Mercer University Atlanta Antisocial Personality Disorder Discussion

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The “IceMan”


Antisocial Personality Disorder

Please review the DSM symptoms for Antisocial Personality Disorder (listed here), watch the video, and answer the questions for Virtual Lab 4 by the end of the day (11:59PM) Friday, February 21st.

Antisocial Personality Disorder: According to the DSM-5, there are four diagnostic criterion, of which Criterion A has seven sub-features.

A. Disregard for and violation of others rights since age 15, as indicated by one of the seven sub features:
1. Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest
2. Lying, deception, and manipulation, for profit or self-amusement,
3. Impulsive behavior
4. Irritability and aggression, manifested as frequently assaults others, or engages in fighting
5. Blatantly disregards safety of self and others,
6. A pattern of irresponsibility and
7. Lack of remorse for actions

The other diagnostic Criterion are:
B. The person is at least age 18,
C. Conduct disorder was present by history before age 15
D. and the antisocial behavior does not occur in the context of schizophrenia or bipolar disorder

(American Psychiatric Association, 2013)

Watch the following Interview with Richard Kuklinski and answer the questions:

The Iceman Tapes - Inside The Mind Of A Mafia Hitman (Links to an external site.)

https://www.youtube.com/watch?v=psoq8qYvx18&feature=emb_logo

  • What are some symptoms of Antisocial Personality Disorder (based on DSM 5 criterion A) that Richard Kuklinski endorses during the interview? Choose and describe
  • 3 examples from his interview as they relate to specific criteria from criterion A.

2. What does the doctor (interviewer) tell The IceMan is a main reason that separates those with this “fearlessness” and risk-taking behaviors from engaging in prosocial behaviors (e.g., fighter pilots) vs. those who engage in antisocial behaviors (such as the IceMan)?

