Antisocial Personality Disorder and

Psychopathy

DSM-IV Criteria for ASPD

• Must be at least 18 years old• Three or more of the following:

– Conduct disorder before the age of 15– Disregard for the rights of others– Impulsive, irresponsible behavior– Deceitfulness– Irritability and aggressiveness– Reckless disregard for the safety of others– Lack of remorse– Low tolerance for frustration and boredom

Prevalence of ASPD

• 3.6% in general population

• 5.5% in men

• 1.9% in women

Negative Outcomes

• Criminality

• Domestic partner violence

• Suicidality

• Substance Use Disorders– Most common comorbid disorder– Greater severity of impairment– Poor treatment outcomes– Higher levels of needle drug use

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

• Childrearing • Abuse• Parental conflict/disrupted families• Large family size• Criminal or antisocial parents or siblings• Other characteristics of parents

– Young age– Substance abuse– Stress or depression– SES factors

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

– 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