Antisocial personality disorder: new directions

Antisocial personality disorder is a complex condition carrying high rates of comorbidity and mortality for individuals as well as harmful consequences for their families and society. Despite the publication of National Institute for Health and Care Excellence (NICE) guidelines for the disorder, the evidence base and provision of effective treatments remain inadequate, and the belief that the condition is untreatable remains widespread among psychiatrists and other professionals. This article highlights current diagnostic controversies and summarises the evidence for conceptualising antisocial personality disorder as a disorder of attachment. Informed by this developmental perspective, we provide a framework for the management and treatment of adults with antisocial personality disorder, highlighting the importance of creating a safe setting and recommending adaptations of therapeutic technique to facilitate the engagement of this ‘treatment-rejecting’ patient population. We conclude with an outline of the current government policy on the treatment of high-risk offenders with personality disorder.Know the current diagnostic criteria and epidemiology of antisocial personality disorder.Evaluate the evidence that antisocial personality disorder can be conceptualised as a disorder of attachment, and use a developmental framework to inform treatment interventions.Gain an understanding of psychological approaches to antisocial personality disorder.

• Publication year

  2014

• Venue

  Advances in Psychiatric Treatment

• Publication date

  2014-03-01

• Fields of study

  Psychology

• Identifiers
  DOI 10.1192/APT.BP.113.011205
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

• [Antisocial personality disorder].

  2016cited by this paper
• The role of mentalising in the management of violence

  2013cited by this paper
• Anxiety Disorders Among Offenders With Antisocial Personality Disorders: A Distinct Subtype?

  2012cited by this paper
• Readiness to Engage in Treatments for Personality Disorder

  2012cited by this paper
• A joint offender personality disorder pathway strategy: an outline summary.

  2012cited by this paper
• Attachment and callous-unemotional traits in children with early-onset conduct problems.

  2012cited by this paper
• Love, eye contact and the developmental origins of empathy v. psychopathy.

  2012cited by this paper
• The dangerous and severe personality disorder experiment--review of empirical research.

  2012cited by this paper
• BECOMING NEGLECTED: A PERVERSE RELATIONSHIP TO CARE

  2010cited by this paper
• The successes and failures of the DSPD experiment: the assessment and management of severe personality disorder

  2010cited by this paper
• V. Differentiating developmental trajectories for conduct, emotion, and peer problems following early deprivation.

  2010cited by this paper
• Working with Violence: A Contemporary Psychoanalytic Approach

  2010cited by this paper
• Change during forensic treatment in psychopathic versus nonpsychopathic offenders

  2010cited by this paper
• Pharmacological interventions for antisocial personality disorder.

  2010cited by this paper
• Engagement in a medium secure personality disorder service: a comparative study of psychological functioning and offending outcomes.

  2010cited by this paper
• Hare Psychopathy Checklist-Revised (PCL-R)

  2010cited by this paper
• Psychological interventions for antisocial personality disorder.

  2010cited by this paper
• Antisocial personality disorder--stable and unstable subtypes.

  2010cited by this paper
• Service provision for men with antisocial personality disorder who make contact with mental health services

  2009cited by this paper
• Appropriate treatment works, but how?: Rehabilitating general, psychopathic, and high-risk offenders.

  2009cited by this paper
• Antisocial personality disorder and psychopathy in women: a literature review on the reliability and validity of assessment instruments.

  2009cited by this paper
• Mentalizing in Clinical Practice

  2009cited by this paper
• Comorbid antisocial and borderline personality disorders: mentalization-based treatment.

  2008cited by this paper
• Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial

  2008cited by this paper
• The use of psychological treatments for people with personality disorder: A systematic review of randomized controlled trials

  2007cited by this paper
• Managing Personality Disordered Offenders in the Community: A Psychological Approach

  2007cited by this paper
• Persistent violent offending: what do we know?

  2007cited by this paper
• DSM-IV personality disorders in the National Comorbidity Survey Replication.

  2007cited by this paper
• Psychopathy/antisocial personality disorder conundrum.

  2006cited by this paper
• Empirical basis and forensic application of affective and predatory violence.

  2006cited by this paper
• Personality disorders as disorganisation of attachment and affect regulation

  2006cited by this paper
• Psychopathy/Antisocial Personality Disorder Conundrum

  2006influential reference
• Prevalence and correlates of personality disorder in Great Britain

  2006cited by this paper
• Evidence for substantial genetic risk for psychopathy in 7-year-olds.

  2005cited by this paper
• Prevalence, correlates, and comorbidity of DSM-IV antisocial personality syndromes and alcohol and specific drug use disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions.

  2005cited by this paper
• Recalled parental bonding, adult attachment style, and personality disorders in child molesters: A comparative study

  2005cited by this paper
• Offending and attachment: The relationship between interpersonal awareness and offending in a prison population with psychiatric disorder

  2004cited by this paper
• Psychotherapy for Borderline Personality Disorder: Mentalization Based Treatment

  2004cited by this paper
• Review of treatments for severe personality disorder

  2003cited by this paper
• Lifetime comorbidity of antisocial personality disorder and anxiety disorders among adults in the community.

