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antisocial personality disorder

 
American Heritage Dictionary:

antisocial personality disorder

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n.
A personality disorder characterized by chronic antisocial behavior and violation of the law and the rights of others.


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Gale Encyclopedia of Children's Health:

Antisocial Personality Disorder

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Definition

Antisocial behavior is that which is verbally or physically harmful to other people, animals, or property, including behavior that severely violates social expectations for a given environment. Antisocial personality disorder in adults is also referred to as sociopathy or psychopathy.

Description

Antisocial behavior can be broken down into two components: the presence of antisocial (i.e., angry, aggressive, or disobedient) behavior and the absence of prosocial (i.e., communicative, affirming, or cooperative) behavior. Most children exhibit some antisocial behavior during their development, and different children demonstrate varying levels of prosocial and antisocial behavior. Some children—for example, the popular but rebellious child—may exhibit high levels of both antisocial and prosocial behaviors. Others—for example, the withdrawn, thoughtful child—may exhibit low levels of both types of behaviors.

High levels of antisocial behavior are considered a clinical disorder. Young children may exhibit hostility towards authority, and be diagnosed with oppositional-defiant disorder. Older children may lie, steal, or engage in violent behaviors, and be diagnosed with conduct disorder. A minority of children with conduct disorder whose behavior does not improve as they mature will go on to develop adult antisocial personality disorder.

A salient characteristic of antisocial children and adolescents is that they appear to have no feelings. They demonstrate no care for others' feelings or remorse for hurting others, and tend not to show their own feelings except for anger and hostility, and even these are communicated through aggressive acts and are not necessarily expressed through affect. One analysis of antisocial behavior is that it is a defense mechanism that helps children avoid painful feelings, or avoid the anxiety caused by lack of control over the environment.

Antisocial behavior may also be a direct attempt to alter the environment. Social learning theory suggests that negative behaviors are reinforced during childhood by parents, caregivers, or peers. In one formulation, a child's negative behavior (e.g., whining, hitting) initially serves to stop the parent from behaving in ways that are aversive to the child (the parent may be fighting with a partner, yelling at a sibling, or even crying). The child will apply the learned behavior at school, and a vicious cycle sets in: he or she is rejected, becomes angry and attempts to force his will or assert his pride, and is then further rejected by the very peers from whom he might learn more positive behaviors. As the child matures, "mutual avoidance" sets in with the parent(s), as each party avoids the negative behaviors of the other. Consequently, the child receives little care or supervision and, especially during adolescence, is free to join peers who have similarly learned antisocial means of expression.

Demographics

Mental health professionals agree, and rising rates of serious school disciplinary problems, delinquency, and violent crime indicate, that antisocial behavior in general is increasing. Thirty to 70% of childhood psychiatric admissions are for disruptive behavior disorders, and diagnoses of behavior disorders are increasing overall. A small percentage of antisocial children (about 3% of males and 1% of females) grow up to become adults with antisocial personality disorder, and a greater proportion suffer from the social, academic, and occupational failures resulting from their antisocial behavior.

Causes and Symptoms

Factors that contribute to a particular child's antisocial behavior vary, but they usually include some form of family problems (e.g., marital discord, harsh or inconsistent disciplinary practices or actual child abuse, frequent changes in primary caregiver or in housing, learning or cognitive disabilities, or health problems). Attention deficit/hyperactivity disorder is highly correlated with antisocial behavior.

A child may exhibit antisocial behavior in response to a specific stressor (such as the death of a parent or a divorce) for a limited period of time, but this is not considered a psychiatric condition. Children and adolescents with antisocial behavior problems have an increased risk of accidents, school failure, early alcohol and substance use, suicide, and criminal behavior. The elements of a moderate to severely antisocial personality are established as early as kindergarten. Antisocial children score high on traits of impulsiveness, but low on anxiety and reward-dependence—the degree to which they value, and are motivated by, approval from others. Yet underneath their tough exterior, antisocial children have low self-esteem.

Although antisocial personality disorder is only diagnosed in people over age 18, the symptoms are similar to those of conduct disorder, and the criteria for diagnosis include the onset of conduct disorder before the age of 15. According to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Text Revision (DSM-IV-TR), people with antisocial personality disorder demonstrate a pattern of antisocial behavior since age 15.

