The Challenges and Stigma of Living with Antisocial Personality Disorder

Case Study/Background: Describe

 observed characteristics

 symptoms

 behaviors of patient living with such a problem.

Literature Review:

 Which databases did you search?

 The peer-reviewed literature (minimum 9 resources, you may use more) related to the
chosen concept and care of the patient is reviewed in this section.

 The psychopathology/behavioral concept need to be identified and analyzed. (For example,

fear, manipulation, anger, dependence.

 What does the literature say about this phenomenon?

 For example, if you observe anger in the patient, what does the literature say about anger,
its origins, its manifestations, its impact on one’s life, is it manifested differently in
different cultures? etc.)

 End the section with a paragraph summarizing (wrap-up) the literature review

Case Study about prisoners: Differentiating between pathological demand avoidance and
antisocial personality disorder: a case study
https://search-proquest-com.libproxy.library.wmich.edu/docview/1862684388?
accountid=15099&rfr_id=info%3Axri%2Fsid%3Aprimo
 In June 2016, there were 85,130 incarcerated males and females in prisons in England

and Wales, 60-70% of which estimated to have at least one personality disorder (PD) with

similar numbers being reported under community supervision. Amongst this group, antisocial

personality disorder (ASPD) is the most frequently reported personality disorder.

Case study
Antisocial personality disorder is identified by traits that include irresponsible and exploitive

behavior, recklessness, impulsivity, high negative emotionality, and deceitfulness. It is

categorized alongside histrionic, narcissistic, and borderline, in “cluster B” of the personality

disorders, which are referred to as the dramatic and erratic cluster of personality disorders (Jones

& Wright, 2016)

Antisocial personality disorder (ASPD) is a pervasive pattern of disregard for and violation of

the rights of others occurring since age 15 years and including three or more of the following

indicators: failure to conform to social norms with respect to lawful behaviors, deceitfulness,

impulsivity, irritability and aggressiveness, reckless disregard for safety of self or others,

consistent irresponsibility, and lack of remorse (DeLisi, et. al., 2018).

___ described ASPD as a psychological condition in which a person has a long-term pattern of

manipulating, exploiting, or violating the rights of others (Wang, et al., 2017).

ASPD is a pervasive pattern of disregard for and violation of the rights of others

occurring since age 15. The disorder is characterized by frequent social and legal

deviances, self-regulatory deficits, disregard for others, and lack of empathy

(American Psychiatric Association, [ 3]). Individuals with ASPD generally experience

reduced quality of life and significant impairments in self-efficacy, and are at an

increased risk for involvement in criminogenic behavior. Compared to the general

population, individuals with ASPD have a greater risk of dying prematurely by violent

means, such as suicide, accidents, and homicides. ASPD is highly co-morbid with

depressive, anxiety, somatization, pathological gambling, and substance-related

disorders (Holthouser & Bui, 2016).

Although there have been many studies done describing the symptoms and behaviors of people

living with ASPD, not all studies have concluded the same findings. A variety of studies have

examined adults with ASPD with and without antecedent CD, and these studies have produced a

range of mixed and at times contradictory findings about their behavioral functioning,

psychiatric morbidity, and criminal careers (DeLisi, et. al., 2018). However, certain behaviors

were congruent in various studies, finding that there were no group differences in terms of their

reckless disregard for safety of self or others, employment or financial irresponsibility,

remorselessness, repeated lying and conning, or global impulsivity. There were also

nonsignificant differences in terms of social functioning, social problem solving, experiences of

shame, dissociative experiences, anger expression, anger control, and anger expression. In terms

of their criminal careers, those with ASPD with or without CD had comparable criminal

convictions, violent crime convictions, and custodial sentences (DeLisi, et. al., 2018).

It is important for health professionals to know that many patients with ASPD struggle

with many different comorbidities. For instance, in the National Comorbidity Survey, more than

54% of adults with ASPD had a lifetime anxiety disorder and persons with ASPD were also

more likely to present with substance use disorders, posttraumatic stress disorder, major

depressive disorder, and suicidality (DeLisi, et. al., 2018). The same study also has found that

ASPD patients are also very likely to be also have sexual issue tendencies. Clients who were

sexually sadistic were 1,033% more likely and those who displayed frotteurism were 311% more

likely to be diagnosed with ASPD but not CD, suggesting that their externalizing sexual

motivations were potent drivers of their antisocial conduct during adulthood (DeLisi, et. al.,

2018).
 References

DeLisi, M., Drury, A. J., Caropreso, D., Heinrichs, T., Tahja, K. N., & Elbert, M. J. (2018).
Antisocial Personality Disorder With or Without Antecedent Conduct Disorder: The
Differences Are Psychiatric and Paraphilic. Criminal Justice and Behavior, 45(6), 902–
917. https://doi.org/10.1177/0093854818765593
Wang, T.-Y., Lee, S.-Y., Hu, M.-C., Chen, S.-L., Chang, Y.-H., Chu, C.-H., … Lu, R.-B. (2017). More
inflammation but less brain-derived neurotrophic factor in antisocial personality
disorder. Psychoneuroendocrinology, 85, 42–48. doi: 10.1016/j.psyneuen.2017.08.006

Jones, E. S., & Wright, K. M. (2016). “They’re Really PD Today.” International Journal of Offender Therapy
and Comparative Criminology, 61(5), 526–543. doi: 10.1177/0306624x15594838

Holthouser, B., & Bui, N. H. (2016). Meditative interventions and antisocial personality
disorder. Counselling Psychology Quarterly, 29(3), 235–252. doi:
10.1080/09515070.2015.1026311