Date of Award

2024

Document Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Graduate Department of Clinical Psychology

First Advisor

Kenneth Logan, PsyD

Second Advisor

Robert Weniger, PsyD

Third Advisor

Nahanni Freeman, PhD

Abstract

Antisocial personality disorder (ASPD) is a diagnosis reserved for individuals who feature deceitfulness, impulsivity, aggressiveness, recklessness, and irresponsibility. Evidence suggests that experiencing trauma is an etiological factor in developing antisocial traits in males. The prevalence of ASPD in the U.S. is three to one, male to female. However, research indicates females are substantially underdiagnosed due to exclusionary diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.-Text Revised; DSM-5-TR; American Psychiatric Association, 2013). The Personality Assessment Inventory (PAI) is a personality measure that features a conceptualization of ASPD that differs from the DSM-5-TR and includes more personality-specific traits that may be more effective in diagnosing females. The following study utilized two sources of data: a dataset of PAI results from a psychiatric facility located in the Pacific Northwest and a questionnaire consisting of diagnostic criteria from the DSM-5-TR and PAI completed by practicing psychologists. A correlational analysis indicated a positive correlation between trauma and ASPD in female patients from the psychiatric facility. Findings identified that psychologists prefer using the DSM-5-TR diagnostic criteria to the PAI criteria for diagnosing ASPD, regardless of which gender they are diagnosing. Results also indicated that the proportion of males and females from the psychiatric facility with clinically significant levels of antisocial traits were near equal—differing from the prevalence ratio identified by DSM-5-TR criteria. Furthermore, findings revealed trauma to be a significant etiological factor in ASPD in female participants. Moreover, females are more likely to be accurately diagnosed with ASPD when diagnostic criteria include relevant descriptions of personality traits and relational functioning.

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