The adult with antisocial personality disorder displays at least three of the following behaviors:

  • fails to conform to social norms, as indicated by frequently performing illegal acts, and pursuing illegal occupations
  • is deceitful and manipulative of others, often in order to obtain money, sex, or drugs
  • is impulsive, holding a succession of jobs or residences
  • is irritable or aggressive, engaging in physical fights
  • exhibits reckless disregard for the safety of self or others, misusing motor vehicles, or playing with fire
  • is consistently irresponsible, failing to find or sustain work or to pay bills and debts
  • demonstrates lack of remorse for the harm his or her behavior causes others

An adult diagnosed with antisocial personality disorder will demonstrate few of his or her own feelings beyond contempt for others. Authorities have linked antisocial personality disorder with abuse, either physical or sexual, during childhood, neurological disorders (which are often undiagnosed), and low IQ. Those with a parent with an antisocial personality disorder or substance abuse problem are more likely to develop the disorder. The antisocially disordered person may be poverty-stricken, homeless, a substance abuser, or have an extensive criminal record. Antisocial personality disorder is associated with low socioeconomic status and urban settings.

When to Call the Doctor

When symptoms of antisocial behavior appear, a child should be taken to his or her health care provider as soon as possible for evaluation and possible referral to a mental health care professional. If a child or teen reveals at any time that he/she has had recent thoughts of self-injury or suicide, or if he/she demonstrates behavior that compromises personal safety or the safety of others, professional assistance from a mental health care provider or care facility should be sought immediately.

Diagnosis

Antisocial behavior and childhood antisocial disorders such as conduct disorder may be diagnosed by a family physician or pediatrician, social worker, school counselor, psychiatrist, or psychologist. A comprehensive evaluation of the child should ideally include interviews with the child and parents, a full social and medical history, review of educational records, a cognitive evaluation, and a psychiatric exam.

One or more clinical inventories or scales may be used to assess the child, including the Youth Self-Report, the School Social Behavior Scales (SSBS), the Overt Aggression Scale (OAS), Behavioral Assessment System for Children (BASC), Child Behavior Checklist (CBCL), the Nisonger Child Behavior Rating Form (NCBRF), Clinical Global Impressions scale (CGI), and Diagnostic Interview Schedule for Children (DISC). The tests are verbal and/or written and are administered in both hospital and outpatient settings.

Treatment

The most important goals of treating antisocial behavior are to measure and describe the individual child's or adolescent's actual problem behaviors and to effectively teach him or her the positive behaviors that should be adopted instead. In severe cases, medication will be administered to control behavior, but it should not be used as a substitute for therapy. A child who experiences explosive rage may respond well to medication. Ideally, an interdisciplinary team of teachers, social workers, and guidance counselors will work with parents or caregivers to provide services to help the child in all aspects of his or her life: home, school, work, and social contexts. In many cases, parents themselves need intensive training on modeling and reinforcing appropriate behaviors in their child, as well as in providing appropriate discipline to prevent inappropriate behavior.

A variety of methods may be employed to deliver social skills training, but especially with diagnosed anti-social disorders, the most effective methods are systemic therapies which address communication skills among the whole family or within a peer group of other antisocial children or adolescents. These probably work best because they entail actually developing (or redeveloping) positive relationships between the child or adolescent and other people. Methods used in social skills training include modeling, role-playing, corrective feedback, and token reinforcement systems. Regardless of the method used, the child's level of cognitive and emotional development often determines the success of treatment. Adolescents capable of learning communication and problem-solving skills are more likely to improve their relations with others.

Unfortunately, conduct disorders, which are the primary form of diagnosed antisocial behavior, are highly resistant to treatment. Few institutions can afford the comprehensiveness and intensity of services required to support and change a child's whole system of behavior. In most cases, for various reasons, treatment is terminated (usually by the client) long before it is completed. Often, the child may be fortunate to be diagnosed at all. Schools are frequently the first to address behavior problems, and regular classroom teachers only spend a limited amount of time with individual students. Special education teachers and counselors have a better chance at instituting long-term treatment programs—if the student stays in the same school for a period of years. One study showed teenage boys with conduct disorder had had an average of nine years of treatment by 15 different institutions. Treatments averaged seven months each.

