Misplaced Pages

Latest revision as of 07:47, 24 December 2024

Antisocial personality disorder (ASPD) is a personality disorder defined by a chronic pattern of behavior that disregards the rights and well-being of others. People with ASPD often exhibit behavior that conflicts with social norms, leading to issues with interpersonal relationships, employment, and legal matters. The condition generally manifests in childhood or early adolescence, with a high rate of associated conduct problems and a tendency for symptoms to peak in late adolescence and early adulthood.

The prognosis for ASPD is complex, with high variability in outcomes. Individuals with severe ASPD symptoms may have difficulty forming stable relationships, maintaining employment, and avoiding criminal behavior, resulting in higher rates of divorce, unemployment, homelessness, and incarceration. In extreme cases, ASPD may lead to violent or criminal behaviors, often escalating in early adulthood. Research indicates that individuals with ASPD have an elevated risk of suicide, particularly those who also engage in substance misuse or have a history of incarceration. Additionally, children raised by parents with ASPD may be at greater risk of delinquency and mental health issues themselves.

Although ASPD is a persistent and often lifelong condition, symptoms may diminish over time, particularly after age 40, though only a small percentage of individuals experience significant improvement. Many individuals with ASPD have co-occurring issues such as substance use disorders, mood disorders, or other personality disorder. Research on pharmacological treatment for ASPD is limited, with no medications approved specifically for the disorder. However, certain psychiatric medications, including antipsychotics, antidepressants, and mood stabilizers, may help manage symptoms like aggression and impulsivity in some cases, or treat co-occurring disorders.

The diagnostic criteria and understanding of ASPD have evolved significantly over time. Early diagnostic manuals, such as the DSM-I in 1952, described “sociopathic personality disturbance” as involving a range of antisocial behaviors linked to societal and environmental factors. Subsequent editions of the DSM have refined the diagnosis, eventually distinguishing ASPD in the DSM-III (1980) with a more structured checklist of observable behaviors. Current definitions in the DSM-5 align with the clinical description of ASPD as a pattern of disregard for the rights of others, with potential overlap in traits associated with psychopathy and sociopathy.

Symptoms and behaviors

Due to tendencies toward recklessness and impulsivity, patients with ASPD are at a higher risk of drug and alcohol abuse. ASPD is the personality disorder most likely to be associated with addiction. Individuals with ASPD are at a higher risk of illegal drug usage, blood-borne diseases, HIV, shorter periods of abstinence, misuse of oral administrations, and compulsive gambling as a consequence of their tendency towards addiction. In addition, sufferers are more likely to abuse substances or develop an addiction at a young age.

Due to ASPD being associated with higher levels of impulsivity, suicidality, and irresponsible behavior, the condition is correlated with heightened levels of aggressive behavior, domestic violence, illegal drug use, pervasive anger, and violent crimes. This behavior typically has negative effects on their education, relationships, and/or employment. Alongside this, sexual behaviors of risk such as having multiple sexual partners in a short period of time, seeing prostitutes, inconsistent use of condoms, trading sex for drugs, and frequent unprotected sex are also common.

Patients with ASPD have been documented to describe emotions with ambivalence and experience heightened states of emotional coldness and detachment. Individuals with ASPD, or who display antisocial behavior, may often experience chronic boredom. They may experience emotions such as happiness and fear less clearly than others. It is also possible that they may experience emotions such as anger and frustration more frequently and clearly than other emotions.

People with ASPD may have a limited capacity for empathy and can be more interested in benefiting themselves than avoiding harm to others. They may have no regard for morals, social norms, or the rights of others. People with ASPD can have difficulty beginning or sustaining relationships. It is common for the interpersonal relationships of someone with ASPD to revolve around the exploitation and abuse of others. People with ASPD may display arrogance, think lowly and negatively of others, have limited remorse for their harmful actions, and have a callous attitude toward those they have harmed.

People with ASPD can have difficulty mentalizing, or interpreting the mental state of others. Alternately, they may display a perfectly intact theory of mind, or the ability to understand one's mental state, but have an impaired ability to understand how another individual may be affected by an aggressive action. These factors might contribute to aggressive and criminal behavior as well as empathy deficits. Despite this, they may be adept at social cognition, or the ability to process and store information about other people, which can contribute to an increased ability to manipulate others.

ASPD is highly prevalent among prisoners. People with ASPD tend to be convicted more, receive longer sentences, and are more likely to be charged with almost any crime, with assault and other violent crimes being the most common charges. Those who have committed violent crimes tend to have higher levels of testosterone than the average person, also contributing to the higher likelihood for men to be diagnosed with ASPD. The effect of testosterone is counteracted by cortisol, which facilitates the cognitive control of impulsive tendencies.

Arson and the destruction of others' property are also behaviors commonly associated with ASPD. Alongside other conduct problems, many people with ASPD had conduct disorder in their youth, characterized by a pervasive pattern of violent, criminal, defiant, and anti-social behavior.

Although behaviors vary by degree, individuals with this personality disorder have been known to exploit others in harmful ways for their own gain or pleasure, and frequently manipulate and deceive other people. While some do so with a façade of superficial charm, others do so through intimidation and violence. Individuals with antisocial personality disorder may deliberately show irresponsibility, have difficulty acknowledging their faults and/or attempt to redirect attention away from harmful behaviors.

Comorbidity

ASPD presents high comorbidity rates with various psychiatric conditions, particularly substance use and mood disorder. Individuals diagnosed with ASPD are significantly more prone to develop substance use disorder (SUDs), with studies showing that they are approximately 13 times more likely to be diagnosed with a SUD than those without ASPD. This population also faces increased risks for mood disorders, including a fourfold likelihood of experiencing major depressive disorder, as well as heightened risks for suicidal ideation and behaviors. Anxiety disorders, particularly post-traumatic stress disorder (PTSD) and social anxiety disorder, are also common comorbidities, affecting up to 50% of individuals with ASPD. These comorbidities often exacerbate the problems of those with ASPD, leading to more severe symptoms, complex treatment needs, and poorer clinical outcomes.

When combined with alcoholism, people may show frontal brain function deficits on neuropsychological tests greater than those associated with each condition. Alcohol use disorder is likely caused by lack of impulse and behavioral control exhibited by antisocial personality disorder patients.

Causes

Personality disorders are generally believed to be caused by a combination and interaction of genetics and environmental influences. People with an antisocial or alcoholic parent are considered to be at higher risk of developing ASPD. Fire-setting and cruelty to animals during childhood are also linked to the development of an antisocial personality disorder, along with being more common in males and among incarcerated populations. Although the causes listed correlate to the risk of developing ASPD, one factor alone is unlikely to be the only cause associated with ASPD and relating to a listed cause does not necessarily mean that a person should identify or be identified as having ASPD.

According to professor Emily Simonoff of the Institute of Psychiatry, Psychology and Neuroscience, there are many variables that are consistently connected to ASPD, such as: childhood hyperactivity and conduct disorder, criminality in adulthood, lower IQ scores, and reading problems. Additionally, children who grow up with a predisposition of ASPD and interact with other delinquent children are likely to later be diagnosed with ASPD.

Genetic

Research into genetic associations in antisocial personality disorder suggests that ASPD has some or even a strong genetic basis. The prevalence of ASPD is higher in people related to someone with the disorder. Twin studies, which are designed to discern between genetic and environmental effects, have reported significant genetic influences on antisocial behavior and conduct disorder.

In the specific genes that may be involved, one gene that has shown particular promise in its correlation with ASPD is the gene that encodes for monoamine oxidase A (MAO-A), an enzyme that breaks down monoamine neurotransmitters such as serotonin and norepinephrine. Various studies examining the gene's relationship to behavior have suggested that variants of the gene resulting in less MAO-A being produced (such as the 2R and 3R alleles of the promoter region) have associations with aggressive behavior in men.

This association is also influenced by negative experiences early in life, with children possessing a low-activity variant (MAOA-L) who have experienced negative circumstances being more likely to develop antisocial behavior than those with the high-activity variant (MAOA-H). Even when environmental interactions (e.g., emotional abuse) are taken out of the equation, a small association between MAOA-L and aggressive and antisocial behavior remains.

The gene that encodes for the serotonin transporter (SLC6A4), a gene that is heavily researched for its associations with other mental disorders, is another gene of interest in antisocial behavior and personality traits. Genetic association's studies have suggested that the short "S" allele is associated with impulsive antisocial behavior and ASPD in the inmate population.

However, research into psychopathy find that the long "L" allele is associated with the Factor 1 traits of psychopathy, which describes its core affective (e.g. lack of empathy, fearlessness) and interpersonal (e.g. grandiosity, manipulativeness) personality disturbances. This is suggestive of two different forms of the disorder, one associated more with impulsive behavior and emotional dysregulation, and the other with predatory aggression and affective disturbance.

Various other gene candidates for ASPD have been identified by a genome-wide association study published in 2016. Several of these gene candidates are shared with attention-deficit hyperactivity disorder, with which ASPD is often comorbid. The study found that those who carry four mutations on chromosome 6 are 50% more likely to develop antisocial personality disorder than those who do not.

Physiological

Hormones and neurotransmitters

Traumatic events can lead to a disruption of the standard development of the central nervous system, which can generate a release of hormones that can change normal patterns of development.

One of the neurotransmitters that has been discussed in individuals with ASPD is serotonin, also known as 5-HT. A meta-analysis of 20 studies found significantly lower 5-HIAA levels (indicating lower serotonin levels), especially in those who are younger than 30 years of age.

While it has been shown that lower levels of serotonin may be associated with ASPD, there has also been evidence that decreased serotonin function is highly correlated with impulsiveness and aggression across a number of different experimental paradigms. Impulsivity is not only linked with irregularities in 5-HT metabolism but may be the most essential psychopathological aspect linked with such dysfunction. Correspondingly, the DSM classifies "impulsivity or failure to plan ahead" and "irritability and aggressiveness" as two of seven sub-criteria in category A of the diagnostic criteria of ASPD.

Some studies have found a relationship between monoamine oxidase A and antisocial behavior, including conduct disorder and symptoms of adult ASPD, in maltreated children.

Neurological

Antisocial behavior may be related to a number of neurological defects, such as head trauma. Antisocial behavior is associated with decreased grey matter in the right lentiform nucleus, left insular, and frontopolar cortex. Increased volumes of grey matter have been observed in the right fusiform gyrus, inferior parietal cortex, right cingulate gyrus, and post-central cortex.

Intellectual and cognitive ability is often found to be impaired or reduced in the ASPD population. Contrary to stereotypes in popular culture of the "psychopathic genius", antisocial personality disorder is associated with reduced overall intelligence and specific reductions in individual aspects of cognitive ability. These deficits also occur in general-population samples of people with antisocial traits and in children with the precursors to antisocial personality disorder.

People that exhibit antisocial behavior tend to demonstrate decreased activity in the prefrontal cortex, and is more apparent in functional neuroimaging as opposed to structural neuroimaging. Some investigators have questioned whether the reduced volume in prefrontal regions is associated with antisocial personality disorder, or whether they result from co-morbid disorders, such as substance use disorder or childhood maltreatment. It is still considered an open question if the anatomical abnormality causes the psychological and behavioral abnormality, or vice versa.

