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反社会人格障碍是一种神经发育障碍。

Antisocial Personality as a Neurodevelopmental Disorder.

机构信息

Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA; email:

出版信息

Annu Rev Clin Psychol. 2018 May 7;14:259-289. doi: 10.1146/annurev-clinpsy-050817-084819. Epub 2018 Jan 25.

Abstract

Although antisocial personality disorder (APD) is one of the most researched personality disorders, it is still surprisingly resistant to treatment. This lack of clinical progress may be partly due to the failure to view APD as a neurodevelopmental disorder and to consider early interventions. After first defining what constitutes a neurodevelopmental disorder, this review evaluates the extent to which APD meets neurodevelopmental criteria, covering structural and functional brain imaging, neurocognition, genetics and epigenetics, neurochemistry, and early health risk factors. Prevention and intervention strategies for APD are then outlined, focusing on addressing early biological and health systems, followed by forensic and clinical implications. It is argued both that APD meets criteria for consideration as a neurodevelopmental disorder and that consideration should be given both to the possibility that early onset conduct disorder is neurodevelopmental in nature, and also to the inclusion of psychopathy as a specifier in future Diagnostic and Statistical Manual revisions of APD.

摘要

虽然反社会人格障碍(APD)是研究最多的人格障碍之一,但它仍然令人惊讶地难以治疗。这种临床进展的缺乏可能部分归因于未能将 APD 视为神经发育障碍并考虑早期干预。在首次定义构成神经发育障碍的内容后,本综述评估了 APD 符合神经发育标准的程度,涵盖了结构和功能脑成像、神经认知、遗传学和表观遗传学、神经化学以及早期健康风险因素。然后概述了针对 APD 的预防和干预策略,重点是解决早期的生物和健康系统问题,其次是法医和临床影响。本文认为,APD 符合作为神经发育障碍的考虑标准,并且应该考虑到早期发作的品行障碍在本质上是神经发育性的,以及将精神病作为 APD 未来诊断和统计手册修订版的一个特征纳入其中的可能性。

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