Studies show that children who are given social skills instruction decrease their antisocial behavior, especially when the instruction is combined with some form of supportive peer group or family therapy. But the long-term effectiveness of any form of therapy for anti-social behavior has not been demonstrated. The fact that peer groups have such a strong influence on behavior suggests that schools that employ collaborative learning and the mainstreaming of antisocial students with regular students may prove most beneficial to the antisocial child. Because the classroom is a natural environment, learned skills do not need to be transferred. By dividing the classroom into groups and explicitly stating procedures for group interactions, teachers can create opportunities for positive interaction between antisocial and other students.

Prognosis

Early and intensive intervention is the best hope for children exhibiting antisocial behaviors or diagnosed conduct disorder. For those who grow into adults with antisocial personality disorder, the prognosis is not promising; the condition is difficult to treat and tends to be chronic. Although there are medications available that could quell some of the symptoms of antisocial personality disorder, noncompliance or abuse of the drugs prevents their widespread use. The most successful treatment programs are long-term, structured residential settings in which the patient systematically earns privileges as he or she modifies behavior.

Prevention

A supportive, nurturing, and structured home environment is believed to be the best defense against anti-social behavioral problems. Children with learning disabilities and/or difficulties in school should get appropriate academic assistance. Addressing these problems when they first appear helps to prevent the frustration and low self-esteem that may lead to antisocial issues later.

Parental Concerns

A child with antisocial behavioral problems can have a tremendous impact on the home environment and on the physical and emotional welfare of siblings and others sharing the household, as well as their peers at school. While seeking help for their child, parents must remain sensitive to the needs of their other children. This may mean avoiding leaving siblings alone together, getting assistance with childcare, or even seeking residential or hospital treatment for the child if the safety and well-being of other family members is in jeopardy. Parents should also maintain an open dialog with their child's teachers to ensure that their child receives appropriate educational assistance and that classmates are not put at risk.

See also Aggression; Conduct disorder; Oppositional defiant disorder.

Resources

Books

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision (DSMIV-TR). Washington, DC: American Psychiatric Press, Inc., 2000.

Connor, Daniel. Aggression and Antisocial Behavior in Children and Adolescents: Research and Treatment. New York: Guilford Press, 2002.

Eddy, J. Mark. Conduct Disorders: The Latest Assessment and Treatment Strategies. Kansas City, MO: Compact Clinicals, 2003.

Periodicals

Cellini, Henry R. "Biopsychological Treatment of Antisocial and Conduct-Disordered Offenders." Federal Probation 66, no. 2 (September 2002): 78+.

Connor, Daniel F. "Aggression and Antisocial Behavior in Youth." Brown University Child & Adolescent Behavior Letter 18, no. 9 (September 2002): 1+.

Organizations

The American Academy of Child and Adolescent Psychiatry. 3615 Wisconsin Ave., N.W., Washington, D.C. 20016-3007. (202) 966-7300. Web site: www.aacap.org

Web Sites

The National Mental Health Association. www.nmha.org.

NYU Child Study Center. Changing the Face of Child Mental Health. www.aboutourkids.org.

[Article by: Paula Ford-Martin]


American Heritage Stedman's Medical Dictionary:

antisocial personality disorder

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Home > Library > Health > Medical Dictionary

n.

A personality disorder characterized by a history of continuous and chronic antisocial behavior that is not attributable to severe mental retardation, schizophrenia, or manic episodes. Also called antisocial personality.

