Symptoms and Main Differences Between a Psychopath and a Sociopath.

ABSTRACT: The research relevance is predefined by the fact that, in modern psychology and psychiatry, the concepts of psychopathy and sociopathy are combined and interchanged. These are two concepts that describe different etiologies of the same mental health condition. The research aims to describe in detail the main manifestations and characteristics of personality disorders (psychopathy and sociopathy) in psychiatry and psychology. The research analyzes the main features and manifestations of sociopathy and psychopathy. It examines the work of psychologists, psychiatrists, neurologists, and neurosurgeons in helping sociopaths and psychopaths. The study also explores the challenges of treating antisocial personality disorders and identifies internal and external factors that influence the development of these conditions. In addition, the article emphasizes the behavioral differences between sociopaths and psychopaths, proposes various methods for integrated therapy, diagnoses the main aspects of these disorders, and highlights the importance of psychiatric care and psychotherapeutic interventions. The research is of theoretical and practical value for psychologists, psychoanalysts, and physicians who can help people with these pathologies of personal development.

The Risk, Need, and Responsivity Relevance of Working Alliance in a Sexual Offense Treatment Program: Its Intersection With Psychopathy, Diversity, and Treatment Change.

The current study examined the self-reported working alliance of men attending a high intensity sexual offense treatment program and its associations with psychopathy, sexual violence risk, treatment change, and recidivism, in a Canadian sample of 317 incarcerated men followed up an average of approximately 10 years post release. Working Alliance Inventory (WAI; Horvath & Greenberg, 1989) self-reported total, Task, Bond, and Goal scores were positively correlated with treatment related changes in risk, and inversely associated with Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Wang & Hare, 2003) scores. The Affective facet of the PCL-R, representing the callous-unemotional features of the syndrome, uniquely predicted lower Bond and Goal scores controlling for the other facets. Cox regression survival analyses demonstrated that sexual violence risk predicted increased sexual recidivism while change predicted decreased sexual recidivism controlling for PCL-R total score; however, WAI scores (particularly the Goal component) were also unexpectedly associated with increased sexual recidivism. For violent recidivism, psychopathy, risk, and change incremented the prediction of general violence, while the WAI was not significantly associated with this outcome. A set of parallel analyses, stratified by Indigenous ethnocultural heritage, demonstrated some continuity, but also potential areas of difference, in substantive findings. Risk, need, responsivity implications of the working alliance for the treatment of high psychopathy correctional clientele, and how this may intersect with Indigenous heritage, are discussed.

Effects of two treatments on interpersonal, affective, and lifestyle features of psychopathy and emotion dysregulation.

This study investigated the relative efficacy of Mentalization-based therapy (MBT) and United Protocol (UP) in reducing symptoms of psychopathy and emotion dysregulation in a sample of Iranian community residents with concurrent diagnoses of antisocial and borderline personality disorders (PDs). Interpersonal, affective, and lifestyle features of psychopathy were measured post-treatment and at 6-, 12-, 18-, 24-, and 36-months follow-up using the 13-item version of the Psychopathy Revised-Checklist (PCL-R), which excluded, by design, criminal history features. Emotion dysregulation was measured using the Deficits in Emotion Regulation Scale (DERS) developed by Gratz and Roemer (2004). After treatment, both UP- and MBT-treated individuals showed significantly fewer features of psychopathy and significantly less emotion dysregulation. Compared with those treated with MBT, UP-treated individuals showed significantly less emotion dysregulation in all DERS subscales and a greater reduction in psychopathy features, particularly affective features. It is suggested that this likely reflected the particular emphasis placed by UP on improving emotional self-regulation and facilitating the therapeutic alliance. These results suggest that, despite the traditional pessimism that surrounds psychopathic individuals' treatability, they can be successfully treated.

Primary and Secondary Capacities in the Context of Positive Psychotherapy in Individuals with Antisocial Personality Disorder: The Relationship with Criminal Behaviors and Anger. / Antisosyal Kisilik Bozuklugu Olan Bireylerde Pozitif Psikoterapi Baglaminda Birincil ve Ikincil Yetenekler: Suç Isleme Davranislari ve Öfke ile Iliskisi.

