ASPD Assessment and Diagnosis 2 — Questions and Answers
Question 1: Which DSM-5 criterion requires that antisocial behavior not occur exclusively during a manic or schizophrenic episode?
- Criterion A
- Criterion B
- Criterion C (Correct answer)
- Criterion D
Correct answer: Criterion C
Criterion C specifies that ASPD cannot be diagnosed if antisocial behavior occurs solely during the course of schizophrenia or bipolar disorder.
Question 2: A forensic evaluator is assessing a 20-year-old for ASPD. Which historical information is MOST critical to obtain?
- Family psychiatric history
- Evidence of conduct disorder before age 15 (Correct answer)
- Substance use patterns in adulthood
- Academic performance in college
Correct answer: Evidence of conduct disorder before age 15
DSM-5 requires evidence of conduct disorder with onset before age 15 as a prerequisite for an ASPD diagnosis.
Question 3: The Hare Psychopathy Checklist-Revised (PCL-R) uses a scoring range of 0 to 40. What score is the commonly accepted clinical threshold for psychopathy in North America?
- 20
- 25
- 30 (Correct answer)
- 35
Correct answer: 30
A PCL-R score of 30 or above is the widely accepted cutoff for diagnosing psychopathy in North American research and forensic settings.
Question 4: Which self-report measure was specifically designed to assess psychopathy across both clinical and community (non-criminal) populations?
- MMPI-2-RF
- Triarchic Psychopathy Measure (TriPM) (Correct answer)
- Antisocial Process Screening Device (APSD)
- Personality Assessment Inventory (PAI)
Correct answer: Triarchic Psychopathy Measure (TriPM)
The TriPM was developed to measure the three factors of psychopathy — boldness, meanness, and disinhibition — in both forensic and non-forensic samples.
Question 5: When diagnosing ASPD, clinicians must confirm that the individual is at least how old?
- 15 years old
- 16 years old
- 17 years old
- 18 years old (Correct answer)
Correct answer: 18 years old
DSM-5 requires a minimum age of 18 for an ASPD diagnosis, though conduct disorder symptoms must have been present before age 15.
Question 6: In the PCL-R, Factor 1 captures which dimension of psychopathy?
- Chronically unstable lifestyle and antisocial behavior
- Interpersonal and affective features such as grandiosity and callousness (Correct answer)
- Impulsivity and poor behavioral controls
- Criminal versatility and juvenile delinquency
Correct answer: Interpersonal and affective features such as grandiosity and callousness
PCL-R Factor 1 reflects the core interpersonal-affective traits of psychopathy, including glibness, pathological lying, shallow affect, and lack of empathy.
Question 7: A clinician notes that a patient's antisocial behavior began at age 13 and has continued into adulthood. To meet full ASPD criteria, what additional requirement must be satisfied?
- The patient must have a documented IQ above 70
- At least three of the seven adult ASPD symptom criteria must be present (Correct answer)
- The patient must have at least one prior arrest
- The behavior must have caused occupational impairment
Correct answer: At least three of the seven adult ASPD symptom criteria must be present
DSM-5 requires that at least three of the seven adult criterion symptoms (e.g., deceitfulness, impulsivity, irritability) be present, in addition to the conduct disorder history.
ASPD Assessment and Diagnosis 2
Which DSM-5 criterion requires that antisocial behavior not occur exclusively during a manic or schizophrenic episode?