Antisocial behavior is also associated with structural brain differences. Some of the major areas involved are areas of the prefrontal cortex, such as the right frontal and temporal cortices, the ventromedial prefrontal cortex, and the middle and orbitofrontal cortices. In these areas, a reduction in gray matter is seen in individuals with antisocial personality disorder, suggesting these structural differences may play a role in their behavior. Reduced gray matter volumes in these areas are in fact associated with a lack of emotional regulation, a lack of behavioral and response inhibition, and poor decision making among other affects.  Additionally, those with ASPD have shown decreased gray matter volumes in other brain areas such as the amygdala and insula, suggesting possible issues with emotional reactions to certain stimuli. People that exhibit antisocial behavior also tend to demonstrate decreased activity in the prefrontal cortex, as is apparent in functional neuroimaging.

Cavum septi pellucidi (CSP) is a marker for limbic neural maldevelopment, and its presence has been loosely associated with certain mental disorders, such as schizophrenia and post-traumatic stress disorder. One study found that those with CSP had significantly higher levels of antisocial personality, psychopathy, arrests and convictions compared with controls.

Environmental

Family environment

Many studies suggest that the social and home environment contribute to the development of ASPD. Parents of children with ASPD may display antisocial behavior themselves, which are then adopted by their children. A lack of parental stimulation and affection during early development can lead to high levels of cortisol with the absence of balancing hormones such as oxytocin.

This disrupts and overloads the child's stress response systems, which is thought to lead to underdevelopment of the part of the child's brain that deals with emotion, empathy, and ability to connect to other humans on an emotional level. According to Dr. Bruce Perry in his book The Boy Who Was Raised as a Dog, "the infant's developing brain needs to be patterned, repetitive stimuli to develop properly. Spastic, unpredictable relief from fear, loneliness, discomfort, and hunger keeps a baby's stress system on high alert. An environment of intermittent care punctuated by total abandonment may be the worst of all worlds for a child."

Parenting styles

Parenting styles can directly affect how children experience and develop in their youth, and can have an impact on a child's diagnosis of ASPD. The four parenting styles demonstrate the main approaches to raising children and their outcomes that lead into adulthood.

Authoritarian - Authoritarian parenting styles involve stricter rules than any other parenting style, with greater consequences if rules are disobeyed. Authoritarian parents set high expectations for their children that may cause the children to later develop rebellious behavior, low self-esteem, aggression, and resentfulness.

Permissive - Permissive parenting styles involve a more relaxed attitude towards rules that are less enforced than any other parenting style. Permissive parents tend to allow more freedom for children to make their own decisions which can lead to impulsivity, lack of self-control, and a lack of acknowledgment of boundaries later in life.

Neglectful - Neglectful parenting styles tend to have little to no rules for children to follow, and may even withhold basic needs required for child development. Parents who display neglectful behavior are less involved than any other parenting style and can cause children to develop mental health issues, withdrawal from emotions, and delinquent behavior.

Authoritative - Authoritative parenting styles involve guidelines and expectations as well as support and understanding. Authoritative parents tend to have more balance within their parenting style compared to the other parenting styles, and parent in a way that lets children understand not only what the rules are, but why they are important. Individuals who were raised by authoritative parents tend to be more self-confident, responsible, successful, and have a greater chance of developing positive coping skills.

Having a healthy, safe, stable/consistent, understanding, and attentive parenting style in an environment with positive role models and influences at home as well as out in the community help to ensure more positive behavior for children and an overall decrease in ASPD symptoms.

Childhood trauma

ASPD is highly comorbid with emotional and physical abuse in childhood. Physical neglect also has a significant correlation to ASPD. The way a child bonds with its parents early in life is important. Poor parental bonding due to abuse or neglect puts children at greater risk for developing antisocial personality disorder. There is also a significant correlation with parental overprotection and people who develop ASPD. Studies have shown that non-abused (especially in childhood) individuals are less likely to develop ASPD.

Those with ASPD may have experienced any of the following forms of childhood trauma or abuse: physical or sexual abuse, neglect, coercion, abandonment or separation from caregivers, violence in a community, acts of terror, bullying, or life-threatening incidents. Some symptoms can mimic other forms of mental illness, such as:

• post-traumatic stress disorder (symptoms of upsetting/terrifying memories of traumatic events)
• reactive attachment disorder (little to no response regarding emotional triggers)
• disinhibited social engagement disorder (roaming off with people you don't know without caregivers being informed)
• dissociative identity disorder (disconnection from self or environment)

The comorbidity rate of the previously listed disorders with ASPD tend to be much higher.

Cultural influences

The sociocultural perspective of clinical psychology views disorders as influenced by cultural aspects; since cultural norms differ significantly, mental disorders (such as ASPD) are viewed differently. Robert D. Hare suggested that the rise in ASPD that has been reported in the United States may be linked to changes in cultural norms, serving to validate the behavioral tendencies of many individuals with ASPD. While the rise reported may be in part a byproduct of the widening use (and abuse) of diagnostic techniques, given Eric Berne's division between individuals with active and latent ASPD – the latter keeping themselves in check by attachment to an external source of control like the law, traditional standards, or religion – it has been suggested that the erosion of collective standards may serve to release the individual with latent ASPD from their previously prosocial behavior.

There is also a continuous debate as to the extent to which the legal system should be involved in the identification and admittance of patients with preliminary symptoms of ASPD. Controversial clinical psychiatrist Pierre-Édouard Carbonneau suggested that the problem with legal forced admittance is the rate of failure when diagnosing ASPD. He contends that the possibility of diagnosing and coercing a patient into prescribing medication to someone without ASPD, but is diagnosed with ASPD, could be potentially disastrous. But the possibility of not diagnosing ASPD and seeing a patient go untreated because of a lack of sufficient evidence of cultural or environmental influences is something a psychiatrist must ignore; and in his words, "play it safe".

Conduct disorder

While antisocial personality disorder is a mental disorder diagnosed in adulthood, it has its precedent in childhood. The DSM-5's criteria for ASPD require that the individual have conduct problems evident by the age of 15. Persistent antisocial behavior, as well as a lack of regard for others in childhood and adolescence, is known as conduct disorder and is the precursor of ASPD. About 25–40% of youths with conduct disorder will be diagnosed with ASPD in adulthood.

Conduct disorder (CD) is a disorder diagnosed in childhood that parallels the characteristics found in ASPD. It is characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated by the child. Children with the disorder often display impulsive and aggressive behavior, may be callous and deceitful, may repeatedly engage in petty crime (such as stealing or vandalism), or get into fights with other children and adults.

This behavior is typically persistent and may be difficult to deter with either threat or punishment. Attention deficit hyperactivity disorder (ADHD) is common in this population, and children with the disorder may also engage in substance use. CD is distinct from oppositional defiant disorder (ODD) in that children with ODD do not commit aggressive or antisocial acts against other people, animals, or property, though many children diagnosed with ODD are subsequently re-diagnosed with CD.

Two developmental courses for CD have been identified based on the age at which the symptoms become present. The first course is known as the "childhood-onset type" and occurs when conduct disorder symptoms are present before the age of 10. This course is often linked to a more persistent life course and more pervasive behaviors, and children in this group express greater levels of ADHD symptoms, neuropsychological deficits, more academic problems, increased family dysfunction, and higher likelihood of aggression and violence.

The second course is known as the "adolescent-onset type" and occurs when conduct disorder develops after the age of 10 years. Compared to the childhood-onset type, less impairment in various cognitive and emotional functions are present, and the adolescent-onset variety may remit by adulthood. In addition to this differentiation, the DSM-5 provides a specifier for a callous and unemotional interpersonal style, which reflects characteristics seen in psychopathy and are believed to be a childhood precursor to this disorder. Compared to the adolescent-onset subtype, the childhood-onset subtype tends to have a worse treatment outcome, especially if callous and unemotional traits are present.

Diagnosis

DSM-5

Section II

The main text of fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines antisocial personality disorder as being characterized by at least three of the following traits:

• Failure to conform to social norms and laws, indicated by repeatedly engaging in illegal activities.
• Deceitfulness, indicated by continuously lying, using aliases, or conning others for personal gain and pleasure.
• Exhibiting impulsivity or failing to plan ahead.
• Irritability and aggressiveness, indicated by repeatedly getting into fights or physically assaulting others.
• Reckless behaviors that disregard the safety of others.
• Irresponsibility, indicated by repeatedly failing to consistently work or honor financial obligations.
• Lack of remorse after hurting or mistreating another person.

In order to be diagnosed with antisocial personality disorder under the DSM-5, one must be at least 18 years old, show evidence of onset of conduct disorder before age 15, and antisocial behavior cannot be explained by schizophrenia or bipolar disorder.

Section III (Alternative Model of Personality Disorders)

In response to criticisms of the extant (Section II/DSM-IV) criteria for personality disorders, including their discordance with current models in the scientific literature, high comorbidity rate, overuse of some categories, underuse of others, and overwhelming use of the personality disorder-not otherwise specified (PD-NOS) diagnosis, the DSM-5 Workgroup on personality disorders devised a dimensional model, wherein categoric personality diagnoses reflect extreme variations of normal personality traits.

In response to criticisms of the extant Section II/DSM-IV criteria for ASPD, namely its failure to capture the interpersonal and affective features of psychopathy, new criteria were proposed.

In addition to the new criteria, the individual must be at least 18 years old, the traits must cause dysfunction or distress, and should not be better explained by another mental disorder, the pathophysiological effects of a substance, or a person's cultural or social background. Also included as a "with psychopathic traits" specifier modelled after the Fearless Dominance scale of the Psychopathic Personality Inventory, defined by low Anxiousness and Withdrawal and high Attention-Seeking. Researchers have also proposed the inclusion of Grandiosity and Restricted Affectivity to better capture psychopathy.

Psychopathy

Psychopathy is commonly defined as a personality construct characterized partly by antisocial behavior, a diminished capacity for empathy and remorse, and poor behavioral controls. Psychopathic traits are assessed using various measurement tools, including Canadian researcher Robert D. Hare's Psychopathy Checklist, Revised (PCL-R). "Psychopathy" is not the official title of any diagnosis in the DSM or ICD; nor is it an official title used by any other major psychiatric organizations. The DSM and ICD, however, state that their antisocial diagnoses are at times referred to (or include what is referred to) as psychopathy or sociopathy.

American psychiatrist Hervey Cleckley's work on psychopathy formed the basis of the diagnostic criteria for ASPD, and the DSM states ASPD is often referred to as psychopathy. However, critics argue ASPD is not synonymous with psychopathy as the diagnostic criteria are not the same, since criteria relating to personality traits are emphasized relatively less in the former. These differences exist in part because it was believed such traits were difficult to measure reliably and it was "easier to agree on the behaviors that typify a disorder than on the reasons why they occur".

