Antisocial Disorders Assessment

Introduction

Using a broad definition, Antisocial Disorders may be defined as pervasive, maladaptive behaviours that violate the norms and rules of a group or society, causing social impairment or distress to others. Currently, the classification and assessment of antisocial disorders may follow (a) the medical model or (b) the dimensional model:

• The medical model uses a categorical approach in which the presence of a variety of diagnostic criteria, such as persistent violations of social norms (including lying, stealing, truancy, inconsistent work behaviour and traffic arrests), is evaluated by experts (clinicians). This model relies on diagnostic criteria as outlined in the DSM-IV (Diagnostic and Statistic Manual of Mental Disorders: APA, 1994) and ICD (International Classification of Diseases: WHO, 1993).
• The dimensional model evaluates antisocial disorders along a continuum of development, from normal to pathological, focusing on behavioural and trait dimensions, and identifying clusters of highly interrelated behaviours and traits.

There is agreement among researchers about the development of antisocial behaviour: it begins early in life (infancy) with aggressive and oppositional behaviours (e.g. conduct problems), gradually advances toward more significant expressions of antisocial acts (e.g. vandalism, stealing, truancy, lying, substance abuse) during adolescence, and lastly, progresses to extreme forms of delinquency in adult life. The most recent longitudinal and retrospective studies (Patterson, Reid & Dishion, 1992) suggest that the ‘early starters’ (childhood and preadolescence) are at greater risk for adult involvement in delinquent acts and are more likely to move toward more serious offences that lead to a ‘criminal career’ compared to the ‘later starters’ (adolescence).

A variety of methods are used for assessing antisocial disorders; these include: self-report instruments, others' ratings, clinical interviews (structured and semi-structured), and direct behavioural observation (see Table 1).

Child and Adolescent Assessment

In order to establish the severity of antisocial behaviours during childhood and adolescence, it is important (a) to determine the age of onset; (b) to evaluate the frequency of aggressive acts; (c) to establish the variety of antisocial behaviours; and (d) to observe them in multiple settings (family, peers, school and community). As a necessary complement to this assessment, it is also important to evaluate other aspects of the individual's functioning in order to rule out the co-occurrence of other psychological disturbances.

For children and adolescents, the terms conduct disorders and conduct problems (aggressive and oppositional behaviours) may be used interchangeably. It is important to note that conduct disorders have different prevalence rates for boys and girls: 6 to 16% for boys, and 2 to 9% for girls.

In recent years, more complete assessment procedures have been developed to cover a full range of childhood and adolescent behaviours directly and indirectly linked to antisocial behaviours in different contexts. The advantages of these assessment procedures are (a) to have a complete picture of child and adolescent functioning for the purpose of differential diagnosis and (b) to collect data to provide empirical and theoretical support of the instruments used.