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Published in: Current Psychiatry Reports 12/2013

01-12-2013 | Personality Disorders (C Schmahl, Section Editor)

Antisocial Personality Disorder: A Current Review

Authors: Andrea L. Glenn, Alexandria K. Johnson, Adrian Raine

Published in: Current Psychiatry Reports | Issue 12/2013

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Abstract

The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classification of antisocial personality disorder (ASPD) describes individuals who engage in repetitive irresponsible, delinquent, and criminal behavior. The diagnosis is highly controversial, with many researchers and clinicians arguing that the category is too heterogeneous, overinclusive, and demonstrates considerable overlap with other disorders. This review focuses on recent studies that have improved our understanding of the characteristics of individuals who fit the ASPD definition by exploring how subtypes differ and how comorbid conditions influence the presentation of ASPD. In addition, we discuss research on the etiology of ASPD that has identified genetic and environmental factors that may contribute to the development and persistence of antisocial behavior, and brain imaging research that has improved our understanding of the relationships between ASPD and other psychopathology. Finally, we discuss promising preliminary research on treatment for this disorder.
Literature
4.
go back to reference Hare RD. Hare Psychopathy Checklist-Revised (PCL-R): 2nd Edition. Toronto: Multi-Health Systems, Inc.; 2003. Hare RD. Hare Psychopathy Checklist-Revised (PCL-R): 2nd Edition. Toronto: Multi-Health Systems, Inc.; 2003.
6.
go back to reference Poythress NG, Edens JF, Skeem JL, Lilienfeld SO, Douglas KS, Frick PJ, et al. Identifying subtypes among offenders with antisocial personality disorder: a cluster-analytic study. J Abnorm Psychol. 2010;119(2):389–400. doi:10.1037/a0018611.PubMedCrossRef Poythress NG, Edens JF, Skeem JL, Lilienfeld SO, Douglas KS, Frick PJ, et al. Identifying subtypes among offenders with antisocial personality disorder: a cluster-analytic study. J Abnorm Psychol. 2010;119(2):389–400. doi:10.​1037/​a0018611.PubMedCrossRef
7.
go back to reference Magyar MS, Edens JF, Lilienfeld SO, Douglas KS, Poythress Jr NG. Examining the relationship among substance abuse, negative emotionality and impulsivity across subtypes of antisocial and psychopathic substance abusers. J Crim Justice. 2011;39(3):232–7. doi:10.1016/j.jcrimjus.2011.02.013.CrossRef Magyar MS, Edens JF, Lilienfeld SO, Douglas KS, Poythress Jr NG. Examining the relationship among substance abuse, negative emotionality and impulsivity across subtypes of antisocial and psychopathic substance abusers. J Crim Justice. 2011;39(3):232–7. doi:10.​1016/​j.​jcrimjus.​2011.​02.​013.CrossRef
8.
9.
go back to reference Lilienfeld SO, Andrews BP. Development and preliminary validation of a self-report measure of psychopathic personality traits in noncriminal populations. J Pers Assess. 1996;66:488–524.PubMedCrossRef Lilienfeld SO, Andrews BP. Development and preliminary validation of a self-report measure of psychopathic personality traits in noncriminal populations. J Pers Assess. 1996;66:488–524.PubMedCrossRef
10.
go back to reference Anton ME, Baskin-Sommers AR, Vitale JE, Curtin JJ, Newman JP. Differential effects of psychopathy and antisocial personality disorder symptoms on cognitive and fear processing in female offenders. Cogn Affect Behav Neurosci. 2012;12(4):761–76. doi:10.3758/s13415-012-0114-x.PubMedCrossRef Anton ME, Baskin-Sommers AR, Vitale JE, Curtin JJ, Newman JP. Differential effects of psychopathy and antisocial personality disorder symptoms on cognitive and fear processing in female offenders. Cogn Affect Behav Neurosci. 2012;12(4):761–76. doi:10.​3758/​s13415-012-0114-x.PubMedCrossRef
12.