3. What other personality disorder does the doctor tell the Iceman that he has?

4. What are your personal thoughts on Richard Kuklinski? Are the stories he shares believable? (no wrong answer here).

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Chapter 12 Personality Disorders Copyright © 2018 Cengage Learning. All Rights Reserved. Outline An Overview of Personality Disorders • Aspects of Personality Disorders • Cluster A Personality Disorders • Paranoid, schizoid, schizotypal • Cluster B Personality Disorders • Antisocial, borderline, histrionic, narcissistic • Cluster C Personality Disorders • Avoidant, dependent, obsessive-compulsive Copyright © 2018 Cengage Learning. All Rights Reserved. Focus Questions • What are the essential features of personality disorders? • What are the features of odd or eccentric personality disorders? • What are the features of dramatic, emotional and erratic personality disorders? • What are the features of anxious or fearful personality disorders? Copyright © 2018 Cengage Learning. All Rights Reserved. What are Personality Disorders? • A persistent pattern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected and/or for others and may cause difficulties with work and relationships Copyright © 2018 Cengage Learning. All Rights Reserved. Personality Disorders: An Overview (slide 1 of 2) • • • • • Enduring, inflexible predispositions Maladaptive, causing distress and/or impairment High comorbidity with other disorders Generally poor prognosis Ego-syntonic: Unlike other disorders, often feel consistent with one’s identity; patients don’t feel that treatment is necessary • 10 specific personality disorders organized into 3 clusters Copyright © 2018 Cengage Learning. All Rights Reserved. Categorical and Dimensional Models • “Kind” vs. “Degree” • Personality disorders have traditionally been assigned as all-or-nothing categories • DSM-5 retained categorical diagnoses but also introduced additional dimensional model of personality disorders • Dimensional model: Individuals are rated on the degree to which they exhibit various personality traits Copyright © 2018 Cengage Learning. All Rights Reserved. Categorical and Dimensional Models, Continued • Cross-cultural research establishes the universal nature of the five dimensions • Five factor model of personality (“Big Five”) • Openness to experience • Conscientiousness • Extraversion • Agreeableness • Neuroticism Copyright © 2018 Cengage Learning. All Rights Reserved. Personality Disorders: An Overview (slide 2 of 2) • DSM-5 personality disorder clusters • Cluster A – odd or eccentric cluster • Cluster B – dramatic, emotional, erratic cluster • Cluster C – fearful or anxious cluster Copyright © 2018 Cengage Learning. All Rights Reserved. Personality Disorders: Statistics • Prevalence of personality disorders • Affects about 10% of the general population • Origins and course of personality disorders • Thought to begin in childhood • Tend to run a chronic course if untreated • May transition into a different personality disorder Copyright © 2018 Cengage Learning. All Rights Reserved. Personality Disorders: Statistics, Continued • Gender distribution and gender bias in diagnosis • Men more often show traits like aggression and detachment; women more often show submission and insecurity • Antisocial – more often male • Histrionic – equal numbers of male and female • Comorbidity is the rule, not the exception • Often have two or more personality disorders or an additional mood or anxiety disorder Copyright © 2018 Cengage Learning. All Rights Reserved. Personality Disorders Under Study • Sadistic: Enjoy inflicting pain • Passive-aggressive: Defiant, undermine authority • Further research is needed Copyright © 2018 Cengage Learning. All Rights Reserved. DSM-5 Personality Disorders • Cluster A = Odd or Eccentric • Paranoid, schizoid, and schizotypal personality disorders • Cluster B = Dramatic or Erratic • Antisocial, borderline, histrionic, and narcissistic personality disorders • Cluster C = Anxious or Fearful • Avoidant, dependent, and obsessive-compulsive personality disorders Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Paranoid Personality Disorder • Overview and clinical features • Pervasive and unjustified mistrust and suspicion • Few meaningful relationships, sensitive to criticism • Poor quality of life Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Paranoid Personality Disorder Causes • Causes • Not well understood • May involve early learning that people and the world are dangerous or deceptive • Cultural factors: more often found in people with experiences that lead to mistrust of other • Prisoners • Refugees • People with hearing impairments • Older adults Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Paranoid Personality Disorder Treatment • Treatment options • Few seek professional help on their own • Treatment focuses on development of trust • Cognitive therapy to counter negativistic thinking • Lack of good outcome studies Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Schizoid Personality Disorder • Overview and clinical features • Pervasive pattern of detachment from social relationships • Very limited range of emotions in interpersonal situations • Significant overlap with Autism Spectrum • The causes • Etiology is unclear • Childhood shyness • Preference for social isolation resembles autism Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Schizoid Personality Disorder Causes • Causes • Etiology is unclear due to scarcity of research • Childhood shyness is usually present • Some individuals experienced abuse or neglect in childhood • Preference for social isolation resembles autism Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Schizoid Personality Disorder Treatment • Treatment