Treatment Of Antisocial Personality Disorder Research Articles

A neuroscience perspective on antisocial personality disorder (ASPD)

Introduction: Antisocial personality disorder (ASPD) is characterized by a persistent pattern of behavior that disregards and violates the rights of others. This disorder has biological-genetic and environmental roots, with the biological aspects playing a more significant role. Therefore, this article aims to examine the different dimensions of ASPD to adopt treatment and a suitable solution for it, considering its important effects on others and society. Method: Using a predefined search strategy, searches were conducted in databases including Google Scholar, PubMed, Criminal Justice Abstracts, and PsycINFO for published articles related to the research topic. Only studies published in English between 1990 and 2024 and containing information about the neuroscience of ASPD were eligible for inclusion. A total of 37 articles were selected for analysis and synthesis of the results. Results: Findings indicate that the limbic and frontal regions are particularly implicated in ASPD, with notable differences in the upper and lower frontal sulcus compared to typical brain variants. Additionally, individuals with ASPD exhibit larger spectral bands in delta and theta waves during a resting state than healthy subjects. Conclusion: This literature review provides valuable information about the neurobiology of ASPD and can enhance the depth and breadth of our knowledge for a more comprehensive and impactful understanding and treatment of ASPD. However, since there are apparent differences in brain function between ASPD subjects and controls, further research is needed to achieve consensus.

From Theory to Therapy: A Review of Anti-Social Personality Disorder

Treatment of anti-social personality disorder in clinical practice is difficult because of the condition's complex etiology, enduring nature, and significant societal impact. This review summarizes evidence-based therapy approaches, comorbidities, and biopsychosocial variables related to ASPD, by indicating the state of the field. Twin studies and neuroimaging research arguing for structural brain anomalies provide clear evidence that genetic predispositions and neurobiological abnormalities play a role in ASPD. Psycho-social variables also participate in the development and characteristics of the condition, such as maltreatment in childhood and disturbed family relationships. Emerging therapeutic approaches such as Mentalization-Based Treatment, Psychodynamic Art Psychotherapy, Transference-Focused Psychotherapy, Schema Therapy, and Mindfulness-Based Interventions show promise, though their efficacy varies and requires further investigation.

Etiological Imaging, Diagnosis and Treatment of Antisocial Personality Disorder

This paper first summarizes the definition of antisocial personality disorder (APD), and then explains the influence of antisocial personality on the patients themselves and the society as well as the etiological diagnosis and treatment methods. Finally, some suggestions for future research and intervention are given. The etiology and influence of antisocial personality disorder are first introduced. The present study found that various factors such as childhood experiences and structural brain abnormalities, could contribute to symptoms of antisocial personality disorder (APD). Secondly, the diagnosis of antisocial personality disorder is introduced, which is based on the common scale test and the patient's actual symptoms and life experiences. Then it introduces the common treatment methods of antisocial personality disorder from the perspective of neurology and psychology. Finally, some suggestions are put forward to provide directions for future research. To sum up, through a systematic review of the previous literatures and analyzing, this paper aims to increase the understanding of APD and provide evidence-based recommendations for optimizing the treatment and intervention of APD.

Causes and prevention methods of antisocial personality disorder

The study of antisocial personality disorder (ASPD) is essential to recognize the psychological and behavioral causes of a portion of perpetrators. This study simply reviews past research on ASPD. Summarizes the causes of ASPD, treatment, shortcomings of existing research, and suggestions for future research. The literature review describes the possible causes of antisocial personality disorder from internal factors (genetic and familial factors) and external factors (family and childhood experiences). To be specific, the influence of family and genes on ASPD is discussed in this paper. In addition, external influences addressed in this paper include childhood experiences and the influence of family members’ behaviors. In the discussion section, some methods for the prevention and treatment of ASPD are given, and some shortcomings of existing research are pointed out. Finally, some suggestions for future research are put forward. This review paper aims to help more people understand ASPD and pay more attention to these people with mental illness.

Antisocial personality disorder in group therapy, kindling pro-sociality and mentalizing.

