Antisocial Personality Disorder and Psychopathy

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Antisocial Personality Disorder and Psychopathy
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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

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Prevalence of ASPD

• 3.6 in general population
• 5.5 in men
• 1.9 in women

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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

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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

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Psychopathy

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

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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

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Environemental Factors

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

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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

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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

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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.

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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

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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

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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