Abstract
Anti-social personality disorder (ASPD) also known as anti-social behavior disorder is often used to predict criminality and recidivism. ASPD is a mental illness characterized by a disregard for social norms, impulsive behavior, inability to feel remorse and low tolerance for frustration. Individuals with ASPD have an inflated sense of self-worth and possess a superficial charm that makes others fall into their traps. The cause of ASPD is highly disputed; some people believe that individuals with ASPD are evil while some studies show that there is a biological explanation for ASPD. Individuals with ASPD have low levels of the neurotransmitter serotonin and maldevelopment of limbic and septal brain region which affects judgment, planning and impulse control. Additionally, individuals with ASPD are exposed to adverse environmental factors such as low socio-economic status, low education status, and poor upbringing that lead to the onset of ASPD. The symptoms, biological, and social explanation for ASPD are evidence that it is hard to treat criminal offenders suffering from anti-social behavior disorder.
Introduction
Once in a while, the news shares gruesome crime stories that scare the public and make them wonder about the mental state of the criminal offender. There are cases of offenders who kill their families or friends because they did not get their way. Individuals with ASPD exploit others and the society for their gain without thinking about the consequences (Pechorro et al., 2015). ASPD has a long history, and it is linked to Prichard’s concept of ‘moral insanity.’ Antisocial personality was added to DSM classification in 1952, and it was initially labeled as antisocial reaction under sociopathic personality disturbance.
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The DSM-5 describes individuals with ASPD as individuals who habitually and pervasively disregard or violate rights of others without remorse. People with ASPD tend to be habitual criminals, or they engage in behaviors that are criminal and make people question their morality. People with ASPD have an impaired moral conscience, and their desires drive them. Since the inclusion of ASPD in DSM in 1952, it has been revised over time. ASPD is now classified as a distinct clinical entity, and the criteria for diagnosing APD has been established (Walsh, 2017).
The DSM-5 has four diagnostic criteria for ASPD. The first criterion is the disregard for and violation of the rights of others since the age of 15. The first criterion has seven sub-features including failure to obey the laws which result in criminal arrest, lying/deception and manipulation of others for self gain or self-amusement, impulsive behavior, irritability and aggression, blatant disregard for safety of self and others, a pattern of irresponsibility and lack of remorse (American Psychiatric Association, 2013). The second criterion is that the person has to be at least 18 years, and the conduct disorder was present before the age of 15. Lastly, the antisocial disorder qualifies as ASPD when it does not occur in the context of schizophrenia or bipolar disorder (American Psychiatric Association, 2013).
Why is this Important?
DSM-5 shows that ASPD can be diagnosed before 18, and there is an annual prevalence of 0.02 to 3.3%. Risk factors include being male. The debate on whether ASPD is primarily genetic or a product of socio-environmental factors continues, and researchers are yet to agree on the exact cause of ASPD. Anti-social behavior disorder used to be commonly referred to as sociopathic behavior (Durmaz, 2017). ASPD affects a significant number of criminals. Criminal offenders with ASPD can engage in very violent criminal acts or violent behavior. Symptoms of anti-social behavior disorder include the lack of remorse or guilt towards a victim symptoms also include failure to conform to social norms, deceitfulness, impulsivity, and consistent irresponsibility. With all of these symptoms, it is hard to treat a criminal who suffers from anti-social behavior disorder because they cam’ be controlled. If the medication were an option, no one would be for sure that the offender would take the medication.
Existing Literature on ASPD and Criminality
Existing literature on ASPD reports a relationship between ASPD and crime. According to Pechorro et al. (2015), adults with psychopathic traits are more likely to engage in violent, aggressive and persistent criminal behaviors. Youth with callous-unemotional (CU) traits, which is a subgroup of antisocial youth also participate in severe, aggressive and persistent antisocial and criminal actions. Youth with CU traits respond poorly to treatment as reported by a study conducted by Kahn, Byrd & Pardini (2013). According to the study, antisocial youth with high levels of CU have diminished responses, including less fear and no reaction to distress from others, and they do not respond to cues of punishment. Consequently, young people with CU traits have severe and persistent behavior problems that persist into their adulthood.
Researchers have also explored the age for the onset of antisocial behavior. Pechorro et al. (2015) state that antisocial behavior starts during childhood, and they are sustained during adolescence into adulthood. Studies demonstrate that young people with antisocial behavior begin engaging in harm from an early age marking their initiation, and as they grow old, they increase the seriousness of their crimes. According to Pechorro et al. (2015), there are two main groups of criminals with ASPD: early starters and life-course persistent. Early starters commit their first crime at a younger age; while life-course-persistent keep engaging in criminal actions throughout their lives. Studies point out that early onset of ASPD starts around 11-12 years. However, childhood onset of ASPD is before ten years, and the offenders show an aggressive and stable pattern of antisocial behavior in comparison to other young people. What makes it hard to treat ASPD is that fact that individuals with ASPD start early and they keep increasing the intensity over the years.
Adults with psychopathic traits have engaged in numerous criminal activities such that they are more violent, aggressive and persistent. Walsh (2017) gives the example of Frank who was accused of rape by eleven women over the course of thirty years. In the 1970s, Frank broke into four homes within a four-month period and forced women to undress, raped them and robbed each other. He was arrested and charged with several counts of sexual assault, and given a 25-year sentence. Frank was released in 1977 after seven years only, and he committed six more home invasions and raped women over a four-month period. The invasion and rape pattern followed a similar pattern, and Frank was sentenced to a thirty-year sentence. He was released in 2010 on parole, and the State of New York started a proceeding to civilly commit Frank under the New York Mental Hygiene Law Article 10. The law gives the power to detain sex offenders like Frank who suffer from a mental abnormality that puts them at risk to commit another sex offense. During Frank’s trial, experts testified that he suffered from paraphilia and antisocial personality disorder (ASPD). ASPD hindered Frank’s volitional control such that he would commit more sexual offenses if released. Consequently, Frank qualified for civil commitment.
