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" There presently exist three recognized conceptualizations of the antisocial construct: antisocial personality disorder (ASPD) as outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013), dissocial personality disorder in the International Classification of Diseases (ICD-10; World Health Organization, 1992), and psychopathy as formalized by Hare with the Psychopathy Checklist—Revised (PCL-R; Hare, 2003). A conundrum for therapists is that these conceptualizations are overlapping but not identical, emphasizing different symptom clusters.
The DSM-5 emphasizes the overt conduct of the patient through a criteria set that includes criminal behavior, lying, reckless and impulsive behavior, aggression, and irresponsibility in the areas of work and finances. In contrast, the criteria set for dissocial personality disorder is less focused on conduct and includes a mixture of cognitive signs (e.g., a tendency to blame others, an attitude of irresponsibility), affective signs (e.g., callousness, inability to feel guilt, low frustration tolerance), and interpersonal signs (e.g., tendency to form relationships but not maintain them). The signs and symptoms of psychopathy are more complex and are an almost equal blend of the conduct and interpersonal/affective aspects of functioning. The two higher-order factors of the PCL-R reflect this blend. Factor 1, Interpersonal/Affective, includes signs such as superficial charm, pathological lying, manipulation, grandiosity, lack of remorse and empathy, and shallow affect. Factor 2, Lifestyle/Antisocial, includes thrill seeking, impulsivity, irresponsibility, varied criminal activity, and disinhibited behavior (Hare & Neumann, 2008). Psychopathy can be regarded as the most severe of the three disorders. Patients with psychopathy would be expected to also meet criteria for ASPD or dissocial personality disorder, but not everyone diagnosed with ASPD or dissocial personality disorder will have psychopathy (Hare, 1996; Ogloff, 2006).
As noted by Ogloff (2006), the distinctions among the three antisocial conceptualizations are such that findings based on one diagnostic group are not necessarily applicable to the others and produce different prevalence rates in justice-involved populations. Adding a further layer of complexity, therapists will encounter patients who possess a mixture of features from all three diagnostic systems rather than a prototypical presentation of any one disorder. "
― Aaron T. Beck , Cognitive Therapy of Personality Disorders
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" First, strive for a solid foundation of trust, loyalty, respect, and security. Your spouse is your closest relative and is entitled to depend on you as a committed ally, supporter, and champion. Second, cultivate the tender, loving part of your relationship: sensitivity, consideration, understanding, and demonstrations of affection and caring. Regard each other as confidante, companion, and friend. Third, strengthen the partnership. Develop a sense of cooperation, consideration, and compromise. Sharpen your communication skills so that you can more easily make decisions about practical issues, such as division of work, preparing and implementing a family budget, and planning leisure-time activities. "
― Aaron T. Beck , Love Is Never Enough: How Couples Can Overcome Misunderstandings, Resolve Conflicts, and Solve Relationship Problems Through Cognitive Therapy
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" What has stripped their conversation of its richness and enjoyments? First, despite the apparent success of their numerous discussions, they may have arrived at the solutions to family problems at a great cost to the relationship. In many relationships, a whole sequence of little kinks gradually adds up to produce stress. These kinks may also be a sign of important differences between the partners in their outlook and values—differences that their surface agreements never resolve. Thus, the free flow of conversation is inhibited by the threat of intrusions of unresolved conflicts. Perfectly tuned conversations are interrupted by signals of possible discord that introduce static into the communications. Second, although the partners may get along when they are dealing with practical problems, their conversation may be devoid of references to the more pleasurable aspects of the relationship. The partners have not learned to demarcate problem-solving discussions from pleasant conversations. Thus when one partner starts a conversation with a loving comment, the other may decide that this is a good time to bring up some conflict. As a result, there is a dearth of conversation that revolves simply around expressions of caring, sharing, and loving. "
― Aaron T. Beck , Love Is Never Enough: How Couples Can Overcome Misunderstandings, Resolve Conflicts, and Solve Relationship Problems Through Cognitive Therapy
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" Sometimes a spouse, in trying to relieve a partner’s distress, accomplishes just the opposite. Judy is an artist. One evening she was quite upset by her problems in getting ready for a show, and she started to tell her husband, Cliff, about them. She wanted his support, encouragement, and sympathy. But Cliff instead fired off a barrage of instructions: “One, you’ve got to get all the people together in the group. Two, you have to call anyone else who is involved. Three, you want to get your accountant in on it—check with the bank to see how much money you still have. Four, you could contact the PR people. Five, call the gallery and see about the time.” Judy felt rejected by Cliff and thought, “He doesn’t care about how I feel. He just wants to get me off his back.” But in his eyes, Cliff thought that he was filling the bill. He had given her his best advice—he thought that he was being supportive. To Judy, however, Cliff was being controlling, not supportive. She was seeking sympathy and emotional rapport, while he was tuned in to problem solving. How can you find the appropriate channel? One point "
― Aaron T. Beck , Love Is Never Enough: How Couples Can Overcome Misunderstandings, Resolve Conflicts, and Solve Relationship Problems Through Cognitive Therapy
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" Egocentricity is a problem, however, when it becomes exaggerated and is not balanced by such social traits as love, empathy, and altruism, the capacity for which is probably also represented in our genome. Interestingly, very few of us think to look for egocentricity in ourselves, although we are dazzled by it in others. "
― Aaron T. Beck , Prisoners of Hate: The Cognitive Basis of Anger, Hostility, and Violence
