Course Title: Antisocial Personality Disorder
Release date: July, 2020
Expiration date: July, 2022
Estimated time to complete activity: 1.5 hours
Hardware / Software Requirements: Compatible with Internet Explorer 6 and up, Mozilla Firefox 3 and up, Safari 4.0, and Google Chrome 10 and up.
If you have any questions, please contact MER at (800)-421-3756, http://www.cmepartner.org/contact
This activity is jointly provided by Medical Education Resources and Symptom Media.
Nurses, general practice physicians, psychiatrists, psychologists, social workers and marriage and family therapists, substance abuse counselors, allied health professionals, and students and trainees of these disciplines.
Underlying Need for this Course
The purpose of this course is to to assist nurses, doctors, and allied health professionals in understanding the definition and diagnostic criteria, etiology, epidemiology, pharmacological and non-pharmacologic treatments, duration of symptoms, and complications associated with antisocial personality disorder.
- Personality disorders, particularly Cluster B personality disorders including antisocial, borderline, narcissistic and histrionic personality disorders are among the most common, challenging to manage, yet least identified and well treated of psychiatric disorders.
- Individuals with antisocial personality personality disorder as well as other cluster b personality disorders tend to be high utilizers of the health care system, therefore health care professionals are likely to see these patients.
- Cluster B personality disorders frequently co-occur with each other and other psychiatric disorders which elevates the risk of harm to self and others. Therefore there is a need for allied health professionals to be able to distinguish between these disorders, as well as identify other risk factors.
- These disorders, particularly antisocial personality disorder, are highly stigmatized by health care providers, leading to treatment that differs from that of the general population.
- Some limited evidence-based and other treatments exist to ameliorate co-morbid symptoms of Cluster B personality disorders, particularly antisocial personality disorder.
Personality disorders are argued to be of the most common yet least identified and well-treated psychiatric disorders. Nurses, physicians and other allied health professional are in an ideal position within the health care system to address deficiencies in treatment outcomes for personality disorders (Woods, 2002).
According to the Diagnostic and Statistical Manuel, borderline, narcissistic, antisocial and histrionic personality disorders are cluster B personality disorders, and frequently co-occur (APA, 2013). Notably, when they do co-occur, the risk for violence and suicide may be elevated. Antisocial personality disorder in particular carried an elevated risk for violence. Moreover, individuals with cluster b personality disorders tend to utilize health care resources more than the general population (Nestadt, et al, 1990). Furthermore, studies have shown that mental health nurses hold among the poorest views of those with these disorders, due to challenging behaviors. Consequently, they may stigmatize and treat these individuals differently than people with other mental health diagnoses (Dickens, et al, 2016).
Therefore, there is a need to address these gaps in professionalism, knowledge and skill in recognizing and differentiating between the cluster b personality disorders. Improving clinical assessment skills of cluster b personality disorders is a necessary step towards improving treatment and outcomes for people suffering from these psychiatric disorders.
- Clinicians need KNOWLEDGE on the signs, symptoms, common behaviors as well as etiology, epidemiology, the course of disease, diagnosis and treatments of antisocial personality disorder.
- Clinicians need to be COMPETENT in recognizing the symptoms of antisocial personality disorder and those that may place the patient at risk of harming themselves or others.
- Clinicians need to PERFORM in being able to identify antisocial personality disorder and behaviors and psychiatric co-morbidities that elevate the risk for harm to self or others.
- Clinicians will improve their knowledge of the clinical presentation of the symptoms, and their knowledge of the causes, diagnostic criteria, risks for poor outcomes and treatments for antisocial personality disorder and general personality disorder.
- Clinicians will feel more competent in recognizing symptoms of antisocial personality disorder.
- Clinicians will feel more prepared to perform a differential diagnosis to rule out other possible causes or psychiatric co-morbidities of antisocial personality disorder and consider possible treatments for clinically presenting symptoms.
By the end of this course learners will be able to:
- Define the criteria for a general personality disorder
- Define antisocial personality disorder (ASPD) and its diagnostic criteria
- Describe the signs, symptoms and common behaviors of ASPD
- Discuss possible causes of ASPD
- Identify behaviors that are a risk for harming the self or others
- Discuss evidence-based and/or other treatments that may be helpful for ASPD.