Wikipedia on Answers.com:

Antisocial personality disorder

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Home > Library > Miscellaneous > Wikipedia
Not to be confused with Anti-social behaviour, Avoidant personality disorder, Schizoid personality disorder, or Dissociative identity disorder.
For the sleep disorder, see Advanced sleep phase disorder
Antisocial personality disorder
Classification and external resources
ICD-10 F60.2
ICD-9 301.7
MeSH D000987
Personality
disorders
Cluster A (odd)
Paranoid · Schizoid
Schizotypal
Cluster B (dramatic)
Antisocial · Borderline
Histrionic · Narcissistic
Cluster C (anxious)
Avoidant · Dependent
Obsessive-compulsive
Not specified
Depressive
Passive–aggressive
Sadistic · Self-defeating

Antisocial personality disorder (ASPD) is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition (DSM-IV-TR), as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."[1]

The World Health Organization's International Statistical Classification of Diseases and Related Health Problems', tenth edition (ICD-10), defines a conceptually similar disorder to antisocial personality disorder called (F60.2) Dissocial personality disorder.[2]

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders incorporated various concepts of psychopathy/sociopathy/antisocial personality in early versions but, starting with the DSM-III in 1980, used instead the term Antisocial Personality Disorder and focused on earlier behavior instead of using personality judgements. The World Health Organization's ICD incorporates a similar diagnosis of Dissocial Personality Disorder. Both the DSM and the ICD state that psychopathy (or sociopathy) are synonyms of their diagnosis.

Psychopathy and sociopathy are terms related to ASPD. ASPD replaced psychopathy as a diagnosis in the DSM but the terms are not identical. Psychopathy is now (like sociopathy) usually seen as a subset of ASPD.[3][4]

Contents

Diagnosis

DSM-IV

The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV-TR), defines antisocial personality disorder (in Axis II Cluster B) as:[1]

A) There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following:
  1. failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
  2. deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
  3. impulsiveness or failure to plan ahead;
  4. irritability and aggressiveness, as indicated by repeated physical fights or assaults;
  5. reckless disregard for safety of self or others;
  6. consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;
  7. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another;
B) The individual is at least age 18 years.
C) There is evidence of conduct disorder with onset before age 15 years.
D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.

New evidence points to the possibility that children often develop antisocial personality disorder as a result of environmental as well as genetic influence. The individual must be at least 18 years of age to be diagnosed with this disorder (Criterion B), but those commonly diagnosed with ASPD as adults were diagnosed with conduct disorder as children. The prevalence of this disorder is 3% in males and 1% from females, as stated in the DSM IV-TR.

ICD-10

The World Health Organization's International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10), defines a conceptually similar disorder to antisocial personality disorder called (F60.2) Dissocial personality disorder.[5]

It is characterized by at least 3 of the following:
  1. Callous unconcern for the feelings of others
  2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
  3. Incapacity to maintain enduring relationships, though having no difficulty in establishing them
  4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
  5. Incapacity to experience guilt or to profit from experience, particularly punishment.
  6. Markedly prone to blame others or to offer plausible rationalizations for the behavior that has brought the person into conflict with society

There may be persistent irritability as an associated feature.

The diagnosis includes what may be referred to as amoral, antisocial, asocial, psychopathic, and sociopathic personality (disorder).

The criteria specifically rule out conduct disorders.[6] Dissocial personality disorder criteria differ from those for antisocial and sociopathic personality disorders.[7]

It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria.

Further diagnostic considerations

Millon's subtypes

Theodore Millon identified five subtypes of antisocial behavior.[8][9] Any antisocial individual may exhibit none, one or more than one of the following:

  • covetous antisocial – variant of the pure pattern where individuals feel that life has not given them their due.
  • reputation-defending antisocial – including narcissistic features
  • risk-taking antisocial – including histrionic features
  • nomadic antisocial – including schizoid, avoidant features
  • malevolent antisocial – including sadistic, paranoid features.

Differential diagnosis

The following conditions commonly coexist with antisocial personality disorder:[10]

When combined with alcoholism, people may show frontal function deficits on neuropsychological tests greater than those associated with each condition.[11]

Antisocial Personality Disorder and Hormones

Serotonin Levels: Anti-Social Personality Disorder (ASPD) is said to be genetically based but typically has environmental factors, such as family relations, that trigger its onset. Traumatic events can lead to a disruption of the standard development of the central nervous system, which can generate a release of hormones that can change normal patterns of development.[12] One of the neurotransmitters that have been discussed in individuals with ASPD is serotonin.