Although the diagnosis of ASPD covers two to three times as many prisoners as the diagnosis of psychopathy, Robert Hare believes the PCL-R is better able to predict future criminality, violence, and recidivism than a diagnosis of ASPD. He suggests there are differences between PCL-R-diagnosed psychopaths and non-psychopaths on "processing and use of linguistic and emotional information", while such differences are potentially smaller between those diagnosed with ASPD and without. Additionally, Hare argued confusion regarding how to diagnose ASPD, confusion regarding the difference between ASPD and psychopathy, as well as the differing future prognoses regarding recidivism and treatability, may have serious consequences in settings such as court cases where psychopathy is often seen as aggravating the crime.

Nonetheless, psychopathy has been proposed as a specifier under an alternative model for ASPD. In the DSM-5, under "Alternative DSM-5 Model for Personality Disorders", ASPD with psychopathic features is described as characterized by "a lack of anxiety or fear and by a bold interpersonal style that may mask maladaptive behaviors (e.g., fraudulence)". Low levels of withdrawal and high levels of attention-seeking combined with low anxiety are associated with "social potency" and "stress immunity" in psychopathy. Under the specifier, affective and interpersonal characteristics are comparatively emphasized over behavioral components. Research suggests that, even without the "with psychopathic traits" specifier, these Section III criteria accurately capture the affective-interpersonal features of psychopathy, though the specifier increases coverage of the Interpersonal and Lifestyle facets of the PCL-R.

Millon's subtypes

Theodore Millon suggested 5 subtypes of ASPD. However, these constructs are not recognized in the DSM or ICD.

Elsewhere, Millon differentiates ten subtypes (partially overlapping with the above) – covetous, risk-taking, malevolent, tyrannical, malignant, disingenuous, explosive, and abrasive – but specifically stresses that "the number 10 is by no means special ... Taxonomies may be put forward at levels that are more coarse or more fine-grained."

Treatment

ASPD is considered to be among the most difficult personality disorders to treat. Rendering an effective treatment for ASPD is further complicated due to the inability to look at comparative studies between psychopathy and ASPD due to differing diagnostic criteria, differences in defining and measuring outcomes and a focus on treating incarcerated patients rather than those in the community. Because of their very low or absent capacity for remorse, individuals with ASPD often lack sufficient motivation and fail to see the costs associated with antisocial acts. They may only simulate remorse rather than truly commit to change: they can be charming and dishonest, and may manipulate staff and fellow patients during treatment. Studies have shown that outpatient therapy is not likely to be successful, but the extent to which persons with ASPD are entirely unresponsive to treatment may have been exaggerated.

Most treatment done is for those in the criminal justice system to whom the treatment regimes are given as part of their imprisonment. Those with ASPD may stay in treatment only as required by an external source, such as parole conditions. Residential programs that provide a carefully controlled environment of structure and supervision along with peer confrontation have been recommended. There has been some research on the treatment of ASPD that indicated positive results for therapeutic interventions.

Psychotherapy, also known as "talk" therapy, has been found to help treat patients with ASPD. Schema therapy is also being investigated as a treatment for ASPD. A review by Charles M. Borduin features the strong influence of multisystemic therapy (MST) that could potentially improve this issue. However, this treatment requires complete cooperation and participation of all family members. Some studies have found that the presence of ASPD does not significantly interfere with treatment for other disorders, such as substance use, although others have reported contradictory findings.

Therapists working with individuals with ASPD may have considerable negative feelings toward patients with extensive histories of aggressive, exploitative, and abusive behaviors. Rather than attempt to develop a sense of conscience in these individuals, which is extremely difficult considering the nature of the disorder, therapeutic techniques are focused on rational and utilitarian arguments against repeating past mistakes. These approaches would focus on the tangible, material value of prosocial behavior and abstaining from antisocial behavior. However, the impulsive and aggressive nature of those with this disorder may limit the effectiveness of this form of therapy.

The use of medications in treating antisocial personality disorder is still poorly explored, and no medications have been approved by the FDA to specifically treat ASPD. A 2020 Cochrane review of studies that explored the use of pharmaceuticals in ASPD patients, of which eight studies met the selection criteria for review, concluded that the current body of evidence was inconclusive for recommendations concerning the use of pharmaceuticals in treating the various issues of ASPD. Nonetheless, psychiatric medications such as antipsychotics, antidepressants, and mood stabilizers can be used to control symptoms such as aggression and impulsivity, as well as treat disorders that may co-occur with ASPD for which medications are indicated.

Prognosis

Boys are almost twice as likely to meet all of the diagnostic criteria for ASPD than girls and they will often start showing symptoms of the disorder much earlier in life. Children that do not show symptoms of the disease through age 15 will almost never develop ASPD later in life. If adults exhibit milder symptoms of ASPD, it is likely that they never met the criteria for the disorder in their childhood and were consequently never diagnosed. Overall, symptoms of ASPD tend to peak in late teens and early twenties, but can often reduce or improve through age 40.

ASPD is ultimately a lifelong disorder that has chronic consequences, though some of these can be moderated over time. There may be a high variability of the long-term outlook of antisocial personality disorder. The treatment of this disorder can be successful, but it entails unique difficulties. It is unlikely to see rapid change especially when the condition is severe. In fact, past studies revealed that remission rates were small, with 27-31% of patients with ASPD seeing an improvement "with the most violent and dangerous features remitting". As a result of the characteristics of ASPD (e.g., displaying charm in effort of personal gain, manipulation), patients seeking treatment (mandated or otherwise) may appear to be "cured" in order to get out of treatment. According to definitions found in the DSM-5, people with ASPD can be deceitful and intimidating in their relationships. When they are caught doing something wrong, they often appear to be unaffected and unemotional about the consequences. Over time, continual behavior that lacks empathy and concern may lead to someone with ASPD taking advantage of the kindness of others, including their therapist.

Without proper treatment, individuals with ASPD could lead a life that brings about harm to themselves or others. This can be detrimental to their families and careers. Those with ASPD lack interpersonal skills (e.g., lack of remorse, lack of empathy, lack of emotional-processing skills). As a result of the inability to create and maintain healthy relationships due to the lack of interpersonal skills, individuals with ASPD may find themselves in predicaments such as divorce, unemployment, homelessness and even premature death by suicide. They also see higher rates of committed crime, reaching peaks in their late teens and often committing higher-severity crimes in their younger ages of diagnoses. Comorbidity of other mental illnesses such as depression or substance use disorder is prevalent among patients with ASPD. People with ASPD are also more likely to commit homicides and other crimes. Those who are imprisoned longer often see higher rates of improvement with symptoms of ASPD than others who have been imprisoned for a shorter amount of time.

According to one study, aggressive tendencies show in about 72% of all male patients diagnosed with ASPD. About 29% of the men studied with ASPD also showed a prevalence of pre-meditated aggression. Based on the evidence in the study, the researchers concluded that aggression in patients with ASPD is mostly impulsive, though there are some long-term evidences of pre-meditated aggressions. It often occurs that those with higher psychopathic traits will exhibit the pre-meditated aggressions to those around them. Over the course of a patient's life with ASPD, he or she can exhibit this aggressive behavior and harm those close to him or her.

Additionally, many people (especially adults) who have been diagnosed with ASPD become burdens to their close relatives, peers, and caretakers. Harvard Medical School recommends that time and resources be spent treating victims who have been affected by someone with ASPD, because the patient with ASPD may not respond to the administered therapies. In fact, a patient with ASPD may only accept treatment when ordered by a court, which will make their course of treatment difficult and severe. Because of the challenges in treatment, the patient's family and close friends must take an active role in decisions about therapies that are offered to the patient. Ultimately, there must be a group effort to aid the long-term effects of the disorder.

Epidemiology

The estimated lifetime prevalence of ASPD amongst the general population falls within 1% to 4%, skewed towards 6% men and 2% women. The prevalence of ASPD is even higher in selected populations, like prisons, where there is a preponderance of violent offenders. It has been found that the prevalence of ASPD among prisoners is just under 50%. According to one study (n=23000), the prevalence of ASPD in prisoners is 47% in men and 21% in women. Thus, with only 27-31% of patients with ASPD seeing an improvement in symptoms over time, statistically around one third (33%) of male prisoners will not see any improvement in their symptoms, and are thus essentially prognostically hopeless. The corresponding percentage of female prisoners with statistically no chance of improvement in symptoms is around 15% or roughly one in six. Similarly, the prevalence of ASPD is higher among patients in alcohol or other drug (AOD) use treatment programs than in the general population, suggesting a link between ASPD and AOD use and dependence. As part of the Epidemiological Catchment Area (ECA) study, men with ASPD were found to be three to five times more likely to excessively use alcohol and illicit substances than those men without ASPD. There was found to be increased severity of this substance use in women with ASPD. In a study conducted with both men and women with ASPD, women were more likely to misuse substances compared to their male counterparts.

Homelessness is also common amongst people with ASPD. A study on 31 youths of San Francisco and 56 youths in Chicago found that 84% and 48% of the homeless met the diagnostic criteria for ASPD respectively. Another study on the homeless found that 25% of participants had ASPD.

Individuals with ASPD are at an elevated risk for suicide. Some studies suggest this increase in suicidality is in part due to the association between suicide and symptoms or trends within ASPD, such as criminality and substance use. Children of people with ASPD are also at risk. Some research suggests that negative or traumatic experiences in childhood, perhaps as a result of the choices a parent with ASPD might make, can be a predictor of delinquency later on in the child's life. Additionally, with variability between situations, children of a parent with ASPD may face consequences of delinquency if they are raised in an environment in which crime and violence is common. Suicide is a leading cause of death among youth who display antisocial behavior, especially when mixed with delinquency. Incarceration, which could come as a consequence of actions from a person with ASPD, is a predictor for suicide ideation in youth.

History

The first version of the DSM in 1952 listed sociopathic personality disturbance. This category was for individuals who were considered "...ill primarily in terms of society and of conformity with the prevailing milieu, and not only in terms of personal discomfort and relations with other individuals." There were four subtypes, referred to as "reactions": antisocial, dyssocial, sexual, and addiction. The antisocial reaction was said to include people who were "always in trouble" and not learning from it, maintaining "no loyalties", frequently callous and lacking responsibility, with an ability to "rationalize" their behavior. The category was described as more specific and limited than the existing concepts of "constitutional psychopathic state" or "psychopathic personality" which had a very broad meaning; the narrower definition was in line with criteria advanced by Hervey M. Cleckley from 1941, while the term sociopathic had been advanced by George Partridge in 1928 when studying the early environmental influence on psychopaths. Partridge discovered the correlation between antisocial psychopathic disorder and parental rejection experienced in early childhood.

The DSM-II in 1968 rearranged the categories and "antisocial personality" was now listed as one of ten personality disorders but still described similarly, to be applied to individuals who are: "basically unsocialized", in repeated conflicts with society, incapable of significant loyalty, selfish, irresponsible, unable to feel guilt or learn from prior experiences, and who tend to blame others and rationalize. The manual preface contains "special instructions" including "Antisocial personality should always be specified as mild, moderate, or severe." The DSM-II warned that a history of legal or social offenses was not by itself enough to justify the diagnosis, and that a "group delinquent reaction" of childhood or adolescence or "social maladjustment without manifest psychiatric disorder" should be ruled out first. The dyssocial personality type was relegated in the DSM-II to "dyssocial behavior" for individuals who are predatory and follow more or less criminal pursuits, such as racketeers, dishonest gamblers, prostitutes, and dope peddlers (DSM-I classified this condition as sociopathic personality disorder, dyssocial type). It would later resurface as the name of a diagnosis in the ICD manual produced by the WHO, later spelled dissocial personality disorder and considered approximately equivalent to the ASPD diagnosis.