go back to reference • Gregory S, Ffytche D, Simmons A, Kumari V, Howard M, Hodgins S, et al. The antisocial brain: psychopathy matters. Arch Gen Psychiatry. 2012;69(9):962–72. doi:10.1001/archgenpsychiatry.2012.222. This study demonstrates the importance of including information about psychopathic traits in studies examining ASPD. The authors find reductions in gray matter only in offenders with ASPD and psychopathic traits.PubMedCrossRef • Gregory S, Ffytche D, Simmons A, Kumari V, Howard M, Hodgins S, et al. The antisocial brain: psychopathy matters. Arch Gen Psychiatry. 2012;69(9):962–72. doi:10.​1001/​archgenpsychiatr​y.​2012.​222. This study demonstrates the importance of including information about psychopathic traits in studies examining ASPD. The authors find reductions in gray matter only in offenders with ASPD and psychopathic traits.PubMedCrossRef
13.
go back to reference • Hodgins S, De Brito SA, Chhabra P, Cote G. Anxiety disorders among offenders with antisocial personality disorders: a distinct subtype? Can J Psychiatr Rev Can Psychiatr. 2010;55(12):784–91. Although it was previously thought that anxiety limited criminal activity, this study reports that two-thirds of prisoners with ASPD present with a lifetime anxiety disorder. This suggests that anxiety is more prevalent than previously thought, and suggests that treatments may benefit from considering the role of anxiety in the development of aggressive behavior. • Hodgins S, De Brito SA, Chhabra P, Cote G. Anxiety disorders among offenders with antisocial personality disorders: a distinct subtype? Can J Psychiatr Rev Can Psychiatr. 2010;55(12):784–91. Although it was previously thought that anxiety limited criminal activity, this study reports that two-thirds of prisoners with ASPD present with a lifetime anxiety disorder. This suggests that anxiety is more prevalent than previously thought, and suggests that treatments may benefit from considering the role of anxiety in the development of aggressive behavior.
17.
go back to reference Mueser KT, Gottlieb JD, Cather C, Glynn SM, Zarate R, Smith LF, et al. Antisocial Personality Disorder in People with Co-Occurring Severe Mental Illness and Substance Use Disorders: Clinical, Functional, and Family Relationship Correlates. Psychosis. 2012;4(1):52–62. doi:10.1080/17522439.2011.639901.PubMedCrossRef Mueser KT, Gottlieb JD, Cather C, Glynn SM, Zarate R, Smith LF, et al. Antisocial Personality Disorder in People with Co-Occurring Severe Mental Illness and Substance Use Disorders: Clinical, Functional, and Family Relationship Correlates. Psychosis. 2012;4(1):52–62. doi:10.​1080/​17522439.​2011.​639901.PubMedCrossRef
18.
go back to reference Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA J Am Med Assoc. 1990;264(19):2511–8.CrossRef Regier DA, Farmer ME, Rae DS, Locke BZ, Keith SJ, Judd LL, et al. Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study. JAMA J Am Med Assoc. 1990;264(19):2511–8.CrossRef
19.
go back to reference Chavez JX. Assessing the incidence rates of substance use disorders among those with antisocial and borderline personality disorders in rural settings. Int J Psychol. 2010;2010(6):57–66. Chavez JX. Assessing the incidence rates of substance use disorders among those with antisocial and borderline personality disorders in rural settings. Int J Psychol. 2010;2010(6):57–66.
20.
go back to reference Sylvers P, Landfield KE, Lilienfeld SO. Heavy episodic drinking in college students: associations with features of psychopathy and antisocial personality disorder. J Am Coll Health J ACH. 2011;59(5):367–72. doi:10.1080/07448481.2010.511363.CrossRef Sylvers P, Landfield KE, Lilienfeld SO. Heavy episodic drinking in college students: associations with features of psychopathy and antisocial personality disorder. J Am Coll Health J ACH. 2011;59(5):367–72. doi:10.​1080/​07448481.​2010.​511363.CrossRef
21.