A recent meta-analysis of 20 studies showed a correlation between ASPD and serotonin metabolic 5-hydroxyindoleacetic acid (5-HIAA). The study found a reasonable effect size, (p=-0.45), suggesting that 5-HIAA levels in antisocial individuals were about half a standard deviation lower than those who did not have antisocial characteristics [13]

J.F.W. Deakin of University of Manchester's Neuroscience and Psychiatry Unit has discussed additional evidence of 5HT's connection with anti social personality disorder. Deakin suggests that low cerebrospinal fluid concentrations of 5-HIAA, and hormone responses to 5HT, have displayed that the two main ascending 5HT pathways mediate adaptive responses to post and current conditions. He states that impairments in the posterior 5HT cells can lead to low mood functioning, as seen in patients with ASPD. It is important to note that the dysregulated serotonergic function may not be the sole feature that leads to ASPD but it is an aspect of a multifaceted relationship between biological and psychosocial factors.

Serotonin Impulsivity and Aggression

While it has been shown that lower levels of serotonin may be associated with ASPD, there has also been evidence that decreased serotonin function is highly correlated with impulsiveness and aggression across a number of different experimental paradigms. Impulsivity is not only linked with irregularities in 5HT metabolism but may be the most essential psychopathological aspect linked with such dysfunction. [14] In a study looking at the relationship between the combined effects of central serotonin activity and acute testosterone levels on human aggression, researchers found that aggression was significantly higher in subjects with a combination of high testosterone and high cortisol responses, which correlated to decreased serotonin levels. [15] Correspondingly, The Diagnostic and Statistical Manual of Mental Disorders classifies "impulsiveness or failure to plan ahead" and "irritability and aggressiveness" as two of the seven criteria in diagnosing someone with ASPD.

Epidemiology

Antisocial personality disorder is seen in 3% to 30% of psychiatric outpatients.[1][10] The prevalence of the disorder is even higher in selected populations, like prisons, where there is a preponderance of violent offenders.[16] A 2002 literature review of studies on mental disorders in prisoners stated that 47% of male prisoners and 21% of female prisoners had anti-social personality disorder.[17] Similarly, the prevalence of ASPD is higher among patients in alcohol or other drug (AOD) abuse treatment programs than in the general population (Hare 1983), suggesting a link between ASPD and AOD abuse and dependence.[18]

Treatment

[icon] This section requires expansion.

To date there have been no controlled studies reported which found an effective treatment for ASPD, although contingency management programs, or a reward system, has been shown moderately effective for behavioral change.[19] Some studies have found that the presence of ASPD does not significantly interfere with treatment for other disorders, such as substance abuse,[20] although others have reported contradictory findings.[21] Schema Therapy is being investigated as a treatment for antisocial personality disorder.[22]

Psychopathy and sociopathy

Psychopathy and sociopathy are terms related to ASPD. ASPD was used rather than psychopathy as a diagnosis in the DSM but the terms are not identical. Psychopathy is now (like sociopathy) usually seen as a subset of ASPD.

Psychopathy

Main article: Psychopathy

Psychopathy (/saɪˈkɒpəθi/[23]) was not used as the official term but referred to a personality disorder characterized by an abnormal lack of empathy combined with strongly amoral conduct but masked by an ability to appear outwardly normal. The DSM-III used the term Antisocial Personality Disorder and changed the diagnostic criteria considerably by shifting from clinical judgements about personality to behavioral diagnostic criteria.[3] The ICD-10 diagnostic criteria of the World Health Organization its 1992 manual has the similar diagnosis Dissocial (Antisocial) Personality Disorder, which encompasses amoral, antisocial, asocial, psychopathic, and sociopathic personalities.[4]

Psychopathy is normally seen as a subset of the antisocial personality disorder, but Blair believes that the antisocial personality disorder and psychopathy may be separate conditions altogether.[24]

