ASPD and Experimental Psychopathology

Punishment seems to have little effect on future destructive behaviour of individuals with Antisocial Personality Disorder (ASPD). One explanation of this is a deficiency in fear of arousal, which appears to cause antisocial behaviour in normal individuals. The lack of fear arousal is a contributor to poor avoidance learning, which in turn causes these individuals to get themselves into trouble, repeatedly.

What would happen if there was a possibility to make people with ASPD more psychologically reactive or fearful? Would it cause their deficiency in avoidance learning to disappear?

Stanley Schachter and Bibb Latane set out to answer this important question.

Method

Schachter and Latane selected two groups of inmates at state prisons on the basis of psychologists diagnoses and life history data. One group consisted of people with ASPD. These prisoners were described by prison psychologists as being completely free from any symptoms of anxiety, lacking any sense of responsibility or shame, being manipulators and habitual liars, able to commit antisocial acts without guilt or remorse, as well as lacking insight and unable to profit from negative experiences.

Most, if not all of these prisoners, would meet current diagnostic criteria for ASPD. A normal (non-psychopathic) group consisted of prisoners matched in age and intelligence, who did not exhibit this pattern of behaviour. Life history data showed that the psychopaths had been arrested more often (8.3 versus 3.3 arrests), and had spent most of their adult lives in prison (36.2% versus 18.1%).

The two groups of prisoners were recruited as paid participants in an investigation of a newly-developed hormone thought to enhance learning. "The researcher used an experimental apparatus which required the participants to learn a complicated mental maze, which consisted of a counter mounted on a metal cabinet, two pilot lights, and four switches.

The maze consisted of 20 choice points. At each choice point, the participant selected one of the four switches. If it was the correct one, a green light flashed and the learner advanced to the next point. If one of the three incorrect switches had been selected, a red light flashed; recording an error on the counter visible to the participant. When the 20th choice point was reached, the procedure began again from the start. The learner repeated the maze 21 times, with the objective being to learn the correct response at each choice point, minimising the total number of errors.

To study avoidance learning, one of the three incorrect switches at each choice point not only activated the red light and recorded an error, but it also resulted in a moderately painful electric shock to the learner. Thus, the learner would do well to learn to avoid not just the correct switch at each point, but also the one that delivered the shock (i.e. to do good and avoid evil).

To manipulate emotional arousal, the prisoners were injected with the experimental hormone, Suproxin, to see if it enhanced learning ability. The prisoners were informed that there would be no side effects. The injection was used to manipulate autonomic arousal. The contents of the injection were adrenaline, which would increase arousal; or placebo, which would inhibit it. Each participant worked until he learned two different mental mazes; one while under the influence of adrenaline and the other, while under the placebo. Half of them received adrenaline on the first maze and placebo for the second. The other half received injections in the reverse order.

Results

In the overall learning, the two groups of prisoners did not differ; their number of responses and errors were similar. This meant they did not differ in ability to learn the positively-reinforced 'correct' responses. Then, a major interest was the avoidance learning measure, which is the ability to learn the positively-reinforced 'correct' responses. Of major interest then, was the avoidance learning measure, (the ability to learn to avoid choosing the switch at each point of choice which would result in an electric shock). The variables of the dependents here were the percentage of incorrect responses made by each participant that resulted in electric shocks. The lower the percentage of shocked incorrect responses, the better the avoidance learning over trials through each maze. 

Avoidance learning under the placebo condition, in which both, those with ASPD and normal prisoners, experienced their normal arousal levels; the normal prisoners made a lower percentage of shock responses during later trips through the maze, indicating avoidance learning. In contrast, the psychopaths showed almost no evidence of learning during their later trials through the maze; they were still as likely to choose the shocked switch as in their previous trials.

If the lack of fear present in those with ASPD underlies their lack of conditioning, what would happen if one artificially increased their arousal levels? When injected with adrenaline, psychopaths showed dramatic evidence of avoidance learning. They actually performed better than the normal prisoners, whose performance on this complex task may have been somewhat impaired by increasing their already-existing fear responses.

