There is a widespread sentiment that society has lost its moral compass and that there needs to be reclamation of traditional values. High-profile, violent crimes committed by adults or adolescents attract media attention. The consequent public furore often fuels political imperatives about being ‘tough on crime and tough on the causes of crime’. Donald Black argues that these crimes may not be a result of erosion of moral societal values, but could be attributed to the actions of a group of individuals who have antisocial personality disorder.
This is a new edition but it builds on earlier research, with its stated goal being to ‘educate the lay reader, mental health professionals, patients and families’. Donald Black draws on his own clinical experience, expertise and research, culminating in a book that should have wide-ranging appeal. He draws on examples from literature and film but also emphasises that those with antisocial personality disorder occupy our families, workplaces and neighbourhoods. He explores the impacts of culture and society on perception of what is deemed antisocial. Evolving psychiatric and historical perspectives explored include those of Pinel, Rush, Pritchard, Cleckley, Robbins and Hare.
Black describes the developmental trajectory of antisocial behaviour, specifically focusing on aspects of conduct disorder and its likely persistence into adulthood. Approaches to diagnosis are outlined, with Black providing a list of questions to aid assessment, adding a caveat that ‘the reader should resist the temptation to diagnose themselves’. The multi-factional aetiology of antisocial personality disorder is explored in a comprehensive, well-researched and balanced way. He describes the natural history of the disorder and the divergent pathways that are possible, and draws usefully on the work of Robbins and Moffitt. Treatment options are outlined, with particular attention being paid to the treatment of comorbidity. Black takes a practical approach to the challenges of psychological treatment in terms of both efficacy and the impact on patient and therapist alike. The book concludes with advice for families and those suffering from the disorder.
As a child psychiatrist, I found the relatively limited exploration of developmental continuity disappointing and outwith what I was expecting, given the title. In conclusion, this is a book that makes the concept of antisocial personality disorder accessible to the lay person and is useful reading for professionals and trainees within health and criminal justice systems. It is relatively jargon free and accessible to a broad readership, and the concept is brought to life through case studies, including those of high-profile offenders.
eLetters
No eLetters have been published for this article.