OBJECTIVE: The aim of this study was to evaluate the development of primary (PCs) and secondary capacities (SCs) in individuals diagnosed with antisocial personality disorder (ASPD) and the effects of these capacities on delinquent behaviors and anger levels. METHODS: 101 male patients aged 18 years and over with a diagnosis of ASPD were divided into two groups as those with a criminal ASPD (cASPD) diagnosis (n=37) and those with a non-criminal ASPD (ncASPD) diagnosis (n=64). Participants were evaluated using a sociodemographic form, Wiesbaden's Inventory of Positive Psychotherapy and Family Therapy (WIPPF-2) and State-Trait Anger Expression Inventory (STAXI). Statistical analyses were performed using the SPSS 22.0 program; significance level was taken as p0.05. RESULTS: PCs, SCs and anger control levels of people with ASPD were lower while trait anger, anger expression and anger import were higher than the control group. In cASPD, among the PCs, belief (ß=0.796, p=0.032), hope (ß=-1.069, p=0.011), relationship (ß=-0.980, p=0.007) and sexuality (ß=0.937, p=0.021) predicted anger-out, and among the SAs politeness (ß=-1.020, p=0.002) and reliability (ß=1.140, p=0.001) predicted trait anger level. In ncASPD, patience predicted anger-out (ß=-1.752, p=0.001) and anger control (ß=1.468, p=0.002); belief (ß=1.468, p=0.005) and trust (ß=-0.845, p=0.002) predicted anger control. CONCLUSIONS: Positive psychotherapy can be effective in improving PCs and SCs of individuals with ASPD, improving interpersonal relationships, reducing criminal behaviors, anger management and psychotherapeutic treatment of ASPD.

Establishing an optimal working relationship with patients with an antisocial personality disorder. Aspects and processes in the therapeutic alliance.

OBJECTIVE: Developing good interpersonal relationships is one of the main impediments for people with an antisocial personality disorder (ASPD). However, in treatment of psychiatric disorders, establishing a strong therapeutic alliance (TA) is important for effective treatment. Nevertheless, there is little knowledge on how to establish this TA with this challenging patient group. This study investigates which factors are important in TA development. METHOD: For this study, a qualitative research methodology is applied. In-depth interviews with therapists experienced in treating ASPD were conducted and analysed through thematic analysis. RESULTS: The analysis revealed six themes important in alliance formation: the patient's needs, regulating interpersonal dynamics, connective attitude, connective skills, treatment process and treatment goals. Each theme is defined including aspects of the recommended therapeutic attitude and required skills for therapists working with patients with ASPD. CONCLUSIONS: This study determined that, for therapists working with patients with ASPD, several key factors are essential in establishing a strong TA. These factors include the ability to be firm, authentic, non-judgmental and genuinely involved. An attentive presence is crucial, in which the therapist takes initiative in establishing contact and makes the patient feel that he is truly seen as an autonomous and equal person. In doing so, the therapist needs to provide clarity and structure while remaining perceptive to boundary violations. The therapist must be able to set limits using a clear yet kind tone of voice. Furthermore, it was notable that an intensive appeal is made to the therapist's reflective capacity in these treatments.

The effectiveness of blended versus regular Forensic Outpatient Systemic Therapy in the treatment of juvenile antisocial behavior: a study protocol of a randomized controlled trial.