The DSM-III in 1980 included the full term antisocial personality disorder and, as with other disorders, there was now a full checklist of symptoms focused on observable behaviors to enhance consistency in diagnosis between different psychiatrists ('inter-rater reliability'). The ASPD symptom list was based on the Research Diagnostic Criteria developed from the so-called Feighner Criteria from 1972, and in turn largely credited to influential research by sociologist Lee Robins published in 1966 as "Deviant Children Grown Up". However, Robins has previously clarified that while the new criteria of prior childhood conduct problems came from her work, she and co-researcher psychiatrist Patricia O'Neal got the diagnostic criteria they used from Lee's husband the psychiatrist Eli Robins, one of the authors of the Feighner criteria who had been using them as part of diagnostic interviews.

The DSM-IV maintained the trend for behavioral antisocial symptoms while noting, "This pattern has also been referred to as psychopathy, sociopathy, or dyssocial personality disorder" and re-including in the 'Associated Features' text summary some of the underlying personality traits from the older diagnoses. The DSM-5 has the same diagnosis of antisocial personality disorder. The Pocket Guide to the DSM-5 Diagnostic Exam suggests that a person with ASPD may present "with psychopathic features" if he or she exhibits "a lack of anxiety or fear and a bold, efficacious interpersonal style".

See also

• Gaslighting
• Animal abuse
• Anti-social behaviour order

References

1. "Antisocial Personality Disorder". National Library of Medicine. Retrieved 16 May 2018.
2. ^ American Psychiatric Association (2013), Diagnostic and Statistical Manual of Mental Disorders (5th ed.), Arlington: American Psychiatric Publishing, pp. 661, ISBN 978-0-89042-555-8
3. Semple D, Smyth R, Burns J, Darjee R, McIntosh A (2005). The Oxford Handbook of Psychiatry. Oxford, England: Oxford University Press. pp. 448–449. ISBN 978-0-19-852783-1.
4. Skeem JL, Polaschek DL, Patrick CJ, Lilienfeld SO (2011). "Psychopathic Personality". Psychological Science in the Public Interest. 12 (3): 95–162. doi:10.1177/1529100611426706. PMID 26167886. S2CID 8521465.
5. Rosenström T, Torvik FA, Ystrom E, Czajkowski NO, Gillespie NA, Aggen SH, et al. (2018). "Prediction of alcohol use disorder using personality disorder traits: A twin study". Addiction. 113 (1): 15–24. doi:10.1111/add.13951. PMC 5725242. PMID 28734091.
6. Widinghoff C, Berge J, Wallinius M, Billstedt E, Hofvander B, Håkansson A (2019). "Gambling Disorder in Male Violent Offenders in the Prison System: Psychiatric and Substance-Related Comorbidity". Journal of Gambling Studies. 35 (2): 485–500. doi:10.1007/s10899-018-9785-8. PMC 6517603. PMID 29971589.
7. Rizeanu S (2012). "The specificity of pathological gambling". Procedia - Social and Behavioral Sciences. 33: 1082–1086. doi:10.1016/j.sbspro.2012.01.289.
8. Falck RS, Wang J, Carlson RG (2008). "Among long-term crack smokers, who avoids and who succumbs to cocaine addiction?". Drug and Alcohol Dependence. 98 (1–2): 24–29. doi:10.1016/j.drugalcdep.2008.04.004. PMC 2564618. PMID 18499357.
9. ^ Van Dongen JD, Buck NM, Barendregt M, Van Beveren NM, De Beurs E, Van Marle HJ (2015). "Anti-social personality characteristics and psychotic symptoms: Two pathways associated with offending in schizophrenia". Criminal Behaviour and Mental Health. 25 (3): 181–191. doi:10.1002/cbm.1923. PMID 25078287.
10. Ma CH, Lin KF, Chen TT, Yu YF, Chien HF, Huang WL (2020). "Specific personality traits and associated psychosocial distresses among individuals with heroin or methamphetamine use disorder in Taiwan". Journal of the Formosan Medical Association. 119 (3): 735–742. doi:10.1016/j.jfma.2019.08.026. PMID 31500938. S2CID 202402587.
11. Gil-Miravet I, Fuertes-Saiz A, Benito A, Almodóvar I, Ochoa E, Haro G (2021). "Prepulse Inhibition in Cocaine Addiction and Dual Pathologies". Brain Sciences. 11 (2): 269. doi:10.3390/brainsci11020269. PMC 7924364. PMID 33672693.
12. Yang M, Liao Y, Wang Q, Chawarski MC, Hao W (2015). "Profiles of psychiatric disorders among heroin-dependent individuals in Changsha, China". Drug and Alcohol Dependence. 149: 272–279. doi:10.1016/j.drugalcdep.2015.01.028. PMC 4609506. PMID 25680517.
13. Chiang SC, Chan HY, Chang YY, Sun HJ, Chen WJ, Chen CK (2007). "Psychiatric comorbidity and gender difference among treatment-seeking heroin abusers in Taiwan". Psychiatry and Clinical Neurosciences. 61 (1): 105–111. doi:10.1111/j.1440-1819.2007.01618.x. PMID 17239047. S2CID 2260942.
14. Smith RV, Young AM, Mullins UL, Havens JR (2017). "Individual and Network Correlates of Antisocial Personality Disorder Among Rural Nonmedical Prescription Opioid Users". The Journal of Rural Health. 33 (2): 198–207. doi:10.1111/jrh.12184. PMC 5107178. PMID 27171488.
15. Szerman N, Ferre F, Basurte-Villamor I, Vega P, Mesias B, Marín-Navarrete R, et al. (2020). "Gambling Dual Disorder: A Dual Disorder and Clinical Neuroscience Perspective". Frontiers in Psychiatry. 11: 589155. doi:10.3389/fpsyt.2020.589155. PMC 7732481. PMID 33329137.
16. Ortiz-Tallo M, Cancino C, Cobos S (2011). "Pathological gambling, personality patterns and clinical syndromes". Adicciones. 23 (3): 189–197. doi:10.20882/adicciones.143. PMID 21814707.
17. Nabi H, Kivimaki M, Zins M, Elovainio M, Consoli SM, Cordier S, et al. (2008). "Does personality predict mortality? Results from the GAZEL French prospective cohort study". International Journal of Epidemiology. 37 (2): 386–396. doi:10.1093/ije/dyn013. PMC 2662885. PMID 18263645.
18. ^ Sargeant MN, Bornovalova MA, Trotman AJ, Fishman S, Lejuez CW (2012). "Facets of impulsivity in the relationship between antisocial personality and abstinence". Addictive Behaviors. 37 (3): 293–298. doi:10.1016/j.addbeh.2011.11.012. PMC 3270493. PMID 22153489.
19. Akçay BD, Akçay D (2020). "What are the factors that contribute to aggression in patients with co-occurring antisocial personality disorder and substance abuse?". Archives of Clinical Psychiatry (São Paulo). 47 (4): 95–100. doi:10.1590/0101-60830000000240. S2CID 225475157.
20. ^ Mayo Clinic Staff (2 April 2016). "Overview- Antisocial personality disorder". Mayo Clinic. Retrieved 12 April 2016.
21. ^ Berger FK (29 July 2016). "Antisocial personality disorder: MedlinePlus Medical Encyclopedia". MedlinePlus. Retrieved 1 November 2016.
22. ^ Antisocial personality disorder: prevention and management. National Institute for Health and Care Excellence: Guidelines. National Institute for Health and Care Excellence. 2013. PMID 32208571.
23. Vassileva J, Georgiev S, Martin E, Gonzalez R, Segala L (2010). "Psychopathic heroin addicts are not uniformly impaired across neurocognitive domains of impulsivity". Drug and Alcohol Dependence. 114 (2–3): 194–200. doi:10.1016/j.drugalcdep.2010.09.021. PMC 3062675. PMID 21112701.
24. Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG (2011). "Interacting mechanisms of impulsivity in bipolar disorder and antisocial personality disorder". Journal of Psychiatric Research. 45 (11): 1477–1482. doi:10.1016/j.jpsychires.2011.06.009. PMC 3195997. PMID 21719028.
25. "Differences Between a Psychopath vs Sociopath". World of Psychology. 12 February 2015. Retrieved 18 February 2018.
26. Swann AC (2011). "Antisocial personality and bipolar disorder: Interactions in impulsivity and course of illness". Neuropsychiatry. 1 (6): 599–610. doi:10.2217/npy.11.69. PMC 3253316. PMID 22235235.
27. Mueser KT, Gottlieb JD, Cather C, Glynn SM, Zarate R, Smith MF, et al. (2012). "Antisocial personality disorder in people with co-occurring severe mental illness and substance use disorders: Clinical, functional, and family relationship correlates". Psychosis. 4 (1): 52–62. doi:10.1080/17522439.2011.639901. PMC 3289140. PMID 22389652.
28. Floyd FJ, Cranford JA, Daugherty MK, Fitzgerald HE, Zucker RA (2006). "Marital interaction in alcoholic and nonalcoholic couples: Alcoholic subtype variations and wives' alcoholism status". Journal of Abnormal Psychology. 115 (1): 121–130. doi:10.1037/0021-843X.115.1.121. PMC 2259460. PMID 16492103.
29. Ford JD, Gelernter J, Devoe JS, Zhang W, Weiss RD, Brady K, et al. (2009). "Association of psychiatric and substance use disorder comorbidity with cocaine dependence severity and treatment utilization in cocaine-dependent individuals". Drug and Alcohol Dependence. 99 (1–3): 193–203. doi:10.1016/j.drugalcdep.2008.07.004. PMC 2745327. PMID 18775607.
30. Wojciechowski T (2022). "Understanding mechanisms underlying the relationship between antisocial personality disorder and substance-impaired driving among young adults involved with the justice system as minors". Journal of Safety Research. 80: 78–86. doi:10.1016/j.jsr.2021.11.009. PMID 35249630. S2CID 247252508.
31. ^ Azevedo J, Vieira-Coelho M, Castelo-Branco M, Coelho R, Figueiredo-Braga M (2020). "Impulsive and premeditated aggression in male offenders with antisocial personality disorder". PLOS ONE. 15 (3): e0229876. Bibcode:2020PLoSO..1529876A. doi:10.1371/journal.pone.0229876. PMC 7059920. PMID 32142531.
32. Pawłowska B, Rzeszutko E (2015). "Personality traits of drivers serving a custodial sentence for drink driving". Psychiatria Polska. 49 (2): 315–324. doi:10.12740/PP/27823. PMID 26093595.
33. Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG (2013). "Antisocial personality disorder and borderline symptoms are differentially related to impulsivity and course of illness in bipolar disorder". Journal of Affective Disorders. 148 (2–3): 384–390. doi:10.1016/j.jad.2012.06.027. PMC 3484175. PMID 22835849.