Critical discussion

This study was done a half-century ago, but it's still considered a classic. Schachter and Latane tested a clinical explanation for a behaviour disorder under controlled laboratory conditions. They not only demonstrated that the deficiency in avoidance learning was presumed to underlie antisocial behaviour; but also showed that it could be reversed, if there was a possibility to experimentally create psychological arousal, which people with ASPD lacked.

The increased arousal produced by the adrenaline injection had a notable effect on the psychopaths, who learned to avoid even better than the normal prisoners did in the placebo condition. This could be due to the former's arousal in this fear-inducing was different from their normal experience.

It is important, however, to rule out other possible explanations for the results, such as whether the pain was experienced differently due to the injections motivating their shock avoidance? The researchers rule this out with evidence of the two groups' rates of pain being equally unpleasant under both injection conditions. Therefore, the psychopathic and normal prisoners apparently experienced pain equally when shocked.

This study exemplifies a research area known as Experimental Psychopathology, a study process on clinical populations in order to underlie a particular disorder under controlled conditions; such as a laboratory, using state-of-the-art science techniques from other areas of psychology such as social psychology, cognitive psychology, and behavioural neuroscience. This kind of research helps in identifying the mechanisms contributing to behavioral disorders.

It also allows researchers to test hypotheses derived from existing theories of psychopathology and, sometimes, to directly pit competing theories against each other. In this manner, clinical observation informs science, and science helps inform clinical understanding and the hopeful treatment of behavioural disorders.

Personality Disorders: Causal Factors of ASPD

Biological Factors

Research on the biological factors of Antisocial Personality Disorder (ASPD) has focused on both genetic and psychological factors. The concordance rate of genetic predisposition shows a higher evident rate among identical twins than in fraternal twins for ASPD. Adoption study conclusions are similar, too. When researchers compared criminal records of men who were adopted, the rate of criminality was almost twice as high when the biological father had a criminal record and the adoptive father did not—a clear sign of genetic predisposition.

The clue to genetic predisposition factors of antisocial behaviour in individuals could be the relative absence of anxiety and guilt, which seems to characterize Antisocial Personality Disorder. According to many researchers' beliefs, the psychological basis for the disorder may be a dysfunction in the brain structures governing emotional arousal and behavioral self-control. This can result in impulsive behaviour and a clinically under-aroused state; impairing avoidance learning, causing boredom, and encouraging a search for excitement. According to psychological basis, children and adults alike with antisocial behaviour patterns tend to have lower heart rates, particularly under stress.

MRIs of antisocial individuals have shown subtle neurological deficits in their prefrontal lobes—the seat of executive function; which are planning, reasoning, and behavioral inhibition; such neurological deficits are associated with a reduction of autonomic activity. This supports a long-suspected idea of severely antisocial individuals being wired differently at a neurological level, causing them to respond with less arousal and a greater sense of impulsiveness to pleasurable and unpleasurable stimuli alike.

Psychological & Environmental Factors

According to psychodynamic theorists, antisocial personalities are individuals with no conscience. Psychoanalytic theorists believe that such individuals lack anxiety and guilt because they did not develop an adequate superego. The absence of a well-developed superego causes reduction of the restraints on the identity, resulting in impulsive behaviour. Inadequate identification with appropriate adult figures is thought to cause these individuals' failure to develop a strong superego because these figures weren’t either physically or psychologically available to the child. Supporting this position, the absence of the father from home has a higher related incidence of antisocial symptoms in children, even with socioeconomic status equated.

Cognitive theorists believe that an important feature of antisocial individuals is their consistent failure in thinking about—or to anticipate the long-term negative consequences—of their acts. This results in impulsive behaviour, with thought only of their wants of the moment. From this perspective, the key to preventing these individuals from getting themselves into trouble is to help them develop cognitive control (executive function) necessary to think before acting. Learning through modelling can play an important role too.

