4.3. Forensic Psychology
Master Psychology
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, Theme 1. The Offender
Sources
Brazil et al. (2017)
Peter et al. in Cima (2016) – Chapter 13
Van Dongen et al. (2016)
Van Dongen et al. (2014)
Keulen-De Vos et al. in Tafrate & Mitchell (2014) – Chapter 4
Hornsveld et al. (2008)
Wong et al. (2015)
PART 1.
Brazil, Van Dongen, Maes, Mars, & Baskin-Sommers (2017). Classification and treatment of
antisocial individuals: From behavior to biocognition
Introduction
- Antisocial behavior is a heterogeneous construct that encompasses a wide range of traits
and behaviors.
- Two subtypes of antisocial offenders, at greater risk for SUDs and criminal activity than
other offenders:
1. Individuals with antisocial personality (diagnosed with ASPD): 50-80% of the prison
population, display excessive reward seeking, intense hostility and reactive
aggression, and poor impulse control.
2. Psychopathic individuals: 15-25% of the prison population, difficulty establishing
genuine relationships, minimal and superficial affective experience, impulsive
behavioral style, and a chronic antisocial lifestyle entailing great costs to society as
well as for the affected individual (e.g., incarceration).
- These two subtypes of antisocial individuals lead to severe adverse consequences affecting
society, e.g., financial and emotional damage.
- Due to the high financial and emotional costs of these disorders, there is a need for
identifying and developing treatment programs targeting these disorders.
- However, these disorders are characterized by recidivism, so these individuals
account for the majority of failed treatments efforts within the penal system.
- This review: Discuss the classification and treatment of adult individuals characterized by
antisocial behavior, such as antisocial personality and psychopathy.
- Historical overview emphasizing key developments helping shape modern views on
antisocial personality and psychopathy.
- Discuss the conceptual divergence related to conceptualization of the constructs,
and show that the lack of conceptual precision is partly caused by the focus on
observable behavior rather than underlying mechanisms.
, - Review the effectiveness of treatment approaches targeting antisocial behavior and
discuss the implications of the lack of clarity in the operationalization of antisocial
behavior and psychopathy.
- Discuss three major approaches aiming at redefining diagnostics and treatment in
psychiatry in general, but also redefine antisocial personality and psychopathy by
incorporating information from biology, cognitive functioning, and clinical
observations.
- Combine elements of these three approaches to obtain profiles for classification
consisting of biocognitive dimensions, while minimizing the reliance on behavioral
observations.
- By combining information at different levels of analysis, we can help improve the
description of different types of antisocial individuals and facilitate the development
of novel therapeutic interventions that are tailored to fit the biocognitive
characteristics of these individuals.
Antisocial personality and psychopathy
Early views on antisocial personality and psychopathy
- 19th century: High prevalence of antisocial behavior in psychiatric populations was attributed
to the patient’s deviant mental functioning (e.g., instinctive fury and uncontrollable
impulses).
- Rush (1812): Causal link between antisocial behavior, personality characteristics, and
hereditary biological factors.
- Cleckly (1941) wrote the book “The Mask of Sanity”, in which he described psychopathy as a
severe form of emotional pathology masked by good mental health, and he described 16
diagnostic criteria spanning disruptive features and features promoting psychological
stability.
- Tension between maladaptive and adaptive features of psychopathy highlights the
complexity of the disorder and the difficulty in distinguishing it from antisocial personality.
- Conceptual divergence is further complicated by the DSM:
- DSM 1: Sociopathic Personality Disturbance, where antisocial behavior is seen in
light of someone’s cultural and social background.
- DSM 3: Introduction of ASPD, combining conduct disorder with adult antisocial
behavior.
- DSM emphasizes observable, behavioral criteria for the diagnosis, so the DSM
discarded the fact that there were multiple types of antisocial individuals (e.g.,
psychopathic versus non-psychopathic).
- Despite this controversy, ASPD remains the dominant diagnosis in clinical settings.
- ICD (International Classification of Diseases and Related Health Problems) has the diagnosis
Dissocial Personality Disorder which resembles ASPD.
- However, the ICD acknowledges the existence of antisocial subtypes (e.g., amoral,
psychopathic, antisocial).
- But the ICD also fails to properly distinguish between these and still collapse them
into one single category, and it is insufficient for scientific research.
- The DSM en ICD-10 provide a broad and easily identifiable target for diagnosis, but they
ignore the evidence that antisocial behavior is heterogeneous and expressed in clinical
diagnosis, like antisocial personality and psychopathy, in quite different ways.