34. Barriga AQ, Sullivan-Cosetti M, Gibbs JC (2009). "Moral cognitive correlates of empathy in juvenile delinquents". Criminal Behaviour and Mental Health. 19 (4): 253–264. doi:10.1002/cbm.740. PMID 19780022.
35. ^ Coid J, González RA, Kallis C, Zhang Y, Liu Y, Wood J, et al. (2020). "Gang membership and sexual violence: Associations with childhood maltreatment and psychiatric morbidity". The British Journal of Psychiatry. 217 (4): 583–590. doi:10.1192/bjp.2020.69. PMC 7525108. PMID 32338230.
36. ^ Janus M, Szulc A (2016). "Sexuality of dissocial persons". Psychiatria Polska. 50 (1): 187–196. doi:10.12740/PP/59330. PMID 27086338.
37. Mueser KT, Crocker AG, Frisman LB, Drake RE, Covell NH, Essock SM (2005). "Conduct Disorder and Antisocial Personality Disorder in Persons with Severe Psychiatric and Substance Use Disorders". Schizophrenia Bulletin. 32 (4): 626–636. doi:10.1093/schbul/sbj068. PMC 2632266. PMID 16574783.
38. Quimby EG, Edidin JP, Ganim Z, Gustafson E, Hunter SJ, Karnik NS (2012). "Psychiatric Disorders and Substance Use in Homeless Youth: A Preliminary Comparison of San Francisco and Chicago". Behavioral Sciences. 2 (3): 186–194. doi:10.3390/bs2030186. PMC 4217629. PMID 25379220.
39. ^ Omar, Hatim A. "Firesetting Behavior and Psychiatric Disorders".
40. ^ Blanco C, Alegria AA, Petry NM, Grant JE, Simpson HB, Liu SM, et al. (2010). "Prevalence and Correlates of Fire-Setting in the United States". The Journal of Clinical Psychiatry. 71 (9): 1218–1225. doi:10.4088/JCP.08m04812gry. PMC 2950908. PMID 20361899.
41. ^ Newberry AL, Duncan RD (2001). "Roles of Boredom and Life Goals in Juvenile Delinquency1". Journal of Applied Social Psychology. 31 (3): 527–541. doi:10.1111/j.1559-1816.2001.tb02054.x.
42. Mohammadzadeh A, Ashouri A (2018). "Comparison of Personality Correlates of Machiavellianism, Narcissism and Psychopathy (Dark Triad of Personality) in Three Factor Personality Model". Iranian Journal of Psychiatry and Clinical Psychology. 24: 44–55. doi:10.29252/nirp.ijpcp.24.1.44.
43. Blanco C, Grant J, Petry NM, Simpson HB, Alegria A, Liu SM, et al. (2008). "Prevalence and Correlates of Shoplifting in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)". American Journal of Psychiatry. 165 (7): 905–913. doi:10.1176/appi.ajp.2008.07101660. PMC 4104590. PMID 18381900.
44. Yousefi F, Talib MA (2022). "Predictors of personality disorders in prisoners". Journal of Medicine and Life. 15 (4): 454–461. doi:10.25122/jml-2021-0317. PMC 9126463. PMID 35646191. S2CID 249232159.
45. Blaszczynski A, Steel Z, McConaghy N (1997). "Impulsivity in pathological gambling: The antisocial impulsivist". Addiction. 92 (1): 75–87. doi:10.1111/j.1360-0443.1997.tb03639.x. PMID 9060199.
46. Chang SA, Tillem S, Benson-Williams C, Baskin-Sommers A (2021). "Cognitive Empathy in Subtypes of Antisocial Individuals". Frontiers in Psychiatry. 12: 677975. doi:10.3389/fpsyt.2021.677975. PMC 8287099. PMID 34290630.
47. McCallum D (2001). Personality and dangerousness: genealogies of antisocial personality disorder. Cambridge, England: Cambridge University Press. ISBN 978-0-521-00875-4. OCLC 52493285.
48. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association. 2000.
49. Lavallee A, Pham TH, Gandolphe MC, Saloppé X, Ott L, Nandrino JL (2022). "Monitoring the emotional facial reactions of individuals with antisocial personality disorder during the retrieval of self-defining memories". PLOS ONE. 17 (6): e0268818. Bibcode:2022PLoSO..1768818L. doi:10.1371/journal.pone.0268818. PMC 9176833. PMID 35675301.
50. Fonagy P, Yakeley J, Gardner T, Simes E, McMurran M, Moran P, et al. (2020). "Mentalization for Offending Adult Males (MOAM): Study protocol for a randomized controlled trial to evaluate mentalization-based treatment for antisocial personality disorder in male offenders on community probation". Trials. 21 (1): 1001. doi:10.1186/s13063-020-04896-w. PMC 7720544. PMID 33287865.
51. Newbury-Helps, John. Are difficulties in mentalizing associated with the severity of Antisocial Personality Disorder? University College London.
52. Newbury-Helps, John. Offenders with Antisocial Personality Disorder Display More Impairments in Mentalizing. St Mary's Hospital, London: University College London.
53. Gawda B (2013). "The Emotional Lexicon of Individuals Diagnosed with Antisocial Personality Disorder". Journal of Psycholinguistic Research. 42 (6): 571–580. doi:10.1007/s10936-012-9237-z. PMC 3825036. PMID 23337952.
54. Muniello J, Vallejos M, Díaz Granados EA, Bertone MS (2017). "Differences in social cognition between male prisoners with antisocial personality or psychotic disorder". International Journal of Psychological Research. 10 (2): 15–24. doi:10.21500/20112084.2903. PMC 7110155. PMID 32612761. S2CID 55567655.
55. Chaudhury S, Ranjan J, Prakash O, Sharma N, Singh A, Sengar KS (2015). "Personality disorder, emotional intelligence, and locus of control of patients with alcohol dependence". Industrial Psychiatry Journal. 24 (1): 40–47. doi:10.4103/0972-6748.160931. PMC 4525430. PMID 26257482.
56. "Antisocial personality disorder: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 4 July 2022.
57. Metcalf S, Dickerson KL, Milojevich HM, Quas JA (2021). "Primary and Secondary Variants of Psychopathic Traits in at-Risk Youth: Links with Maltreatment, Aggression, and Empathy". Child Psychiatry & Human Development. 52 (6): 1060–1070. doi:10.1007/s10578-020-01083-5. PMID 33099658. S2CID 225072146.
58. Seid M, Anbesaw T, Melke S, Beteshe D, Mussa H, Asmamaw A, et al. (2022). "Antisocial personality disorder and associated factors among incarcerated in prison in Dessie city correctional center, Dessie, Ethiopia: A cross-sectional study". BMC Psychiatry. 22 (1): 53. doi:10.1186/s12888-022-03710-y. PMC 8785502. PMID 35073903.
59. Archer J (February 1991). "The influence of testosterone on human aggression". British Journal of Psychology. 82 ( Pt 1) (1): 1–28. doi:10.1111/j.2044-8295.1991.tb02379.x. PMID 2029601. S2CID 26281585.
60. Aromäki A, Lindman R, Erikson C (12 February 1999). "Testosterone, aggressiveness, and antisocial personality. Hormone Sensitivity and Bone Mineral Metabolism". Aggressive Behavior. 25 (2). doi:10.1002/(SICI)1098-2337(1999)25:2<113::AID-AB4>3.0.CO;2-4.
61. Archer J (February 1991). "The influence of testosterone on human aggression". British Journal of Psychology. 82 (1): 1–28. doi:10.1111/j.2044-8295.1991.tb02379.x. PMID 2029601. S2CID 26281585.
62. Mehta PH, Josephs RA (November 2010). "Testosterone and cortisol jointly regulate dominance: evidence for a dual-hormone hypothesis". Hormones and Behavior. 58 (5): 898–906. doi:10.1016/j.yhbeh.2010.08.020. PMID 20816841. S2CID 16459329.
63. Fisher KA, Hany M (2022). "Antisocial Personality Disorder". StatPearls. Treasure Island (FL): StatPearls Publishing. PMID 31536279.
64. Zoccolillo M, Pickles A, Quinton D, Rutter M (1992). "The outcome of childhood conduct disorder: Implications for defining adult personality disorder and conduct disorder". Psychological Medicine. 22 (4): 971–986. doi:10.1017/s003329170003854x. PMID 1488492. S2CID 25470721.
65. Regier D, eds. (2013). Diagnostic and Statistical Manual of Mental Disorders (5 ed.). Washington, DC: American Psychiatric Association.ISBN 978-0-89042-555-8.
66. Hinshaw SP, Lee SS (2003). "Conduct and Oppositional Defiant Disorders" (PDF). In Mash EJ, Barkely RA (eds.). Child Psychopathology (2 ed.). New York City: Guilford Press. pp. 144–198. ISBN 978-1-57230-609-7.
67. ^ "Antisocial Personality Disorder". Psychology Today. New York City: Sussex Publishers. Retrieved 18 February 2018.
68. Tuvblad C (2013). "Genetic and environmental influence on antisocial behavior-PMC". Journal of Criminal Justice. 41 (5): 273–276. doi:10.1016/j.jcrimjus.2013.07.007. PMC 3920596. PMID 24526799.
69. Werner KB, Few LR, Bucholz KK (April 2015). "Epidemiology, Comorbidity, and Behavioral Genetics of Antisocial Personality Disorder and Psychopathy". Psychiatric Annals. 45 (4): 195–199. doi:10.3928/00485713-20150401-08. ISSN 0048-5713. PMC 4649950. PMID 26594067.
70. Oscar-Berman M, Valmas MM, Sawyer KS, Kirkley SM, Gansler DA, Merritt D, et al. (April 2009). "Frontal brain dysfunction in alcoholism with and without antisocial personality disorder". Neuropsychiatric Disease and Treatment. 5: 309–26. doi:10.2147/NDT.S4882. PMC 2699656. PMID 19557141.
71. Helle AC, Watts AL, Trull TJ, Sher KJ (2019). "Alcohol Use Disorder and Antisocial and Borderline Personality Disorders". Alcohol Research: Current Reviews. 40 (1): 1. doi:10.35946/arcr.v40.1.05. PMC 6927749. PMID 31886107.
72. ^ "Antisocial Personality Disorder | MentalHealth.gov". mentalhealth.gov. Retrieved 18 February 2018.
73. Molina BSG, Gnagy EM, Joseph HM, Pelham WE Jr. Antisocial Alcoholism in Parents of Adolescents and Young Adults With Childhood ADHD. J Atten Disord. 2020 Jul;24(9):1295-1304. doi: 10.1177/1087054716680074. Epub 2016 Nov 27. PMID 27895188; PMCID: PMC5446804.
74. Arehart-Treichel J (20 September 2002). "Researchers Explore Link Between Animal Cruelty, Personality Disorders". Psychiatric News. 37 (18): 22. doi:10.1176/pn.37.18.0022a.
75. Black D (December 2021). "6 Seeds of Despair: The Causes of Antisocial Personality Disorder". Oxford Academic.
76. Simonoff E, Elander J, Holmshaw J, Pickles A, Murray R, Rutter M (February 2004). "Predictors of antisocial personality. Continuities from childhood to adult life". The British Journal of Psychiatry: The Journal of Mental Science. 184: 118–27. doi:10.1192/bjp.184.2.118. PMID 14754823.