Many antisocial personalities come from homes of aggressive and inattentive parents. Such parents become role models for aggressive behaviour and disregard for others' needs. Another important environmental factor is exposure to deviant peers. Antisocial children often learn some of their deviant behaviour from peer groups that help model antisocial behaviour and reinforce it with social approval. When environmental factors are combined with a possible genetic predisposition for antisocial behaviour, it clearly encourages a pattern of deviant behaviour.

According to the learning explanations of some biological theorists, it suggests that individuals with antisocial behaviour lack impulse control. Learning theorists believe that the reason for poor impulse control in these individuals occur due to impaired ability to develop conditioned fear responses when they are punished. This results in a deficit of avoidance learning. Hans Eysenck said a person's ability to develop a conscience depended on that person’s ability to learn fear and inhibitory avoidance responses. Individuals who fail in these aspects will have less ability to inhibit their behaviour.

Clinical studies

In accordance with this hypothesis, Adrian Raine and his co-workers did a 14-year follow-up on males who had been subjected to classical conditioning at the age of 15, in which a soft tone had been used as the conditioned stimulus (CS) and a loud averse tone as the unconditioned stimulus (UCS). Conditioned fear was measured by the participant’s skin conductance response when the CS occurred after a number of pairings with the loud UCS. According to the research findings, the men who accumulated a criminal record by the age of 29 had shown poorer conditioning at the age of 15 than those with no criminal record.

According to further studies, major damage to the grey and white matter in the prefrontal cortex, as well as autonomic deficits, can result in pseudo-psychopathic personality in patients with neurological disorders, but it is not known whether individuals with antisocial personality disorder in the community, with no discernible brain trauma, also have subtle prefrontal deficits.

When prefrontal grey and white matter volumes were assessed using structural magnetic resonance imaging in 21 community volunteers with ASPD; as well as in two control groups which comprised of 34 healthy subjects, 26 subjects with substance dependence, and 21 psychiatric controls. The autonomic activity of (skin conductance and heart rate) was assessed during a social stressor in which the participants gave a videotaped speech of their faults.

The ASPD group showed an 11 percent reduction of prefrontal grey matter volume in the absence of ostensible brain lesions and reduced autonomic activity during the stressor. These deficits were a prediction of group membership independent of psychosocial risk factors. These findings are said to be the first evidence of structural brain deficits in ASPD. This prefrontal structural deficit may underlie the low arousal, poor fear conditioning, lack of conscience, and decision-making deficits known to characterize antisocial behaviour.

Personality Disorders: Introduction to ASPD

People diagnosed with personality disorders exhibit stable, ingrained, inflexible and maladaptive thinking, feeling, and behavioural patterns. When encountered by situations where their typical pattern of behaviour does not work, their inappropriate coping skills are likely to intensify, causing their emotional controls to breakdown and unresolved conflicts to reemerge.

Personality disorders happen to be an important part of the DSM (Diagnostic and Statistical Manual of Mental Disorders) system due to the increased likelihood of them acquiring several Axis I (symptom) Disorders, particularly depression, anxiety, and substance abuse. They are also associated with a poorer recovery course from such disorders. Ann Mason and her coworkers followed anxiety patients for five years. They discovered that those who were diagnosed with additional personality disorders were 30 to 40 percent less likely to recover from their anxiety disorders.

There are ten personality disorders in the Axis II Disorders, which are divided into three clusters capturing important commonalities: dramatic and impulsive behaviours, anxious and fearful behaviours, as well as odd and eccentric behaviours.

In Europe and America, around 10 to 15 percent adults may have personality disorders. A study conducted in Norway on personality disorders has found that 13.4 percent of the condition equally distributed among both genders. The most frequently encountered were paranoid, histrionic, avoidant, and obsessive-compulsive personality disorders.

