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Alcohol Research : Current Reviews 2019Alcohol use disorder (AUD) frequently co-occurs with other psychiatric disorders, including personality disorders, which are pervasive, persistent, and impairing.... (Review)
Review
Alcohol use disorder (AUD) frequently co-occurs with other psychiatric disorders, including personality disorders, which are pervasive, persistent, and impairing. Personality disorders are associated with myriad serious outcomes, have a high degree of co-occurrence with substance use disorders, including AUD, and incur significant health care costs. This literature review focuses on co-occurring AUD and personality disorders characterized by impulsivity and affective dysregulation, specifically antisocial personality disorders and borderline personality disorders. Prevalence rates, potential explanations and causal models of co-occurrence, prognoses, and the status of existing treatment research are summarized. Several important future research considerations are relevant to these complex, co-occurring conditions. Research assessing mechanisms responsible for co-occurring AUD and antisocial personality disorder or borderline personality disorder will further delineate the underlying developmental processes and improve understanding of onset and courses. In addition, increased focus on the efficacy and effectiveness of treatments targeting underlying traits or common factors in these disorders will inform future prevention and treatment efforts, as interventions targeting these co-occurring conditions have relatively little empirical support.
Topics: Alcoholism; Anticonvulsants; Antidepressive Agents; Antipsychotic Agents; Antisocial Personality Disorder; Behavior Therapy; Borderline Personality Disorder; Comorbidity; Humans; Impulsive Behavior; Personality Disorders; Prognosis
PubMed: 31886107
DOI: 10.35946/arcr.v40.1.05 -
Progress in Neurobiology Nov 2020Over the past two decades, research has revealed that genetic factors shape the propensity for aggressive, antisocial, and violent behavior. The best-documented gene... (Review)
Review
Over the past two decades, research has revealed that genetic factors shape the propensity for aggressive, antisocial, and violent behavior. The best-documented gene implicated in aggression is MAOA (Monoamine oxidase A), which encodes the key enzyme for the degradation of serotonin and catecholamines. Congenital MAOA deficiency, as well as low-activity MAOA variants, has been associated with a higher risk for antisocial behavior (ASB) and violence, particularly in males with a history of child maltreatment. Indeed, the interplay between low MAOA genetic variants and early-life adversity is the best-documented gene × environment (G × E) interaction in the pathophysiology of aggression and ASB. Additional evidence indicates that low MAOA activity in the brain is strongly associated with a higher propensity for aggression; furthermore, MAOA inhibition may be one of the primary mechanisms whereby prenatal smoke exposure increases the risk of ASB. Complementary to these lines of evidence, mouse models of Maoa deficiency and G × E interactions exhibit striking similarities with clinical phenotypes, proving to be valuable tools to investigate the neurobiological mechanisms underlying antisocial and aggressive behavior. Here, we provide a comprehensive overview of the current state of the knowledge on the involvement of MAOA in aggression, as defined by preclinical and clinical evidence. In particular, we show how the convergence of human and animal research is proving helpful to our understanding of how MAOA influences antisocial and violent behavior and how it may assist in the development of preventative and therapeutic strategies for aggressive manifestations.
Topics: Aggression; Animals; Antisocial Personality Disorder; Behavior, Animal; Gene-Environment Interaction; Humans; Monoamine Oxidase; Social Behavior; Violence
PubMed: 32574581
DOI: 10.1016/j.pneurobio.2020.101875 -
Cerebral Cortex (New York, N.Y. : 1991) Jul 2021Psychopathy is characterized by persistent antisocial behavior, impaired empathy, and egotistical traits. These traits vary also in normally functioning individuals....
Psychopathy is characterized by persistent antisocial behavior, impaired empathy, and egotistical traits. These traits vary also in normally functioning individuals. Here, we tested whether such antisocial personalities are associated with similar structural and neural alterations as those observed in criminal psychopathy. Subjects were 100 non-convicted well-functioning individuals, 19 violent male offenders, and 19 matched controls. Subjects underwent T1-weighted magnetic resonance imaging and viewed movie clips with varying violent content during functional magnetic resonance imaging. Psychopathic traits were evaluated with Levenson Self-Report Psychopathy Scale (controls) and Psychopathy Checklist-Revised (offenders). Psychopathic offenders had lower gray matter density (GMD) in orbitofrontal cortex and anterior insula. In the community sample, affective psychopathy traits were associated with lower GMD in the same areas. Viewing violence increased brain activity in periaqueductal grey matter, thalamus, somatosensory, premotor, and temporal cortices. Psychopathic offenders had increased responses to violence in thalamus and orbitofrontal, insular, and cingulate cortices. In the community sample, impulsivity-related psychopathy traits were positively associated with violence-elicited responses in similar areas. We conclude that brain characteristics underlying psychopathic spectrum in violent psychopathy are related to those observed in well-functioning individuals with asocial personality features.