Patients with antisocial personality disorder (ASPD) are known for being difficult to treat. Treatment for ASPD is debated and lacking evidence. Among several reasons for treatment difficulties concerning ASPD, negative countertransference in health personnel is one central topic. Mentalization based treatment (MBT) is a reasonable candidate treatment for ASPD. From an ongoing pilot-study on MBT with substance using ASPD patients, we explore therapist experiences. Four experienced MBT therapists together with the principal investigator performed a focus group together. The therapists were themselves involved in performing this study and analyses are made as an autoethnographic study, with thematic analyses as methodological approach. As this study involved a qualitative investigation of own practice, reflexivity of the processes was performed. The aim was to explore in depth: therapist experiences and therapist wellbeing in MBT-ASPD. We found four main themes on therapist experiences. 1) gaining safety by getting to know them better, 2) gaining cooperation through clear boundaries and a non-judgmental stance, 3) shifting inner boundaries and 4) timing interventions in a high-speed culture. These four themes point to different therapist experiences one can have in MBT-ASPD. Our findings resonate well with the clinical literature on ASPD, the findings imply that clinical teams should have a focus on therapist countertransference and burnout, ensure that therapists uphold boundaries and open-mindedness in treatment of ASPD and that therapists experience vitalizing feelings in this line of work.

Consent or public reason? Legitimacy of norms applied in ASPD and COVID-19 situations

This paper extends Alan John Simmons?s conceptual distinction between Lockean (or consent) and Kantian (or justificatory) conceptions of legitimacy that he applied to the question of the legitimacy of states, to the issue of legitimacy of public decisions. I criticise the consent conception of legitimacy defended by Simmons, and I defend the Rawlsian version of the justificatory conception of legitimacy from his objection. The approach of this paper is distinctive because the two conceptions are assessed by investigating, using the method of reflective equilibrium, their respective prescriptions concerning the treatment of antisocial personality disorder (ASPD) and epidemiologic measures. I argue that the method of reflective equilibrium does not support the consent conception. Considering the issues of treatment of APD and of epidemiologic measures, I argue that the consent conception of legitimacy is not well-equipped for the evaluation of norms that are not strictly self-regarding. This causes a deficit of prescriptions for relevant social responses. Further, by considering the case of responses to epidemics, I argue that such a conception can avoid harmful consequences only by recurring to additional, and independent, premises. This does not cause incoherence but reduces the coherence of a normative system. Finally, the consent conception is not equipped to support social cooperation in an optimal way, which has proved to be necessary in critical conditions, like a pandemic. On the other hand, I argue that the method of reflective equilibrium supports the Rawlsian version of justificatory conception of legitimacy, because of its advantages in handling the indicated issues. In addition, I maintain that this justificatory conception is respectful of freedom and equality of agents as moral self-legislators, and, thus, it is not vulnerable to Simmons?s main criticism.

Pharmacological interventions for antisocial personality disorder.

Pharmacological interventions for antisocial personality disorder.

Diagnosis and Treatment of Antisocial Personality Disorder: A Case Report

Abstract
 Introduction. Antisocial personality disorder (ASPD) defines patterns of behavior that are irresponsible for social, exploitative, and unproblematic issues that begin in early childhood or adolescence and are manifested by changes in the life phase. This case report was aimed to describe antisocial personality disorder experienced by a girl in Aceh, Indonesia.
 Case Presentation. A woman, 19 years old, a college student, living in a suburban area, came to consult to hospital with complaints of anxiety and difficulty sleeping. The patient claimed that she often wanted to hurt and persecute others. She often try to hurt other people, but do not get caught because she said the act was carried out accidentally. When she was a child, she liked to torture animals and she did it without guilty and pity. Lately patient felt the desire to hurt others is getting bigger.
 Conclusion. Management of antisocial personality disorder can be adjusted to the circumstances and background or risk factors of the disorder, and treatment is used to reduce symptoms.

Treatment of antisocial personality disorder: Development of a practice focused framework

There is little to no evidence of effective treatment methods for patients with an antisocial personality disorder (ASPD). One of the reasons could be the fact that they are often excluded from mental healthcare and thus from studies. A treatment framework based on ‘state of the art’ methods and best practices, offering guidelines on the treatment of ASP and possibilities for more systematical research, is urgently needed. This research involved a literature search and an international Delphi-study (N = 61 experts in research, management and clinical practice focused on ASPD). The results suggested important preconditions with regard to organization of care, healthcare workers and therapy. Conclusions are that there are many ways to coordinate effective treatment and management and work toward the increased availability of evidence based care for persons with ASPD.

