The treatment of substance misuse in psychopathic individuals: why heterogeneity matters.
Psychopathy is a personality syndrome characterized by egocentricity, grandiosity, remorselessness, callousness, impulsivity, and manipulativeness. It is also a disorder highly comorbid with substance use disorders ( Derefinko and Lynam, 2007 ; Smith and Newman, 1990 ; Tourian et al., 1997 ). However, unlike their other criminal counterparts, psychopaths' substance use related problems appear remarkably resilient despite treatment ( Smith and Newman, 1990 ) leading many to conclude the dually diagnosed psychopathic substance misuser is "untreatable." However, this pessimistic stance is predicated upon the notion that psychopathy is a homogeneous, categorical construct. Such a conclusion leaves little hope for treating substance use problems in this population, and has certainly attenuated efforts at developing effective clinical interventions ( Seto and Quinsey, 2006 ). In this review, we argue that conceptualizing psychopathy as a heterogeneous and dimensional construct reveals a common thread of negative emotionality (NEM) that may clarify the relations between psychopathy and substance use disorders as well as pave the way for more practical and viable treatment options.
Gudonis
Lauren C
LC
Department of Psychology, University of Kentucky, Lexington, Kentucky, USA.
Derefinko
Karen
K
Giancola
Peter R
PR
D000987:Antisocial Personality Disorder / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D017831:Diagnosis, Dual (Psychiatry); D004644:Emotions; D006801:Humans; D019966:Substance-Related Disorders / Q000150:complications / Q000628:therapy*