Antisocial Personality Disorder

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PSYCHOLOGY AND
CRIMINAL BEHAVIOUR
Conduct disroders:
ODD
CD
ASPD
Conduct Problems
Age-inappropriate actions and attitudes
that violate family expectations, societal
norms, or property rights of others
 Several different types and pathways
 Often associated with extremely
unfortunate family and neighborhood
circumstances

Context of Antisocial Behavior
Antisocial acts relatively “normal” among
children
 Range of severity, from minor
disobedience to fighting
 Most antisocial behaviors decline during
normal development, with the exception
of aggression
 More common in boys in childhood, but
relatively equal by adolescence

Social and Economic Costs of
Conduct Problems
Antisocial behavior is the most costly
mental health problem
 An early, persistent, and extreme pattern
of antisocial behavior occurs in about 5%
of children, and these children account
for over half of all crime and about 1/3 of
clinic referrals

Legal Perspectives
Conduct problems defined as delinquent
or criminal acts resulting in apprehension
and court contact
 Minimum age of responsibility is 12 -1416
 Only a subgroup of children meeting
legal definitions also meet definition of a
mental disorder

Psychological Perspectives
Conduct problems seen as falling on a
continuous dimension of externalizing
behavior
 Externalizing behavior seen as
consisting of several related but
independent sub-dimensions:

delinquent-aggressive
 overt-covert
 destructive-nondestructive

Psychological Perspectives
(cont.)
Four categories of conduct
problems
Psychiatric Perspectives
Conduct problems viewed as distinct
mental disorders based on DSM
symptoms
 In the DSM-IV, conduct problems fall
under the category of disruptive behavior
disorders, and include oppositional
defiant disorder and conduct disorder

Oppositional Defiant Disorder
(ODD)

Age-inappropriate stubborn, irritable, and defiant
behavior, including:
 losing temper
 arguing with adults
 active defiance or refusal to comply
 deliberately annoying others
 blaming others for mistakes or misbehavior
 being “touchy” or easily annoyed
 anger and resentfulness
 spitefulness or vindictiveness
Conduct Disorder (CD)

A repetitive and persistent pattern of violating basic
rights of others and/or age-appropriate societal norms
or rules, including:
 aggression to people and animals such as
bullying, threatening, fighting, physical cruelty,
using a weapon
 destruction of property, including deliberate fire
setting
 deceitfulness or theft, including “conning” others,
forgery, shoplifting, breaking into others’ property
 serious violations of rules, such as running away,
truancy, staying out at night without permission
Conduct Disorder (cont.)

Childhood versus adolescent onset CD
 Children with childhood onset CD
 display at least one symptom before age 10
 more likely to be boys
 are aggressive
 account for a disproportionate amount of legal
activity
 persist in antisocial behavior over time
Conduct Disorder (cont.)

Children with adolescent onset CD
 as likely to be girls as boys
 do not show the severity or psychopathology of
the early-onset group
 less likely to commit violent offenses or persist
as they get older
Conduct Disorder (cont.)
CD and Antisocial Personality Disorder
(APD)

as many as 40% of children with CD later
develop Antisocial Personality Disorder a pervasive pattern of disregard for, and
violation of, the rights of others, as well as
engagement in multiple illegal acts
Associated Characteristics

Cognitive and verbal deficits
 normal IQ, but generally 8 points lower than
peers
 deficits present before conduct problems
 deficits in executive functioning
 School and learning problems
 underachievement, especially in language
and reading
 relationship often best accounted for by
presence of ADHD
The School 

Academic performance and delinquency
The general path towards occupational prestige is
education, and when youth are deprived of this
avenue of success through poor school performance
there is a greater likelihood of delinquent behaviour
(Singer and Jou, 1992)
 Poor academic performance has been directly linked
to delinquent behaviour
 School failure is stronger predictor of delinquency than
personal variables
 School failure commonly found among chronic
offenders (Farrington and West, 1988)
 Supported by studies of prison inmates
Causes of school failure
Social class
 Streaming
 Alienation of students from the school
experience – lack of attachment
 Irrelevant curriculum
 Labeling within the school system
 Negative interaction with teachers and
school officials

Associated Characteristics
Inflated and unstable self-esteem
 Peer problems

verbal and physical aggression toward
peers, may become bullies
 often rejected as they get older
 involvement with other antisocial peers
 underestimate own aggression,
overestimate others’ aggression
 often a lack of concern for others

Older peers
“The people I hang around with used to like me
because I was good at stealing. Because I was
young nobody would suspect me and then I
would get away with it. They liked to have me
stay with them and I liked to be with them
because I felt good.”
 Co –offending declines steadily from age 10
(Reiss and Farrington, (9991)
 Delinquent friends are likely to have most
influence when they have high status within the
peer group and are popular

