The Role of Antisocial Personality Disorder and Antisocial Behavior in Crime

The Development and Outcomes of ASPD in Children

ASPD children are at high risk of committing criminal acts in adolescence and adulthood. Loeber et al. suggested that early onset of ASPD may promote chronic forms of violent behaviour in 35-75% of cases.13

The development and outcome of ASPD is influenced by neurobiological (E.g. neurotransmitter imbalance), environmental (E.g. harsh parental discipline), and social (E.g. lack of personal relationships) factors.13 18 22 The onset of ASPD in toddlers or children is often the result of a disturbed temperament and a substandard environment. An introverted or difficult child who is raised in harsh circumstances, for instance, is at risk of developing ASPD.

Interestingly, Lynam and Robins showed that antisocial children are not destined to become antisocial adolescents or antisocial adults.15 27 The maintenance of ASPD is influenced by numerous biological factors, including neurotransmitter (E.g. serotonin) and hormone (E.g. testosterone and cortisol) levels (discussed above).

ASPD in Male Offenders vs. ASPD in Female Offenders

Criminological evidence has found that antisocial and aggressive behaviour is highly prevalent in males. Indeed, prevalence of ASPD in males is 3%.2 In contrast, few females exhibit antisocial and aggressive behaviour. Consequently, prevalence of ASPD in females is 1%.2 ASPD in male offenders is often associated with “Cluster B” personality traits, including a blatant disregard for the emotions of others, an inability to experience guilt, consistent irritability, and a low tolerance for frustration.2 In contrast, ASPD in female offenders is commonly associated with “Cluster A” personality traits, including irresponsible behaviour, impulsivity, high rates of childhood abuse, and aggression.2 20

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Additionally, ASPD in female offenders is often associated with high rates of unemployment, marital separation, substance abuse, depression, and suicidal behaviour.2 20 Scientific evidence has attributed gender differences in antisocial and aggressive behaviours to varying levels of gonadal hormones (namely testosterone) in male and female offenders.11 A population-based study by Hines et al. reported a positive association between concentrations of maternal testosterone (measured in blood samples of pregnant women) and antisocial and/or aggressive behaviour in 3.5 year-old female children.11 However, the neurobiological mechanism that underlies gender differences in antisocial and aggressive behaviours is poorly understood. Hence, further research is required.

Conclusion: Neurological and Psychological Treatments for ASPD

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) is often used to treat ASPD sufferers. CBT is a psychotherapeutic treatment that addresses cognitive processes and maladaptive behaviours through goal-oriented procedures. ASPD patients are encouraged to recognize negative or violent thought processes (E.g. suicidal or homicidal urges) and assess their validity.17 Furthermore, ASPD sufferers are taught to replace dysfunctional ideas with healthier ideas. CBT involves two tasks.

In cognitive restructuring, the therapist and the ASPD patient evaluate antisocial tendencies and discuss possible strategies for improvement. In behavioural activation, patients are encouraged to overcome behavioural obstacles by completing take-home reflections and activities (called “homework”).17 A study conducted by Davidson et al. evaluated the effectiveness of CBT for ASPD sufferers. ASPD patients were randomly assigned to a CBT-treatment group and a TAU-treatment group. Patients in the CBT-treatment group showed lower levels of physical aggression and antisocial behaviour after 6 months of training.17

Schema-Based Therapy

Schema-based therapy may be used to treat ASPD patients.22 Developed by Dr. Jeffery Young, schema-based therapy is a psychotherapeutic treatment that integrates elements of cognitive therapy, object relations, attachment theory, gestalt therapy, and behavioural therapy.22 According to schema-based therapy, “schemas” or “life traps” are self-defeating thought patterns that are established in childhood. Schemas may be altered using “coping styles” (E.g. schema maintenance, schema avoidance, and schema compensation). Schema-based therapy involves three tasks.17 Firstly, schemas are identified using questionnaires. Secondly, ASPD patients are taught to recognize schemas in daily life. Finally, ASPD patients are encouraged to replace negative schemas with positive thought processes.17 A 2004 study by Ben-Porath et al. investigated the effectiveness of schema-based therapy for ASPD sufferers. Patients showed improvements in social functioning after 18-36 months of training.17

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Endnotes

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