Personality Disorders 597
Psychological Factors in Antisocial Personality Disorder and Psychopathy
Antisocial personality disorder and psychopathy appear to arise, in part, because of
problems with classical and operant conditioning processes. These processes nor-
mally help to socialize children into law-abiding citizens who learn from their mis-
takes and who develop the ability to empathize with others. Instead, people with
antisocial personality disorder view others as “marks” and look for opportunities
to exploit them (Beck, Freeman, & Davis, 2004).
Whereas classical conditioning and operant conditioning lead most people tolearn to avoid encounters with a painful stimulus (such as a shock), criminals with
psychopathic traits do not learn to avoid painful stimuli—but when such criminals
are given medication to increase the activity of their sympathetic nervous system,
they do learn to avoid shocks at the same rate as control participants (Schachter &
Latane, 1964). Thus, when not medicated, they cannot easily learn from punish-
ing experiences (Eysenck, 1957) and are likely to repeat behavior associated with
a negative consequence, despite receiving punishment (such as a prison sentence;
Zuckerman, 1999). Moreover, their temperament of low harm avoidance means
that they are less likely to be afraid of the threat of punishment. And because they
are highly motivated by rewarding activities, they are less inclined to inhibit them-
selves to avoid punishment; they thus behave in ways that are impulsive, have dif-
fi culty delaying gratifi cation, and have poor judgment (Silverstein, 2007).
Social Factors in Antisocial Personality Disorder and Psychopathy
One risk factor for conduct disorder and subsequent antisocial personality disorder
is a child’s relationship with his or her parents or primary caretakers. Each parent or
other primary caretaker has a style of interacting with the child from infancy. Some
parents abuse or neglect their children or are inconsistent in disciplining them, which
can lead to an insecure attachment (Bowlby, 1969). These children have a relatively
high risk of developing conduct disorder and later antisocial personality disorder
(Levy & Orlans, 1999, 2000; Ogloff, 2006). Note, however, that this fi nding is simply
a correlation and does not necessarily mean that attachment diffi culties cause later an-
tisocial behavior; it is possible that some other variable makes it diffi cult for the chil-
dren to develop normal attachment and more likely to develop antisocial behaviors.
Other childhood factors associated with the later development of antisocial per-sonality disorder include poverty, family instability, and—in those who are geneti-
cally vulnerable—adoptive parents’ criminality (Raine et al, 1996).
FEEDBACK LOOPS IN ACTION: Antisocial Personality Disorder and Psychopathy
The various factors create feedback loops that ultimately produce psychopathy or
antisocial personality disorder (see Figure 13.7). Twin and adoption studies reveal
that some people have a predisposition toward criminality or associated tempera-
ments (neurological factor), but the environment in which children grow up (social
factor) infl uences whether that predisposition is likely to lead to criminal behavior.
One study found that children with conduct disorder who were punished for their
offenses were less likely to develop antisocial personality disorder later in life, con-
fi rming the contribution of operant conditioning to the disorder (Black, 2001).
Moreover, the types of temperaments that are associated with antisocial personal-ity disorder and psychopathy can impede the normal classical and operant condition-
ing processes that promote empathy and discourage antisocial behaviors (psychological
factor; Kagan & Reid, 1986; Martens, 2005; Pollock et al., 1990). Finally, the experi-
ence of abuse or neglect by parents (social factor) may contribute to a tendency toward
underarousal (Schore, 2003), which in turn leads people to seek out more arousing
(and reckless) activities that may increase their risk of seeing or experiencing violence
(Jang, Vernon, & Livesley, 2001)—which they may fi nd stimulating, and hence which
may reinforce such behavior (making it more likely to occur in the future).
Treating Antisocial Personality Disorder and Psychopathy
Medication is usually prescribed to people with antisocial personality disorder or
psychopathy only for comorbid disorders such as depression or a substance-use dis-
order (Gacono et al., 2001). The psychosocial treatments offered to these people
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