Frank’s case above makes one wonder whether biological or socio-environmental factors cause ASPD. According to Aggarwal (2013), research on ASPD claims that people with ASPD have abnormalities in the chemistry and anatomy of their brain. They have low levels of the neurotransmitter serotonin and poor development of limbic and septal brain regions affecting judgment and impulse control. Environmental factors also influence the biological basis for ASPD. Aggarwal (2013) notes that traumatic events can offset the healthy development of the central nervous system causing abnormal development in neuronal chemistry that can trigger ASPD. Serotonin is downgraded in ASPD patients, and decreased serotonin level alters the processing of sensory information leading to disinhibition of violent behavior. There is scientific evidence that confirms serotonin regulates aggressive action directed towards self and others.
Another biological explanation as to why it hard to treat ASPD among offenders is because they have high levels of testosterone. Aggarwal (2013) references a study by Fang et al. which reported a positive association between free testosterone and delinquency. The study explains why ASPD is common in male in comparison to women because testosterone is a male hormone. A longitudinal study by Tarter et al. concluded that high levels of testosterone in male children between 12 and 14 predicted antisocial behavior.
Other studies show that offenders with ASPD have different brain structures in comparison to individuals who do not have ASPD. According to Aggarwal (2013), they have a significant deficit of PFC gray matter reducing the activity of the orbitofrontal PFC. The cortical deficiencies make it impossible to down-regulate PFC contributing to criminal tendencies. The brain of individuals with ASPD also has anatomical abnormalities with the superior temporal gyrus causing behavioral control issues and violence. Individuals with ASPD have increased white matter in the superior temporal gyrus making them erratic due to poor neuronal functioning.
Environmental factors also play a role in the onset and progression of ASPD. According to Pecherro et al. (2015) parents of children with ASPD are often alcoholic, or have broken families. Studies also found out that adopted children have a high risk for ASPD because they cannot form emotional connections with adult figures; thus they engage in antisocial and high-risk behaviors in their childhood and adulthood. Physical and mental abuse during childhood also increases the risk for ASPD as scientific studies show that violent behaviors can be learned. Children who grow up in neglectful and violent environments can grow up to be violent, negligent and sociopathic. Lastly, low socio-economic status and low education level is a risk factor for ASPD.
The role of ASPD in crime cannot be underestimated when biological and environmental factors are at play. Pecherro et al. (2015) conducted a study on juvenile criminals with high CU and low CU. In the study, Pecherro et al. (2015) found out that there are severe and persistent juvenile criminals with ASPD who have committed serious crimes at a young age. The young offenders did not show remorse, and they only get worse with time. Environmental factors such as abuse and neglect during childhood affect brain structure and function, making it hard to treat or reform criminal offenders with ASPD.
McRae (2013) explores strategies for treating criminal offenders with ASPD. According to McRae (2013), the primary challenge lies in getting the criminal offenders to cooperate with the treatment because they do not believe that there is anything wrong with them. McRae (2013) suggests the use of offender responsibilization where the intervention attempts to meet all the needs of offenders and make them productive members of the society. The psychiatric treatment imposes normative constraints on offenders to encourage the pro-social behavior. Criminal offenders are more likely to cooperate with the treatment if they are told that cooperation will lead to reduced sentences, making it hard to determine whether the treatment is working or not. McRae (2013) talks about a study conducted on recidivism among offenders with ASPD which concluded that 41% of offenders were back in jail within two years after engaging in serious crime.
Conclusion
Criminal offenders suffering from antisocial behavior disorder are hard to rehabilitate. Therapy tends to work for most mental disorders apart from ASPD because individuals with ASPD do not believe that they are mentally impaired. Research suggests that ASPD is caused by a myriad of biological and environmental factors; it is common in men, and it progresses with time. Criminal offenders with ASPD are more likely to commit more crime even after treatment. The criminal justice system is only left with the option of violating offender’s rights by detaining them for public safety reasons. Further research should be done to identify the specific cause of ASPD in an effort to find the best treatment option that will safeguard the public from being victimized by offenders with ASPD.
References
Aggarwal, I. (2013). The Role of Antisocial Personality Disorder and Antisocial Behavior in Crime. Inquiries Journal , 5 (09).
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. (5th Edition). Washington, DC.
Durmaz, O. (2017). The Relationship Between Harming Behavior and Substance Use Profile, and Attention Deficit Hyperactivity Disorder Symptoms in Antisocial Personality Disorder. Dusunen Adam: Journal of Psychiatry & Neurological Sciences , 30 (3).
McRae, L. (2013). Rehabilitating antisocial personalities: treatment through self-governance strategies. The journal of forensic psychiatry & psychology , 24 (1), 48-70.
Pechorro, P., Nunes, C., Jiménez, L., & Hidalgo, V. (2015). Incarcerated youths with high or low callous–unemotional traits: a comparison controlling for age of crime onset. The Journal of Forensic Psychiatry & Psychology , 26 (1), 78-93.
Walsh, K. (2017). Antisocial Personality Disorder and Donald DD: Distinguishing the Sex Offender from the Typical Recidivist in the Civil Commitment of Sex Offenders. Fordham Urb. LJ , 44 , 867.