22.
go back to reference Moffitt TE. The new look of behavioral genetics in developmental psychopathology: Gene-environment interplay in antisocial behaviors. Psychol Bull. 2005;131:533–54.PubMedCrossRef Moffitt TE. The new look of behavioral genetics in developmental psychopathology: Gene-environment interplay in antisocial behaviors. Psychol Bull. 2005;131:533–54.PubMedCrossRef
24.
go back to reference • Barnes JC, Beaver KM, Boutwell BB. Examining the genetic underpinnings to Moffitt’s developmental taxonomy: A behavioral genetic analysis. Criminology. 2011;49(4):923–54. doi:10.1111/j.1745-9125.2011.00243.x. This study examines sibling pairs and finds that genetic factors explain more of the variance in being classified as a life-course persistent offender than as an adolescent-limited offender. This highlights the idea that these two groups have different underlying etiologies.CrossRef • Barnes JC, Beaver KM, Boutwell BB. Examining the genetic underpinnings to Moffitt’s developmental taxonomy: A behavioral genetic analysis. Criminology. 2011;49(4):923–54. doi:10.​1111/​j.​1745-9125.​2011.​00243.​x. This study examines sibling pairs and finds that genetic factors explain more of the variance in being classified as a life-course persistent offender than as an adolescent-limited offender. This highlights the idea that these two groups have different underlying etiologies.CrossRef
25.
go back to reference Moffitt TE. Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychol Rev. 1993;100(4):674–701.PubMedCrossRef Moffitt TE. Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychol Rev. 1993;100(4):674–701.PubMedCrossRef
27.
go back to reference Caspi A, McClay J, Moffitt TE, Mill J, Martin J, Craig IW, et al. Role of genotype in the cycle of violence in maltreated children. Science. 2002;297:851–4.PubMedCrossRef Caspi A, McClay J, Moffitt TE, Mill J, Martin J, Craig IW, et al. Role of genotype in the cycle of violence in maltreated children. Science. 2002;297:851–4.PubMedCrossRef
28.
go back to reference Ponce G, Jimenez-Arriero MA, Rubio G, Hoenicka J, Ampuero I, Ramos JA, et al. The A1 allele of the DRD2 gene (TaqI A polymorphisms) is associated with antisocial personality in a sample of alcohol-dependent patients. Eur Psychiatry. 2003;18(7):356–60. doi:10.1016/j.eurpsy.2003.06.006.PubMedCrossRef Ponce G, Jimenez-Arriero MA, Rubio G, Hoenicka J, Ampuero I, Ramos JA, et al. The A1 allele of the DRD2 gene (TaqI A polymorphisms) is associated with antisocial personality in a sample of alcohol-dependent patients. Eur Psychiatry. 2003;18(7):356–60. doi:10.​1016/​j.​eurpsy.​2003.​06.​006.PubMedCrossRef
29.
go back to reference Basoglu C, Oner O, Ates A, Algul A, Bez Y, Cetin M, et al. Synaptosomal-associated protein 25 gene polymorphisms and antisocial personality disorder: association with temperament and psychopathy. Can J Psychiatr Rev Can Psychiatr. 2011;56(6):341–7. Basoglu C, Oner O, Ates A, Algul A, Bez Y, Cetin M, et al. Synaptosomal-associated protein 25 gene polymorphisms and antisocial personality disorder: association with temperament and psychopathy. Can J Psychiatr Rev Can Psychiatr. 2011;56(6):341–7.
30.
go back to reference Lesch K-P, Bengel D, Heils A, Sabol SZ, Greenberg B, Petri S, et al. Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science. 1996;274:1527–31.PubMedCrossRef Lesch K-P, Bengel D, Heils A, Sabol SZ, Greenberg B, Petri S, et al. Association of anxiety-related traits with a polymorphism in the serotonin transporter gene regulatory region. Science. 1996;274:1527–31.PubMedCrossRef
31.
go back to reference Roberts AL, Gilman SE, Fitzmaurice G, Decker MR, Koenen KC. Witness of intimate partner violence in childhood and perpetration of intimate partner violence in adulthood. Epidemiology (Cambridge, Mass). 2010;21(6):809–18. doi:10.1097/EDE.0b013e3181f39f03.CrossRef Roberts AL, Gilman SE, Fitzmaurice G, Decker MR, Koenen KC. Witness of intimate partner violence in childhood and perpetration of intimate partner violence in adulthood. Epidemiology (Cambridge, Mass). 2010;21(6):809–18. doi:10.​1097/​EDE.​0b013e3181f39f03​.CrossRef
32.