Associated Characteristics

Health-Related Problems
rates of premature death 3-4 times higher
 higher risk of personal injury and illness
 early onset of sexual activity, higher sexrelated risks
 substance abuse, higher risk of overdose


Co-morbid Disorders
ADHD
 Depression & anxiety

Prevalence & Gender
Differences

Prevalence
 2%-6% for CD; 12% for ODD
 Gender differences
 in childhood, antisocial behavior 3-4 times
more common in boys
 differences decrease/disappear by age 15,
due to increase in covert non-aggressive
antisocial acts in girls
 for girls, lifetime prevalence for severe
conduct problems about 3%
Developmental Course

Earliest sign usually difficult temperament in
infancy
 Two Pathways
 Life-course-persistent (LCP) path begin at
an early age and persists into adulthood
 Adolescent-limited (AL) path begins around
puberty and ends in young adulthood (more
common and less serious than LCP)
 Often negative adult outcomes, especially for
those on the LCP path
Three Pathways to Boys’ Disruptive Behavior and Delinquency
Source: Thornberry, Huizinga, & Loeber, 2004. U.S. Department of Justice: Juvenile Justice
Developmental Course (cont.)
Approximate ordering of the different forms of disruptive and
antisocial behavior from childhood through adolescence
Causes of Conduct Problems

Genetic Influences
 difficult early temperament or impulsivity may
predispose certain children
 adoption and twin studies support genetic
contribution, especially for overt behaviors
 “reward dominance” has been linked to a
possible genetic deviation
 some children may have “reward deficiency
syndrome”, which has been linked to a variant
form of the dopamine D2 receptor gene
Causes of Conduct Problems

Neurobiological factors
overactive behavioral activation system (BAS)
and underactive behavioral inhibition system
 low psychophysiological and/or cortical
arousal, and autonomic reactivity- may lead to
diminished avoidance learning
 higher rates of neurodevelopmental risk
factors
 childhood exposure to lead
 neuropsychological deficits

Causes of Conduct Problems

Social-Cognitive Factors
egocentrism and lack of perspective taking
 inability to use verbal mediators to regulate
behavior
 hostile attributions to ambiguous stimuli
 deficits in stages of social informationprocessing

Causes of Conduct Problems

Family Contributions
Coercion Theory- through an escapeconditioning sequence the child learns to use
increasingly intense forms of noxious
behavior to avoid unwanted parental
demands
 insecure parent-child attachments
 family instability and stress
 parental criminality
 parental psychopathology

Causes of Conduct Problems

Societal Influences
more common in neighborhoods with
criminal subcultures, frequent transitions,
low social support among neighbors
 established correlation between media
violence and antisocial behavior


Cultural Factors

associated with minority status, but this is
likely due to low SES
Treatment

Generally, few effective interventions
 Interventions with some empirical support:
 Parent-Management Training (PMT)
 Cognitive problem solving skills training
(PSST)
 Multisystemic treatment (MST)
 Mixed findings regarding the effectiveness of
medications- may be useful to reduce overt
behaviors, must be used in combination with
other interventions
Personality Disorders

Personality Disorders refer to long-standing,
pervasive and inflexible patterns of behavior



Depart from cultural expectations
Impair social and occupational functioning
Cause emotional distress
Paranoid, Schizoid, Antisocial, Borderline,
Narcissistic, Histrionic, Avoidant, Dependent
Antisocial Personality
Shows a pervasive pattern of disregard
for, and violation of other people’s rights.
 Up to 3.5% manifest an antisocial
personality disorder (APA, 1994)
 Symptoms: Repeatedly deceitful,
irresponsible with money, impulsive,
tendency to start fights, egocentric, no
regard for safety of self or others.

Dramatic/Erratic Cluster

Antisocial personality disorder (PD) involves
 The presence of conduct disorder before the
age of fifteen
 Conduct disorder includes truancy, lying,
theft, arson, running away from home and
destruction of property
 The continuation of these behaviors into
adulthood
 Prevalence of antisocial PD is about 3% of men
and 1 % of women
Antisocial Personality
Tend to be skillful at manipulating
people.
 Are not distressed by the pain they
cause, often perceived as lacking any
moral conscience.
 “They glibly rationalize their actions by
characterizing their victims as weak and
deserving of being conned or stolen
from” (Comer, 1997)

Criteria and features of ASPD
A. Pattern of disregard for and violation of
the rights of others occurring since age 15 as
indicated by 3 or more:
(1) failure to conform to social norms
(2) repeated lying/conning
(3) impulsivity or failure to plan ahead
4) irritability and aggressiveness
(5) reckless disregard for safety
(6) consistent irresponsibility
(7) lack of remorse
Criteria (cont.)
B. Individual is at least 18 years old
C. Evidence of Conduct Disorder before age 15
D. Occurrence of antisocial behavior not
exclusively during course of schizophrenia
or a manic episode
Criteria and features of ASPD
2. Course and statistics
- prevalence is 3% in men; lower in
women
- sex difference is probably real, but may
be inflated by clinician bias
- onset in childhood (by definition)
- CD portion may start as early as age 3-5
Statistics and course (cont.)

