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

Davidson, K.M. et al. (2009) Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial. Psychological Medicine, 39(4), pp. 569-577. (doi: 10.1017/S0033291708004066)

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<b>BACKGROUND</b> 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.<p></p> <b>METHOD</b> 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.<p></p> <b>RESULTS</b> 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.<p></p> <b>CONCLUSIONS</b> 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.<p></p>

Item Type:Articles
Glasgow Author(s) Enlighten ID:Davidson, Professor Kate and Bezlyak, Dr Vladimir and Walker, Dr Andrew and Robertson, Ms Heather and Ford, Professor Ian
Authors: Davidson, K.M., Tyrer, P., Tata, P., Cooke, D., Gumley, A., Ford, I., Walker, A., Bezlyak, V., Seivewright, H., Robertson, H., and Crawford, M.J.
Subjects:R Medicine > R Medicine (General)
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
Journal Name:Psychological Medicine
Publisher:Cambridge University Press
ISSN (Online):1469-8978
Published Online:30 July 2008
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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
394191Trial platform - a pilot study of cognitive behaviour therapy versus usual treatment in those with anti-social personality disorder with aggressive behaviour. ref ISCRCTN89922377Kate DavidsonMedical Research Council (MRC)G0400922Centre for Population and Health Sciences