BACKGROUND: Antisocial behavior during adolescence can have long-lasting negative effects and leads to high societal costs. Forensic Outpatient Systemic Therapy (Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles aged 12-21 showing severe antisocial behavior. The intensity, content and duration of FAST can be adjusted to the needs of the juvenile and their caregiver(s), which is considered crucial for effective treatment. Next to the regular version of FAST (FASTr), a blended version (FASTb) in which face-to-face contacts are replaced by minimally 50% online contacts over the duration of intervention was developed during the Covid-19 pandemic. The current study will investigate whether FASTb is equally effective as FASTr, and through which mechanisms of change, for whom, and under which conditions FASTr and FASTb work. METHODS: A randomized controlled trial (RCT) will be carried out. Participants (N = 200) will be randomly assigned to FASTb (n = 100) or FASTr (n = 100). Data collection will consist of self-report questionnaires and case file analysis, and include a pre-test at the start of the intervention, a post-test immediately after the intervention, and a six month follow-up. Mechanisms of change will be investigated using monthly questionnaires of key variables during treatment. Official recidivism data will be collected at two-year follow-up. DISCUSSION: This study aims to improve the effectiveness and quality of forensic mental health care for juveniles with antisocial behavior by studying the effectiveness of blended care, which has not been studied before in treatment of externalizing behavior. If found to be at least as effective as face-to-face treatment, blended treatment can help meet the urgent need for more flexible and efficient interventions in this field. In addition, the proposed study aims to unravel what works for whom, knowledge urgently needed in mental health care for juveniles with severe antisocial behavior. TRIAL REGISTRATION: This trial was registered at ClinicalTrials.gov on 07/11/2022, registration number NCT05606978.

Psychopathy in Correctional Settings: Considerations for Developing and Implementing a Treatment Program.

Psychopathy is associated with higher levels of violence as well as general and violent recidivism after release from prison. A disorder with a long and rich clinical and research history, psychopathy has gained an undeserved reputation as a syndrome that is unresponsive to treatment. This article presents information that undermines long-standing problematic assumptions regarding the treatability of individuals with psychopathic traits and posits that implementing treatment programs in correctional settings is critical to decrease recidivism and violence. We discuss several treatment programs that have evidenced some success in the treatment of individuals with psychopathy and have the potential to be widely implemented in correctional settings, as well as general tenets of successful treatment programs and specific targets.

Promoting a compassionate motivation in detained youth: A secondary analysis of a controlled trial with the PSYCHOPATHY.COMP program.

This study aims to assess the efficacy of the PSYCHOPATHY.COMP in promoting a compassionate motivation among male detained youth, also testing its role as a potential mechanism of change on the reduction of psychopathic traits. A treatment group (n = 58) and a control group (n = 61) answered a set of self-report measures on psychopathic traits, shame, fears of compassion, social safeness, self-compassion, and compassion for others at three timepoints: baseline, posttreatment, and 6 months' follow-up. Treatment participants attended the PSYCHOPATHY.COMP. Controls received the treatment as usual delivered at juvenile detention facilities. The treatment effects were tested with latent growth curve models. At baseline, no significant differences between groups were found. Results from latent growth curve models showed that condition was a significant predictor of change over time observed in all outcome measures, even after controlling for psychopathic traits scores. When compared with the control group, the treatment group showed a significant decrease on shame and fears of compassion and a significant increase on social safeness, self-compassion, and compassion for others over time (medium-to-large effect sizes; growth modeling analysis d ranging from .57 to .96). It was also observed that increases in self-compassion and, in some cases, decreases in fears of receiving compassion, were crucial to the decrease of psychopathic traits. These findings suggest that the PSYCHOPATHY.COMP is a promising approach to promote a compassionate motivation in these youth, strengthening their rehabilitation odds. Increasing self-compassion and decreasing fears of receiving compassion should be considered when designing intervention programs for detained youth. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Lighten the darkness: Personality interventions targeting agreeableness also reduce participants' levels of the dark triad.

OBJECTIVE: Previous research suggests that people want to change their big five traits-and moreover, they may be able to do so. This paper extends these findings in three ways. First, I examined the extent to which people want to change their levels of the dark triad-Machiavellianism, narcissism, and psychopathy. Second, I tested whether desires to change the dark triad predicted actual changes in the corresponding traits across approximately four months. Finally, participants received an intervention designed to change their big five personality traits. Consequently, I tested whether this intervention could also facilitate changes in the dark triad. METHOD: The present study was a 16-wave, weekly, intensive longitudinal design (N = 467). RESULTS: Results revealed that participants generally did not want to change their levels of the dark triad. Nevertheless, individual variance in desires to change the dark triad did predict actual changes in the dark triad across four months. Moreover, interventions targeting agreeableness spurred changes in all three dark triad traits. CONCLUSIONS: This research suggests that taking small steps to become more agreeable may also reduce individuals' levels of the dark triad. These findings may have implications for future research, as well as therapeutic treatments.

