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Psychopathy and antisocial personality are controversial disorders with alternate behavioral and dynamic formulations. As such, diagnostic approaches are often fragmentary and inconsistent. The purpose of this paper is to delineate the various conceptual parameters and to propose a comprehensive diagnostic approach.

A model is presented based on the congruence and differences among various categories of psychopathic and antisocial personality disorders and their clinical manifestations. Diagnostic approaches are critiqued and evaluated. Specific assessment tools and measures are recommended based on referrals and symptomatology.

Key factors of low frustration tolerance, poor social intelligence, aggression-driven psychopathy, sadism, and superego impairment are shown as central in the differential diagnostics of antisocial individuals.

The model enables the differentiation of problematic behaviors which may appear similar but require different forensic, legal, diagnostic, and intervention strategies.

The purpose of this paper is to explore the range of personality disorder diagnoses and levels of psychopathy as assessed by the Psychopathy Checklist-Revised (PCL-R) associated with treatment discontinuation in a sample of adult male prisoners.

Data from 92 male offenders in a high secure prison personality disorder treatment unit was analysed. PCL-R and personality disorder diagnoses were predicted as being related to increased treatment dropout.

Having a diagnosis of narcissistic personality disorder was related to treatment dropout, but PCL-R total scores were not. There was a trend for a diagnosis of antisocial personality disorder being associated with remaining in treatment.

The current study highlights that narcissistic personality disorder can be associated with treatment dropout, warranting further exploration as to why this is the case.

Managing responsivity issues for those presenting with a personality disorder diagnosis could be effective in maximising treatment engagement from this specific offender group.

Although treatment dropout has been explored previously, this is the first study to explore treatment dropout at a specialised unit designed specifically to provide treatment for this client group.

This paper reviews the medico‐legal background to the development of the pilot programme for treatment and assessment of dangerous individuals with severe personality disorder. It raises the question: is personality disorder related to dangerousness, and (if so) what mediates the relationship? It then reviews recent findings suggesting that patients deemed to be dangerous and severely personality disordered are characterised by a combination of antisocial and borderline traits, and as such are a source of distress both to themselves and to others. It remains for future research to determine how this particular constellation of personality disorders is functionally linked to dangerousness, and whether the link is mediated by neuropsychological impairment resulting from early‐onset alcohol abuse, as recently proposed by Howard (2006). It is recommended that the current criteria for ‘dangerous and severe personality disorder’ be dispensed with.

This paper explores the link between sexual offending and antisocial personality. Drawing on previous research, it illustrates that sex offenders with an antisocial personality are a heterogeneous group, differentiated by several factors. They victimise children, adults or both, those who victimise adults or adults and children are more psychopathic. They are motivated primarily by non‐sexual factors like opportunistic impulsivity or generalised anger, and violence is a source of erotic pleasure in some cases. A small group of men, however, are driven to offend by sadistic sexual fantasies of a serious nature, which develop over time and later form the basis of their violent predatory assaults. Varying definitions of antisocial personality confuse the research, and diagnostic co‐morbidity means that pure psychopathic types are probably rare.

This article presents the Impulsive Lifestyle Counselling program, a time-limited psychoeducational approach to increasing patient awareness of antisocial personality disorder and its consequences.

This article describes the ILC program, a program developed as an add-on to treatment for substance use disorders, gives examples of issues and patient-counsellor interactions in the ILC sessions.

During the ILC sessions the patients engaged with the counsellors in diverse ways, reflecting the varying levels of psychopathology and overall functioning and barriers and incentive for lifestyle changes.

Patients with substance use disorder and comorbid antisocial personality disorder can receive better care with brief counselling that focuses on antisocial behavior and thinking. More diverse evidence-based treatments are needed for this disorder.

Antisocial personality disorder (ASPD) and psychopathy are similar, but distinct, psychiatric conditions that are common in male and female inmates; a segment of the population with high rates of trauma exposure. It is unclear whether specific types of lifetime trauma are associated with ASPD and psychopathy in incarcerated women and men. Furthermore, the unique roles of post-traumatic stress disorder (PTSD) symptom severity and trauma victimization in antisocial personality disturbance are not well-understood. The paper aims to discuss these issues.

This study investigated associations between trauma variables (different kinds of traumatic experiences and PTSD) and antisocial personality variables (ASPD and psychopathy) in a sample of incarcerated women and men who participated in a randomized clinical trial for major depressive disorder. In total, 88 incarcerated men and women were assessed for ASPD diagnosis, psychopathy severity, PTSD symptom severity, and history of physical, sexual, and crime-related trauma. Regression analyses predicted ASPD or psychopathy from trauma variables, controlling for gender.

Physical trauma was the only form of trauma that was significantly related to psychopathy. Physical trauma and crime-related trauma were associated with ASPD. PTSD symptom severity was not associated with psychopathy or ASPD.

There are associations between some kinds of lifetime trauma exposure and current ASPD/psychopathy in the target sample, but these associations do not appear to be mediated through current PTSD symptoms.

The purpose of this paper is to introduce a contextualistic account of antisocial responding, with the addition of recent developments on the study of personality.

