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Antisocial Personality Disorder

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Psychiatry/psychology. based on determinism ... because psychiatry/psychology view all behaviors, thoughts, and feelings as ... – PowerPoint PPT presentation

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Title: Antisocial Personality Disorder


1
Antisocial Personality Disorder
2
Personality Traits
  • characteristic ways of thinking, feeling, and
    behaving that are stable across time and across
    situations
  • considered to be a disorder when
  • traits are inflexible and maladaptive
  • cause significant functional impairment and/or
    distress

3
A Diagnostic Question
  • Are people with personality disorders
    qualitatively different from people without?
  • OR
  • Are people with personality disorders individuals
    who have extreme versions of otherwise normal
    personality traits?

4
The Answer
  • Personality disorders are probably best thought
    of as extreme positions on one or more
    personality dimensions

5
Course
  • thought to originate in childhood and continue
    into adulthood
  • believed to be relatively stable, difficult to
    treat

6
Lack of Research
  • for many personality disorders, there is
    relatively little empirical research on the
    causes and treatments

7
Some Examples
  • Paranoid personality disorder
  • pervasive pattern of distrust and suspiciousness
    of others such that their motives are interpreted
    as malevolent
  • Narcissistic personality disorder
  • pervasive pattern of grandiosity, need for
    admiration, and lack of empathy

8
Antisocial Personality Disorder
  • pervasive pattern of disregard for and violation
    of the rights of others since age 15

9
DSM-IV-TR criteria
  • at least 3 sx
  • failure to conform to social norms with respect
    to lawful behavior (repeated arrests)
  • deceitfulness (repeated lying, use of aliases,
    conning)
  • impulsivity, failure to plan ahead
  • irritability and aggressiveness (repeated fights)
  • reckless disregard for safety of others
  • consistent irresponsibility (no steady
    employment, doesnt honor financial obligations)
  • lack of remorse (indifferent to or rationalizes
    having hurt, mistreated, or stolen from others)

10
DSM-IV-TR (continued)
  • must be at least 18
  • evidence of conduct disorder prior to age 15
  • violation of basic rights of others and major
    social rules
  • aggression toward people and/or animals
  • destruction of property
  • deceitfulness or theft
  • serious violation of rules (stays out all night,
    truant)

11
Prevalence
  • community samples
  • males 3
  • females 1
  • clinical settings
  • 3 - 30, depending upon characteristics of
    population sampled
  • higher prevalence rates are found in substance
    abuse treatment settings and prison

12
Causes Biological
  • genetics
  • family, adoption, and twin studies show evidence
    of a genetic link
  • examples
  • offspring of felons raised by adoptive families
    show higher rates of arrests and antisocial
    personality disorder than controls
  • concordance rates for criminality are 55 for MZ
    twins and 13 for DZ twins

13
But what do they inherit?
  • underarousal hypothesis
  • psychopaths have abnormally low levels of
    cortical arousal
  • engage in antisocial and risk-taking behaviors to
    increase level of arousal
  • evidence
  • longitudinal study found that future criminals
    had lower skin conductance activity, lower heart
    rate, and more slow-frequency brain wave activity

14
  • fearlessness hypothesis
  • psychopaths have a higher threshold for
    experiencing fear than most people
  • evidence
  • psychopaths are less likely to develop a
    classically conditioned fear response

15
Psychological and Social Influences
  • oversensitivity to reward
  • will persist in efforts to achieve goal, even
    when goal is no longer attainable
  • inconsistent parental discipline
  • giving in to problem behavior and poor monitoring
  • other environmental influences
  • low SES, stress, and degree of mutual trust and
    solidarity in neighborhood linked to antisocial
    behaviors

16
Treatment
  • prognosis for adults is poor
  • best strategy is to intervene with high risk
    children
  • teach parents to use behavioral management
    principles to reduce problem behavior and
    increase prosocial behavior
  • research suggests such programs reduce antisocial
    behavior

17
A Philosophical Debate
  • Lykken (1982) has argued that the assumptions of
    the legal system and psychology/psychiatry differ
  • Legal system
  • assumes the existence of free will
  • belief that, with rare exceptions, humans are
    capable of freely choosing their actions

18
A Philosophical Debate (continued)
  • Psychiatry/psychology
  • based on determinism
  • belief that thoughts, feelings, and behaviors
    have potentially identifiable causes (such as
    biological or environmental factors) that can be
    explained in terms of scientific principles

19
Ramifications for Legal System
  • Lykken (1982)
  • legal system wants to know if person should be
    held responsible for his/her crime
  • in order to be held responsible, person must have
    freely chosen the act
  • it is logically contradictory to ask
    psychiatry/psychology experts to distinguish
    individuals who are responsible for their crimes
    from individuals who are not

20
Lykken (1982) continued
  • because psychiatry/psychology view all behaviors,
    thoughts, and feelings as determined, these
    disciplines cannot provide a meaningful answer as
    to whether a person should be held responsible
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