Substance Use Disorders and Antisocial Personality Disorder among a Sample of Incarcerated Individuals with Inadequate Health Care: Implications for Correctional Mental-Behavioural Health and Addiction Services.

Epidemiological estimates of substance use disorders (SUD) are critical for the planning of evidence-informed intervention and services. In this study, 250 incarcerated individuals in Nigeria were interviewed with the Mini International Neuropsychiatric Inventory (MINI) to diagnose SUD and antisocial personality disorder (ASPD). Most of the participants were males (97.6%), and the mean age was 35.4 (SD=13.5) years. Substance use disorder and ASPD were prevalent in 57.6% and 11.2% of the participants, respectively. Of those diagnosed with SUD, 35.2% and 22.4% had poly-SUD and mono-SUD respectively. Psychotic and dependence syndromes involving cannabis misuse were the most prevalent poly-SUD, and mono-SUD was characterized by alcohol, nicotine, and opioid dependence syndromes. Substance use disorder was more likely in participants charged with robbery and convicted, while ASPD was associated with prior and long-term imprisonment. There is a need for effective integration of treatment for ASPD/SUD into correctional mental health services in settings with inadequate health care using an appropriate model and a viable strategy.

Mediating Effects of Discipline Approaches on the Relationship between Parental Mental Health and Adolescent Antisocial Behaviours: Retrospective Study of a Multisystemic Therapy Intervention.

Poor parental mental health is one of the risk factors for child emotional and behavioural problems because it reduces caregiver's ability to provide appropriate care for their child. This study aimed to measure changes in parenting factors and adolescent behaviours after Multisystemic Therapy (MST), and to explore the mediating role of discipline approaches on the relationship between parental mental health and adolescent behavioural problems. This retrospective study extracted data collected from 193 families engaged with the MST research program during 2014-2019. Data was collected at different time points (pre-treatment, post-treatment, 6- and 12-months follow-up). Statistically significant changes were found in adolescent behaviours and parenting factors following the MST intervention and these positive changes were maintained over the following 12 months. Results of the parallel multiple mediator model analysis confirmed mediating effects of discipline approaches on the relationship between parental mental health and adolescent's behavioural problems. The findings suggested that parental mental well-being significantly contributes to effectiveness of parenting, which resulted in positive changes in adolescent's behavioural problems. It is recommended caregiver's parental skills and any mental health issues are addressed during the intervention to enhance positive outcomes in adolescent behaviour.

Impulsive Lifestyle Counselling versus treatment as usual to reduce offending in people with co-occurring antisocial personality disorder and substance use disorder: a post hoc analysis.

OBJECTIVES: To assess the impact of a short psychoeducation intervention for antisocial personality disorder on offending after randomization to treatment. DESIGN: Multicentre, superiority, non-blinded randomized controlled trial. Random assignment was conducted in blocks of varying sizes at a central randomization centre. Participants were followed using national register data until 365 days after randomization, migration, or death, whichever occurred first. SETTING: Thirteen outpatient uptake areas in Denmark. PARTICIPANTS: Patients with antisocial personality disorder in treatment for substance use disorders were randomized to treatment as usual (TAU, n = 80) or Impulsive Lifestyle Counselling (ILC, n = 96). A total of 165 patients could be linked to criminal records (TAU, n = 74; ILC, n = 91). INTERVENTION: ILC is a brief psychoeducational program targeting antisocial behavior. The trial was conducted between January 2012 and June 2014. OUTCOMES: Number of criminal offences leading to convictions based on national registers. RESULTS: The mean number of offences was 2.76 in the TAU group (95% Poisson confidence interval [CI] = 2.39, 3.16) and 1.87 in the ILC group (95% CI = 0.97, 1.43). Negative binomial regression was used to assess total number of convictions, as well as convictions for violent, property, driving under the influence, and drug-related crimes. In both adjusted and unadjusted analyses, random assignment to ILC was associated with a lower number of total offences (incidence rate risk ratio [IRR] = 0.43, p = .013; adjusted IRR = 0.45, p < .001) and convictions related to violence (IRR = 0.19, p = .001 adjusted IRR = 0.19, p = .007) and property offences (unadjusted IRR = 0.30, p = 0.003, adjusted IRR = 0.42, p = 0.010). Differences between conditions were not significant for driving under the influence (unadjusted IRR = 0.49, p = .370; adjusted IRR = 0.53, p = .417) or drug offences (unadjusted IRR = 1.06, p = .907; adjusted IRR = 0.55, p = .223). CONCLUSIONS: The ILC program shows promise in reducing offending behavior in people with comorbid substance use and antisocial personality disorder. TRIAL REGISTRATION: ISRCTN registry, ISRCTN67266318 , 15/10/2012.