Topics: Adult; Affect; Antisocial Personality Disorder; Brain; Brain Mapping; Criminals; Female; Gray Matter; Healthy Volunteers; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Neuropsychological Tests; Photic Stimulation; Self Report; Violence; Young Adult
PubMed: 33834203
DOI: 10.1093/cercor/bhab072 -
Annual Review of Psychology Jan 2022Early-onset disruptive, aggressive, and antisocial behavior is persistent, can become increasingly serious as children grow older, and is difficult to change. In 2007,... (Review)
Review
Early-onset disruptive, aggressive, and antisocial behavior is persistent, can become increasingly serious as children grow older, and is difficult to change. In 2007, our group proposed a theoretical model highlighting the interplay between neurobiological deficits and cognitive and emotional functioning as mediators of the link between genetic influences and early social adversity, on the one hand, and antisocial behavioral problems in childhood, on the other. In this article, we review the post-2007 evidence relevant to this model. We discuss research on genetics/epigenetics, stress/arousal regulation, and emotion and executive functioning in support of the argument that antisocial children, especially those who persist in engaging in antisocial behavior as they grow older, have a range of neuropsychological characteristics that are important in explaining individual differences in the severity and persistence of antisocial behavior. Current clinical practice tends not to acknowledge these individual neuropsychological risk factors or to target them for intervention. We argue that aggressive and disruptive behavior in childhood should be regarded as a neurodevelopmental problem and that intervening at the level of mediating neuropsychological processes represents a promising way forward in tackling these serious behavioral problems.
Topics: Aggression; Antisocial Personality Disorder; Child; Emotions; Executive Function; Humans
PubMed: 34587779
DOI: 10.1146/annurev-psych-052621-045243 -
Current Psychiatry Reports Nov 2023Sadistic pleasure-the enjoyment of harm-infliction to others-can have devastating interpersonal and societal consequences. The goal of the current review is to... (Review)
Review
PURPOSE OF REVIEW
Sadistic pleasure-the enjoyment of harm-infliction to others-can have devastating interpersonal and societal consequences. The goal of the current review is to illuminate the nomological net of traits related to sadism. We aim to achieve an understanding of the current empirical status on the link between sadism and personality disorders, psychopathy, the Dark Triad, and basic personality traits in clinical and community-based samples.
RECENT FINDINGS
The field is dominated by self-report studies on the Dark Triad with convenience samples. The link with DSM personality disorders has hardly been empirically studied. Existing evidence shows that sadism is most strongly related to increased psychopathic personality traits. Sadism can originate both from the interpersonal, affective, and behavioural basis of dark personality traits. There are diverging ideas on the differential status between sadism, psychopathy, and other dark traits. Research is needed on the causal impact of the broader range of personality disorders on sadism, in more diverse samples, including behavioural assessments of sadistic pleasure, as well as on the interplay of such personality traits with situational and affective aspects, and victim attitudes.
Topics: Humans; Sadism; Personality Disorders; Antisocial Personality Disorder; Personality
PubMed: 37856033
DOI: 10.1007/s11920-023-01466-0 -
Comprehensive Psychiatry Jul 2019Antisocial Personality Disorder (ASPD) is a severe personality disorder with robust associations with crime and violence, but its precise etiology is unknown. Drawing on...
Antisocial Personality Disorder (ASPD) is a severe personality disorder with robust associations with crime and violence, but its precise etiology is unknown. Drawing on near-population of federal correctional clients in the Midwestern United States, the current study examined antecedent background factors spanning adverse childhood experiences and childhood psychopathology. Greater adverse childhood experiences were associated with ASPD diagnosis with physical abuse showing associations with ASPD symptoms and sexual abuse with lifetime diagnosis for ASPD. Conduct Disorder was strongly linked to ASPD; however, Oppositional Defiant Disorder and ADHD had null associations. Given the role of environmental factors in the development of ASPD, greater criminological attention should be devoted to understanding how assorted forms of abuse and neglect coupled with childhood psychopathology contribute to ASPD especially given its linkages to severe criminal offending.
Topics: Adult; Adverse Childhood Experiences; Antisocial Personality Disorder; Attention Deficit and Disruptive Behavior Disorders; Conduct Disorder; Criminals; Female; Humans; Male; Middle Aged; Psychopathology; Retrospective Studies
PubMed: 31079021
DOI: 10.1016/j.comppsych.2019.04.001 -
Molecular Psychiatry Dec 2020Psychopathy is an extreme form of antisocial behavior, with about 1% prevalence in the general population, and 10-30% among incarcerated criminal offenders. Although the...