The Treatment of Antisocial Personality Disorder

Purpose of Review Antisocial personality disorder (ASPD) is defined by its pattern of socially irresponsible, exploitative, and guiltless behavior. The disorder is common and costly to society. ASPD starts in childhood or early adolescence when it is diagnosed as conduct disorder. If the symptoms persist past age 18, the diagnosis changes to ASPD. The disorder moderates with advancing age and many individuals will no longer meet criteria for the disorder as older adults. Recent Findings The treatment of ASPD is challenging and complicated by a dearth of research evidence. There are no medications approved by the US Food and Drug Administration for treatment of the disorder, nor are there proven psychological treatments. Medications can be prescribed to treat comorbid disorders (e.g., panic disorder, major depression), or “off-label” to target aggression and impulsivity associated with ASPD. Treatment models employing cognitive-behavioral therapy have been developed, and some reports suggest benefit. Summary Patients with ASPD should not routinely be treated with psychotropic medication. Medications may be helpful in treating comorbid psychiatric disorders such as major depression, or aggressive symptoms common in these patients. Cognitive-behavior therapy may be helpful for those with milder syndromes.

Patterns of Mood and Personality Factors and Associations With STI/HIV-Related Drug and Sex Risk Among African American Male Inmates

ABSTRACTBackground: Research on the association between antisocial personality disorder (ASPD) with comorbid mental disorders and sexually transmitted infection (STI)/HIV risk among inmates is scant despite the high prevalence of psychopathology and of STI/HIV in this population. Methods: We used baseline data from Project DISRUPT, a cohort study conducted among incarcerated African American men (n = 207), to measure associations between ASPD and STI/HIV risk. We also conducted latent class analyses (LCAs) to identify subgroups defined by ASPD with comorbid stress, depression, and borderline personality disorder symptoms and measured associations between latent class membership and STI/HIV risk. Results: Approximately 15% had ASPD and 39% reported depression. Controlling for sociodemographics, stress, and depression, ASPD was independently associated with illicit [AOR = 3.23, 95% confidence interval (CI): 1.18–8.87] and injection drug use (AOR: 5.49, 95% CI: 1.23–24.42) but not with sexual risk. LCAs suggested that those at high risk of ASPD were likely to experience co-morbid mental disorders. ASPD comorbid with these disorders was linked to drug and sex risk. Conclusions: STI/HIV prevention for inmates should incorporate diagnosis and treatment of ASPD and comorbid disorders, and interventions to address ASPD-related factors (e.g., impulsivity) that drive STI/HIV risk.

Dialectical behavior therapy approaches with disruptive behavior disorders

Disruptive behaviour disorders comprise the diagnosis conduct disorder (CD) and in adults the diagnosis antisocial personality disorder (APD). CD is seen as a difficult-to-treat disorder with a high risk for persistent behavioral problems. In addition, CD is seen as the precursor to antisocial personality disorder (Kretschmer et al., 2014). Dialectical behavior therapy (DBT) was originally developed by Marsha Linehan (1991) for the treatment of borderline personality disorder, but because of the core deficits in emotion regulation in disruptive behavior disorders, DBT is also increasingly being recommended for the treatment of CD and APD. This review presents DBT adaptions for the forensic setting and for the treatment of CD/APD. Clinical implications are discussed.

Antisocial Personality Disorder among Prison Inmates: TheMediating Role of Schema-Focused Therapy

This study investigated the mediating role of schema-focused therapy in the treatment of antisocial personality disorder among prison inmates. The participants of the study were three hundred (300) prison inmates of Agodi Prison in Ibadan, Oyo State, Nigeria. The instruments used for the study were Antisocial Personality Disorder Self- Test (APDSF), deployed for screening the participants, and Antisocial Personality Disorder Symptoms Questionnaire (APDSQ) developed by the researcher. Pre-test Post-Test, control group experimental design was adopted for this study. The data were analysed using ANCOVA. There was significant main effect of treatment on antisocial personality disorder of the prison inmates. There was significant interaction effect of treatment of participants based on gender. There was also significant interaction effect of treatment on prison inmates based on time of incarceration.

Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital

A number of studies have demonstrated the anti-aggressive properties of clozapine in schizophrenia and its positive effect in borderline personality disorder. There is no published literature on the treatment of antisocial personality disorder (ASPD) with clozapine. We present a case series of 7 patients with primary ASPD and high psychopathic traits treated with clozapine, having a significant history of serious violence and currently detained in a UK based high-security hospital. A retrospective review of case notes was carried out to formulate Clinical Global Impression (CGI) scores and record incidents of violence and aggression. Effect on specific symptom domains (cognitive-perceptual, impulsive-behavioural dyscontrol, affective dysregulation) was also noted. Metabolic parameters and serum clozapine levels were also sampled. All 7 patients showed significant improvement on clozapine. It was shown to benefit all symptom domains, especially impulsive behavioral dyscontrol and anger. The number of violent incidents committed by 6 of the 7 patients reduced significantly, and all patients' risk of violence reduced. Clozapine serum levels for 6 of the 7 patients were in the range 150-350 ng/mL. Clozapine is of benefit in reducing the clinical severity of ASPD. It improved all symptom domains, especially impulsive-behavioral dyscontrol and anger, and reduced levels of aggression and violence, especially at lower doses (serum levels <350 ng/m). To our knowledge, this is the first account of clozapine treatment in patients with ASPD and high psychopathy.

Pharmacological interventions for antisocial personality disorder

Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance misuse, unemployment, homelessness and relationship difficulties. To evaluate the potential beneficial and adverse effects of pharmacological interventions for people with AsPD. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to September 2009), EMBASE (1980 to 2009, week 37), CINAHL (1982 to September 2009), PsycINFO (1872 to September 2009) , ASSIA (1987 to September 2009) , BIOSIS (1985 to September 2009), COPAC (September 2009), National Criminal Justice Reference Service Abstracts (1970 to July 2008), Sociological Abstracts (1963 to September 2009), ISI-Proceedings (1981 to September 2009), Science Citation Index (1981 to September 2009), Social Science Citation Index (1981 to September 2009), SIGLE (1980 to April 2006), Dissertation Abstracts (September 2009), ZETOC (September 2009) and the metaRegister of Controlled Trials (September 2009). Controlled trials in which participants with AsPD were randomly allocated to a pharmacological intervention and a placebo control condition. Two trials comparing one drug against another without a placebo control are reported separately. Three review authors independently selected studies. Two review authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. Eight studies met the inclusion criteria involving 394 participants with AsPD. Data were available from four studies involving 274 participants with AsPD. No study set out to recruit participants solely on the basis of having AsPD, and in only one study was the sample entirely of AsPD participants. Eight different drugs were examined in eight studies. Study quality was relatively poor. Inadequate reporting meant the data available were generally insufficient to allow any independent statistical analysis. The findings are limited to descriptive summaries based on analyses carried out and reported by the trial investigators. All the available data were derived from unreplicated single reports. Only three drugs (nortriptyline, bromocriptine, phenytoin) were effective compared to placebo in terms of improvement in at least one outcome. Nortriptyline was reported in one study as superior for men with alcohol dependency on mean number of drinking days and on alcohol dependence, but not for severity of alcohol misuse or on the patient's or clinician's rating of drinking. In the same study, both nortriptyline and bromocriptine were reported as superior to placebo on anxiety on one scale but not on another. In one study, phenytoin was reported as superior to placebo on the frequency and intensity of aggressive acts in male prisoners with impulsive (but not premeditated) aggression. In the remaining two studies, both amantadine and desipramine were not superior to placebo for adults with opioid and cocaine dependence, and desipramine was not superior to placebo for men with cocaine dependence. The body of evidence summarised in this review is insufficient to allow any conclusion to be drawn about the use of pharmacological interventions in the treatment of antisocial personality disorder.

The generation of a guideline: National Institute for Health and Clinical Excellence recommendations for the treatment of borderline personality disorder

