Habermeyer E, Herpertz S C
Klinik und Poliklinik für Psychiatrie und Psychotherapie, Zentrum für Nervenheilkunde der Universität Rostock, Gehlsheimer Strasse 20, 18147 Rostock, Deutschland.
Nervenarzt. 2006 May;77(5):605-15; quiz 616. doi: 10.1007/s00115-006-2081-3.
Deviant behavior is gaining in clinical importance if it is founded on stable, characteristic, and enduring patterns of psychopathologically relevant personality traits which have their onset in childhood or adolescence. The classification of these traits shows variations, so that a distinction between the ICD-10 diagnosis of dis-social personality disorder, DSM-IV diagnosis of antisocial personality disorder, and the concept "psychopathy" is necessary. Our knowledge about the biological basis of antisocial behavior includes neurophysiologic, psychophysiologic, and genetic findings. Also relevant are results of neurotransmitter studies and structural resp. functional neuroimaging findings. Psychosocial risk factors include parental deficits, rejection, disregard, unstable relations, and abuse. Efficient psychotherapeutic treatment is cognitive-behavioral. Pharmacologic treatment is largely "off-label". The diagnosis of antisocial and dis-social personality disorders allows no conclusions on criminal responsibility. In addition to psychiatric diagnostics, considerations on the severity of the disorder and its effects on the ability to inhibit actions are necessary.
如果异常行为基于稳定、独特且持久的与精神病理学相关的人格特质模式，且这些特质始于童年或青少年时期，那么它在临床上就越发重要。这些特质的分类存在差异，因此有必要区分国际疾病分类第10版（ICD - 10）中的反社会人格障碍诊断、精神疾病诊断与统计手册第四版（DSM - IV）中的反社会人格障碍诊断以及“心理变态”这一概念。我们关于反社会行为生物学基础的知识包括神经生理学、心理生理学和遗传学研究结果。神经递质研究结果以及结构性和功能性神经影像学研究结果也具有相关性。社会心理风险因素包括父母养育缺陷、被拒斥、被忽视、关系不稳定以及虐待。有效的心理治疗方法是认知行为疗法。药物治疗大多属于“超说明书用药”。反社会人格障碍和反社会型人格障碍的诊断并不能得出刑事责任方面的结论。除了进行精神科诊断外，还需要考虑障碍的严重程度及其对抑制行为能力的影响。