options • Few seek professional help on their own • Focus on the value of interpersonal relationships • Building empathy and social skills • Lack of good outcome studies Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Schizotypal Personality Disorder • Overview and clinical features • Behavior and dress is odd and unusual • Socially isolated and highly suspicious • Magical thinking, ideas of reference, and illusions • Many meet criteria for major depression • Some conceptualize this as resembling a milder form of schizophrenia Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Schizotypal Personality Disorder Causes • Causes • Mild expression of schizophrenia genes? • May be more likely to develop after childhood maltreatment or trauma, especially in men • More generalized brain deficits may be present (e.g., problems with learning or memory) Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster A: Schizotypal Personality Disorder Treatment • Treatment options • Address comorbid depression • Schizotypal personality disorder significantly increases the risk for developing major depressive disorder • Main focus is combination of antipsychotic medication, cognitive behavior therapy, and social skills training Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Antisocial Personality Disorder • Overview and clinical features • Failure to comply with social norms • Violation of the rights of others • Irresponsible, impulsive, and deceitful • Lack of a conscience, empathy, and remorse • “Sociopathy,” “psychopathy” typically refer to this disorder or very similar traits • May be very charming, interpersonally manipulative Copyright © 2018 Cengage Learning. All Rights Reserved. Criminality in Antisocial Psychopaths Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Antisocial Personality Disorder, Continued • Often show early histories of behavioral problems, including conduct disorder • “Callous-unemotional” type of conduct disorder more likely to evolve into antisocial PD • Families with inconsistent parental discipline and support • Families often have histories of criminal and violent behavior • Recent research suggests that psychopathy is a less reliable predictor of criminality Copyright © 2018 Cengage Learning. All Rights Reserved. Neurobiological Contributions to Antisocial Personality • Prevailing neurobiological theories • Underarousal hypothesis – cortical arousal is too low • Cortical immaturity hypothesis – cerebral cortex is not fully developed • Fearlessness hypothesis – fail to respond to danger cues • Gray’s model: Inhibition signals are outweighed by reward signals Copyright © 2018 Cengage Learning. All Rights Reserved. Development of Antisocial Personality • Genetic influences • More likely to develop antisocial behavior if parents have a history of antisocial behavior or criminality • Developmental influences • High-conflict childhood increases likelihood of APD in at-risk children  Impaired fear conditioning • Children who develop APD may not adequately learn to fear aversive consequences of negative actions (e.g., punishment for setting fires) Copyright © 2018 Cengage Learning. All Rights Reserved. Development of Antisocial Personality, Continued • Arousal theory • People with APD are chronically under-aroused and seek stimulation from the types of activities that would be too fearful or aversive for most • Psychological and social influences • In research studies, psychopaths are less likely to give up when goal becomes unattainable – may explain why they persist with behavior (e.g. crime) that is punished Copyright © 2018 Cengage Learning. All Rights Reserved. Development of Antisocial Personality, Part 3 • APD is the result of multiple interacting factors • Mutual biological-environmental influence • Early antisocial behavior alienates peers who would otherwise serve as corrective role models • Antisocial behavior and family stress mutually increase one another Copyright © 2018 Cengage Learning. All Rights Reserved. Treatment of Antisocial Personality • • • • • Few seek treatment on their own Antisocial behavior is predictive of poor prognosis Emphasis is placed on prevention and rehabilitation Often incarceration is the only viable alternative May need to focus on practical (or selfish) consequences (e.g., if you assault someone you’ll go to prison) Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Borderline Personality Disorder • Overview and clinical features • Unstable moods and relationships • Impulsivity, fear of abandonment, very poor self-image • Self-mutilation and suicidal gestures • Comorbidity rates are high with other mental disorders, particularly mood disorders Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Borderline Personality Disorder, Continued • Comorbid disorders • 80% borderline patients also have major depression; 10% are bipolar • Suicide attempts – 10% • 67% are diagnosed with at least one Substance Use Disorder • Eating disorders • 25% of bulimia patients have borderline personality disorder • 20% have anorexia Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Borderline Personality Disorder Causes • Causes • Strong genetic component • Also linked to depression genetically • High emotional reactivity may be inherited • May have impaired functioning of limbic system • Early trauma/abuse increase risk • Many BPD patients have high levels of shame and low self esteem Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Borderline Personality Disorder Causes, Continued • “Triple vulnerability” model of anxiety applies to borderline personality too • Results form the combination of: • generalized biological vulnerability (reactivity) • generalized psychological vulnerability (lash out when threatened) • specific psychological vulnerability (stressors