Personality and Mental HealthVolume 4, Issue 1 p. 34-38 Commentary The generation of a guideline: National Institute for Health and Clinical Excellence recommendations for the treatment of borderline personality disorder Peter Tyrer, Corresponding Author Peter Tyrer p.tyrer@imperial.ac.uk Department of Psychological Medicine, Imperial College, London, UKProfessor of Community Psychiatry, Division of Neurosciences and Mental Health, Centre for Mental Health, Imperial College, London, UKSearch for more papers by this authorRex Haigh, Rex Haigh Berkshire Healthcare NHS Foundation Trust, Skimped Hill Lane, Bracknell, Berkshire, UKSearch for more papers by this author Peter Tyrer, Corresponding Author Peter Tyrer p.tyrer@imperial.ac.uk Department of Psychological Medicine, Imperial College, London, UKProfessor of Community Psychiatry, Division of Neurosciences and Mental Health, Centre for Mental Health, Imperial College, London, UKSearch for more papers by this authorRex Haigh, Rex Haigh Berkshire Healthcare NHS Foundation Trust, Skimped Hill Lane, Bracknell, Berkshire, UKSearch for more papers by this author First published: 28 January 2010 https://doi.org/10.1002/pmh.118Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume4, Issue1Special Issue: National Institute for Health and Clinical Excellence Guidelines for the Treatment of Antisocial Personality Disorder and Borderline Personality DisorderFebruary 2010Pages 34-38 RelatedInformation

Response to NICE: Guidelines for the treatment of antisocial personality disorder

Response to NICE: Guidelines for the treatment of antisocial personality disorder

Psychological treatments for antisocial personality disorder: Where is the evidence that group treatment and therapeutic community should be recommended?

Personality and Mental HealthVolume 4, Issue 1 p. 30-33 Commentary Psychological treatments for antisocial personality disorder: Where is the evidence that group treatment and therapeutic community should be recommended? Paul M. G. Emmelkamp, Corresponding Author Paul M. G. Emmelkamp [email protected] Department of Clinical Psychology, University of Amsterdam & Center for Forensic Psychiatry De Waag, AmsterdamAcademy Professor, Department of Clinical Psychology, University of Amsterdam, Roetersstraat 15, 1018 WB Amsterdam, The NetherlandsSearch for more papers by this authorEllen Vedel, Ellen Vedel Jellinek Addiction Treatment Centre, Arkin, AmsterdamSearch for more papers by this author Paul M. G. Emmelkamp, Corresponding Author Paul M. G. Emmelkamp [email protected] Department of Clinical Psychology, University of Amsterdam & Center for Forensic Psychiatry De Waag, AmsterdamAcademy Professor, Department of Clinical Psychology, University of Amsterdam, Roetersstraat 15, 1018 WB Amsterdam, The NetherlandsSearch for more papers by this authorEllen Vedel, Ellen Vedel Jellinek Addiction Treatment Centre, Arkin, AmsterdamSearch for more papers by this author First published: 28 January 2010 https://doi.org/10.1002/pmh.110Citations: 8AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Citing Literature Volume4, Issue1Special Issue: National Institute for Health and Clinical Excellence Guidelines for the Treatment of Antisocial Personality Disorder and Borderline Personality DisorderFebruary 2010Pages 30-33 RelatedInformation

Treatment of antisocial personality disorder

Although Professor Maden's article was only 100 words long,[1][1] it contained some profound and, I think, unfair and unsubstantiated, statements. Where is the evidence that patients with severe antisocial personality disorders who do not want to be treated, like many of those detained in the

Mental health services responding to men and their anger

Due to their propensity for acting out with antisocial behaviours, angry men are often regarded as having antisocial personality disorder with little hope for treatment success. Whilst not denying the difficulties in working with angry men, this paper looks to challenge some of the received wisdom in this area. Antisocial personality disorder is compared with borderline personality disorder and the many similarities, including the association with childhood trauma, course of illness, symptoms and rates of occurrence, are discussed. Differences between the two groups may be associated with the internalization or externalization of anger. Some issues related to bias in diagnosis are raised, as is the universal hopelessness implied in the literature related to treatment of antisocial personality disorder. Some issues related to engaging traditional men are discussed. In this paper the term 'traditional men' is used to describe men who value stoicism, self-reliance, strength, work, status and aggression highly whilst denying any vulnerability and exhibiting restricted emotionality. There is a need to reframe the diagnosis in order to recognize the associated behaviours as being an adult manifestation of complex childhood trauma. Further, there is a need for treatment directed towards altering ongoing patterns of retraumatization which characterize the lives of these men. A case study is included to demonstrate a number of the issues involved in working with angry men. These include issues of connection, boundaries, safety and utilization of the general practitioner in setting up a containing structure. The case study is used to illustrate that when issues of connection and anger containment are positively addressed, good therapeutic outcomes are possible.