Arts and Cultural Engagement, Reportedly Antisocial or Criminalized Behaviors, and Potential Mediators in Two Longitudinal Cohorts of Adolescents.

Arts and cultural engagement is a potential strategy for reducing or preventing reportedly antisocial or criminalized behaviors (those previously and problematically termed as "delinquent") in adolescence. However, most research to date has focused on arts-based interventions and has not tested arts and cultural engagement in large population-based longitudinal studies. This study investigated whether arts and cultural engagement reduced reportedly antisocial or criminalized behaviors in two large nationally representative cohorts, the National Longitudinal Study of Adolescent to Adult Health (n = 10,610; 50% female, 72% White, age range = 11-21 mean = 15.07) and the National Education Longitudinal Study of 1988 (n = 15,214; 50% female, 73% White, age range = 13-16 mean = 14.38). Structural equation modelling also allowed exploration of two potential mechanisms that might link arts and cultural engagement to reportedly antisocial or criminalized behaviors (self-control and attitudes towards these behaviors). More arts and cultural engagement was associated with fewer reportedly antisocial or criminalized behaviors, better self-control scores, and fewer positive perceptions of reportedly antisocial or criminalized behaviors concurrently and one to two years later. Arts and cultural engagement may provide opportunities for adolescents to realize positive developmental outcomes, reducing their risk of reportedly antisocial or criminalized behaviors.

The contribution of psychopathic traits and substance use in the prediction of recidivism of sexual offenders.

Substance use and dependence may play an essential role in the risk of reoffending by sex offenders. Research examining the influence of substance use and dependence on the criminal behaviour of psychopathic sex offenders is limited. Alcohol and drug use have been identified as factors which promote criminal behaviour and are suspected to contribute, at least partially, to the probability of reoffending. For instance, previous research showed that elevated scores on the Michigan Alcohol Screening Test (MAST) contribute to the predictability of the Hare Psychopathy Checklist - Revised (PCL-R) on recidivism. The current study retrospectively evaluated a database of incarcerated high-risk offenders registered in the Regional Treatment Center, Sex Offender Treatment Program (RTCSOTP); in order to assess the contribution of self-disclosed histories of alcohol and substance use and dependency have, in concert with measures of psychopathic characteristics, on the predictability of recidivism. Results of the retrospective data identified PCL-R and DAST (Drug Abuse Screening Test) scores as significant predictors of sexual and violent recidivism of male inmates undergoing treatment in RTCSOTP within 5 years of their release. MAST scores, however, did not significantly contribute to the predictability of sexual and violent recidivism in this population. We conclude, drug use should be considered as an important factor when addressing recidivism in sexual offenders who demonstrate psychopathic characteristics.

Contextualist Perspectives in the Treatment of Antisocial Behaviors and Offending: A Comparative Review of FAP, ACT, DBT, and MDT.

This article presents a comparative review of the application of four contextualist therapies in the treatment of antisocial behavior and offending. The therapies reviewed are functional analytic psychotherapy (FAP), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), and mode deactivation therapy (MDT). A descriptive and comparative review was conducted through a search carried out in both general and specific databases related to each therapy. We included a total of 44 studies treating any type of antisocial behavior or offending. Results show that these interventions have been used to treat challenging behavioral patterns, inmates' institutional behaviors, exhibitionism, at-risk adolescents' aggressive conducts, and offending behaviors performed by juveniles who committed robbery and/or serious sexual offenses. The main conclusions are that the four therapies show very positive outcomes: Although FAP and ACT have been used more sparsely, DBT and MDT have been employed in a larger number of interventions and using more controlled comparative designs. The therapeutic components that seem to be relevant to understanding in a transversal way how changes in behavior are achieved are acceptance/validation of clients' histories of neglect and abuse and clients' commitment to behaving toward their valued directions in life.