that elicit borderline behavior) Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Borderline Personality Disorder Treatment • Treatment options – few good outcome studies • Antidepressant medications provide some shortterm relief • Dialectical behavior therapy is most promising treatment • Focus on dual reality of acceptance of difficulties and need for change • Focus on interpersonal effectiveness • Focus on distress tolerance to decrease reckless/self-harming behavior Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Histrionic Personality Disorder • Overview and clinical features • Overly dramatic and sensational • May be sexually provocative • Often impulsive and need to be the center of attention • Thinking and emotions are perceived as shallow • More commonly diagnosed in females Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Histrionic Personality Disorder Causes and Treatment • Causes • Etiology unknown due to lack of research • Often co-occurs with antisocial PD • Feminine variant of antisocial traits? • Treatment options • Focus on attention seeking and long-term negative consequences • Targets may also include problematic interpersonal behaviors • Little evidence that treatment is effective Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Narcissistic Personality Disorder • Overview and clinical features • Exaggerated and unreasonable sense of selfimportance • Preoccupation with receiving attention • Lack sensitivity and compassion for other people • Highly sensitive to criticism; envious and arrogant Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster B: Narcissistic Personality Disorder Causes and Treatment • Causes are largely unknown • Failure to learn empathy as a child • Sociological view – product of the “me” generation • Treatment options • Focus on grandiosity, lack of empathy, unrealistic thinking • Emphasize realistic goals and coping skills for dealing with criticism • Little evidence that treatment is effective Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster C: Avoidant Personality Disorder • Overview and clinical features • Extreme sensitivity to the opinions of others • Highly avoidant of most interpersonal relationships • Interpersonally anxious and fearful of rejection • Low self esteem Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster C: Avoidant Personality Disorder Causes and Treatment • Causes • May be linked to schizophrenia; occurs more often in relatives of people with schizophrenia • Experiences of early rejection • Childhood experiences of neglect, isolation, rejection, and conflict with others • Treatment • Similar to treatment for social phobia • Focus on social skills, entering anxiety-provoking situations • Good relationship with therapist is important Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster C: Dependent Personality Disorder • Overview and clinical features • Reliance on others to make major and minor life decisions • Unreasonable fear of abandonment • Clingy and submissive in interpersonal relationships Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster C: Dependent Personality Disorder Causes and Treatment • Causes • Not well understood due to lack of research • Linked to early disruptions in learning independence • Treatment options • Research on treatment efficacy is lacking • Therapy typically progresses gradually due to lack of independence Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster C: Obsessive-Compulsive Personality Disorder • Overview and clinical features • Excessive and rigid fixation on doing things the right way • Highly perfectionistic, orderly, and emotionally shallow • Unwilling to delegate tasks because others will do them wrong • Difficulty with spontaneity • Often have interpersonal problems • Obsessions and compulsions are rare Copyright © 2018 Cengage Learning. All Rights Reserved. Cluster C: Obsessive-Compulsive Personality Disorder Causes and Treatment • Causes are not well known • Moderate genetic contribution • Treatment • Treatment targets include cognitive reappraisal techniques to reframe compulsive thoughts • Target rumination, procrastination, and feelings of inadequacy Copyright © 2018 Cengage Learning. All Rights Reserved. Summary of Personality Disorders • Long-standing patterns of behavior • Begin early in development and run a chronic course • Disagreement exists over how to categorize personality disorders • Categorical vs. dimensional, or some combination of both • For most, little is known about causes or treatment Copyright © 2018 Cengage Learning. All Rights Reserved.
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Antisocial Personality
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Submission date: 21-Feb-2020 05:40PM (UTC-0500)
Submission ID: 1261715353
File name: Antisocial_Personality_Disorder.edited.docx (20.92K)
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Antisocial Personality
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Running head: ANTISOCIAL PERSONALITY DISORDER

Antisocial Personality Disorder
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Institution

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ANTISOCIAL PERSONALITY DISORDER

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Antisocial Personality Disorder

1. i} What are some symptoms of Antisocial Personality Disorder (based on DSM
5 criterion A) that Richard Kuklinski endorses during the interview? Choose
and describe

Personality disorder can be characterized as the tenacious sequence of cognitions,
emotions, and behaviors that causes lasting emotional suffering for the individual impacted and
for others may cause challenges with relationships and work as well. Richard Kuklinski is one o...


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