This document discusses Antisocial Personality Disorder (APD) by outlining the DSM-5 criteria, comparing it to psychopathy, examining risk factors and heritability, the development from conduct disorder to APD, and treatment options. The key points are: the DSM-5 criteria for APD includes a disregard for others' rights since age 15; psychopathy is assessed using Hare's Psychopathy Checklist measuring grandiosity and impulsivity; risk factors include biological and environmental influences like abuse or unstable parenting; those with childhood-onset conduct disorder are more likely to develop APD; and treatment focuses on reducing substance abuse and using mentalization-based therapy.

1. Antisocial Personality Disorder
Ashley Wheeler
University of South Florida St. Petersburg
Fall 2013

2. DSM-5 Criteria for APD
A. A pervasive pattern of disregard for and violation of the rights of others, occurring
since age 15 years, as indicated by three (or more) of the following:
1. Failure to conform to social norms with respect to lawful behaviors, as
indicated by repeatedly performing acts that are grounds for arrest.
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others
for personal profit or pleasure.
3. Impulsivity or failure to plan ahead.
4. Irritability and aggressiveness, as indicated by repeated physical fights or
assaults.
5. Reckless disregard for safety of self or others.
6. Consistent irresponsibility, as indicated by repeated failure to sustain
consistent work behavior or honor financial obligations.
7. Lack of remorse, as indicated by being indifferent to or rationalizing having
hurt, mistreated, or stolen from another.
B. The individual is at least age 18 years.
C. There is evidence of conduct disorder with onset before age 15 years.
D. The occurrence of antisocial behavior is not exclusively during the course of
schizophrenia or bipolar disorder.

3. Psychopathy
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New conceptualization of the Personality Disorders in
Section III of the DSM-5
Hare's (2003) Psychopathy Checklist (PCL-R)
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Factor 1: grandiosity, lying, lack of remorse/guilt
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Factor 2: early behavior problems, juvenile
delinquency, and impulsivity

4. Heritability
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Differences in genetic and
environmental factors between
individuals, not within individuals
High heritability does not mean that we
cannot change that trait

5. Risk Factors
DSM-5:
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Biological predisposition
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Environment:
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Abuse or neglect
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Unstable or erratic parenting or discipline
Kendler et al. (2012)
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Genetic: aggressive disregard & disinhibition
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Environmental: lack of remorse

6. From Conduct Disorder to APD
Frick (2012):
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Preadolescent-onset Conduct Disorder:
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More neurological and cognitive deficits
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More impulsivity and emotional regulation issues
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More violence and aggression
More likely to develop APD
Adolescent-onset Conduct Disorder:
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More likely to come from stable and financially secure homes
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Most concerned with defying authority
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May not display lack of remorse

7. Treatment
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Pharmocological: focus on reduction of
substance abuse
Psychological:
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Mentalization-Based Treatment (MBT)
–
Mentalization is “the process by which we
make sense of each other and ourselves,
implicitly and explicitly, in terms of
subjective states and mental processes”
Bateman and Fonagy (2010).

8. Where do we go from here?
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Prevention through early treatment via
IDEA
Research for psychological and
pharmacological interventions