emotional state.
• It increases for a negative emotional state
  decreases for a positive emotional state.

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Patrick (1994) Startle blink study

• Subjects 4 groups of prisoners selected with
  Hare checklist participated.
• Group 1 nonpsychopaths (low on antisocial
  behavior emotional detachment)
• Group 2 Detached white collar offenders (high
  only on emotional detachment)
• Group 3 Antisocial offenders (high only on
  antisocial behavior)
• Group 4 Psychopaths (high on both factors).

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Procedure

• Baseline condition- prisoners were presented with
  a visual cue, sometimes with a blast of loud
  noise.
• Experimental condition - Ss experienced the
  visual cue were told that when it disappeared
  the loud noise would occur.
• Both psychopaths detached offenders showed much
  smaller increases in their startle responses,
  indicating that less fear had been aroused.

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Do psychopaths show less empathy for distress of
others?

• Yes!!! Blair coworkers (1997), examined skin
  conductance of psychopaths controls (men) to
  slides of varying images.
• Ss were shown threatening (guns), neutral (lamp),
  distress-provoking (crying person) slides.
• The two groups showed the same responses to the
  threatening neutral slides. However,
  psychopaths were less responsive to the distress
  slides.

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Summary

• Psychopaths feel emotions less intensely than
  normal individuals.
• Psychopaths not under-aroused compared to normal
  Ss, but are better at tuning out unpleasant
  stimuli.
• They lack empathy.