The Barroom Blitz: Competing Neural Underliers of Impulsive Aggressive Phenotype Have Different Implications in Antisocial Personality Disorder

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Katherine Dodson


The DSM-V diagnostic criteria for antisocial personality disorder (ASPD) focus on indicators of impulsive aggressive phenotype (IAP), such as reckless, aggressive, or law-breaking behavior (American Psychiatric Association, 2013). However, concentrating primarily on behavioral data casts a wide diagnostic net, enabling criteria to describe various individuals with little in common aside from a history of rule-breaking (Hare, Hart, & Harpur, 1991). Other diagnoses, including borderline personality disorder (BPD) and intermittent explosive disorder (IED), and clinical constructs, such as psychopathy, are associated with and often comorbid with ASPD, due to some shared symptoms of IAP, although the three clinical constructs differ in many ways (APA, 2013; Lenzenweger, Lane, Loranger, & Kessler, 2007). Due to the poor discriminant validity of ASPD criteria, these clinical populations are at risk of conflation under the ASPD umbrella due to shared IAP, with little consideration that underlying factors and other symptoms may differ and thus have different clinical implications. This review describes distinguishing structural and functional neural traits of psychopathy, BPD, and IED and discusses how these differences produce distinct subjective experiences contributing to IAP. The article additionally discusses potential harmful consequences of failure to differentiate these clinical populations, including heterogenous research populations that yield nongeneralizable results, limited or inappropriate treatment of some psychiatric patients, and general mischaracterization of the disorders (Hare, 1996; Hare et al., 1991). To illustrate these differences, the paper includes an entertaining thought exercise involving a dispute amongst three very different, but equally aggressive, characters at their local pub.        

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Author Biography

Katherine Dodson, Villanova University

Katherine (Kat) Dodson is a second-year M.S. student and graduate assistant in the Department of Psychology. She received her B.A. in Psychology and Communication Studies from Wilkes University. Between graduating from Wilkes and beginning studies at Villanova, she held jobs as a foster/adoption caseworker, mental health technician, admissions clerk for a psychiatric unit, and neurofeedback technician. She is very interested in contributing – through hands-on work or research – to the improvement of outcomes for individuals with externalizing disorders associated with impulsive behavior and (auto)aggression. As a lab assistant, Kat has worked on projects investigating serotonin deficiency's effects on alcohol-mediated aggression and genetic risk for trauma-susceptibility. She is currently developing her thesis under the direction of Dr. Benjamin Sachs. Kat is interested in pursuing a career related to psychiatric clinical research or science policy. Currently, she is a volunteer with the March for Science Philadelphia outreach team. She also shoots photography and plays the piano in her spare time.