Antisocial Personality Disorder (ASPD) is disproportionately represented within correctional populations, with prevalence estimates ranging from 40% to 70% among incarcerated individuals (Fazel & Danesh, 2002). In many institutional contexts, ASPD is conceptualized primarily through observable conduct—impulsivity, aggression, deceitfulness, and disregard for the rights of others—often reinforcing the belief that the disorder is static and largely untreatable (American Psychiatric Association [APA], 2022). A common refrain in correctional settings when individuals present as disruptive yet non-psychotic is: “That isn’t mental health—that is behavioral.” Such statements reflect a behavior-only framework that risks obscuring developmental and trauma-related contributors to antisocial presentations. Research consistently demonstrates high rates of childhood maltreatment, attachment disruption, and exposure to chronic violence among incarcerated individuals (Ford & Courtois, 2014). Trauma exposure frequently precedes conduct disorder and may shape neurodevelopmental, affect-regulation, and relational patterns that later meet criteria for ASPD. This paper argues for a trauma-informed reconceptualization of ASPD that integrates developmental history, attachment disruption, and adverse childhood experiences into clinical assessment and documentation practices. A structured framework is proposed to support differential diagnosis, reduce diagnostic overshadowing, and enhance ethical precision in forensic mental health settings. By contextualizing antisocial behaviors without minimizing accountability, forensic counselors can advance more clinically nuanced, trauma-responsive, and professionally responsible interventions.
Citation: Sturiale, R. L., & Andrews, R. (2026). Reconsidering Antisocial Personality Disorder: A Trauma-Informed Framework for Clinical Assessment in Correctional Settings. J Sur & Surgic Proce.,4(4):1-14. DOI : https://doi.org/10.47485/3069-8154.1037