Explaining the willingness of clinicians to work with patients with antisocial personality disorder using the theory of planned behaviour and emotional reactions.

Many clinicians seem to experience negative emotions towards patients with antisocial personality disorder (ASPD), resulting in the exclusion of patients in many treatment programmes. The behaviour of individuals with ASPD has a significant impact on society, which affects ASPD patients and their environment, and therefore, the exclusion from programmes is a serious concern. Relatively, little is known about why some clinicians are willing to work with ASPD patients and others are not and what factors contribute to an increase in the motivation to do so. In this study, clinicians (n = 130) working in a regular and forensic mental health service in the Netherlands completed a questionnaire based on the theory of planned behaviour (TPB) and the Feeling Word Checklist and questions about the relevant experience gained and education received. The current study confirms the limited willingness to work with ASPD patients, especially in regular mental health care. Experience working with ASPD patients, education on cluster B personality disorders and having experienced verbal and/or physical violence in clinical practice did not fully explain whether or not clinicians were motivated to provide treatment to ASPD patients. TPB appeared to predict the intention to provide psychological therapy to ASPD patients adequately. The impact of positive emotions towards ASPD patients on providing treatment appeared to be stronger than negative emotions. This study provides more insight into why so few clinicians are willing to work with ASPD patients and what may increase motivation to include this group in treatment programmes.

Juvenile Psychopathy and Community Treatment Response in Youth Adjudicated for Sexual Offenses.

The present study examined the association of juvenile psychopathy features and treatment response in a sample of 102 youth, court adjudicated for sexual offenses and followed up more than 11 years in the community. The Psychopathy Checklist: Youth Version (PCL: YV) was rated from comprehensive archival sources, along with a youth sexual offense risk assessment and treatment planning measure scored pre-and posttreatment. The PCL: YV converged with domains of sexual offense risk and change in conceptually meaningful ways, and significantly predicted nonsexual violent, general violent, and any recidivism; it did not significantly predict sexual recidivism. Higher levels of psychopathy-related personality features were significantly associated with noncompletion of youth sexual offense-specific treatment, while changes in risk were associated with decreased recidivism controlling for PCL: YV score and baseline risk at p < .10. The findings underscore the importance of intervention and support services for youth convicted of sexual offenses as well as the clinical and risk relevance of the juvenile psychopathy construct to decrease violent victimization to others.

Relevance of psychopathic traits to therapeutic processes and outcomes for veterans with substance use disorders.

Psychopathic traits have been routinely associated with poor treatment outcomes in correctional settings. Less is known about how psychopathic traits relate to treatment processes (e.g., perceptions of treatment; adjustment to treatment), particularly in nonforensic settings. The current study tested for relationships between psychopathic traits, as operationalized by the Triarchic Psychopathy Measure (TriPM) and treatment processes and outcomes in a sample of 200 U.S. military veterans enrolled in a residential substance use disorder treatment program at a Veteran's Affairs (VA) medical center. Participants were interviewed using several measurement instruments at 4 time points: treatment entry, 1 month into treatment, treatment discharge, and 12 months post discharge. The TriPM was administered at baseline, and measures of treatment processes/outcomes were measured during treatment and at postdischarge. The TriPM scales exhibited differential associations with treatment processes and outcomes in multivariate analyses. Specifically, higher Boldness was associated with fewer psychiatric symptoms at baseline, but more rule-breaking behaviors and more peer-reported conflicts with other residents in treatment; higher Meanness predicted more negative perceptions of the treatment milieu; and higher Disinhibition predicted poorer substance use outcomes posttreatment. Together, these findings demonstrate associations between psychopathy and therapy processes/outcomes and highlight the potentially unique contribution of psychopathic traits to substance use disorder treatment programming. (PsycInfo Database Record (c) 2022 APA, all rights reserved).