77. ^ Azeredo A, Moreira D, Figueiredo P, Barbosa F (December 2019). "Delinquent Behavior: Systematic Review of Genetic and Environmental Risk Factors". Clinical Child and Family Psychology Review. 22 (4): 502–526. doi:10.1007/s10567-019-00298-w. PMID 31367800. S2CID 199055043.
78. ^ Baglivio MT, Wolff KT, Piquero AR, Epps N (May 2015). "The relationship between adverse childhood experiences (ACE) and juvenile offending trajectories in a juvenile offender sample". Journal of Criminal Justice. 43 (3): 229–41. doi:10.1016/j.jcrimjus.2015.04.012.
79. Baker LA, Bezdjian S, Raine A (1 January 2006). "Behavioral Genetics: The Science of Antisocial Behavior". Law and Contemporary Problems. 69 (1–2): 7–46. PMC 2174903. PMID 18176636.
80. Guo G, Ou XM, Roettger M, Shih JC (May 2008). "The VNTR 2 repeat in MAOA and delinquent behavior in adolescence and young adulthood: associations and MAOA promoter activity". European Journal of Human Genetics. 16 (5): 626–34. doi:10.1038/sj.ejhg.5201999. PMC 2922855. PMID 18212819.
81. Guo G, Roettger M, Shih JC (August 2008). "The integration of genetic propensities into social-control models of delinquency and violence among male youths" (PDF). American Sociological Review. 73 (4): 543–568. doi:10.1177/000312240807300402. S2CID 30271933. Archived from the original (PDF) on 3 March 2016. Retrieved 20 November 2016.
82. Caspi A, McClay J, Moffitt TE, Mill J, Martin J, Craig IW, et al. (August 2002). "Role of genotype in the cycle of violence in maltreated children". Science. 297 (5582): 851–4. Bibcode:2002Sci...297..851C. doi:10.1126/science.1072290. PMID 12161658. S2CID 7882492.
    • Lay summary in: "Gene may protect abused kids against behavior problems". EurekAlert!.org. 1 August 2002.
83. Frazzetto G, Di Lorenzo G, Carola V, Proietti L, Sokolowska E, Siracusano A, et al. (May 2007). "Early trauma and increased risk for physical aggression during adulthood: the moderating role of MAOA genotype". PLOS ONE. 2 (5): e486. Bibcode:2007PLoSO...2..486F. doi:10.1371/journal.pone.0000486. PMC 1872046. PMID 17534436.
84. Ficks CA, Waldman ID (September 2014). "Candidate genes for aggression and antisocial behavior: a meta-analysis of association studies of the 5HTTLPR and MAOA-uVNTR". Behavior Genetics. 44 (5): 427–44. doi:10.1007/s10519-014-9661-y. PMID 24902785. S2CID 11599122.
85. Aluja A, Garcia LF, Blanch A, De Lorenzo D, Fibla J (July 2009). "Impulsive-disinhibited personality and serotonin transporter gene polymorphisms: association study in an inmate's sample". Journal of Psychiatric Research. 43 (10): 906–14. doi:10.1016/j.jpsychires.2008.11.008. PMID 19121834.
86. Glenn AL (January 2011). "The other allele: exploring the long allele of the serotonin transporter gene as a potential risk factor for psychopathy: a review of the parallels in findings". Neuroscience and Biobehavioral Reviews. 35 (3): 612–20. doi:10.1016/j.neubiorev.2010.07.005. PMC 3006062. PMID 20674598.
87. Yildirim BO, Derksen JJ (August 2013). "Systematic review, structural analysis, and new theoretical perspectives on the role of serotonin and associated genes in the etiology of psychopathy and sociopathy". Neuroscience and Biobehavioral Reviews. 37 (7): 1254–96. doi:10.1016/j.neubiorev.2013.04.009. PMID 23644029. S2CID 19350747.
88. Rautiainen MR, Paunio T, Repo-Tiihonen E, Virkkunen M, Ollila HM, Sulkava S, et al. (September 2016). "Genome-wide association study of antisocial personality disorder". Translational Psychiatry. 6 (9): e883. doi:10.1038/tp.2016.155. PMC 5048197. PMID 27598967.
89. ^ Black D. "What Causes Antisocial Personality Disorder?". Psych Central. Archived from the original on 17 May 2013. Retrieved 1 November 2011.
90. Moore TM, Scarpa A, Raine A (2002). "A meta-analysis of serotonin metabolite 5-HIAA and antisocial behavior". Aggressive Behavior. 28 (4): 299–316. doi:10.1002/ab.90027.
91. Olivier B (December 2004). "Serotonin and aggression". Annals of the New York Academy of Sciences. 3–4. 1036 (3): 382–92. doi:10.1300/J076v21n03_03. PMID 15817750.
92. American Psychiatric Association (2000). "Diagnostic criteria for 301.7 Antisocial Personality Disorder". BehaveNet. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Retrieved 8 July 2013.
93. Huizinga D, Haberstick BC, Smolen A, Menard S, Young SE, Corley RP, et al. (October 2006). "Childhood maltreatment, subsequent antisocial behavior, and the role of monoamine oxidase A genotype". Biological Psychiatry. 60 (7): 677–83. doi:10.1016/j.biopsych.2005.12.022. PMID 17008143. S2CID 12744470.
94. Séguin JR (June 2004). "Neurocognitive elements of antisocial behavior: Relevance of an orbitofrontal cortex account". Brain and Cognition. 55 (1): 185–97. doi:10.1016/S0278-2626(03)00273-2. PMC 3283581. PMID 15134852.
95. Aoki Y, Inokuchi R, Nakao T, Yamasue H (August 2014). "Neural bases of antisocial behavior: a voxel-based meta-analysis". Social Cognitive and Affective Neuroscience. 9 (8): 1223–31. doi:10.1093/scan/nst104. PMC 4127028. PMID 23926170.
96. ^ Sánchez de Ribera O, Kavish N, Katz IM, Boutwell BB (1 September 2019). "Untangling Intelligence, Psychopathy, Antisocial Personality Disorder, and Conduct Problems: A Meta–Analytic Review". European Journal of Personality. 33 (5): 529–564. doi:10.1002/per.2207. S2CID 202253144.
97. Stevens MC, Kaplan RF, Hesselbrock VM (March 2003). "Executive–cognitive functioning in the development of antisocial personality disorder". Addictive Behaviors. 28 (2): 285–300. doi:10.1016/S0306-4603(01)00232-5. PMID 12573679.
98. Unsworth N, Miller JD, Lakey CE, Young DL, Meeks JT, Campbell WK, et al. (2009). "Exploring the relations among executive functions, fluid intelligence, and personality". Journal of Individual Differences. 30 (4): 194–200. doi:10.1027/1614-0001.30.4.194.
99. Loney BR, Frick PJ, Ellis M, McCoy MG (September 1998). "Intelligence, Callous-Unemotional Traits, and Antisocial Behavior". Journal of Psychopathology and Behavioral Assessment. 20 (1): 231–247. doi:10.1023/A:1023015318156. S2CID 146174376.
100. Yang Y, Raine A (November 2009). "Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: a meta-analysis". Psychiatry Research. 174 (2): 81–8. doi:10.1016/j.pscychresns.2009.03.012. PMC 2784035. PMID 19833485.
101. ^ Glenn AL, Johnson AK, Raine A (December 2013). "Antisocial personality disorder: a current review". Current Psychiatry Reports. 15 (12): 427. doi:10.1007/s11920-013-0427-7. PMID 24249521. S2CID 10578128.
102. ^ Raine A, Yang Y (2009). "Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: a meta-analysis". Psychiatry Research. 174 (2): 81–88. doi:10.1016/j.pscychresns.2009.03.012. PMC 2784035. PMID 19833485.
103. Davidson RJ, Putnam KM, Larson CL (28 July 2000). "Dysfunction in the neural circuitry of emotion regulation--a possible prelude to violence". Science (New York, N.Y.). 289 (5479): 591–594. doi:10.1126/science.289.5479.591. ISSN 0036-8075. PMID 10915615.
104. Campbell TG (17 January 2007). "The best of a bad bunch: the ventromedial prefrontal cortex and dorsal anterior cingulate cortex in decision-making". The Journal of Neuroscience: The Official Journal of the Society for Neuroscience. 27 (3): 447–448. doi:10.1523/jneurosci.4967-06.2007. ISSN 1529-2401. PMC 6672800. PMID 17240549.
105. Franklin TB, Silva BA, Perova Z, Marrone L, Masferrer ME, Zhan Y, et al. (February 2017). "Prefrontal cortical control of a brainstem social behavior circuit". Nature Neuroscience. 20 (2): 260–270. doi:10.1038/nn.4470. ISSN 1546-1726. PMC 5580810. PMID 28067904.
106. Aoki Y, Inokuchi R, Nakao T, Yamasue H (August 2014). "Neural bases of antisocial behavior: a voxel-based meta-analysis". Social Cognitive and Affective Neuroscience. 9 (8): 1223–1231. doi:10.1093/scan/nst104. ISSN 1749-5016. PMC 4127028. PMID 23926170.
107. Galarza M, Merlo AB, Ingratta A, Albanese EF, Albanese AM (2004). "Cavum septum pellucidum and its increased prevalence in schizophrenia: a neuroembryological classification". The Journal of Neuropsychiatry and Clinical Neurosciences. 16 (1): 41–6. doi:10.1176/appi.neuropsych.16.1.41. PMID 14990758.
108. May FS, Chen QC, Gilbertson MW, Shenton ME, Pitman RK (March 2004). "Cavum septum pellucidum in monozygotic twins discordant for combat exposure: relationship to posttraumatic stress disorder". Biological Psychiatry. 55 (6): 656–8. doi:10.1016/j.biopsych.2003.09.018. PMC 2794416. PMID 15013837.
109. ^ Raine A, Lee L, Yang Y, Colletti P (September 2010). "Neurodevelopmental marker for limbic maldevelopment in antisocial personality disorder and psychopathy". The British Journal of Psychiatry. 197 (3): 186–92. doi:10.1192/bjp.bp.110.078485. PMC 2930915. PMID 20807962.
110. Perry B, Szalavitz M (2017) . The Boy Who Was Raised as a Dog. New York: Basic Books. p. 123. ISBN 978-0-465-09445-5.
111. Álvarez-García D (September 2016). "Parenting Style Dimensions As Predictors of Adolescent Antisocial Behavior". Frontiers in Psychology. 7: 1383. doi:10.3389/fpsyg.2016.01383. PMC 5020069. PMID 27679591.
112. "The 4 types of parenting styles". American Society for the Positive Care of Children. 2023.
113. Trautner T (19 January 2017). "Authoritarian parenting style". Michigan State University.
114. Ciancio S (12 November 2021). "Permissive Parenting". Human Life International.
115. Dlamini S (31 December 2022). "The effects of uninvolved parents". Rights for Education.
116. Trautner T (January 2017). "Authoritative parenting style". Michigan State University.
117. Scott S (11 May 2010). "How is parenting style related to child antisocial behaviour" (PDF). Archived from the original (PDF) on 30 May 2023. Retrieved 10 May 2023.
118. Lampard R (August 2022). "Parenting Styles- Which One is Best?". National Fatherhood Initiative.