Some researchers are critical of the official diagnostic criteria. Antisocial personality disorder is diagnosed via behavior and social deviant behaviors, whereas a diagnosis of psychopathy also includes affective and interpersonal personality factors. The Hare Psychopathy Checklist is better able to predict future criminality, violence, and recidivism than the diagnosis of ASPD using the DSM-III-R. Robert D. Hare writes that there are also differences between psychopaths and others on "processing and use of linguistic and emotional information" while such differences are small between those diagnosed with ASPD and not.[3][25] However, the Hare Psychopathy Checklist requires the use of a rather long interview and availability of considerable additional information[25] as well as depending in part on judgements of character rather than observed behavior. Hare writes that the field trials for the DSM-IV found personality traits judgements to be as reliable as those diagnostic criteria relying only on behavior but that the personality traits criteria were dropped in part because it was feared that the average clinician would not use them correctly. Hare criticizes the instead used DSM-IV criteria for being poorly empirically tested. In addition, the introductory text description describes the personality characteristics typical of psychopathy, which Hare argues make the manual confusing and actually containing two different sets of criteria. He also argues that confusion regarding how to diagnose ASPD, confusion regarding the difference between ASPD and psychopathy, as well as the differing future prognoses regarding recidivism and treatability, may have serious consequences in settings such as court cases where psychopathy is often seen as aggravating the crime.[3]

The DSM-V working party is recommending a revision of Antisocial Personality Disorder to include "Antisocial/Psychopathic Type", with the diagnostic criteria having a greater emphasis on character than on behavior.[26]

Sociopathy

Hare writes that the difference between sociopathy and psychopathy may "reflect the user's views on the origins and determinates of the disorder." The term sociopathy may be preferred by sociologists that see the causes as due to social factors. The term psychopathy may be preferred by psychologists who see the causes as due to a combination of psychological, genetic, and environmental factors.[27]

David T. Lykken proposed psychopathy and sociopathy are two distinct kinds of antisocial personality disorder. He believed psychopaths are born with temperamental differences such as impulsivity, cortical underarousal, and fearlessness that lead them to risk-seeking behavior and an inability to internalize social norms. On the other hand, he claimed that sociopaths have relatively normal temperaments; their personality disorder being more an effect of negative sociological factors like parental neglect, delinquent peers, poverty, and extremely low or extremely high intelligence. Both personality disorders are the result of an interaction between genetic predispositions[citation needed] and environmental factors[citation needed], but psychopathy leans towards the hereditary whereas sociopathy tends towards the environmental.[28]