Course of all APDs is chronic, but overt
antisocial behavior seems to age out
after 40
- could still show ASPD features (e.g., lying;
poor work habits)
Criteria and features of ASPD
3. Causal influences
- twin, family, and adoption data show
strong genetic influence
- CD also appears to have shared
environment influence
- poor socialization due to low
fearfulness may account for some cases
Treatment
Most don’t seek treatment for ASPD
(usually substance abuse)
 No treatment shown to be efficacious
 More likely to end up in jail than in
treatment
 Focus is on prevention – target antisocial
children

Antisocial Personality Disorder
Overlap and lack of
overlap among antisocial
personality disorder,
psychopathy, and
criminality
Psychopathy

Cleckley (1941) Disorder characterised by
constellation of interpersonal, affective and
behavioural traits:


superficial charm, affective deficits (low
guilt/empathy), pathological egocentricity,
impulsivity and irresponsibility
Criminality considered neither necessary nor
sufficient for a diagnosis

“Successful” psychopaths
Psychopathy

Cleckley’s description of psychopathy:
1.
2.
3.
4.
5.
6.
7.
8.
Superficial charm
Absence of delusions and irrational thinking
Absence of “nervousness”
Unreliability
Untruthfulness and insincerity
Lack of remorse or shame
Inadequately motivated antisocial behavior
Poor judgment and failure to learn by experience
Psychopathy (cont.)
9.
10.
11.
12.
13.
14.
15.
16.
Pathological egocentricity and incapacity for
love
General poverty in major affective reactions
Specific loss of insight
Unresponsiveness in general interpersonal
relations
Fantastic and uninviting behavior with drink
Suicide rarely carried out
Sex life impersonal, trivial, and poorly
integrated
Failure to follow any life plan
Psychopathy (cont.)

-MOST PSYCHOPATHS ARE ANTISOCIAL
PERSONALITIES BUT NOT ALL ANTISOCIAL
PERSONALITIES ARE PSYCHOPATHS.
 - This is because APD is defined mainly by
behaviors (Factor 2 antisocial behaviors) and
doesn't tap the affective/interpersonal
dimensions (Factor 1 core psychopathic
features, narcissism) of psychopathy.
 - Further, criminals and APDs tend to "age out"
of crime; psychopaths do not, and are at high
risk of recidivism.
PCL-R 20-item
Hare's checklist is based on Cleckley's 16-item checklist, and the following is a discussion
of the concepts in the PCL-R:

1. GLIB and SUPERFICIAL CHARM

2. GRANDIOSE SELF-WORTH

3. NEED FOR STIMULATION or PRONENESS TO BOREDOM –

4. PATHOLOGICAL LYING

5. CONNING AND MANIPULATIVENESS

6. LACK OF REMORSE OR GUILT

7. SHALLOW AFFECT

8. CALLOUSNESS and 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 CONDITION RELEASE

20. CRIMINAL VERSATILITY
Psychopathy and ASPD



Most psychopaths (with the exception of those who somehow
manage to plow their way through life without coming into formal
or prolonged contact with the criminal justice system) meet the
criteria for ASPD, but most individuals with ASPD are not
psychopaths. Further, ASPD is very common in criminal
populations, and those with the disorder are heterogeneous with
respect to personality, attitudes and motivations for engaging in
criminal behavior.
As a result, a diagnosis of ASPD has limited utility for making
differential predictions of institutional adjustment, response to
treatment, and behavior following release from prison.
In contrast, a high PCL-R score depends as much on inferred
personality traits as on antisocial behaviors, and when used alone
or in conjunction with other variables has considerable predictive
validity with respect to treatment outcome, institutional
adjustment, recidivism and violence
Psychopathy and ASPD

For example, several studies have found that
psychopathic offenders or forensic psychiatric
patients (as defined by the PCL-R) are as
much as three or four times more likely to
violently reoffend following release from
custody than are nonpsychopathic offenders
or patients. ASPD, on the other hand, has
relatively little predictive power, at least with
forensic populations (Hart and Hare, in press).
Lifetime course
Lifetime course of
criminal behavior in
psychopaths and nonpsychopaths
Questions?
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