Bad boys, bad men : confronting antisocial personality disorder (sociopathy)

327 Pages·2013·1.38 MB·English

by  Donald W Black

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B A D BOYS, BA D MEN
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B A D BOYS, BA D MEN
C onfronting
A ntisocial Personality Disorder ( Sociopathy)
R evised and Updated
D onald W. Black, M D
P ROFESSOR OF PSYCHIATRY
D IRECTOR OF RESIDENCY TRAINING
D EPARTMENT OF PSYCHIATRY
U NIVERSIT Y OF IOWA CARVER COLLEGE OF MEDICINE
I OWA CIT Y, IA
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3
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L ibrary of Congress Cataloging-in-Publication Data
B lack, Donald W., 1956–
B ad boys, bad men : confronting antisocial personality
disorder (sociopathy) / Donald W. Black.—2nd ed., rev. and updated. p . ; cm.
I ncludes bibliographical references and index.
I SBN 978-0-19-986203-0 (pbk)
I . Title.
[ DNLM: 1. Antisocial Personality Disorder. 2. Men—psychology. WM 190.5.A2]
6 16.85'82—dc23 2012025162
T he science of medicine is a rapidly changing field. As new research and clinical experience broaden our
knowledge, changes in treatment and drug therapy occur. The author and publisher of this work have
checked with sources believed to be reliable in their efforts to provide information that is accurate and
complete, and in accordance with the standards accepted at the time of publication. However, in light of
the possibility of human error or changes in the practice of medicine, neither the author, nor the publisher,
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information contained herein is in every respect accurate or complete. Readers are encouraged to confirm
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1 3 5 7 9 8 6 4 2
P rinted in the United States of America
on acid-free paper
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T o the memory of the late George Winokur,
my f iend and mentor
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C ON TEN TS
P reface to the Second Edition i x
A cknowledgments x iii
I ntroduction x vii
1 . A Lurking Threat: Antisocial Personality
Disorder and Society 1
2 . S earching for Answers: The Evolving Psychiatric
View of Antisocial Personality Disorder 1 9
3 . B ad Boys to Bad Men: The Symptoms of Antisocial
Personality Disorder 4 1
4 . N aming the Problem: The Diagnosis of Antisocial
Personality Disorder 7 5
5 . D ivergent Paths: The Natural History of Antisocial
Personality Disorder 1 01
6 . S eeds of Despair: The Causes of Antisocial
Personality Disorder 1 31
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C O N T E N T S
7. O vercoming Antisocial Personality Disorder:
Options for Treatment 1 63
8. P ower and Pretense: The Hidden Antisocials 1 91
9. T he Antisocial Murderer: Gacy and Others 2 11
1 0. A ntisocial Personality Disorder and Families:
Finding Ways to Cope 2 39
E pilogue: Dispelling the Myths 2 59
N otes 2 65
R ecommended Readings 2 97
I ndex 0 0

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P R EFACE TO THE SECOND EDITION
M uch has happened since this book was f rst published. T e country
has engaged in wars with Iraq and Afghanistan; Osama bin Laden
was killed by Seal Team Six; the economy collapsed in 2008; and the
Arab Spring brought unexpected surprises in the Middle East, not all
of them good. And much has happened with antisocial personality
disorder, or ASP, the acronym I use throughout this book. Data have
accumulated regarding its prevalence and gender gap, possible caus-
ative factors (brain imaging and molecular genetics are hot topics
these days), and new approaches to treatment. With all that has hap-
pened, I thought it was the right time to revise and update the book.
Any reader who has writ en a book will understand my interest in
writing a second edition. It presents an opportunity to make correc-
tions, to edit or delete awkwardly writ en sentences (or paragraphs),
and to include new material. It also gives the writer an opportunity to
ref ect on mountains of correspondence one has received.
In the past 13 years, as I’m sure is true for many authors, I have
received a steady stream of let ers and comments. People have
purchased or borrowed the book for many reasons, and some
are motivated to write (let ers, emails) or phone to share their
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