119. Dargis M, Newman J, Koenigs M (21 September 2015). "Clarifying the link between childhood abuse history and psychopathic traits in adult criminal offenders". Personality Disorders. 7 (3): 221–228. doi:10.1037/per0000147. PMC 4801766. PMID 26389621.
120. Schorr MT, Quadors dos Santos BT, Feiten JG, Sordi AO, Pessi C, Diemen LV, et al. (2021). "Association between childhood trauma, parental bonding and antisocial personality disorder in adulthood: A machine learning approach". Psychiatry Research. 304 (114082): 114082. doi:10.1016/j.psychres.2021.114082. PMID 34303948. S2CID 235664980.
121. Semiz UB (2007). "Childhood trauma history and dissociative experiences among Turkish men diagnosed with antisocial personality disorder". Social Psychiatry and Psychiatric Epidemiology. 42 (11): 865–873. doi:10.1007/s00127-007-0248-2. PMID 17721668. S2CID 32065022.
122. Duquesne University (4 January 2021). "Childhood Trauma: Understanding How Trauma Impacts Mental Health and Wellness".
123. Children's Hospital of Philadelphia (14 June 2017). "Trauma and Stressor- related Disorders in Children".
124. McLean (29 August 2022). "Understanding Dissociative Identity Disorder".
125. Sareen J (April 2023). "Posttraumatic stress disorder in adults: Epidemiology, Pathophysiology, Clinical manifestations, course assessment, and diagnosis". UpToDate. Archived from the original on 10 May 2023. Retrieved 10 May 2023.
126. Lock MP (November 2008). "Treatment of antisocial personality disorder". The British Journal of Psychiatry. 193 (5): 426, author reply 426. doi:10.1192/bjp.193.5.426. PMID 18978330.
127. ^ Stout M (2006). The sociopath next door: the ruthless versus the rest of us (1st ed.). New York: Broadway Books. ISBN 978-0-7679-1582-3.
128. Sutker PB, Allain AN (2002). "Antisocial Personality Disorder". In Sutker PB, Adams HE (eds.). Comprehensive Handbook of Psychopathology (3rd ed.). Boston, MA: Springer. pp. 445–490. doi:10.1007/0-306-47377-1_16. ISBN 978-0-306-46490-4.
129. Berne E (1976). A Layman's Guide to Psychiatry and Psychoanalysis (first ed.). New York, NY: Grove. pp. 241–2. ISBN 978-0-394-17833-2.
130. McCallum D (2001). Personality and Dangerousness: Genealogies of Antisocial Personality Disorder. New York: Cambridge Univ. Press. p. 7. ISBN 978-0-521-00875-4.
131. Archer R, Wheeler E (2006). Forensic Uses of Clinical Assessment Instruments. Routledge. pp. 247–250.
132. McCallum D (2001). Personality and dangerousness: genealogies of antisocial personality disorder. Cambridge, England: Cambridge University Press. ISBN 978-0-521-00875-4. OCLC 52493285.
133. Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association. 2000.
134. Zoccolillo M, Pickles A, Quinton D, Rutter M (November 1992). "The outcome of childhood conduct disorder: implications for defining adult personality disorder and conduct disorder". Psychological Medicine. 22 (4). Cambridge University Press: 971–86. doi:10.1017/s003329170003854x. PMID 1488492. S2CID 25470721.
135. ^ Kupfer D, Regier D, eds. (2013). Diagnostic and Statistical Manual of Mental Disorders (5 ed.). Washington, DC: American Psychiatric Association. ISBN 978-0-89042-555-8.
136. Hinshaw SP, Lee SS (2003). "Conduct and Oppositional Defiant Disorders" (PDF). In Mash EJ, Barkely RA (eds.). Child Psychopathology (2 ed.). New York City: Guilford Press. pp. 144–198. ISBN 978-1-57230-609-7.
137. Lynskey MT, Fergusson DM (June 1995). "Childhood conduct problems, attention deficit behaviors, and adolescent alcohol, tobacco, and illicit drug use". Journal of Abnormal Child Psychology. 23 (3). Springer Science+Business Media: 281–302. doi:10.1007/bf01447558. PMID 7642838. S2CID 40789985.
138. Loeber R, Keenan K, Lahey BB, Green SM, Thomas C (August 1993). "Evidence for developmentally based diagnoses of oppositional defiant disorder and conduct disorder". Journal of Abnormal Child Psychology. 21 (4): 377–410. doi:10.1007/bf01261600. PMID 8408986. S2CID 43444052.
139. Moffitt TE (October 1993). "Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy". Psychological Review. 100 (4): 674–701. doi:10.1037/0033-295x.100.4.674. PMID 8255953.
140. Moffitt TE, Caspi A (June 2001). "Childhood predictors differentiate life-course persistent and adolescence-limited antisocial pathways among males and females". Development and Psychopathology. 13 (2): 355–75. doi:10.1017/s0954579401002097. PMID 11393651. S2CID 29182035.
141. Baumgärtner G, Soyka M (November 2013). "[DSM-5--what has changed in therapy for and research on substance-related and addictive disorders?]" (PDF). Fortschritte der Neurologie-Psychiatrie. 81 (11). Translated by Welsh S: 648–54. doi:10.1159/000356537. PMID 24194058. Retrieved 20 May 2017.
142. Wampold BE (2015). "How important are the common factors in psychotherapy? An update". World Psychiatry. 14 (3): 270–277. doi:10.1002/wps.20238. PMC 4592639. PMID 26407772.
143. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA.
144. ^ Wygant DB, Sellbom M, Sleep CE, Wall TD, Applegate KC, Krueger RF, et al. (2016). "Examining the DSM–5 alternative personality disorder model operationalization of antisocial personality disorder and psychopathy in a male correctional sample". Personality Disorders: Theory, Research, and Treatment. 7 (3): 229–239. doi:10.1037/per0000179. PMID 26914324.
145. Anderson JL, Sellbom M, Wygant DB, Salekin RT, Krueger RF (October 2014). "Examining the Associations Between DSM-5 Section III Antisocial Personality Disorder Traits and Psychopathy in Community and University Samples". Journal of Personality Disorders. 28 (5): 675–697. doi:10.1521/pedi_2014_28_134. PMID 24689766.
146. Lynam DR, Vachon DD (2012). "Antisocial personality disorder in DSM-5: Missteps and missed opportunities". Personality Disorders: Theory, Research, and Treatment. 3 (4): 483–495. doi:10.1037/per0000006. PMID 23106185.
147. ^ Skeem JL, Polaschek DL, Patrick CJ, Lilienfeld SO (December 2011). "Psychopathic Personality: Bridging the Gap Between Scientific Evidence and Public Policy". Psychological Science in the Public Interest. 12 (3): 95–162. doi:10.1177/1529100611426706. PMID 26167886. S2CID 8521465.
148. Blair RJ (January 2003). "Neurobiological basis of psychopathy". The British Journal of Psychiatry. 182: 5–7. doi:10.1192/bjp.182.1.5. PMID 12509310.
149. Merriam-Webster Dictionary. "Definition of psychopathy". Retrieved 15 May 2013.
150. ^ Encyclopedia of Mental Disorders. "Hare Psychopathy Checklist". Retrieved 15 May 2013.
151. Hare RD (2003). Manual for the Revised Psychopathy Checklist (2nd ed.). Toronto, ON, Canada: Multi-Health Systems.
152. "Dissocial personality disorder – International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)". Archived from the original on 11 September 2013. Retrieved 8 April 2020.
153. DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders (Fourth ed.). United States: American Psychiatric Association Press Inc. 2000. ISBN 978-0-89042-025-6.
154. "International Statistical Classification of Diseases and Related Health Problems" (10th ed.). World Health Organization. 2016.
155. Horley J (2014). "The emergence and development of psychopathy". History of the Human Sciences. 27 (5): 91–110. doi:10.1177/0952695114541864. S2CID 145719285.
156. ^ Patrick CJ (2005). Handbook of Psychopathy. Guilford Press. ISBN 978-1-60623-804-2.
157. ^ Hare RD (1 February 1996). "Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion". Psychiatric Times. 13 (2). New York City: UBM plc. Archived from the original on 28 May 2013. Retrieved 19 May 2017.
158. ^ Hare RD, Hart SD, Harpur TJ (August 1991). "Psychopathy and the DSM-IV criteria for antisocial personality disorder" (PDF). Journal of Abnormal Psychology. 100 (3): 391–8. doi:10.1037/0021-843x.100.3.391. PMID 1918618. Archived from the original (PDF) on 26 September 2007. Retrieved 19 May 2017.
159. Semple D, Smyth R, Burns J, Darjee R, McIntosh A (2005). The Oxford Handbook of Psychiatry. Oxford, England: Oxford University Press. pp. 448–449. ISBN 978-0-19-852783-1.
160. ^ Nussbaum A (2013). The Pocket Guide to the DSM-5 Diagnostic Exam. Arlington: American Psychiatric Association. ISBN 978-1-58562-466-9. Retrieved 5 January 2014.
161. Millon T (2000). Personality Disorders in Modern Life (Second ed.). Hoboken, New Jersey: John Wiley & Sons, Inc. pp. 158–161. ISBN 978-0-471-23734-1.
162. Millon, Theodore – Personality Subtypes. Millon.net. Retrieved on 7 December 2011. Archived 1 March 2018 at the Wayback Machine
163. ^ Gabbard GO, Gunderson JG (2000). Psychotherapy for Personality Disorders. Vol. 9 (First ed.). American Psychiatric Publishing. pp. 1–6. ISBN 978-0-88048-273-8. PMC 3330582. PMID 10608903. {{cite book}}: |journal= ignored (help)
164. Stone MH (1993). Abnormalities of Personality. Within and Beyond the Realm of Treatment. Norton. ISBN 978-0-393-70127-2.
165. "Antisocial Personality Disorder". 2023. Retrieved 24 January 2024.
166. ^ Nolen-Hoeksema S (2 December 2013). Abnormal psychology (Sixth ed.). New York, NY. ISBN 978-0-07-803538-8. OCLC 855264280.{{cite book}}: CS1 maint: location missing publisher (link)
167. Meloy JR, Yakeley AJ (2011). Antisocial personality disorder.
168. Oldham JM, Skodol AE, Bender DS (2005). The American Psychiatric Publishing Textbook of Personality Disorders. American Psychiatric Publishing. ISBN 978-1-58562-159-0.
169. Salekin RT (February 2002). "Psychopathy and therapeutic pessimism. Clinical lore or clinical reality?". Clinical Psychology Review. 22 (1): 79–112. doi:10.1016/S0272-7358(01)00083-6. PMID 11793579.
