The Paradox of Childhood Cumulative Adversity in Antisocial Personality Disorder: Reconsidering Trauma-Informed Approaches in Carceral Settings

Ahmed Rady; Celia Rupaire; Manuel Bermejo; Jerome Lacoste

doi:10.56508/mhgcj.v9i1.338

Authors

Ahmed Rady SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France; Alexandria University School of Medicine, Egypt https://orcid.org/0000-0002-9104-4740
Celia Rupaire SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France; Centre Hospitalier Maurice Despinoy, DOM, France https://orcid.org/0009-0006-3328-5841
Manuel Bermejo SMPR Centre Hospitalier Universitaire CHU de Martinique https://orcid.org/0009-0007-1782-681X
Jerome Lacoste SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France; UR PSYCOMADD, Paris Saclay University, Villejuif, France https://orcid.org/0000-0002-4994-1683

DOI:

https://doi.org/10.56508/mhgcj.v9i1.338

Keywords:

Antisocial Personality, Adverse Childhood Experiences, Psychopathy, Psycho trauma, carceral, Forensic, Prison

Abstract

Introduction and Purpose: High levels of Adverse Childhood Experiences (ACEs), is often associated with Antisocial Personality Disorder (ASPD) psychopathology. Our study investigates if childhood adversities directly manifest through the dimensions of emotion regulation, psychopathy, impulsivity, and aggression. Dimensions that are commonly addressed in carceral settings.

Methodology: A retrospective study conducted in a carceral setting. We analyzed records of male inmates with a clinical diagnosis of ASPD who consulted the prison psychiatric service from January to June 2025. Records with comorbid Borderline Personality Disorder (BPD) or active psychosis were excluded and only included medical records incorporating the relevant psychometric evaluations, the Difficulties in Emotion Regulation Scale (DERS), Psychopathy Checklist-Revised (PCL-R), Levenson Self-Report Psychopathy Scale (LSRP), Barratt Impulsiveness Scale (BIS-11), and Buss-Perry Aggression Questionnaire (BPAQ). Participants were stratified into High (ACE?4) and Low (ACE <4) cumulative adversity groups.

Results: The final sample comprised (N=47) participants. No statistically significant differences were found between the High and Low cumulative adversity groups on the total scores of the DERS (p=0.11), PCL-R (p=0.63), LSRP (p=0.55), BIS-11 (p=0.19), and BPAQ (p=0.64). ACE correlation with those psychological dimensions did not reach significance.

Conclusion: Within a pure ASPD sample, a higher load of childhood adversity was not associated with greater deficits in emotion regulation, impulsivity, or overall aggression. This dissociation suggests that the phenotypic expression of ASPD in adulthood may represent a final common etiologic pathway, not necessarily associated with severity of childhood adversities. The findings invite reconsideration of current models and open insights to investigate the utility of integrating trauma-specific, explorative therapies to address deeply seated pathological schemas not addressed by classical Interventions with focus on the measured dimensions.

Author Biographies

Ahmed Rady, SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France; Alexandria University School of Medicine, Egypt

SMPR - Dispositif Psychiatrique de l'USMP, Centre Hospitalier Universitaire CHU de Martinique, DOM, France

Department of Psychiatry, Alexandria University School of Medicine, Alexandria, Egypt

Celia Rupaire, SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France; Centre Hospitalier Maurice Despinoy, DOM, France

SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France

Centre Hospitalier Maurice Despinoy, DOM, France

Jerome Lacoste, SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France; UR PSYCOMADD, Paris Saclay University, Villejuif, France

SMPR Centre Hospitalier Universitaire CHU de Martinique, DOM, France

UR PSYCOMADD, Paris Saclay University, Villejuif, France

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