Antisocial PD & Intermittent Explosive Disorder

Antisocial Personality Disorder (ASPD)

• difficulties forming positive relationships with others

• violation of basic rights of others, social norms, and expectations

• satisfying one’s personal desires

• deceitfulness and conning

• poor impulse control and take risks with no regard for danger or harm to others

• consistent irresponsibility, boredom, restlessness

• violence towards others

• lack of remorse

Psychopathy

Superficial charm, grandiose sense of self, frequently bored and seek stimulation, history of pathological lying, cunning and manipulative, lack of remorse, cold and callous, cruel and malicious

Brain Abnormalities

• Neurotransmitters: serotin (impulsivity and aggression)

• deficits in verbal skills and executive functioning areas of brain (prefrontal cortex and amygdala)

• abnormal functioning in temporal and frontal lobes

• medical illnesses or toxin exposure

Stimulation Seeking

Based on reinforcement they receive

Treatment of ASPD

• difficult as the do not seek treatment due to not believing they need it

• blame others rather than accept responsibility which makes therapy difficule

Behavioral CBT

Recognize triggers, develop alternative coping strategies

Cognitive CBT

Increased understanding of impact of behaviors

Medication

Lithium and atypical antipsychotics (treat impulsiveness and aggressiveness)

Intermittent Explosive Disorder

• impulsive verbal or physical (non-injurious) aggression

• aggression is grossly out of proportion to the situation

• “out of control” as result of anger

• inability to inhibit the impulse to be aggressive

• must be at least 6 years of age

• typically begins late childhood or adolescence, rarely onsetting after 40

Theories of IED

• imbalance in serotonin levels

• lowered activation in orbitofrontal cortex and hyperactivity of amygdala

• runs in families - could be genetic or environmental or combination

Treatment of IED

CBT: identify and avoid triggers for explosive behaviors and appraise situations in manners that do not provoke aggression on their part

• SSRIs AND SNRIs show some reduction in aggression