The 'antisocial' person: an insight in to biology, classification and current evidence on treatment

Abstract

BackgroundThis review analyses and summarises the recent advances in understanding the neurobiology of violence and empathy, taxonomical issues on defining personality disorders characterised by disregard for social norms, evidence for efficacy of different treatment modalities and ethical implications in defining 'at-risk' individuals for preventive interventions.MethodsPubMed was searched with the keywords 'antisocial personality disorder', 'dissocial personality disorder' and 'psychopathy'. The search was limited to articles published in English over the last 10 years (1999 to 2009)ResultsBoth diagnostic manuals used in modern psychiatry, the Diagnostic and Statistical Manual published by the American Psychiatric Association and the International Classification of Diseases published by the World Health Organization, identify a personality disorder sharing similar traits. It is termed antisocial personality disorder in the diagnostic and statistical manual and dissocial personality disorder in the International Classification of Diseases. However, some authors query the ability of the existing manuals to identify a special category termed 'psychopathy', which in their opinion deserves special attention. On treatment-related issues, many psychological and behavioural therapies have shown success rates ranging from 25% to 62% in different cohorts. Multisystemic therapy and cognitive behaviour therapy have been proven efficacious in many trials. There is no substantial evidence for the efficacy of pharmacological therapy. Currently, the emphasis is on early identification and prevention of antisocial behaviour despite the ethical implications of defining at-risk children.ConclusionsFurther research is needed in the areas of neuroendocrinological associations of violent behaviour, taxonomic existence of psychopathy and efficacy of treatment modalities.

Borderline personality disorder associates with violent criminality in women: A population based follow-up study of adolescent psychiatric inpatients in Northern Finland

“…In particular, people with an antisocial or borderline PD have been found to be more likely to commit crimes [11]. Assessment of the diagnosis of antisocial PD even requires criminal of unlawful behaviour to have taken place [7,8,12]. Some studies have suggested that particular PD features may lead to a certain kind of criminality, for example that subjects with antisocial PD engage more in crimes against property, whereas subjects with borderline PD are seen as emotionally unstable and impulsive, which may lead to physical violence [13,14].…”

Are Psychopathy Checklist (PCL) psychopaths dangerous, untreatable, and without conscience? A systematic review of the empirical evidence.

“…4The unsystematic reviews are Abracen et al, 2008; Bailey, Sehgal, Coscia, & Shelton, 2015; D’Silva, Duggan, & McCarthy, 2004; de Ruiter et al, 2016; Doren & Yates, 2008; Gacono et al, 2001; Garrido, Esteban, & Molero, 1995; Harris & Rice, 2006; Hecht et al, 2018; Polaschek, 2014; Polaschek & Daly, 2013; Polaschek & Skeem, 2018; Reidy et al, 2013; Rodrigo, Rajapakse, & Jayananda, 2010; Rosenfeld, Howe, Pierson, & Foellmi, 2015; Salekin, 2002; Salekin et al, 2010; Shaw & Porter, 2012.…”

Genome-wide association study of antisocial personality disorder

“…5 , 49 Although ASPD and psychopathy diagnoses are based on different assessment tools, the distinction between those two is not completely clear. 50 , 51 We consider our study sample relatively homogenous as the participants were all criminal offenders and had a convergent diagnosed ASPD. However, to further study the behavioral origin of our genome-wide significant hit, rs4714329, we investigated its association individually with each of the SCID II items used in this study.…”