Lecture 4 Flashcards
What was Cleckley’s contribution to the study of psychopathy ?
Cleckley’s book The Mask of Sanity (1941) laid the foundation for modern conceptualizations and measures of psychopathy
What tool did Hare develop to assess psychopathy ?
The Psychopathy Checklist-Revised (PCL-R) (Hare, 1988)
Why was psychopathy not included as a diagnosis in the DSM ?
The DSM is influenced by societal viewpoints, cultural and gender biases, and political factors rather than solely empirical evidence
What is a major criticism of the DSM’s approach to mental disorders ?
It is based on consensus rather than strong empirical research
How was antisocial behavior categorized in the DSM-I (1952) and DSM-II (1968) ?
As “Antisocial Reaction/Disorder” & “Dissocial Reaction”
How did the DSM-I define antisocial disorder ?
It described individuals as unsocialized, selfish, impulsive, and lacking guilt, often blaming others for their behavior
What are the consequences of defining ASPD in the DSM ?
Stigmatization
- Path dependency (continuing use of psychopathy in practice)
- Higher prevalence of ASPD in disadvantaged neighborhoods
- Potentially medicalizing social problems
How does living in disadvantaged neighborhoods affect antisocial behavior ?
It increases mistrust, aggression, and the need for self-protection (Code of the Street)
How does poverty affect cognitive functioning ?
Poverty impairs cognitive function, making it harder to regulate behavior & avoid antisocial tendencies
What percentage of antisocial behavior is explained by genetics ?
50% (aggressive, impulsive temperament)
What are environmental factors contributing to antisocial behavior ?
- Shared: Low family income, single-parent household, poor supervision (20%)
- Nonshared: Delinquent peers, abuse, academic struggles (30%)
How does trauma influence antisocial behavior ?
Trauma & emotional neglect lead to hypervigilance and difficulty trusting others
How does emotional neglect affect ASPD patients ?
It reduces their ability to understand & respond to others’ emotions
What treatments help ASPD patients improve empathy ?
- Social Cognition Training (VR)
- Mentalization-Based Treatment (MBT)
How does psychopathy differ from ASPD ?
Psychopaths recognize emotions but lack concern for others
What treatment strategies exist for psychopathy ?
- CBT
- External structuring
- Protective factors
- Treatment of addiction/trauma/aggression
Is there an evidence-based treatment for ASPD ?
No, but some therapies show promise
What are promising treatment approaches for ASPD ?
- Dialectical Behavioral Therapy (DBT)
- Mentalization-Based Therapy (MBT)
- Schema-Focused Therapy (SFT)
- Cognitive Behavioral Therapy (CBT)
What emotions do ASPD patients evoke in therapists ?
Rejection, hostility, fear, moral outrage, helplessness
Why should clinicians still treat ASPD patients ?
To reduce aggression, addiction, & mental health issues, benefiting both the individual & society
How do ASPD patients typically view therapists ?
With distrust, skepticism & concern about being judged
What do ASPD patients value in a therapist ?
- Open, nonjudgmental attitude
- Firm but kind approach
- Consistency & clarity
- Mutual respect & autonomy
What should therapists avoid when working with ASPD patients ?
- Being overly cautious or insecure
- Pushing too hard too soon
- Rigidly following protocols without flexibility
What qualities make a therapist effective with ASPD patients ?
- Confidence
- Predictability
- Flexibility in approach
- Ability to maintain firm but respectful boundaries
What was Robert Spitzer’s criticism of the DSM-III (2007) ?
He argued that operationalizing mental disorder definitions without considering context led to the medicalization of normal human experiences
What is The Code of the Street (Anderson, 1999) ?
A cultural framework in disadvantaged areas where people use violence to maintain respect and avoid being seen as weak
What are the estimated causes of antisocial behavior ?
- 20%: Shared environmental factors
- 30%: Nonshared environmental factors
- 50%: Genetic factors
What is the goal of the Pathways to Antisocial Behavior framework ?
To improve diagnosis and develop more tailored therapeutic interventions for ASPD
How does trauma and neglect influence antisocial behavior ?
- High levels of trauma and neglect in youth contribute to ASPD
- ASPD individuals often grow up in competitive, hostile environments
- They are hypervigilant to threats
Why do some ASPD individuals struggle with emotional recognition ?
Emotional neglect in childhood leads to poor mentalizing abilities, making it hard to assess emotions like fear and sadness
What are the three key treatment pathways for ASPD ?
- Trust Issues: Trauma treatment (EMDR, CBT) to reduce threat perception
- Reduced Reciprocity: Social Cognition Training (VR, MBT) to improve empathy
- Psychopathy (Callous-Unemotional Traits): CBT, external structuring, cognitive remediation to improve long-term decision-making
