Risk Domain 6: Psychopathy Related, Impulsivity/Anger/Antisociality

Below are the report responses of an individual who has sexually offended. First, his MIDSA responses for each subcomponent of the Impulsivity-Anger-Antisociality domain are presented as they appear in the report followed by an interpretation in red of each subcomponent. At the end of the subcomponents is an overall integrative interpretation in red.

The respondent acknowledges problems both with Impulsivity (> 94% of ACCs* and 62% of ASOs**) and Constant Anger (> 99% of ACCs and 83% of ASOs). This admitted emotional dysregulation does not, however, extend either to his Physical Fighting, where he admits only an average amount (> 56% of ACCs and 44% of ASOs) or to Fantasies of Hurting People, which is relatively low (> 43% of ACCs and 20% of ASOs). In his Fantasies of Hurting People he respond “never” to all questions and achieves the lowest T-Score possible (44.1).

In contrast to the impulsivity and anger reported in the Impulse-Antisocial Scales section above, the respondent’s Attention Deficit and Inhibition Difficulties scores are below the median for ASOs (> 19% and 36%, respectively). His Oppositional Behavior score is moderate (> 56% of ASOs), approaching his Impulsivity scale percent of > 62% of ASOs).  These three scales are all answered for before age 12. The Oppositional Behavior score suggests that the origins of his present impulsivity and anger might be early and are not likely to be related to ADHD.

The respondent’s reported use of drugs and alcohol in adolescence is extremely high (> 99% of ACCs and > 96% of ASOs), and his fighting and assaultive behavior is moderately high (> 91% of ACCs and > 69% of ASOs).  In contrast, his acknowledgment of delinquency during adolescence is low (> 31% of ACCs and > 43% of ASOs).

Consistent with his antisocial behavior scores in adolescence, the respondent’s reported use of drugs and alcohol in adulthood has remained extremely high (> 99% of ACCs and > 93% of ASOs) and his fighting and assaultive behavior scale is higher than in adolescence (> 99% of ACCs and > 88% of ASOs).  His acknowledgment of conduct disorder behavior in adulthood is now high relative to comparable delinquency behavior in adolescence (> 83% of ACCs and > 83% of ASOs).

Overview of the Entire Impulsive-Antisocial Scales Domain

The respondent acknowledges sufficient impulsivity and difficulties managing his anger to make his emotional dysregulation an important treatment target. This dysregulation in the form of oppositional behavior appears to have begun early in his life and exploring the early roots of this would be important. Although his Physical Fighting scale is average, in the behavior-focused antisocial measures, his fighting and assaultive behaviors are high in adolescence and even higher in adulthood. In both adolescence and adulthood, he also reports significant problems with drugs and alcohol, probably contributing to his assaultive behaviors. In adulthood his emotional dysregulation, interpersonal aggressiveness, and difficulties controlling his drug and alcohol usage have possibly contributed to his acknowledged conduct problems in adulthood (disturbing the peace, vandalism, etc.).  This should also be explored in treatment.

*  ACC = Adult Community Control Group.

**ASO = Adults who have Sexually Offended.