go back to reference Berg-Nielsen TS, Wichstrom L. The mental health of preschoolers in a Norwegian population-based study when their parents have symptoms of borderline, antisocial, and narcissistic personality disorders: at the mercy of unpredictability. Child Adolesc Psychiatry Mental health. 2012;6(1):19. doi:10.1186/1753-2000-6-19.CrossRef Berg-Nielsen TS, Wichstrom L. The mental health of preschoolers in a Norwegian population-based study when their parents have symptoms of borderline, antisocial, and narcissistic personality disorders: at the mercy of unpredictability. Child Adolesc Psychiatry Mental health. 2012;6(1):19. doi:10.​1186/​1753-2000-6-19.CrossRef
34.
go back to reference Robertson LA, McAnally HM, Hancox RJ. Childhood and Adolescent Television Viewing and Antisocial Behavior in Early Adulthood. Pediatrics. 2013. doi:10.1542/peds.2012-1582. Robertson LA, McAnally HM, Hancox RJ. Childhood and Adolescent Television Viewing and Antisocial Behavior in Early Adulthood. Pediatrics. 2013. doi:10.​1542/​peds.​2012-1582.
35.
go back to reference Shi Z, Bureau JF, Easterbrooks MA, Zhao X, Lyons-Ruth K. Childhood Maltreatment and Prospectively Observed Quality of Early Care as Predictors of Antisocial Personality Disorder Features. Infant Ment Health J. 2012;33(1):55–96. doi:10.1002/imhj.20295.PubMedCrossRef Shi Z, Bureau JF, Easterbrooks MA, Zhao X, Lyons-Ruth K. Childhood Maltreatment and Prospectively Observed Quality of Early Care as Predictors of Antisocial Personality Disorder Features. Infant Ment Health J. 2012;33(1):55–96. doi:10.​1002/​imhj.​20295.PubMedCrossRef
36.
go back to reference Liu N, Zhang Y, Brady HJ, Cao Y, He Y, Zhang Y. Relation between childhood maltreatment and severe intrafamilial male-perpetrated physical violence in Chinese community: the mediating role of borderline and antisocial personality disorder features. Aggress Behav. 2011. doi:10.1002/ab.20417.PubMed Liu N, Zhang Y, Brady HJ, Cao Y, He Y, Zhang Y. Relation between childhood maltreatment and severe intrafamilial male-perpetrated physical violence in Chinese community: the mediating role of borderline and antisocial personality disorder features. Aggress Behav. 2011. doi:10.​1002/​ab.​20417.PubMed
37.
go back to reference Kumari V, Gudjonsson GH, Raghuvanshi S, Barkataki I, Taylor P, Sumich A, et al. Reduced thalamic volume in men with antisocial personality disorder or schizophrenia and a history of serious violence and childhood abuse. Eur Psychiatr J Assoc Eur Psychiatr. 2013;28(4):225–34. doi:10.1016/j.eurpsy.2012.03.002.CrossRef Kumari V, Gudjonsson GH, Raghuvanshi S, Barkataki I, Taylor P, Sumich A, et al. Reduced thalamic volume in men with antisocial personality disorder or schizophrenia and a history of serious violence and childhood abuse. Eur Psychiatr J Assoc Eur Psychiatr. 2013;28(4):225–34. doi:10.​1016/​j.​eurpsy.​2012.​03.​002.CrossRef
38.
go back to reference Moffitt TE, Caspi A, Harrington H, Milne BJ. Males on the life-course-persistent and adolescence-limited antisocial pathways: follow-up at age 26 years. Dev Psychopathol. 2002;14(1):179–207.PubMedCrossRef Moffitt TE, Caspi A, Harrington H, Milne BJ. Males on the life-course-persistent and adolescence-limited antisocial pathways: follow-up at age 26 years. Dev Psychopathol. 2002;14(1):179–207.PubMedCrossRef
39.
go back to reference Glenn AL, Yang Y, Raine A. Neuroimaging in psychopathy and antisocial personality disorder: Functional significance and a neurodevelopmental hypothesis. In: Simpson J, editor. Neuroimaging in Forensic Psychiatry. Oxford: Wiley-Blackwell; 2012. Glenn AL, Yang Y, Raine A. Neuroimaging in psychopathy and antisocial personality disorder: Functional significance and a neurodevelopmental hypothesis. In: Simpson J, editor. Neuroimaging in Forensic Psychiatry. Oxford: Wiley-Blackwell; 2012.
