Abstract
Antisocial personality disorder, psychopathy, dissocial personality disorder and sociopathy are constructs that have generally been used to predict recidivism and dangerousness, alongside being used to exclude patients from treatment services. However, 'antisocial personality disorder' has recently begun to emerge as a treatment diagnosis, a development reflected within cognitive behaviour therapy and mentalisation-based psychotherapy. Many of the behaviour characteristics of antisocial personality disorder are, at the same time, being targeted by interventions at criminal justice settings. A significantly higher proportion of published articles focusing on antisocial personality concern treatment when compared to articles on psychopathy. Currently, the proposal for antisocial personality disorder for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, suggests a major change in the criteria for this disorder. While the present definition focuses mainly on observable behaviours, the proposed revision stresses interpersonal and emotional aspects of the disorder drawing on the concept of psychopathy. The present commentary suggests that developments leading to improvement in the diagnosis of this type of disorder should, rather than focusing exclusively on elements such as dangerousness and risk assessment, point us to ways in which patients can be treated for their problems.
Highlights
The personality disorder currently known as antisocial personality disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), has a long history
This leads to the question: what would happen in this line of research if the concept of psychopathy were to replace the concept of antisocial personality disorder? Would researchers and clinicians continue to refine tools for evaluating dangerousness, and would the focus on treatment and counselling slip out of focus?
Antisocial personality disorder is associated with suffering for the individual and, perhaps more so than any other psychiatric disorder, causes problems for people living with antisocial patients
Summary
The personality disorder currently known as antisocial personality disorder, as defined by the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), has a long history. Several related concepts describe the personality problems that can lead to antisocial behaviour. These concepts include psychopathy, dissocial personality disorder, and antisocial personality disorder [3]. Given the impact that antisocial personality can have on individuals and society in general, one should expect that high priority be given to the development of effective treatments for this disorder. What would happen if the new criteria were to be introduced? The present commentary discusses the advantages and disadvantages of this development, in particular with a focus on the likelihood that the new diagnostic criteria will inspire the development of effective treatments
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