See also

References

  1. ^ a b c Antisocial personality disorder – Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000) pp. 645–650
  2. ^ Dissocial personality disorder – International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)
  3. ^ a b c d Robert D. Hare Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion, Psychiatric Times. Vol. 13 No. 2 February 1, 1996
  4. ^ a b Antisocial Personality Disorder: European Description. Mentalhealth.com. Retrieved on 2011-12-07.
  5. ^ WHO (2010) ICD-10: Clinical descriptions and diagnostic guidelines: Disorders of adult personality and behaviour
  6. ^ "F60.2 Dissocial personality disorder". World Health Organization. http://apps.who.int/classifications/icd10/browse/2010/en#/F60.2. Retrieved 2008-01-12. 
  7. ^ Early Prevention of Adult Antisocial Behavior. Cambridge University Press. 2003-06-16. p. 82. ISBN 9780521651943. http://books.google.com/?id=KtXU8R8oZYwC&pg=PA82&lpg=PA82&dq=dissocial+personality+disorder. Retrieved 2008-01-12. 
  8. ^ Millon, Theodore, Personality Disorders in Modern Life, 2004
  9. ^ Millon, Theodore – Personality Subtypes. Millon.net. Retrieved on 2011-12-07.
  10. ^ a b Internet Mental Health – antisocial personality disorder. Mentalhealth.com. Retrieved on 2011-12-07.
  11. ^ Oscar-Berman M; Valmas M, Sawyer K, Kirkley S, Gansler D, Merritt D, Couture A (April 2009). "Frontal brain dysfunction in alcoholism with and without antisocial personality disorder". Neuropsychiatric Disease and Treatment 2009 (5): 309–326. PMC 2699656. PMID 19557141. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=2699656. 
  12. ^ Black, D. "What Causes Antisocial Personality Disorder?". Psych Central. http://psychcentral.com/lib/2006/what-causes-antisocial-personality-disorder/. Retrieved 1 November 2011. 
  13. ^ Gx, Johnx. "Antisocial Brain Abnormalities, Serotonin Levels and Treatments". http://becomingjon.blogspot.com/2009/03/antisocial-brain-abnormalities.html. Retrieved 30 October 2011. 
  14. ^ Brown, Serena-Lynn; Botsis, Alexander; Van Praag; Herman M. (1994). "Serotonin and Aggression". Journal of Offender Rehabilitation. 3-4 21: 27–39. doi:10.1300/J076v21n03_03. 
  15. ^ Kuepper, Y; Alexander, N., Osinsky, R., Mueller, E., Schmitz, a., Netter, P., & Hennig, J. (2010). "Aggression--Interactions of serotonin and testosterone in healthy men and women". Behavioural Brain Research. 1 206: 93–100. doi:10.1016/j.bbr.2009.09.006. 
  16. ^ Hare 1983
  17. ^ Fazel, Seena; Danesh, John (2002). "Serious mental disorder in 23 000 prisoners: A systematic review of 62 surveys". The Lancet 359 (9306): 545. doi:10.1016/S0140-6736(02)07740-1. 
  18. ^ Moeller, F. Gerard; Dougherty, Donald M. (2006). "Antisocial Personality Disorder, Alcohol, and Aggression". Alcohol Research & Health. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/arh25-1/5-11.pdf. Retrieved 2007-02-20. 
  19. ^ J. E. Fisher & W. T. O'Donohue (eds). (2006). Practitioner's Guide to Evidence-Based Psychotherapy, Springer, ISBN 1441939385 p. 63
  20. ^ Darke, S; Finlay-Jones, R; Kaye, S; Blatt, T (1996). "Anti-social personality disorder and response to methadone maintenance treatment". Drug and alcohol review 15 (3): 271–6. doi:10.1080/09595239600186011. PMID 16203382. 
  21. ^ Alterman, AI; Rutherford, MJ; Cacciola, JS; McKay, JR; Boardman, CR (1998). "Prediction of 7 months methadone maintenance treatment response by four measures of antisociality". Drug and alcohol dependence 49 (3): 217–23. PMID 9571386. 
  22. ^ "Schema Focused Therapy in Forensic Settings: Theoretical Model and Recommendations for Best Clinical Practice". International Journal of Forensic Mental Health 6 (2): 169–183. 2007. http://web.archive.org/web/20110726163913/http://www.iafmhs.org/files/Bernstein.pdf. 
  23. ^ Merriam-Webster's Online Dictionary. Merriam-webster.com. Retrieved on 2011-12-07.
  24. ^ Blair, J; Mitchel D; Blair K (2005). Psychopathy: Emotion and the Brain. Blackwell Publishing. p. 16. ISBN 0631233369.
  25. ^ a b Hare, R.D., Hart, S.D., Harpur, T.J. (1991). Psychopathy and the DSM—IV "Criteria for Antisocial Personality Disorder". Journal of abnormal psychology 100 (3): 391–8. PMID 1918618. http://www.psych.utoronto.ca/~peterson/psy430s2001/Hare%20RD%20Psychopathy%20JAP%201991.pdf Psychopathy and the DSM—IV. 
  26. ^ "Proposed revision". DSM5. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=16#. 
  27. ^ Robert D. Hare (8 January 1999). Without conscience: the disturbing world of the psychopaths among us. Guilford Press. p. 23. ISBN 978-1-57230-451-2. http://books.google.com/books?id=xfIEVtzj52YC&pg=PA23. Retrieved 7 December 2011. 
  28. ^ Lykken, David T. The Antisocial Personalities. Hillsdale N.J: L. Erlbaum, 1995. Print.[page needed]

External links

Look up antisocial in Wiktionary, the free dictionary.


DSM-III-R only
DSM-IV
Antisocial · Borderline · Histrionic · Narcissistic
Schizotypal
Specific
Eccentric · Haltlose type · Immature · Narcissistic · Passive-aggressive · Psychoneurotic
Unspecified
Mixed and other

This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

 
 

 

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American Heritage Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
$copyright.smallImage.alttext Gale Encyclopedia of Children's Health. © 2006 by The Gale Group, Inc. All rights reserved.  Read more
American Heritage Stedman's Medical Dictionary. The American Heritage® Stedman's Medical Dictionary Copyright © 2002, 2001, 1995 by Houghton Mifflin Company.  Read more
Wikipedia on Answers.com. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article Antisocial personality disorder.  Read more

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