Dafne Lazaro

English 1012- Period 1

September 27, 2018

Reaction Paper #1 - Antisocial Personality Disorder

Chapter 69 of the book ​Gabbard’s Treatments of Psychiatric Disorders​ was

written by J. Reid Meloy, board-certified forensic psychologist (ABPP), and Jessica

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Yakeley, ​Fellow of the Royal College of Psychiatrists (2014) . This section focused on 

Antisocial Personality Disorder​, its diagnosis, and treatments. 

To begin, Antisocial Personality Disorder was defined as “the most reliable 

diagnosed condition among the personality disorders”, however, it was also stated that 
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treatment efforts are notoriously difficult . The authors then contradicted the belief of 

many psychiatrists who believe that patients with ASPD are untreatable. The passage 

then evolved into a description of how patients with ASPD are diagnosed. Overall, 

patients are put through a psychological test known as the PCL-R that ranges from a 

scale of 0 to a midpoint of 30 and above. Those who score in the range of 20-29 are 

considered to have moderate psychopathy; while those who range 30 and above 

indicate severe psychopathy. Treatments are designed by the categorization of 

psychopathy level, based on this system, some patients have a better response to 

treatment. 

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​Meloy, Reid. “Dr. Reid Meloy Biography.” ​Dr. Reid Meloy​, 2018, drreidmeloy.com/
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​ eloy, Reid, and Jessica Yakeley. ​Gabbard’s Treatments of Psychiatric Disorders​. 5th ed.,
M
American Psychiatric Publishing, 2014.
 In contradiction to what is believed it was stated that only 1 out of every 3 

prisoners suffer from severe psychopathy and they receive a significantly poorer 

treatment prognosis than other patients with lower levels of ASPD (​Gabbard’s

Treatments of Psychiatric Disorders​,​ 1016). This issue has risen due to the false belief 

that these patients are incurable. However, several following studies proved that long 

individual psychotherapy several times a week is effective. In a future study, it was also 

demonstrated that treatment in psychopathic youths was more promising than in 

adults: 6/8 young patients showed treatment benefits in comparison to the ⅜ adult 

patients (​Gabbard’s Treatments of Psychiatric Disorders​, 1017). 

The authors mentioned additional problems in trying to offer high-quality 

treatments to patients with ASPD. This list included difficulty in finding appropriate 

therapists and a strategy to avoid manipulation by the patients.

My reaction to this chapter in the book was that it was impressive to learn about 

the diagnosis method for patients with ASPD and that it is shocking to hear about the 

difficult reality that it is to treat people with this condition. I think it is incredible to 

imagine the vulnerability of both the patients and the therapists themselves. Not only is 

it complex to find a suitable treatment for an individual with ASPD, but the therapist may 

be put at danger when experiencing countertransference reactions towards their 

patients. 

This issue is important to today’s world because there is a large number of 

people who are imprisoned for reasons that include: violent conduct, substance abuse, 

robbery, etc. According to the Pew Research Center, about 2.2 million people in the 
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United States are incarcerated in 2016 . I​ f these prisoners experience a moderate level

of ASPD along with other conditions such as anxiety or depression, then their situation

worsens and leads to a complicated treatment. Many people who find themselves in this

situation cannot help but fall into the depth of crime. Similarly, if the prisoners are

diagnosed with a high level of psychopathy, they pose a danger for the public,

themselves, and their therapists. It would be ideal to treat these patients at a young age

to prevent an increase in their condition.

This chapter definitely increased my understanding of the condition of ASPD, its

symptoms and side effects; it also gave me the awareness of how a person with this

condition may appear. I believe this chapter holds credibility because it was written by

people who focus on forensic psychology and apply their knowledge towards criminality

and mental disorders. In addition, I believe this piece was well put together because it

contained subtitles, charts, and definitions with examples that helped the reader

understand complex psychological terms. Finally, I would recommend this work to

people who wish to gain a better understanding of what Antisocial personality disorder

is and what approaches are being made to reduce its severity.

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​Gramlich, John. “America’s Incarceration Rate Is at a Two-Decade Low.” ​Pew Research Center,​ 2 May 2018,
www.pewresearch.org/fact-tank/2018/05/02/americas-incarceration-rate-is-at-a-two-decade-low/.
 Bibliography

Gramlich, John. “America’s Incarceration Rate Is at a Two-Decade Low.” ​Pew Research Center​,

2 May 2018,

www.pewresearch.org/fact-tank/2018/05/02/americas-incarceration-rate-is-at-a-two-decade-l

ow/.

Meloy, Reid, and Jessica Yakeley. ​Gabbard’s Treatments of Psychiatric Disorders​. 5th ed.,

American Psychiatric Publishing, 2014.

Meloy, Reid. “Dr. Reid Meloy Biography.” ​Dr. Reid Meloy​, 2018, drreidmeloy.com/.