Transcript Antisocial Personality Disorder and Psychopathy

Antisocial Personality Disorder
and
Psychopathy
DSM-IV Criteria for ASPD
• Must be at least 18 years old
• Three or more of the following:
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Conduct disorder before the age of 15
Disregard for the rights of others
Impulsive, irresponsible behavior
Deceitfulness
Irritability and aggressiveness
Reckless disregard for the safety of others
Lack of remorse
Low tolerance for frustration and boredom
Prevalence of ASPD
• 3.6% in general population
• 5.5% in men
• 1.9% in women
Negative Outcomes
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Criminality
Domestic partner violence
Suicidality
Substance Use Disorders
– Most common comorbid disorder
– Greater severity of impairment
– Poor treatment outcomes
– Higher levels of needle drug use
ASPD and Psychopathy
• Psychopathy
– Factor 1: affective interpersonal component
– Factor 2: antisocial component
• Farrington Chapter
– Cambridge Study: The two factors related
differentially to convictions and ASPD criteria
– Predictors of psychopathy similar to that of
ASPD
Psychopathy
• DSM-IV equates psychopathy and
ASPD
• ASPD research has focused on
behavioral features
• Psychopathy research has focused
on emotional features
Family Factors
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Childrearing
Abuse
Parental conflict/disrupted families
Large family size
Criminal or antisocial parents or siblings
Other characteristics of parents
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Young age
Substance abuse
Stress or depression
SES factors
Environemental Factors
• Delinquent peers
• Schools
– Those with high rates of delinquency
• Inconsistent rule enforcement
• Lack of commitment by staff, teachers
• Neighborhoods
Other Risk Factors
• Predictors of psychopathy at age 48
– Low non-verbal IQ
– Low verbal IQ
– High risk-taking
– Poor concentration or restlessness
– High impulsivity on psychomotor tests
Biopsychosocial Interactions
and Protective Factors
• Multiple risk factors often exist for
any individual and have multiplicative
interaction effects
• However sometimes protective
effects may offset this
Lahey, 2005
• Background
– Childhood CD behaviors are significant
predictors of adulthood ASPD
– However many boys with CD do not develop
ASPD
• Purpose: Determine greater specificity of
risk for development of ASPD
• Hypothesis: Childhood CD is an
independent predictor of adult APD in
males, but childhood ADHD does not
predict later APD when controlling for CD
and ODD.
Results (Lahey, 2005)
• Childhood Characteristics predicting adult ASPD
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Race
Total family income
Maternal education
SES
CD Symptoms
ODD Symptoms
Maternal ASPD, not Paternal
• Regression analyses
– CD and low SES
– Engagement in covert behaviors
• CD and ADHD did not predict later ASPD
– Most boys with CD had ADHD
– However not all boys with ADHD had CD
Psychopathy Research
• Consistent finding of lack of
emotionality in response to aversive
events
– Startle-elicited blink response
– Aversive noise blast paradigms
• Callous and unemotional traits
responsible for these findings
ASPD and Psychopathy
• Most psychopaths would qualify as
having ASPD, but not all individuals
with ASPD are psychopaths
• All serial killers would probably
qualify as psychopaths, but not all
psychopaths are serial killers