  2003cited by this paper
• Personality disorder: no longer a diagnosis of exclusion

  2003cited by this paper
• Dysregulation of the Right Brain: A Fundamental Mechanism of Traumatic Attachment and the Psychopathogenesis of Posttraumatic Stress Disorder

  2002cited by this paper
• Role of Genotype in the Cycle of Violence in Maltreated Children

  2002cited by this paper
• Three degrees of security: attachment and forensic institutions.

  2002cited by this paper
• Current attachment representations of incarcerated offenders varying in degree of psychopathy

  2001cited by this paper
• The effects of early relational trauma on right brain development, affect regulation, and infant mental health.

  2001cited by this paper
• The prevalence of personality disorders in a community sample.

  2001cited by this paper
• Relationship between 5-HT function and impulsivity and aggression in male offenders with personality disorders.

  2001cited by this paper
• HCR‐20. Assessing risk for violence, version 2. By C. Webster, K. Douglas, D. Eaves and S. Hart. Mental Health, Law and Policy Institute, British Columbia. 1997. 98 + vii pp

  2001cited by this paper
• Psychiatric Morbidity Among Prisoners in England and Wales

  2000cited by this paper
• Reduced prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder.

  2000cited by this paper
• The epidemiology of antisocial personality disorder

  1999cited by this paper
• Does criminal offender treatment work

  1998cited by this paper
• Self-Reports of Early Childhood Victimization Among Incarcerated Adult Male Felons

  1998cited by this paper
• Progression from conduct disorder to antisocial personality disorder following treatment for adolescent substance abuse.

  1998cited by this paper
• Childhood experiences of patients with schizophrenia and a history of violence: a special hospital sample

  1997cited by this paper
• Attachment representations of personality-disordered criminal offenders.

  1997cited by this paper
• The experience-dependent maturation of a regulatory system in the orbital prefrontal cortex and the origin of developmental psychopathology

  1996cited by this paper
• Death rates in 71 men with antisocial personality disorder. A comparison with general population mortality.

  1996cited by this paper
• Relationship of prolactin response to d-fenfluramine to behavioral and questionnaire assessments of aggression in personality-disordered men.

  1996cited by this paper
• Impulsive aggression in personality disorder correlates with tritiated paroxetine binding in the platelet.

  1996cited by this paper
• The psychology of criminal conduct and effective treatment.

  1995cited by this paper
• Genetic-environmental interaction in the genesis of aggressivity and conduct disorders.

  1995cited by this paper
• Antisocial Personality Disorders

  1994cited by this paper
• Epidemiology of psychiatric disorders in Edmonton. Antisocial personality disorders.

  1994cited by this paper
• Violent Recidivism of Mentally Disordered Offenders

  1993cited by this paper
• Antisocial Personality Disorder: Proposals for DSM-IV

  1993cited by this paper
• DSM‐III diagnosis in criminal psychopaths: a way forward

  1992cited by this paper
• The psychopathic mind : origins, dynamics, and treatment

  1989cited by this paper
• The antisocial personality.

  1978cited by this paper
• The mask of sanity.

  1951cited by this paper
• Journal of Child Psychology and Psychiatry 47:3/4 (2006), pp 262–275 doi:10.1111/j.1469-7610.2006.01596.x The development of psychopathy

  year unknowncited by this paper

• Clinicians' Assessment of Antisocial Personality Disorder (ASPD): A Network Analysis Approach on DSM‐5‐TR Criteria and Domains

  2025cites this paper
• Antisosyal Kişilik Bozukluğu’nda Ceza Sorumluluğunun Değerlendirilmesi ve İlgili Raporların Yargılama Süreci Üzerindeki Etkileri: Adli Psikiyatrik Bilirkişilikte Güncel Bir Sorun

  2025cites this paper
• Differential associations between mentalizing dimensions and psychopathy subtypes: the moderating role of borderline personality traits

  2025cites this paper
• A point prevalence survey of personality disorder in an Australian secondary care mental health service

  2025cites this paper
• Part of the Conversation? Exploring Male Patients’ Experiences with Mentalization-Based Treatment

  2025cites this paper
• Sociodemographic, Clinical and Criminal Characteristics of Offenders Disqualified from Conscription with Antisocial Personality Disorder: A Sample from Türkiye

  2024cites this paper
• Doubling down on dosage: exploring the interplay between dosage effects, antisocial traits, treatment attitudes, and recidivism-related therapy outcomes

  2024cites this paper
• Antisocial personality disorder and therapeutic pessimism – how can mentalization-based treatment contribute to an increased therapeutic optimism among health professionals?

