Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What happens if antisocial personality disorder is not treated? What is the prognosis of antisocial personality disorder?
Some societal costs of antisocial personality disorder, like the suffering endured by victims of the crimes committed by people with this disorder, are clear. However, when people with ASPD are the charismatic leaders of religious cults, the devastation they can create is often not known unless and until a catastrophe results. The multiple murders orchestrated by Charles Manson and the mass suicide that occurred at the command of the Reverend Jim Jones in Guyana in 1978 are just two such examples.
Individuals who suffer from antisocial personality disorder have a higher risk of abusing alcohol and other drugs and repeatedly committing crimes. Imprisonment is a potential consequence. People with antisocial personality disorder are also vulnerable to mood problems, such as major depression, anxiety, and bipolar disorder; having other personality disorders, especially borderline (BPD) and narcissistic personality disorders; self-mutilation and other forms of self-harm, as well as dying from homicide, suicide, or accident.
Antisocial personality disorder tends to make the prognosis of virtually any other condition more problematic. Having antisocial personality disorder makes the treatment for substance-abuse problems more difficult. People who have both antisocial personality disorder and schizophrenia are less likely to comply with treatment programs and are more likely to remain in an institution like prison or a hospital. These risks become magnified if antisocial personality disorder is not treated. Statistics indicate that many people with antisocial personality disorder experience a remission of symptoms by the time they reach 50 years of age.
Armelius, B.A., and T.H. Andreassen. "Cognitive-Behavioral Treatment for Antisocial
Behavior in Youth in Residential Treatment." Cochrane Database Systems Review 17.4 Oct. 2007: CD 005650.
Barnow, S., I. Ulrich, H.J. Grabe, H.J. Freyberger, and C. Spitzer. "The Influence of
Parental Drinking Behavior and Antisocial Personality Disorder on Adolescent Behavioural
Problems: Results of the Greifswalder Family Study." Alcohol and Alcoholism Advance Access, Oxford University Press, 8/1/07.
Bienenfeld, D. "Personality Disorders." eMedicine.com. July 17, 2008. <http://emedicine.medscape.com/article/294307-overview>.
Blackburn, R., and J.M. Lee-Evans. "Reactions of Primary and Secondary Psychopaths to
Anger-Evoking Situations." British Journal of Clinical Psychology 24.2 May 1985: 93-100.
Blair, RJR. "Neurobiological Basis of Psychopathy." The British Journal of Psychiatry 182 (2003): 5-7.
Caldwell, M., J. Skeem, R. Salekin, and G.V. Rubroek. "Treatment Response of
Adolescent Offenders With Psychopathy Features." Criminal Justice and Behavior
33.5 (2006): 571-596.
Caspi, A., J. McClay, T.E. Moffitt, J. Mill, J. Martin, I.W. Craig, A. Taylor,
and R. Poulton. "Role of Genotype in the Cycle of Violence in Maltreated Children."
Science 297.5582 Aug. 2, 2002: 851-854.
Compton, W.M., L.B. Cottler, J.L. Jacobs, A. Ben-Abdallah, and E.L. Spitznagel. "The
Role of Psychiatric Disorders in Predicting Drug Dependence Treatment Outcomes."
American Journal of Psychiatry 160 May 2003: 890-895.
Deeley, Q., E. Daly, S. Surguladze, N. Tunstall, G. Mezey, D. Beer, A. Ambikapathy,
et al. "Facial Emotion Processing in Criminal Psychopathy. Preliminary Functional
Magnetic Resonance Imaging Study." British Journal of Psychiatry 189 Dec. 2006: 533-539.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Treatment Revision.
Washington, D.C.: American Psychiatric Association, 2000.
Dolan, M., and G. Davies. "Psychopathy and Institutional Outcome in Patients
With Schizophrenia in Forensic Settings n the U.K." Schizophrenia Research 81.2-3 (2003): 277-281.
Foulks, E.F. "Commentary: Racial Bias in Diagnosis and Medication of Mentally
Ill Minorities in Prisons and Communities." Journal of the American Academy of Psychiatry and the Law
32 (2004): 34-35.
Grekin, E.R., P.A. Brennan, S. Hodgins, and S.A. Mednick. "Male Criminals With
Organic Brain Syndrome: Two Distinct Types Based on Age at First Arrest." American Journal of Psychiatry
158 July 2001: 1099-1104.
Harris, G.T., and M.E. Rice. "What Treatment Should Psychopaths Receive?" Cross Currents
Liu, J. "Early health risk factors for violence: conceptualization, review of the evidence and implications." Aggressive Violent Behavior 16.1 (2011): 63-73.
Luntz, B.K., and C.S. Widom. "Antisocial Personality Disorder in Abused and Neglected Children Grown Up." American Journal of Psychiatry 151. 5 May 1994: 670-674.
Martens, W.H.J. "Antisocial and Psychopathic Personality Disorders: Causes,
Course and Remission- A Review Article." International Journal of Offender Therapy and Comparative Criminology
44.4 (2000): 406-430.
Pearson, C. "A Psychopath Unplugged." Neurological Correlates Mar. 19, 2008.
Simonoff, E., J. Elander, J. Holmshaw, A. Pickles, et al. "Predictors of Antisocial
Personality: Continuities From Childhood to Adult Life." The British Journal of Psychiatry 184 (2004): 118-127.
Sjoberg, R.L., F. Ducci, C.S. Barr, T.K. Newman, L. Dell'Osso, M. Virkkunen, and
D. Goldman. "A Non-additive Interaction of a Functional MAO-A VNTR and Testosterone Predicts Antisocial Behavior." Neuropsychopharmacology 33 (2008): 425-430.
Verona, E., J. Sprague, and S. Javdani. "Gender and factor-level interactions in psychopathy: Implications for self-directed violence risk and borderline personality disorder symptoms." Personality Disorders: Theory, Research, and Treatment 3.3 July 2012: 247-262.
Virkkunen, M. "Self-mutilation in Antisocial Personality (Disorder). Acta Psychiatrica Scandinavica
54.5 Aug. 23, 2007: 347-352.
Westen, D., and J. Harnden-Fischer. "Personality Profiles in Eating Disorders:
Rethinking the Distinction Between Axis I and Axis II." American Journal of Psychiatry
158 Apr. 2001: 547-562.