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Flashcards in ASPD & Pscyhopathy Deck (17):
1

Antisocial Personality Disorder (ASPD), general

Most common personality disorder

Pervasive, long-standing, disregard for others

Blames others, or external circumstances, for own mistakes/behaviors

Impulsive

Irresponsible

Lack of motivation to plan ahead

Quick to respond with anger/frustration

Deceitful/manipulative

Inability to follow approved models of behavior

Lack of remorse

*Shallow affect

History of conduct disorder from childhood

MS: DSM dx lacks important feature of egocentrism

2

"early starter"

Kolko research:

Histories of conduct, ADHD, and ODD (usually combined) as “early starters” for antisocial personality disorder

Though new research shows ODD possibly being a standalone with its own developmental path

3

Psychopathy Checklist (PCL)

Semi-structured tool that uses clinical history to rate 20 items that generate, initially over two factors, but later expanded to for factors in the 1990s

Scale 0-40 estimate degree of match with a prototypical psychopath

Long-term Traits

1a) Interpersonal Dimension

1b) Affective Dimension

More similar to ASPD dx
2a) Lifestyle Dimension

2b) Antisocial Dimension


Many prisoners, (~70%) demonstrate symptoms of ASPD

But fewer, using the PCL, are diagnosed with psychopathy (20-30%)

Criminality; ASPD; Psychopathy
All share common factors

4

PCL 1a: Interpersonal Dimension

Superficial charm

Grandiose self-worth

Pathological lying

Manipulating others

5

PCL 1b) Affective Dimension

Lack of remorse/guilt

Cold, callous, attitude

Lack of empathy

Shallow affect

Failure to accept responsibility

6

PCL 2a) Lifestyle Dimension

Need for stimulation

Impulsive

Lack of reasonable long-term goals

Parasitic lifestyle

Tendency to become easily bored

Irresponsible

7

PCL 2b) Antisocial Dimension

Poor behavioral control

Criminality

Early behavioral problems

Delinquency

8

Robert Hare

Disagreed with ASPD definition in the DSM

Provided a definition for “psychopathy”

Added features to ASPD dx that more closely resembled Cleckley’s definition

Selfishness

Manipulation

Lack of remorse

Deceitful

MS: most who meet criteria for psychopathy meet criteria for ASPD, not necessarily vice versa

9

Cleckley’s "Mask of Sanity" 1941

Provided the first diagnostic criteria for psychopathy

Violators of norms, but superficial charm

Social skills are more developed than conscience


Psychopathy characterized by
ABSENCE OF:

delusions

nervousness

reliability

truthfulness

shame

capacity to form loving relationships

insight

responsibility in relationships

ability to form attachments

proper motivation for antisocial behavior

valid judgement

ability to learn

fully developed emotions

10

DSM Section 3, Proposed Criteria

A subtype of ASPD is available that focuses more on the psychopathic traits

This is the diagnosis that most closely resembles psychopathy

The DSM-5 fails to capture the ego-centric symptoms of ASPD

11

Genetics

Vitting (2005)
callous, unemotinal, highly heritable

~40-50% genetic

Early signs of callous behavior is apparent in twins

12

Alteration in fear

Low levels of fear

Poor conditioning to fear

Linked with decreased amygdala functioning

Those with these disorders do not learn via fear no (most cases of) positive reinforcement

*however, reinforcing via payment tends to work

13

Decreased physiological arousal

Decreased skin response, basal heart rates, and blood pressure

Almost no startle response

Chronic understimulation may explain the increased chance of these individuals in engaging in risky behaviors

*possible tied to smoking during pregnancy

*study showed lower resting HR predicts psychopathy

14

Violent Recidivism

Antisocial behavior in the past is the strongest predictor of violent behavior, in general, across all disorders, in the future ~80%

~10% of recidivism can be explained by intermittent explosive disorder

15

Family risk factors

Parent loss

Parental rejection

Authoritarian parenting style

But must recognize the bidirectional function between child behavior and parenting style/behavior

16

Treating Antisocial Personality Disorder and Psychopathy

Anger management training

Identify triggers, imaginal exposure, generate competing responses

Impulse-control training
imag exp, systematic desensitization

17

Prior to DSM-III 1980 dx of ASPD

No DSM dx for ASPD in I or II, but long history of different dx's to describe bx

Sociopathic personality

Moral weakness

Moral insanity

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