Among these personality disorders, the most destructive to society is Antisocial Personality Disorder.  Therefore, this disorder has got the most attention from clinicians and researchers over the years. A second personality disorder that attracts a great deal of attention is Borderline Personality Disorder.

Antisocial Personality Disorder (ASPD)

In the past, people with ASPD were referred to as 'sociopaths' or 'psychopaths': such terms are still in use today, though not for the purpose of formal diagnosis. In the 19th century, at times, such individuals were referred to as moral imbeciles. Individuals with Antisocial Personality Disorder are among the most inter-personally destructive and emotionally-harmful individuals. Men outnumber women by 3 to 1 according to diagnosis.

Individuals with Antisocial Personality Disorder show lack of conscience: they exhibit less guilt and anxiety, and tend to be impulsive and unable to delay gratification of their needs. They lack emotional attachment towards others. For example, a report from a person diagnosed with the disorder was as follows:

When I was in high school, my best friend died of leukaemia, and I went to his funeral. Everybody there was crying...but I suddenly realised that I didn't feel a thing. That night, I thought more about it and realised I wouldn't miss my parents if they were to die. I also realised that I didn't care for my siblings either. There was no one I cared for, but I didn't need any of them to begin with, so I rolled over and slept.

The lack of capacity to care about others may make antisocial individuals a danger to society. For example, murderers such as Ted Bundy, Charles Manson, and Jeffrey Dahmer failed to show remorse for the crimes they committed, or sympathy for their victims.

Behavioural contradictions

Antisocial individuals may often verbalise feelings and commitments with great sincerity, but their behaviours tend to indicate otherwise. They often appear to be very intelligent and charming. They also have the ability to rationalise their inappropriate behaviour, making it appear reasonable and justifiable. Consequently, they often tend to be virtuosos at manipulating others in order to talk their way out of trouble.

The aforementioned antisocial characteristics can be reflected in psychological test responses and in social behaviours. According to the Multiphasic Personality Inventory (MMPI) profile of Milwaukee killer Jeffrey Dahmer, over a period of three years, he killed and dismembered at least 17 male victims. He slept with the dead bodies, engaged in sexual acts with them, stored body parts in jars and cannibalised many of them. He was convicted for the serial murders, for which he was sentenced to 1,070 years in prison.

According to MMPI expert Alex B. Caldwell, several aspects of this profile can help explain Dahmer's bizarre and destructive behaviour. His extraordinary high score on the psychopathic deviate scale is a reflection of antisocial impulsiveness coupled with a total lack of capacity for empathy and compassion. In all likelihood, his victims were regarded as no more than objects to satisfy his perverse needs.

Depression-Anxiety Discrepancies

According to Caldwell, there was a marked discrepancy between the depression and psychasthenia (anxiety) scales, which is rarely seen on the MMPI, reflecting Dahmer's sense of being fated or doomed to repeat his acts until he's caught: the high depression score, together with an absence of fear that, in normal people, may inhibit murderous behaviour (the low psychasthenia score).

Even though his profile was an indication of his high levels of psychological disturbance, it also reflects Dahmer's ability to mask his pathology under the normal facade which he used for years to fool law enforcement officials. Dahmer's general demeanour looked so normal that despite the horrific acts and the level of psychopathology shown in his results, his plea of not guilty by reason of insanity was rejected by the jury. Instead, he was sent to prison, where he was murdered by another inmate.

Individuals with antisocial personalities tend to display a perplexing failure in response to punishment due to their lack of anxiety, making the threat of punishment not a reason to deter from engaging in self-defeating or illegal acts over and over. This results in some of them developing imposing prison records.

An individual has to be at least 18 years old to be diagnosed with antisocial personality disorder. However, there is a requirement of substantial diagnostic criteria before the age of 15, which includes acts of habitual lying, excessive drinking, use of drugs, theft, vandalism, early and aggressive sexual behaviour, and chronic rules violations at home and school. Thus, Antisocial Personality Disorder is the culmination of deviant patterns of behaviour typically beginning at childhood.