Psychopathy is an extreme form of antisocial behavior, with about 1% prevalence in the general population, and 10-30% among incarcerated criminal offenders. Although the heritability of severe antisocial behavior is up to 50%, the genetic background is unclear. The underlying molecular mechanisms have remained unknown but several previous studies suggest that abnormal glucose metabolism and opioidergic neurotransmission contribute to violent offending and psychopathy. Here we show using iPSC-derived cortical neurons and astrocytes from six incarcerated extremely antisocial and violent offenders, three nonpsychopathic individuals with substance abuse, and six healthy controls that there are robust alterations in the expression of several genes and immune response-related molecular pathways which were specific for psychopathy. In neurons, psychopathy was associated with marked upregulation of RPL10P9 and ZNF132, and downregulation of CDH5 and OPRD1. In astrocytes, RPL10P9 and MT-RNR2 were upregulated. Expression of aforementioned genes explained 30-92% of the variance of psychopathic symptoms. The gene expression findings were confirmed with qPCR. These genes may be relevant to the lack of empathy and emotional callousness seen in psychopathy, since several studies have linked these genes to autism and social interaction.
Topics: Aggression; Antisocial Personality Disorder; Criminals; Emotions; Empathy; Humans
PubMed: 31455857
DOI: 10.1038/s41380-019-0488-z -
The Psychiatric Quarterly Mar 2020For centuries, attempting a successful rehabilitation of youth with antisocial behaviors has challenged juvenile justice systems and society. More recently, advances in... (Review)
Review
For centuries, attempting a successful rehabilitation of youth with antisocial behaviors has challenged juvenile justice systems and society. More recently, advances in science and neuroimaging have permitted a deeper understanding of the biological underpinnings of antisocial behavior and psychopathic tendencies. This paper reviews biological findings in youth with conduct disorder, highlighting comparisons to biological findings in adults with antisocial personality disorder and psychopathy. Overall, youth with conduct disorder exhibit several biological findings that are similar to adults with antisocial personality disorder and psychopathy, consistent with theories that conduct disorder is a neurodevelopmental disorder that progresses to these adult conditions. There is evidence that treatment interventions might mitigate this progression and induce biological changes. Further, biological findings might guide interventions to rehabilitate youth and change the developmental trajectory of antisocial behaviors.
Topics: Adolescent; Adult; Antisocial Personality Disorder; Conduct Disorder; Human Development; Humans; Young Adult
PubMed: 31768912
DOI: 10.1007/s11126-019-09678-5 -
Fortschritte Der Neurologie-Psychiatrie Aug 2019Therapeutic relationship in forensic psychiatry is believed to be affected by the coercive setting and the role conflict of the therapists as both treaters and...
INTRODUCTION
Therapeutic relationship in forensic psychiatry is believed to be affected by the coercive setting and the role conflict of the therapists as both treaters and court-appointed experts. The aim of the study was to examine and compare the therapeutic relationship in forensic and general psychiatric settings.
MATERIAL AND METHODS
52 forensic patients and 66 general psychiatric patients filled in the Psychopathy Personality Inventory - Revised (PPI-R), the Inventory of Interpersonal Problems - German Version (IIP-D), the Questionnaire on Motivation for Psychotherapy (Fragebogen zur Erfassung der Psychotherapiemotivation (FPTM)) as well as the Working Alliance Inventory - Short Revised (WAI-SR). We applied descriptive analyses, calculated univariate -tests as well as multivariate -tests and performed general linear models.
RESULTS
The quality of the therapeutic alliance does not differ significantly between forensic and general psychiatric patients. Moreover, patients of forensic psychiatry consider therapeutic techniques applied by their therapists as more valuable for achieving their therapeutic aims than patients of the general psychiatry.
DISCUSSION
The therapeutic relationship in forensic psychiatry is as viable as in general psychiatry. This can be regarded as a result of the long-term therapy in the context of forensic psychiatry which allows more time to be spent on relationship building than in a general psychiatry setting where therapy is limited to a few weeks.
Topics: Antisocial Personality Disorder; Forensic Psychiatry; Humans; Motivation; Psychiatry; Psychotherapy; Surveys and Questionnaires
PubMed: 30060288
DOI: 10.1055/a-0586-3253 -
Journal of the American Academy of... Feb 2020Conduct disorder affects up to 10% of youths. It is heritable, stable, and highly associated with important psychiatric comorbidities and has significant predictive...
Conduct disorder affects up to 10% of youths. It is heritable, stable, and highly associated with important psychiatric comorbidities and has significant predictive value for life course with respect to education, employment, intimate relationships, and legal problems. In 25% of youths diagnosed with conduct disorder, the diagnosis serves as a prelude to adult antisocial personality. In nearly all adults with antisocial behavior, conduct disorder was a harbinger of behaviors and attitudes to come. Despite all this, conduct disorder remains an underdiagnosed, understudied, underemphasized phenomenon at both societal and neuropsychiatric levels. Most attention to the disorder lies in the imagination of Hollywood, where rebellious youth, liberated of societal norms, combine wanton aggression with unlikely cleverness to the delight of audiences, without depiction of the suffering and impairment far more common to individuals with the phenotype.
Topics: Adolescent; Adult; Aggression; Antisocial Personality Disorder; Conduct Disorder; Emotions; Female; Humans; Learning; Male
PubMed: 31843566
DOI: 10.1016/j.jaac.2019.06.020