Meet your instructor: Aaron Miller, MS, RN, PMHNP-BC is an ANCC Board Certified Family Psychiatric Mental Health Nurse Practitioner with over 11 years of experience working as an Advanced Practice Registered Nurse with individuals with serious mental illness including personality disorders. Aaron has a master’s degree in science, currently works as a faculty member in a Psychiatric Mental Health Nurse Practitioner Master’s program in San Francisco, CA, and maintains a clinical practice in Oakland and Santa Rosa, CA with individuals with severe and chronic mental illness.
The course includes material designed to assist nurses, doctors, and allied health professionals in understanding the definition and diagnostic criteria, etiology, epidemiology, pharmacological and non-pharmacologic treatments, duration of symptoms, and complications associated with antisocial personality disorder.
Online course slides with course objectives, a purpose statement, relevant course content, and references are offered alongside video demonstrations of symptoms and behaviors. Expert commentary is interspersed throughout the course videos to enhance learning and symptom recognition, and subject matter tests are offered to learners in multiple-choice format.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Medical Education Resources (MER) and Symptom Media. MER is accredited by the ACCME to provide continuing medical education for physicians.
Medical Education Resources designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
This CE activity provides 1.5 contact hours of continuing nursing education.
Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299, for 1.5 contact hours.
Disclosure of Conflicts of Interest
Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a continuing education activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality activities that promote improvements or quality in health care and not the business interest of a commercial interest.
The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:
The content managers reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:
Method of Participation
There are no fees for participating in and receiving credit for this activity (or insert fee amount if applicable). During the period July, 2020 through July, 2022, participants must 1) read the learning objectives and faculty disclosures, 2) study the educational activity, 3) complete the posttest by recording the best answer to each question, 4) complete the evaluation.
A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better.
- American Psychiatric Association. (2013) Diagnostic and Statistical Manual, Fifth Edition. APA publishing. Washington D.C./ London
- Bateman, A.W., Gunderson, J., Mulder, R. (2015) Treatment of personality disorders. Lancet. 385 (9969): 735-43.
- Black, D.W., Baumgard, C.H., & Bell, S.E. (1995) A 16- to 45-year follow-up of 71 men with antisocial personality disorder. Compr Psychiatry. 36:130-140.
- Black, D., Gunter, T., Loveless, P., Allen, J., & Seileni, B. (2010). Antisocial personality disorder in incarcerated offenders: Psychiatric comorbidity and quality of life. Annals of Clinical Psychiatry. 22(2):113-120
- Dickens, G.L, Hallett, N., Lamont, E. (2016). Interventions to improve mental health nurses skills, attitudes, and knowledge related to people with a diagnoses of borderline personality disorder. International Journal of Nursing Studies, 56 (2016). 114-127. Available at https://www.sciencedirect.com/science/article/pii/S0020748915003363
- Diever, L.J., Insel, T.R. & Uhde, T.W. (1983). Biogenetic factors in personalities. In Personality Disorders, edited by J.P. Frosch. Washington, DC, pp.42-65
- Glenn, A., Johnson, A.K. & Raine, A. (2013). Antisocial Personality Disorder: A Current Review. Curr Psychiatry Rep. 15:427
- Sadock, B.J., Sadock, V.A. & Ruiz, P. Wolters (2015) Kaplan & Sadock’s Synopsis of Psychiatry, 11th edition. Philadelphia, PA.
- Lowenstein, J., Purvis, C. & Rose, K. (2016). A systematic review on the relationship between antisocial, borderline and narcissistic personality disorder diagnostic traits and risk of violence to others in a clinical and forensic sample. Borderline Personality Disorder and Emotion Dysregulation. 3:14
- Shea, S. (1998). Psychiatric Interviewing, The Art of Understanding, 2nd Edition. Saunders. Philadelphia, PA.
Verona, E., Patrick, C. J., & Joiner, T. E. (2001). Psychopathy, antisocial personality, and suicide risk. Journal of Abnormal Psychology, 110(3), 462–470. https://doi.org/10.1037/0021-843X.110.3.462
- National Collaborating Centre for Mental Health UK. (2015). Antisocial Personality Disorder: Treatment, Management and Prevention. Leicester (UK): British Psychological Society; (NICE Clinical Guidelines, No. 77.) 7, Interventions for people with antisocial personality disorder and associated symptoms and behaviours. Available from: https://www.ncbi.nlm.nih.gov/books/NBK55350/
- Woods P., Richards D. (2003) Effectiveness of nursing interventions in people with personality disorders. Journal of Advanced Nursing. 44(2)154–172
The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources and / or Symptom Media. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.