Diagnostic procedures and classification of antisocial behavior in Norwegian inmates in preventive detention

In official Norwegian government reports’ prison statistics, it is claimed that the prevalence of Dissocial Personality Disorder (DPD) or Antisocial Personality Disorder (APD) among inmates in preventive detention is approximately 50%. Furthermore, previous findings have described a practice in which forensic examiners use the DSM SCID axis II for APD to confirm an ICD 10 diagnosis of DPD. Clinical investigation supported by the use of SCID Axis II for quality assurance was performed on almost half the population of inmates (46.4%) in preventive detention at a high security prison. The inmates had all committed severe violent acts including murder. All the information obtained by applying the DSM IV-TR criteria was tested against the ICD-10 Research Criteria (ICD-10-RC) for Dissocial Personality Disorder (ICD-10, DPD). It was found that all inmates met the ICD-10-RC for (DPD) and the DSM-IV-TR definition for Adult Antisocial Behavior (AAB). On the other hand, none met the DSM-IV-TR criteria for (APD). The SCID Axis II failed to identify inmates with APD because the DSM-IV-TR C-criteria, referring to symptoms of childhood Conduct Disorder (CD), were not met. These findings raise important questions since the choice of diagnostic system may influence whether a person’s clinically described antisocial behaviour should be classified as a personality disorder or not. For the inmates, a diagnosis of APD or DPD may compromise their legal rights and affect decisions on prolongation of the preventive detention. Studies have shown that combining the DSM and the ICD diagnostic systems may have consequences for the reliability of the diagnosis.

White matter abnormalities in young males with antisocial personality disorder Evidence from voxel-based morphometry-diffeomorphic anatomical registration using exponentiated lie algebra analysis

Voxel-based morphometry-diffeomorphic anatomical registration using exponentiated lie algebra analysis was used to investigate the structural characteristics of white matter in young males with antisocial personality disorder （APD） and healthy controls without APD. The results revealed that APD subjects, relative to healthy subjects, exhibited increased white matter volume in the bilateral prefrontal lobe, right insula, precentral gyrus, bilateral superior temporal gyrus, right postcentral gyrus, right inferior parietal Iobule, right precuneus, right middle occipital lobe, right parahippocampal gyrus and bilateral cingulate, and decreased volume in the middle temporal cortex and right cerebellum. The white matter volume in the medial frontal gyrus was significantly correlated with antisocial type scores on the Personality Diagnostic Questionnaire in APD subjects. These experimental findings indicate that white matter abnormalities in several brain areas may contribute to antisocial behaviors in APD subjects.

Understanding Relational Dysfunction in Borderline, Narcissistic, and Antisocial Personality Disorders: Clinical Considerations, Presentation of Three Case Studies, and Implications for Therapeutic Intervention

Personality disorders are a class of mental disorders involving enduring maladaptive patterns of behaving,thinking,and feeling which profoundly affect functioning,inner experience,and relationships.This work focuses on three Cluster B personality disorders(PDs)(Borderline,Narcissistic,and Antisocial PDs),specifically illustrating how relational dysfunction manifests in each condition.People with Borderline Personality Disorder(BPD)experience pervasive instability in mood,behavior,self-image,and interpersonal patterns.In relationships,they tend to alternate between extremes of over-idealization and devaluation.Intense fear of abandonment,fluctuating affect,inappropriate anger,and black/white thinking deeply influence how they navigate personal relationships,which are often unstable,chaotic,dramatic,and ultimately destructive.They have a fundamental incapacity to self-soothe the explosive emotional states they experience as they oscillate between fears of engulfment and abandonment.This leads to unpredictable,harmful,impulsive behavior and chronic feelings of insecurity,worthlessness,shame,and emptiness.Their relationships are explosive,marked by hostility/contempt for self and partner alternating with bottomless neediness.Manipulation,lying,blaming,raging,and“push-pull”patterns are common features.Individuals with Narcissistic Personality Disorder(NPD)exhibit a long-standing pattern of grandiosity and lack of empathy.They have an exaggerated sense of self-importance,are self-absorbed,feel entitled,and tend to seek attention.Scarcely concerned with others’feelings,they can be both charming and exploitative.Oversensitive to criticism,they are prone to overt or covert rage,gaslighting and self-referential thinking.Antisocial Personality Disorder(APD)is marked by impulsive,callous,and irresponsible behavior with no regard to be manipulative,parasitic,aggressive,cold,cruel,and self-serving.In addition to analyzing relational dysfunction in each disorder,this paper presents three relational case studies(BPD-couple,NPD-parent/child,APD-various relations)and discusses treatment implications.

Sex dimorphic cortical brain volumes associated with antisocial behavior in young adults

Background:Although sex differences in antisocial behavior are well-documented,the extent to which neuroanatomical differences are related to sex differences in antisocial behavior is unclear.The inconsistent results from different clinical populations exhibiting antisocial behaviors are mainly due to the heterogeneity in etiologies,comorbidity inequality,and small sample size,especially in females.Objective:The study aimed to find sexual dimorphic brain regions associated with individual differences in antisocial behavior while avoiding the issues of heterogeneity and sample size.Methods:We collected structural neuroimaging data from 281 college students(131 males,150 females)and analyzed the data using voxel-based morphometry.Results:The gray matter volume in three brain regions correlates with self-reported antisocial behavior in males and females differ-ently:the posterior superior temporal sulcus,middle temporal gyrus,and precuneus.The findings have controlled for the total cortical gray matter volume,age,IQ,and socioeconomic status.Additionally,we found a common neural substrate of antisocial behavior in both males and females,extending from the anterior temporal lobe to the insula.Conclusion:This is the first neuroanatomical evidence from a large non-clinical sample of young adults.The study suggests that differences in males and females in reading social cues,understanding intentions and emotions,and responding to conflicts may contribute to the modulation of brain morphometry concerning antisocial behavior.

Is the Current Diagnosis of Schizophrenia Useful or Harmful?

In recent decades, evidence has appeared in various scientific fields—genetic, psychopharmacological, neuro-psychological, etc.—which makes it difficult to maintain the positive and negative syndrome of schizophrenia under one and the same diagnosis. On the other hand, there are social and legal reasons recommending the conception of these two syndromes as different entities. In this paper, we conduct appropriate bibliographical researches to reveal these evidences. We discuss these findings and conclude proposing the split of positive and negative syndromes of schizophrenia in two different disorders.