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Conduct Disorder, Antisocial Personality Disorder, and Psychopathy

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A repetitive & persistent pattern of seriously antisocial behavior, usually ... Major distinction appears to be in symptomatology. ... – PowerPoint PPT presentation

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Title: Conduct Disorder, Antisocial Personality Disorder, and Psychopathy


1
Conduct Disorder, Antisocial Personality
Disorder, and Psychopathy
2
What is conduct disorder?
  • A repetitive persistent pattern of seriously
    antisocial behavior, usually criminal (illegal)
    in nature marked by extreme callousness.
  • Diagnosis is made in individuals under age 18.
  • Behaviors may include (but not limited to)
  • Cruelty toward animals and/or people
  • Vandalism
  • Lying
  • Theft
  • Physical aggressiveness

3
Conduct Disorder comorbidity
  • Attention Deficit Hyperactivity Disorder
  • Substance use disorders (alcohol, marijuana)
  • Anxiety
  • Depression (15-45)

4
What is prevalence of conduct disorder?
  • Offord colleagues (1987) conducted a study of
    more than 2,500 children in Ontario, Canada.
  • They found that 8 of boys 3 of girls aged
    4-16 met the DSM criteria for conduct disorder.
  • Rates may climb to 16 in boys during
    adolescence.
  • Violent crimes, such as rape aggravated assault
    are largely crimes produced by adolescents.
    Activity peaks by age 17 then drops off.

5
Do kids with conduct disorder become antisocial
adults?
  • More than half of children diagnosed with conduct
    disorder do not become antisocial personalities
    in adulthood (Loeber, 1991 Zoccolillo et al.,
    1992).
  • Males with conduct disorder who had fathers with
    antisocial behavior poor verbal intelligence,
    more likely to develop APD.

6
Moffitts theory Two courses of conduct
disorder
  • 1. Life-course persistent pattern of
    antisocial behavior, beginning with problems by
    age 3 continuing into adulthood.
  • 2. Adolescent-limited normal childhood with
    high levels of antisocial behavior during
    adolescence that does not continue into adulthood.

7
What are Personality Disorders (Axis II)?
  • These are long-standing, pervasive, inflexible
    patterns of behavior.
  • Usually impair social occupational functioning.
  • Are often comorbid with Axis I disorders (e.g.,
    substance use, depression)
  •  
  • Make treating an Axis I disorder more difficult.

8
What is an Antisocial Personality Disorder (APD)?
  • DSM diagnosis
  • 1. The presence of a conduct disorder before
    the age of 15
  • Truancy running away from home
  • Theft compulsive lying
  • Arson vandalism
  • 2. The continuation of this pattern of behavior
    into adulthood.

9
APD features
  • Irresponsible antisocial behavior
  • Criminality (breaking laws)core feature
  • Irritability
  • Physical aggressiveness
  • Defaulting on debts
  • Impulsivity
  • Pathological lying
  • Lack of remorse Not necessary for diagnosis
  • Prevalence 3 of males 1 of females in U.S.

10
What is Psychopathy?
  • Core features-
  • Psychopaths lack remorse
  • Poverty of emotions (positive negative)
  • Psychopaths are
  • Superficially charming
  • Pathological liars cheaters
  • Impulsive sensations seekers
  • Manipulative, will change story to fit facts
  • Less responsive to fear/anxiety
  • Immoral
  • Usually men

11
Psychopaths identified by Hare checklist
  • Two clusters
  • 1. Emotional detachment cluster (a selfish
    remorseless individual with inflated self-esteem
    who exploits others.)
  • 2. Antisocial lifestyle cluster- marked by
    impulsivity irresponsibility.

12
What is the difference between APD and
psychopathy?
  • Major distinction appears to be in
    symptomatology.
  • Lack of remorse, a core symptom of psychopathy,
    is not required for diagnosis of APD.
  • In one study, 75 to 80 of convicted felons met
    criteria for APD, but failed to meet criteria for
    psychopathy.

13
Are psychopaths born or made?
  • Most likely there are components of both that
    account for the development of full fledged
    psychopathy.

14
Putative causes of APD psychopathy?
  • 1. Family
  • McCord McCord (1964) concluded that lack of
    affection severe parental rejection may be
    primary causes of psychopathic behavior.
  • Other suspected family related factors are
  • Inconsistencies in discipline or no discipline at
    all, physical abuse, marital discord, substance
    use.

15
2. Both antisocial personalities criminal
behavior have heritable components.
  • Twin Studies
  • 1. Higher concordance rate for MZ twins than for
    DZ twins in APD (Lyons et al., 1995).
  • Adoption Studies
  • 2. Higher rate of antisocial behavior in adopted
    children of biological parents with APD.

16
3. Fathers behavior
  • Fathers of psychopaths are likely to be
    antisocial personalities themselves!!!!!!

17
Whats likely to be going on?
  • Child with diathesis for antisocial behavior may
    be difficult to deal with produce environmental
    changes that result in harsh conditions
    (treatment) by family members.
  • This may fuel development of full blown
    antisocial behavior.

18
Are psychopaths less prone to anxiety than normal
people?
  • Yes!!!
  • Lykken (1957) studied the ability of psychopaths
    controls to avoid shock.
  • Psychopaths were poorer than controls at avoiding
    the shocks, suggesting they are low in anxiety
    compared to controls.

19
Do psychopaths show less autonomic arousal to
fear eliciting stimuli than controls?
  • Psychopaths show a pattern of autonomic activity
    that suggests they tune out aversive stimuli.
  • Their hearts beat faster than normals when
    anticipating stress, but their skin conductance
    levels are lower than controls in response to
    aversive stimuli.
  • This makes them appear under-aroused when they
    are not.

20
Startle Blink studies
  • The startle blink response is a good non-verbal
    indicator of emotional state.
  • Magnitude of the startle blink changes with
    emotional state.
  • It increases for a negative emotional state
    decreases for a positive emotional state.

21
Patrick (1994) Startle blink study
  • Subjects 4 groups of prisoners selected with
    Hare checklist participated.
  • Group 1 nonpsychopaths (low on antisocial
    behavior emotional detachment)
  • Group 2 Detached white collar offenders (high
    only on emotional detachment)
  • Group 3 Antisocial offenders (high only on
    antisocial behavior)
  • Group 4 Psychopaths (high on both factors).

22
Procedure
  • Baseline condition- prisoners were presented with
    a visual cue, sometimes with a blast of loud
    noise.
  • Experimental condition - Ss experienced the
    visual cue were told that when it disappeared
    the loud noise would occur.
  • Both psychopaths detached offenders showed much
    smaller increases in their startle responses,
    indicating that less fear had been aroused.

23
Do psychopaths show less empathy for distress of
others?
  • Yes!!! Blair coworkers (1997), examined skin
    conductance of psychopaths controls (men) to
    slides of varying images.
  • Ss were shown threatening (guns), neutral (lamp),
    distress-provoking (crying person) slides.
  • The two groups showed the same responses to the
    threatening neutral slides. However,
    psychopaths were less responsive to the distress
    slides.

24
Summary
  • Psychopaths feel emotions less intensely than
    normal individuals.
  • Psychopaths not under-aroused compared to normal
    Ss, but are better at tuning out unpleasant
    stimuli.
  • They lack empathy.
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