CONTACT: BECKY SOGLIN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-6660; fax (319) 335-9917
Release: March 8, 1999
UI psychiatrist publishes book on antisocial personality disorder
IOWA CITY, Iowa -- Some men seem to break all the rules, drifting from
job to job, abusing alcohol or drugs, abandoning their families, running
into trouble with the law. Almost everyone knows such a man, whether firsthand
or from media accounts. But few realize that a disturbingly common psychiatric
disorder may be at the root of these men's behavior.
Donald W. Black, M.D., professor of psychiatry at the University of
Iowa College of Medicine, wants to change that. His new book, "Bad
Boys, Bad Men: Confronting Antisocial Personality Disorder," published
in March by Oxford University Press, examines this condition and the trouble
"I find it incredible that a disorder affecting at least seven
million Americans is the subject of such little attention," Black
said. "Many of us are affected by people with this condition, from
the women they batter to the taxpayers who pay for their adjudication and
incarceration. I hope this book stirs more discussion of these issues."
In the psychiatric sense, antisocial refers not to people who are shy
or withdrawn, but rather to those who disregard all of society's regulations
and expectations. At their worst, people with antisocial personality disorder
(ASP) seem to completely lack a conscience, acting only with their own
interests at heart.
Black argues that many social problems from crime to drug abuse
to "deadbeat dads" can be traced to ASP. His book also
details the history of ASP as a psychiatric disorder, discusses its symptoms
in detail, outlines treatment strategies and offers advice for families
dealing with the condition. It is written for a general audience and includes
many examples of antisocial behavior drawn from recent headlines.
ASP is found mostly in men and always begins early in life. "These
people start out as troubled children and end up as very troubled adults,"
Black said. "We just don't see cases of bad men who were not bad children."
Not all children with behavior problems go on to develop ASP, Black
explains. However, the kids who misbehave the most stand the greatest chance
of becoming antisocial. The problem spans all areas of life, from education
to work to relationships.
The range of problems associated with the disorder may distract attention
from their common cause. "Too often we see an individual's behavior
blamed on his alcoholism, abusive childhood or some other issue without
the realization that he has been difficult from day one," Black said.
Although ASP probably stems from a blend of hereditary and environmental
factors perhaps including genetics, birth injury, body chemistry
and home life Black maintains that people with the condition should
be held responsible for their actions.
"People with ASP will blame everyone but themselves for their problems.
If they are to get better, they have to learn to accept responsibility,"
he said. "Ever since this disorder was first defined by psychiatry,
critics have worried that it would become a license for bad behavior. It
isn't. People with ASP have the ability to choose right from wrong, but
they simply fail to do so."
"Bad Boys, Bad Men" draws on case studies from Black's research,
including a profile of notorious serial killer John Wayne Gacy, who was
diagnosed with ASP at the UI in the late 1960s. Gacy's story, Black said,
presents an example of the disorder at its most deadly extreme.
Black's experience with ASP began during his medical residency training
in psychiatry. The sheer number of problems associated with the disorder
and psychiatry's trouble treating it led him to research the condition
He conducted a follow-up study of men diagnosed as antisocial at the
UI in order to discover what happened to them decades after their initial
diagnoses. Most, he found, never improved, and some became even worse.