  2024influential citation
• What is the experience of engaging in mentalization-based treatment? A meta-ethnography of client perspectives of the therapeutic process and outcome

  2024cites this paper
• Forensic mental health: envisioning a more empirical future.

  2024cites this paper
• Excluding autism or excluding everything? The problem of broad definitions in the England and Wales Draft Mental Health Bill

  2023cites this paper
• Paraphilic disorders, psychopathy, and those who sexually offend: a narrative review of treatment modalities

  2023cites this paper
• Antisocial personality disorder in group therapy, kindling pro-sociality and mentalizing

  2022influential citation
• Examining influencers of treatment engagement by patients in an NHS medium-secure hospital treating high-risk offenders with personality disorder

  2022cites this paper
• Antisocial Personality Disorder

  2022cites this paper
• Development of the Dimensional Clinical Personality Inventory Antisocial Personality Disorder Scale based on the HiTOP

  2022cites this paper
• An Interpretative Phenomenological Analysis on the Experience of Probation Officers in Managing People With Antisocial Personality Disorder

  2022cites this paper
• Management of ADHD in Prisoners—Evidence Gaps and Reasons for Caution

  2022influential citation
• Brief Psychodynamic Psychotherapies

  2021cites this paper
• Psychodynamic Psychotherapy Practice: An Introduction

  2021cites this paper
• Psychodynamic Theory: The Development of a Model of the Mind

  2021cites this paper
• Psychedelic-Assisted Psychotherapy

  2021cites this paper
• Referral for Psychodynamic Psychotherapy: Processes and Considerations

  2021cites this paper
• Neuropsychoanalysis and Relational Neuroscience

  2021cites this paper
• Exploring Clinician Wellbeing within a Mentalization-Based Treatment Service for Adult Offending Males with Antisocial Personality Disorder in the Community

  2021cites this paper
• Circumstances Leading to and Characteristics of Belgian Forensic Patients Remitted to Prison

  2021cites this paper
• Complex post-traumatic stress disorder.

  2021cites this paper
• Psychological Approaches to Psychosis

  2021cites this paper
• Introduction to Organisational Dynamics

  2021cites this paper
• Working Psychotherapeutically with Children

  2021cites this paper
• Psychodynamic Aspects of Suicide and Homicide

  2021cites this paper
• A Psychodynamic Approach to Psychiatry

  2021cites this paper
• Psychological Approaches to Medically Unexplained Symptoms

  2021cites this paper
• Cognitive Behavioural Therapy and Dialectical Behavioural Therapy: An Introduction

  2021cites this paper
• Cognitive Analytic Therapy (CAT):

  2021cites this paper
• Systemic Family Therapy

  2021cites this paper
• The psychodynamics of self-harm

  2021cites this paper
• Psychotherapeutic Development through the Life of the Psychiatrist

  2021cites this paper
• Mentalizing in Psychiatric Practice

  2021cites this paper
• Group Analytic Psychotherapy and the Group Analytic Model: A Clinician’s Guide

  2021cites this paper
• Psychological Approaches to Affective Disorders

  2021cites this paper
• Psychological Models for Case Formulation

  2021cites this paper
• Reflective Practice and Its Central Place in Mental Health Care

  2021cites this paper
• Psychodynamic Psychotherapy: The Consultation Process

  2021cites this paper
• The Effect on Staff and Organisations of Working with Patients with Psychotic Illness

  2021cites this paper
• The Open Dialogue Approach

  2021cites this paper
• How the Good Lives Model Can Complement Mentalization-Based Treatments for Individuals Who Have Offended With Anti-Social Personality Disorder and General Forensic Mental Health Needs: Practice Update

  2020cites this paper
• Personality disorder: Complexity, countertransference and co-production

  2019cites this paper
• De therapeutische relatie bij cliënten met antisociale persoonlijkheidsproblematiek; cliënt en behandelaar aan het woord

  2019cites this paper
• Mentalization-based treatment and its evidence-base status: A systematic literature review.

  2018cites this paper
• Violent women: treatment approaches and psychodynamic considerations

  2018cites this paper
• Personality disorder service provision: a review of the recent literature

  2017cites this paper
• Antisocial Behavior and Interpersonal Values in High School Students

  2017cites this paper
• Antisocial Behavior and Interpersonal Values in High School Students.

  2017cites this paper
• Attachment and Personality Disorders Among Child Molesters: The Role of Trust

  2017cites this paper
• Mindfulness moderates the relationship between aggression and Antisocial Personality Disorder traits: Preliminary investigation with an offender sample.

  2016cites this paper
• Personality disorder : complex cases or difficult cases? : a question of placement in forensic services

  2015cites this paper
• Threats of violence

  2015cites this paper
• Clinicians' perspectives on the treatment of psychopathic and borderline personality disorders: Identifying current strategies to better inform future treatment directions

  2014cites this paper
• PSYCHOLOGICAL PROFILING OF SEXUAL ASSAULT OFFENDERS

  year unknowncites this paper