40.
go back to reference Yang Y, Raine A. Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: a meta-analysis. Psychiatry Res. 2009;174:81–8.PubMedCrossRef Yang Y, Raine A. Prefrontal structural and functional brain imaging findings in antisocial, violent, and psychopathic individuals: a meta-analysis. Psychiatry Res. 2009;174:81–8.PubMedCrossRef
41.
go back to reference • Raine A, Yang Y, Narr KL, Toga AW. Sex differences in orbitofrontal gray as a partial explanation for sex differences in antisocial personality. Mol Psychiatry. 2011;16(2):227–36. doi:10.1038/mp.2009.136. This study proposes a potential explanation for the large gender difference in antisocial behavior – the gender difference in the size of the orbitofrontal cortex, which is smaller in males. Controlling for size of the orbitofrontal cortex reduced the gender difference in antisocial personality by 77.3%.PubMedCrossRef • Raine A, Yang Y, Narr KL, Toga AW. Sex differences in orbitofrontal gray as a partial explanation for sex differences in antisocial personality. Mol Psychiatry. 2011;16(2):227–36. doi:10.​1038/​mp.​2009.​136. This study proposes a potential explanation for the large gender difference in antisocial behavior – the gender difference in the size of the orbitofrontal cortex, which is smaller in males. Controlling for size of the orbitofrontal cortex reduced the gender difference in antisocial personality by 77.3%.PubMedCrossRef
42.
go back to reference Krueger RF, Hicks BM, Patrick CJ, Carlson SR, Iacono WG, McGue M. Etiologic connections among substance dependence, antisocial behavior, and personality: modeling the externalizing spectrum. J Abnorm Psychol. 2002;111(3):411–24.PubMedCrossRef Krueger RF, Hicks BM, Patrick CJ, Carlson SR, Iacono WG, McGue M. Etiologic connections among substance dependence, antisocial behavior, and personality: modeling the externalizing spectrum. J Abnorm Psychol. 2002;111(3):411–24.PubMedCrossRef
45.
go back to reference Davidson KM, Tyrer P, Tata P, Cooke D, Gumley A, Ford I, et al. Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial. Psychol Med. 2009;39(4):569–77. doi:10.1017/s0033291708004066.PubMedCrossRef Davidson KM, Tyrer P, Tata P, Cooke D, Gumley A, Ford I, et al. Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial. Psychol Med. 2009;39(4):569–77. doi:10.​1017/​s003329170800406​6.PubMedCrossRef
46.
go back to reference Bateman AW, Fonagy P. The structure of mentalization based treatment. In: Bateman AW, Fonagy P, editors. Mentalization-based treatment for borderline personality disorder. Oxford: Oxford University Press; 2006. p. 37–59.CrossRef Bateman AW, Fonagy P. The structure of mentalization based treatment. In: Bateman AW, Fonagy P, editors. Mentalization-based treatment for borderline personality disorder. Oxford: Oxford University Press; 2006. p. 37–59.CrossRef
47.
go back to reference McGauley G, Yakeley J, Williams A, Bateman A. Attachment, mentalization and antisocial personality disorder: The possible contribution of mentalization-based treatment. Eur J Psychother Couns. 2011;13(4):371–93. doi:10.1080/13642537.2011.629118.CrossRef McGauley G, Yakeley J, Williams A, Bateman A. Attachment, mentalization and antisocial personality disorder: The possible contribution of mentalization-based treatment. Eur J Psychother Couns. 2011;13(4):371–93. doi:10.​1080/​13642537.​2011.​629118.CrossRef
Metadata
Title
Antisocial Personality Disorder: A Current Review
Authors
Andrea L. Glenn
Alexandria K. Johnson
Adrian Raine
Publication date
01-12-2013
Publisher
Springer US
Published in
Current Psychiatry Reports / Issue 12/2013
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-013-0427-7

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