Antisocial Personality Disorder

Antisocial personality disorder (ASPD) is the most reliably diagnosed condition among the personality disorders, yet treatment efforts are notoriously difficult. Many psychiatrists are reluctant to treat patients with ASPD because of widespread belief that such patients are always untreatable. There is increasing evidence, however, that ASPD may, in certain cases, be treatable. In this chapter, we briefly review historical and contemporary nosological controversies regarding the ASPD construct, and summarize the general research findings for this condition. We then discuss treatment planning in detail, based on thorough assessment of the individual’s personality characteristics to determine prognosis, risk management, and appropriate treatment. We conclude by evaluating the specific treatment approaches available for ASPD, drawing from our own clinical experience and the research evidence to date. Psychodiagnostic Refinements