A behavioural and contextualistic view point is developed to account for antisocial personality and related topics, inasmuch as traditional definitions of antisocial personality disorder as provided on formal diagnostic manuals derive on several and not always coherent classifications of antisocial behaviours. Some of these classifications centre on issues like guilt, impulsivity or aggressiveness for establishing different types of offending and antisocial patterns. This paper focuses on functional personal backgrounds.

A total of five types of “potentiated contingencies” are described as being the main underpinnings involved in antisocial patterns. An analysis of the transformation of aversive functions of antisocial behaviours, leads to specify a distinctive rule-following behaviour that is concerned with that responding. Finally, the exposition of the four verbal clinical contexts that behaviour analysis highlights as taking place at therapeutic settings, serves to propose a fitter contextualistic intervention for antisocial personality patterns.

Novel investigations should contrast the functional classification of antisocial responding. Those studies should experimentally demonstrate the way in which the different instances of transformation of antisocial functions the author has described are prompted.

The analysis also allows for the anticipation of the behaviour of individuals fitting to every category of antisocial avoidance. And as the functional analysis of “antisocial avoidance” uncovers specific relations between environmental stimuli as they are produced and established in the history of interactions of individuals, a more fitting intervention based upon those relations is feasible.

An exhaustive functional taxonomy of antisocial personalities and delinquent behaviours has never been presented before elsewhere. Besides the author reinterprets from a contextualist position traditional empirical studies.

In light of the clinical importance of understanding co-morbidity within offender populations, the purpose of this paper is to examine the prevalence and comorbidities of clinical disorder (Axis I) and personality disorder (Axis II) within a sample of high risk, male offenders located in a high secure, prison-based personality disorder treatment service.

The study utilised clinical assessment data for both Axis I diagnoses (Structured Clinical Interview for DSM-IV) and Axis II diagnoses (International Personality Disorder Examination) of 115 personality disordered offenders who met the criteria for the treatment service between 2004 and 2015.

Co-morbidity between Axis I and Axis II diagnoses was high, with 81 per cent of the sample having co-morbid personality disorder and clinical disorder diagnosis. The most prevalent Axis I disorder was substance misuse, and Axis II was antisocial, borderline, and paranoid personality disorder. Following χ² analysis, Cluster A personality disorder demonstrated co-morbidity with both mood disorder and schizophrenia/other psychotic disorder. Paranoid, schizoid, narcissistic, and avoidant personality disorder demonstrated a level of co-morbidity with Axis I disorders. There was no association found between the clinical disorders of substance use and anxiety with any personality disorder within this sample.

In part these results suggest that certain Axis II disorders may increase the risk of lifetime Axis I disorders.

The findings of no co-morbidity between the clinical disorders of substance use and anxiety with any personality disorder within sample are inconsistent to previous findings.

Assessment of personality disorders in substance abusing patients may produce important insights. Little is known about the value of routine personality disorder assessment in a clinical context. Adults with past‐year substance dependence seeking treatment at a centralised intake unit for substance abusers in the City of Copenhagen were randomised to assessment of personality disorders and individual psychoeducation vs. attention placebo (n=75). All patients received psychoeducation for attention deficit hyperactive disorder (ADHD) and anxiety/depression when indicated. Patients were followed at three and six months post‐treatment. The psychoeducation for personality disorder did not result in improved functioning. Significant differences indicated a larger drop in substance use in the experimental group. Assessing personality disorders and providing psychoeducation is a promising treatment in a clinical context. There is a need for relevant treatment options to improve functioning and quality of life for this group of patients.

The purpose of this paper is to examine gender differences in lifetime substance use and non-substance use (non-SUD) psychiatric disorders among illicit drug users and determine factors associated with non-SUD psychiatric disorders independently for males and for females.

Secondary analysis of five cross-sectional studies conducted in Barcelona, Spain during 2000-2006. Lifetime DSM-IV substance use and non-SUD psychiatric diagnoses were assessed using the Spanish Psychiatric Research Interview for Substance and Mental disorders (PRISM) among 629 people who use substances (68 per cent male) recruited from treatment (n=304) and out of treatment (n=325) settings. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using binary logistic regression.

The prevalence of any lifetime psychiatric (non-SUD) disorder was 41.8 per cent, with major depression (17 per cent) and antisocial personality disorder (17 per cent) being the most prevalent disorders. After adjusting for age and study, the odds of having any lifetime non-SUD (OR 2.10; 95%CI 1.48, 2.96); any mood disorder (OR 2.13; 95%CI 1.46, 3.11); any anxiety disorder (OR 1.86; 95%CI 1.19; 2.92); any eating disorder (OR 3.09; 95%CI 1.47, 6.47); or borderline personality disorder (OR 2.30; 95%CI 1.36, 3.84) were greater for females than males. Females were less likely than males to meet criteria for antisocial personality disorder (OR 0.59; 95%CI 0.36, 0.96) and attention deficit disorder (OR 0.37; 95%CI 0.17, 0.78).

Psychiatric disorders are common among people who use substances, with gender differences reported for specific disorders. Gender-sensitive integrated treatment approaches are required to prevent and to address comorbidity psychiatric disorders among this population.

This secondary analysis of five cross-sectional studies included a large sample size allowing sufficient power to examine the differences between men and women. An additional strength of the methodology is the use of the gold standard PRISM which was used to assess disorders.