Offenders With Antisocial Personality Disorder Display More Impairments in Mentalizing

Abstract

This study was designed to test the hypothesis that individuals with antisocial, particularly violent, histories of offending behavior have specific problems in social cognition, notably in relation to accurately envisioning mental states. Eighty-three male offenders on community license, 65% of whom met the threshold for antisocial personality disorder (ASPD), completed a battery of computerized mentalizing tests requiring perspective taking (Perspectives Taking Test), mental state recognition from facial expression (Reading the Mind in the Eyes Test), and identification of mental states in the context of social interaction (Movie for the Assessment of Social Cognition). The results were compared with a partially matched sample of 42 nonoffending controls. The offender group showed impaired mentalizing on all of the tasks when compared with the control group for this study when controlling for demographic and clinical variables, and the offending group performed poorly in comparisons with participants in published studies, suggesting that limited capacity to mentalize may be part of the picture presented by individuals with histories of offending behavior. Offenders with ASPD demonstrated greater difficulty with mentalizing than non-ASPD offenders. Mentalization subscales were able to predict offender status and those with ASPD, indicating that specific impairments in perspective taking, social cognition, and social sensitivity, as well as tendencies toward hypomentalizing and nonmentalizing, are more marked in individuals who meet criteria for a diagnosis of ASPD. Awareness of these deficits may be helpful to professionals working with offenders, and specifically addressing these deficits may be a productive aspect of therapy for this "hard to reach" clinical group.

Attachment, mentalisation and expressed emotion in carers of people with long-term mental health difficulties

“…Originally developed as a tool to discriminate adults with Asperger syndrome or high-functioning autism from controls, the RMET [ 30 ] is now widely used to assess ToM (the ability to conceive of and determine others’ mental states). It was chosen for use in this study because it is the only validated test of the extent to which individuals can identify external aspects of emotion in others that demonstrates no correlation with general intelligence [ 32 ]. Participants are presented with 36 photographs of the facial region around the eyes and are asked to choose one of four single-word descriptors of possible mental states.…”

Reflective Functioning on the Parent Development Interview: validity and reliability in relation to socio-demographic factors

“…As parental mentalization is thought essential to a range of developmental and socio-emotional processes, impingements on its development, particularly as the result of adverse childhood experiences, will generate maladaptive (psychopathological) outcomes (Fonagy, 2003). Evidence consistent with this developmental model has been accumulating, for example, in investigations of the impact of severe childhood trauma on RF (Berthelot et al, 2015;Ensink, Bégin, Normandin, & Fonagy, 2015;Ensink, Berthelot, Bernazzani, Normandin, & Fonagy, 2014;Ensink, Leroux, Normandin, Biberdzic, & Fonagy, 2015;Newbury-Helps, Feigenbaum, & Fonagy, 2016;Sharp et al, 2016).…”

A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder

“…It appears that those with BPD tend to mentalize ‘normally’ except in the context of attachment relationships, in which emotional arousal occludes the ability to accurately interpret mind states (both their own minds and those of others)—particularly when the fear of real or imagined abandonment arises. Difficulties with mentalization manifest slightly differently for antisocial individuals, who show a more general and deeper impairment, including deficits in the recognition of basic emotions [25], and perform far worse than controls on subtle tests of mentalizing [26, 27]. Deficits in social cognition in general and the capacity to link mental states to behaviour in particular are commonly identified in association with antisocial behaviour [28, 29].…”