Current Psychiatry Reports

, 15:427 | Cite as

Antisocial Personality Disorder: A Current Review

  • Andrea L. Glenn
  • Alexandria K. Johnson
  • Adrian Raine
Personality Disorders (C Schmahl, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Personality Disorders

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.

Keywords

Crime subtypes DSM 5 Psychopathy Substance use Brain imaging Genetics Child abuse Treatment Personality disorder 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Andrea L. Glenn, Alexandria K. Johnson, and Adrian Raine declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Recently published papers of particular interest have been highlighted as:• Of importance

  1. 1.
    Gibbon S, Duggan C, Stoffers J, Huband N, Vollm BA, Ferriter M, et al. Psychological interventions for antisocial personality disorder. Cochrane Database Syst Rev. 2010;6, CD007668. doi: 10.1002/14651858.CD007668.pub2.PubMedGoogle Scholar
  2. 2.
    Fazel S, Danesh J. Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys. Lancet. 2002;359(9306):545–50. doi: 10.1016/s0140-6736(02)07740-1.PubMedCrossRefGoogle Scholar
  3. 3.
    Ogloff JR. Psychopathy/antisocial personality disorder conundrum. Aust NZ J Psychiatry. 2006;40(6–7):519–28. doi: 10.1111/j.1440-1614.2006.01834.x.CrossRefGoogle Scholar
  4. 4.
    Hare RD. Hare Psychopathy Checklist-Revised (PCL-R): 2nd Edition. Toronto: Multi-Health Systems, Inc.; 2003.Google Scholar
  5. 5.
    Patrick CJ, Fowles DC, Krueger RF. Triarchic conceptualization of psychopathy: Developmental origins of disinhibition, boldness, and meanness. Dev Psychopathol. 2009;21(Special Issue 03):913–38. doi: 10.1017/S0954579409000492.PubMedCrossRefGoogle Scholar
  6. 6.
    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.PubMedCrossRefGoogle Scholar
  7. 7.
    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.CrossRefGoogle Scholar
  8. 8.
    Cox J, Edens JF, Magyar MS, Lilienfeld SO, Douglas KS, Poythress Jr NG. Using the Psychopathic Personality Inventory to identify subtypes of antisocial personality disorder. Journal of Criminal Justice. 2013;41(2):125–34. doi: 10.1016/j.jcrimjus.2012.12.001.CrossRefGoogle Scholar
  9. 9.
    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.PubMedCrossRefGoogle Scholar
  10. 10.
    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.PubMedCrossRefGoogle Scholar
  11. 11.
    Drislane LE, Vaidyanathan U, Patrick CJ. Reduced cortical call to arms differentiates psychopathy from antisocial personality disorder. Psychol Med. 2013;43(04):825–35. doi: 10.1017/S0033291712001547.PubMedCrossRefGoogle Scholar
  12. 12.
    • 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.PubMedCrossRefGoogle Scholar
  13. 13.
    • 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.Google Scholar
  14. 14.
    DeShong HL, Kurtz JE. Four factors of impulsivity differentiate antisocial and borderline personality disorders. J Pers Disord. 2013;27(2):144–56. doi: 10.1521/pedi.2013.27.2.144.PubMedCrossRefGoogle Scholar
  15. 15.
    Whiteside SP, Lynam DR. The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity. Pers Individ Differ. 2001;30(4):669–89. doi: 10.1016/S0191-8869(00)00064-7.CrossRefGoogle Scholar
  16. 16.
    Swann AC, Lijffijt M, Lane SD, Steinberg JL, Moeller FG. Interactions between bipolar disorder and antisocial personality disorder in trait impulsivity and severity of illness. Acta Psychiatr Scand. 2010;121(6):453–61. doi: 10.1111/j.1600-0447.2009.01528.x.PubMedCrossRefGoogle Scholar
  17. 17.
    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.PubMedCrossRefGoogle Scholar
  18. 18.
    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.CrossRefGoogle Scholar
  19. 19.
    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.Google Scholar
  20. 20.
    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.CrossRefGoogle Scholar
  21. 21.