170. McRae L (February 2013). "Rehabilitating antisocial personalities: treatment through self-governance strategies". The Journal of Forensic Psychiatry & Psychology. 24 (1): 48–70. doi:10.1080/14789949.2012.752517. PMC 3756620. PMID 24009471.
171. Derefinko KJ, Widiger TA (2008). "Antisocial Personality Disorder". The Medical Basis of Psychiatry. pp. 213–226. doi:10.1007/978-1-59745-252-6_13. ISBN 978-1-58829-917-8.
172. "Treatment – Mayo Clinic". Mayo Clinic. Retrieved 13 June 2017.
173. Bernstein DP, Arntz A, Vos Md (2007). "Schema Focused Therapy in Forensic Settings: Theoretical Model and Recommendations for Best Clinical Practice" (PDF). International Journal of Forensic Mental Health. 6 (2): 169–183. doi:10.1080/14999013.2007.10471261. hdl:11577/3237556. S2CID 145389897. Archived from the original (PDF) on 26 July 2011.
174. Gatzke LM, Raine A (February 2000). "Treatment and prevention implications of antisocial personality disorder". Current Psychiatry Reports. 2 (1): 51–5. doi:10.1007/s11920-000-0042-2. PMID 11122932. S2CID 33844568.
175. Darke S, Finlay-Jones R, Kaye S, Blatt T (September 1996). "Anti-social personality disorder and response to methadone maintenance treatment". Drug and Alcohol Review. 15 (3): 271–6. doi:10.1080/09595239600186011. PMID 16203382.
176. Alterman AI, Rutherford MJ, Cacciola JS, McKay JR, Boardman CR (February 1998). "Prediction of 7 months methadone maintenance treatment response by four measures of antisociality". Drug and Alcohol Dependence. 49 (3): 217–23. doi:10.1016/S0376-8716(98)00015-5. PMID 9571386.
177. "Antisocial personality disorder". NHS. Retrieved 11 May 2016.
178. "Antisocial personality disorder: prevention and management". NICE. March 2013. Archived from the original on 11 June 2016. Retrieved 11 May 2016.
179. Beck AT, Freeman A, Davis DD (2007). Cognitive Therapy of Personality Disorders (Second ed.). New York: Guilford Press. ISBN 978-1-59385-476-8.
180. Mayo Clinic staff (12 April 2013). "Antisocial personality disorder: Treatments and drugs". Mayo Clinic. Mayo Foundation for Medical Education and Research. Retrieved 17 December 2013.
181. Khalifa NR, Gibbon S, Völlm BA, Cheung NH, McCarthy L (September 2020). "Pharmacological interventions for antisocial personality disorder". The Cochrane Database of Systematic Reviews. 2020 (9): CD007667. doi:10.1002/14651858.CD007667.pub3. PMC 8094881. PMID 32880105.
182. Brown D, Larkin F, Sengupta S, Romero-Ureclay JL, Ross CC, Gupta N, et al. (2014). "Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital". CNS Spectrums. 19 (5): 391–402. doi:10.1017/S1092852914000157. ISSN 1092-8529. PMC 4255317. PMID 24698103.
183. "Antisocial Personality Disorder: Beyond Keeping to Yourself". Cleveland Clinic. Retrieved 25 January 2024.
184. Bucholz KK, Frey RJ, Edens EL (2009). "Antisocial Personality Disorder". In Korsmeyer P, Kranzler HR (eds.). Encyclopedia of Drugs, Alcohol & Addictive Behavior. Vol. 1 (3rd ed.). Detroit, MI: Macmillan Reference USA. pp. 181–183.
185. Hatchett G (1 January 2015). "Treatment Guidelines for Clients with Antisocial Personality Disorder". Journal of Mental Health Counseling. 37 (1): 15–27. doi:10.17744/mehc.37.1.52g325w385556315. ISSN 1040-2861.
186. ^ Fisher KA, Hany M (23 November 2019). "Antisocial Personality Disorder". StatPearls . Treasure Island (FL): StatPearls Publishing. PMID 31536279.
187. ^ "Antisocial Personality Disorder". Harvard Health Publishing. 13 March 2019. Retrieved 13 December 2020.
188. Mann FD, Briley DA, Tucker-Drob EM, Harden KP (November 2015). "A behavioral genetic analysis of callous-unemotional traits and Big Five personality in adolescence". Journal of Abnormal Psychology. 124 (4): 982–993. doi:10.1037/abn0000099. PMC 5225906. PMID 26595476.
189. Habel U, Kühn E, Salloum JB, Devos H, Schneider F (September 2002). "Emotional processing in psychopathic personality". Aggressive Behavior. 28 (5): 394–400. doi:10.1002/ab.80015.
190. ^ Mueser KT, Crocker AG, Frisman LB, Drake RE, Covell NH, Essock SM (October 2006). "Conduct disorder and antisocial personality disorder in persons with severe psychiatric and substance use disorders". Schizophrenia Bulletin. 32 (4): 626–36. doi:10.1093/schbul/sbj068. PMC 2632266. PMID 16574783.
191. ^ Krasnova A, Eaton WW, Samuels JF (May 2019). "Antisocial personality and risks of cause-specific mortality: results from the Epidemiologic Catchment Area study with 27 years of follow-up". Social Psychiatry and Psychiatric Epidemiology. 54 (5): 617–625. doi:10.1007/s00127-018-1628-5. PMID 30506390. S2CID 54221869.
192. ^ Azevedo J, Vieira-Coelho M, Castelo-Branco M, Coelho R, Figueiredo-Braga M (March 2020). "Impulsive and premeditated aggression in male offenders with antisocial personality disorder". PLOS ONE. 15 (3): e0229876. Bibcode:2020PLoSO..1529876A. doi:10.1371/journal.pone.0229876. PMC 7059920. PMID 32142531.
193. "Antisocial personality disorder". nhs.uk. 21 March 2018. Retrieved 13 December 2020.
194. Lenzenweger MF, Lane MC, Loranger AW, Kessler RC (September 2007). "DSM-IV Personality Disorders in the National Comorbidity Survey Replication". Biological Psychiatry. 62 (6): 553–564. doi:10.1016/j.biopsych.2006.09.019. PMC 2044500. PMID 17217923.
195. ^ Compton WM, Conway KP, Stinson FS, Colliver JD, Grant BF (15 June 2005). "Prevalence, Correlates, and Comorbidity of DSM-IV Antisocial Personality Syndromes and Alcohol and Specific Drug Use Disorders in the United States: Results From the National Epidemiologic Survey on Alcohol and Related Conditions". The Journal of Clinical Psychiatry. 66 (6): 677–685. doi:10.4088/JCP.v66n0602. ISSN 0160-6689. PMID 15960559.
196. ^ National Collaborating Centre for Mental Health (UK). (2010). "Antisocial Personality Disorder". Antisocial Personality Disorder: Treatment, Management and Prevention. Leicester (UK): British Psychological Society. PMID 21834198.
197. Fazel S, Danesh J (16 February 2002). "Serious mental disorder in 23,000 prisoners: a systematic review of 62 surveys". The Lancet. 359 (9306): 545–550. doi:10.1016/S0140-6736(02)07740-1. PMID 11867106.
198. Robins LN, Tipp J, Przybeck T (1991). "Antisocial personality". In Robins LN, Regier DA (eds.). Psychiatric Disorders in America. New York: Free Press. pp. 258–290.
199. Fletcher JB, Reback CJ (2017). "Mental health disorders among homeless, substance-dependent men who have sex with men". Drug and Alcohol Review. 36 (4): 555–559. doi:10.1111/dar.12446. PMC 5303689. PMID 27516073.
200. Swann AC, Lijffijt M, Lane SD, Kjome KL, Steinberg JL, Moeller FG (2011). "Criminal conviction, impulsivity, and course of illness in bipolar disorder". Bipolar Disorders. 13 (2): 173–181. doi:10.1111/j.1399-5618.2011.00900.x. PMC 3151155. PMID 21443571.
201. Howard R (2015). "Personality disorders and violence: What is the link?". Borderline Personality Disorder and Emotion Dysregulation. 2: 12. doi:10.1186/s40479-015-0033-x. PMC 4579506. PMID 26401314. S2CID 7048653.
202. Verona E, Patrick CJ, Joiner TE (August 2001). "Psychopathy, antisocial personality, and suicide risk". Journal of Abnormal Psychology. 110 (3): 462–70. doi:10.1037/0021-843x.110.3.462. PMID 11502089.
203. ^ Mok PL, Pedersen CB, Springate D, Astrup A, Kapur N, Antonsen S, et al. (October 2016). "Parental Psychiatric Disease and Risks of Attempted Suicide and Violent Criminal Offending in Offspring: A Population-Based Cohort Study". JAMA Psychiatry. 73 (10): 1015–1022. doi:10.1001/jamapsychiatry.2016.1728. PMC 5079483. PMID 27580483.
204. Abram KM, Choe JY, Washburn JJ, Teplin LA, King DC, Dulcan MK (March 2008). "Suicidal ideation and behaviors among youths in juvenile detention". Journal of the American Academy of Child and Adolescent Psychiatry. 47 (3): 291–300. doi:10.1097/CHI.0b013e318160b3ce. PMC 2945393. PMID 18216737.
205. Diagnostic and Statistical Manual of Mental Disorders (PDF) (1st ed.). Washington, D. C.: American Psychiatric Association. 1952. pp. 38–39. Individuals to be placed in this category are ill primarily in terms of society and of conformity with the prevailing cultural milieu, and not only in terms of personal discomfort and relations with other individuals.
206. Forrest G (1994). Chemical dependency and antisocial personality disorder: psychotherapy and assessment strategies. New York: Haworth Press. ISBN 978-1-56024-308-3. OCLC 25246264.
207. Diagnostic and Statistical Manual of Mental Disorders (DSM-II) (PDF). Washington, D. C.: American Psychiatric Association. 1968. p. 43. Archived from the original (PDF) on 1 November 2014.
208. International Handbook on Psychopathic Disorders and the Law, Volume 1, Alan Felthous, Henning Sass, 15 April 2008, e.g. Pgs 24 – 26
209. Kendler KS, Muñoz RA, Murphy G (February 2010). "The development of the Feighner criteria: a historical perspective". The American Journal of Psychiatry. 167 (2): 134–42. doi:10.1176/appi.ajp.2009.09081155. PMID 20008944.
210. Livesley WJ, ed. (1995). The DSM-IV Personality Disorders. Guilford Press. p. 135. ISBN 978-0-89862-257-7.

Further reading

• Millon T, Davis RD (1998). "Ten Subtypes of Psychopathy". In Millon T (ed.). Psychopathy: Antisocial, Criminal and Violent Behavior. New York, NY: Guilford Press. ISBN 978-1-57230-344-7.
• Hofer P (1989). "The Role of Manipulation in the Antisocial Personality". International Journal of Offender Therapy and Comparative Criminology. 33 (2): 91–101. doi:10.1177/0306624X8903300202. S2CID 145103240.

External links

• DSM-V-TR criteria + additional information
• DSM-IV-TR Criteria for Antisocial personality disorder
• Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion

• Anti-social behaviour
• Behavioural sciences
• Cluster B personality disorders
• Criminology
• Forensic psychology
• Psychopathy