Chamberlain Samuel R, Derbyshire Katie L, Leppink Eric W, Grant Jon E
Dr. Chamberlain is a Clinical Lecturer, Honorary Specialty Registrat (SpR), Department of Psychiatry, University of Cambridge and Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK. Ms. Derbyshire and Mr. Lippink are Research Specialists and Dr. Grant is Professor, Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL. This research was supported by a Center for Excellence in Gambling Research grant by the Institute for Responsible Gaming (U.S.) to Dr. Grant. Dr. Chamberlain's involvement in this study was supported by a grant from the Academy of Medical Sciences (U.K.). The funding agency had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
J Am Acad Psychiatry Law. 2016 Jun;44(2):218-25.
Antisocial personality disorder (ASPD) is a relatively common problem, but the neuropsychological profile of affected individuals has seldom been studied outside of criminal justice recruitment settings. Non-treatment-seeking young adults (18-29 years) were recruited from the general community by media advertisements. Participants with ASPD (n = 17), free from substance use disorders, were compared with matched controls (n = 229) using objective computerized neuropsychological tasks tapping a range of cognitive domains. Compared with controls, individuals with ASPD showed significantly elevated pathological gambling symptoms, previous illegal acts, unemployment, greater nicotine consumption, and relative impairments in response inhibition (Stop-Signal Task) and decision-making (less risk adjustment, Cambridge Gamble Task). General response speed, set-shifting, working memory, and executive planning were intact. ASPD was also associated with higher impulsivity and venturesomeness on the Eysenck Questionnaire. These findings implicate impaired inhibitory control and decision-making in the pathophysiology of ASPD, even in milder manifestations of the disorder. Future work should explore the neural correlates of these impairments and use longitudinal designs to examine the temporal relationship between these deficits, antisocial behavior, and functional impairment.
反社会型人格障碍（ASPD）是一个相对常见的问题，但除刑事司法招募环境外，很少有研究关注受影响个体的神经心理学特征。通过媒体广告从普通社区招募了未寻求治疗的年轻成年人（18至29岁）。使用客观的计算机化神经心理学任务，对一系列认知领域进行测试，将无物质使用障碍的ASPD患者（n = 17）与匹配的对照组（n = 229）进行比较。与对照组相比，ASPD患者表现出明显更高的病态赌博症状、既往违法行为、失业、更高的尼古丁消费量，以及在反应抑制（停止信号任务）和决策制定（较少的风险调整，剑桥赌博任务）方面的相对损伤。一般反应速度、定势转换、工作记忆和执行计划功能完好。在艾森克问卷上，ASPD还与更高的冲动性和冒险性相关。这些发现表明，即使在该障碍的较轻表现中，抑制控制和决策制定受损也存在于ASPD的病理生理学中。未来的研究应探索这些损伤的神经相关性，并采用纵向设计来研究这些缺陷、反社会行为和功能损害之间的时间关系。