    Schiffer B, Muller BW, Scherbaum N, Hodgins S, Forsting M, Wiltfang J, et al. Disentangling structural brain alterations associated with violent behavior from those associated with substance use disorders. Arch Gen Psychiatry. 2011;68(10):1039–49. doi: 10.1001/archgenpsychiatry.2011.61.PubMedCrossRefGoogle Scholar
  22. 22.
    Moffitt TE. The new look of behavioral genetics in developmental psychopathology: Gene-environment interplay in antisocial behaviors. Psychol Bull. 2005;131:533–54.PubMedCrossRefGoogle Scholar
  23. 23.
    Ferguson CJ. Genetic contributions to antisocial personality and behavior: a meta-analytic review from an evolutionary perspective. J Soc Psychol. 2010;150(2):160–80. doi: 10.1080/00224540903366503.PubMedCrossRefGoogle Scholar
  24. 24.
    • 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.CrossRefGoogle Scholar
  25. 25.
    Moffitt TE. Adolescence-limited and life-course-persistent antisocial behavior: a developmental taxonomy. Psychol Rev. 1993;100(4):674–701.PubMedCrossRefGoogle Scholar
  26. 26.
    Ducci F, Enoch MA, Hodgkinson C, Xu K, Catena M, Robin RW, et al. Interaction between a functional MAOA locus and childhood sexual abuse predicts alcoholism and antisocial personality disorder in adult women. Mol Psychiatry. 2007;13:334–47. http://www.nature.com/mp/journal/v13/n3/suppinfo/4002034s1.html.PubMedCrossRefGoogle Scholar
  27. 27.
    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.PubMedCrossRefGoogle Scholar
  28. 28.
    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.PubMedCrossRefGoogle Scholar
  29. 29.
    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.Google Scholar
  30. 30.
    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.PubMedCrossRefGoogle Scholar
  31. 31.
    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.CrossRefGoogle Scholar
  32. 32.
    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.CrossRefGoogle Scholar
  33. 33.
    Herndon RW, Iacono WG. Psychiatric disorder in the children of antisocial parents. Psychol Med. 2005;35(12):1815–24. doi: 10.1017/s0033291705005635.PubMedCrossRefGoogle Scholar
  34. 34.
    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.Google Scholar
  35. 35.
    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.PubMedCrossRefGoogle Scholar
  36. 36.
    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.PubMedGoogle Scholar
  37. 37.
    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.CrossRefGoogle Scholar
  38. 38.
    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.PubMedCrossRefGoogle Scholar
  39. 39.
    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.Google Scholar
  40. 40.
    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.PubMedCrossRefGoogle Scholar
  41. 41.
    • 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%.PubMedCrossRefGoogle Scholar
  42. 42.
    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.PubMedCrossRefGoogle Scholar
  43. 43.
    Tang Y, Jiang W, Liao J, Wang W, Luo A. Identifying Individuals with Antisocial Personality Disorder Using Resting-State fMRI. Plos One. 2013;8(4):e60652. doi: 10.1371/journal.pone.0060652.PubMedCrossRefGoogle Scholar
  44. 44.
    Jiang W, Liu H, Liao J, Ma X, Rong P, Tang Y, et al. A functional MRI study of deception among offenders with antisocial personality disorders. Neuroscience. 2013;244:90–8. doi: 10.1016/j.neuroscience.2013.03.055.PubMedCrossRefGoogle Scholar
  45. 45.
    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.PubMedCrossRefGoogle Scholar
  46. 46.
    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.CrossRefGoogle Scholar
  47. 47.
    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.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Andrea L. Glenn
    • 1
  • Alexandria K. Johnson
    • 2
  • Adrian Raine
    • 3
  1. 1.Center for the Prevention of Youth Behavior Problems, Department of PsychologyUniversity of AlabamaTuscaloosaUSA
  2. 2.Department of PsychologyUniversity of AlabamaTuscaloosaUSA
  3. 3.Departments of Criminology, Psychiatry, and PsychologyUniversity of PennsylvaniaPhiladelphiaUSA

Personalised recommendations