Description

Antisocial personality disorder exacts a costly toll on society and poses many unique challenges for treatment. Historic conceptions of antisocial personality disorder and the related but distinct condition of psychopathy. The systematic co-occurrence of antisocial personality disorder with other diagnostic conditions (e.g., alcoholism, other forms of drug dependence) is discussed, and research is reviewed indicating that disorders of these types (termed “externalizing” disorders) share a common underlying dispositional vulnerability. This is followed by a review of current diagnostic criteria for antisocial personality disorder and changes to the diagnosis that have been proposed for the DSM-5, highlighting parallels to the literature (including changes proposed for the DSM-5) on conduct disorder, the childhood precursor to adult antisocial personality disorder. The chapter concludes with a discussion of currently available methods of treatment for antisocial populations, emphasizing the best-supported cognitive behavioral approaches, and future directions for treatment based on recent developments in the literature reviewed. Particular emphasis is placed on ways in which interventions could be tailored to meet the unique treatment needs of phenotypically distinct subgroups of antisocial individuals, and how emerging knowledge of the neurobiological underpinnings of antisocial personality disorder and psychopathy might be applied to developing alternative methods of treatment such as pharmacologically based or neuro-reprogramming (e.g., brain-process oriented training, or direct brain biofeedback) approaches that directly target cognitive and affective processing deficits common in these populations.

The hallmark symptoms of borderline personality disorder are maladaptive behavior and impulsive emotional reactions. However, the condition is occasionally associated with cognitive alterations. Recently, it has been found that the function of the basal ganglia and the hippocampi might also be affected. Hence, deterioration in learning and memory processes associated with these structures is expected. Thus, we sought to investigate visually guided associative learning, a type of conditioning associated with the basal ganglia and the hippocampi, in patients suffering from borderline personality disorder. In this study, the modified Rutgers Acquired Equivalence Test was used to assess associative learning in 23 patients and age-, sex-, and educational level-matched controls. The acquisition phase of the test, which is associated primarily with the front striatal loops, was altered in patients with borderline personality disorder: the patients exhibited poor performance in terms of building associations. However, the retrieval and generalization functions, which are primarily associated with the hippocampi and the medial temporal lobes, were not affected.

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Andy
Journal Coordinator
Journal of Annals of Behavioural Science