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Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial

Published online by Cambridge University Press:  30 July 2008

K. M. Davidson ,
P. Tyrer ,
P. Tata ,
D. Cooke ,
A. Gumley ,
I. Ford ,
A. Walker ,
V. Bezlyak ,
H. Seivewright  and
H. Robertson
...Show all authors
K. M. Davidson*
Affiliation:
Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
P. Tyrer
Affiliation:
Department of Psychological Medicine, Imperial College London, London, UK
P. Tata
Affiliation:
Adult Psychology Services, Central North West London NHS Foundation Trust, Psychology Department, London, UK
D. Cooke
Affiliation:
Department of Psychology, Glasgow Caledonian University, Glasgow, UK
A. Gumley
Affiliation:
Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
I. Ford
Affiliation:
Robertson Centre for Biostatistics, Boyd Orr Building, University of Glasgow, UK
A. Walker
Affiliation:
Robertson Centre for Biostatistics, Boyd Orr Building, University of Glasgow, UK
V. Bezlyak
Affiliation:
Robertson Centre for Biostatistics, Boyd Orr Building, University of Glasgow, UK
H. Seivewright
Affiliation:
Department of Psychological Medicine, Imperial College London, London, UK
H. Robertson
Affiliation:
Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Glasgow, UK
M. J. Crawford
Affiliation:
Department of Psychological Medicine, Imperial College London, London, UK
*
*Address for correspondence: Professor K. M. Davidson, Faculty of Medicine, University of Glasgow, Gartnavel Royal Hospital, Great Western Road, Glasgow G12 0XH, UK. (Email: [email protected])
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Abstract

Background

Little information exists on treatment effectiveness in antisocial personality disorder (ASPD). We investigated the feasibility and effectiveness of carrying out a randomized controlled trial of cognitive behaviour therapy (CBT) in men with ASPD who were aggressive.

Method

This was an exploratory two-centre, randomized controlled trial in a community setting. Fifty-two adult men with a diagnosis of ASPD, with acts of aggression in the 6 months prior to the study, were randomized to either treatment as usual (TAU) plus CBT, or usual treatment alone. Change over 12 months of follow-up was assessed in the occurrence of any act of aggression and also in terms of alcohol misuse, mental state, beliefs and social functioning.

Results

The follow-up rate was 79%. At 12 months, both groups reported a decrease in the occurrence of any acts of verbal or physical aggression. Trends in the data, in favour of CBT, were noted for problematic drinking, social functioning and beliefs about others.

Conclusions

CBT did not improve outcomes more than usual treatment for men with ASPD who are aggressive and living in the community in this exploratory study. However, the data suggest that a larger study is required to fully assess the effectiveness of CBT in reducing aggression, alcohol misuse and improving social functioning and view of others. It is feasible to carry out a rigorous randomized controlled trial in this group.

Keywords

AntisocialCBTpersonality disordertrial
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 4 , April 2009 , pp. 569 - 577
Copyright
Copyright © 2008 Cambridge University Press

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