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Book Review: Bad Boys, Bad Men
By Donald W. Black, with C. L. Larson
Oxford University Press, $20.00 (hardcover), $11.96
(paperback)
Psychiatrist/researcher Black has gathered new evidence from
genetics, neuroscience, current events, and his own case studies to
describe the disordered behavior of the seven million Americans who
reportedly have antisocial personality disorder, or ASP.
Black has presented ASP in an extremely readable, comprehensive,
and well-documented book. His descriptions of those with ASP are
superb, as he describes how symptoms of the disorder appear in early
childhood and details their devastating consequences as the ASP
individual grows into adulthood. He describes the warning signs that
predict which children are more likely to become dangerous adults, and
examines the role of the criminal justice system in dealing with
individuals with ASP. Under "Finding Ways to Cope," he offers advice
to individuals having ASP and families affected by it.
One criticism: Black suggests psychotherapy for individuals with
ASP, but considering his descriptions of this disorder, such treatment
would seem to have limited therapeutic value.
However, if you want to be able to identify someone with ASP, we
recommend that you read this book. And if you know individuals who
are dealing with the havoc wreaked by "Hidden Antisocials," as Black
calls them, Bad Boys, Bad Men can be an invaluable gift.
*****
Quotes from Bad Boys, Bad Men, by Donald Black:
Adults who defy social norms often establish a pattern of misbehavior in
childhood, sometimes seeming to live without a conscience, to shirk the
rules and expectations that keep most of us in check. They show a
disturbing lack of empathy and fail to learn from their experiences,
always blaming someone else for their problems and misdeeds. Such
people can explain why the shopkeeper deserves to be robbed, why the
spouse asks to be beaten, why their every betrayal is justified.
While antisocials can understand the concepts of right and
wrong on an intellectual level, they have no emotional
connections to commonly held standards of behavior.
Family studies of ASP have generally shown that nearly 20
percent - one in five-of antisocials' first-degree relatives
are themselves antisocial and that between one-quarter and
one-third are alcoholic. Depression, drug abuse, somatization
disorder, ADD, and learning disabilities also seem to run in
these families.
I think it is reasonable to conclude that disturbed serotonin function plays
a critical role in antisocial behavior and personality.
A wide range of factors may disrupt the central nervous system as it
develops during gestation and early life, producing abnormal effects that
may include a propensity for antisocial behavior. Poor prenatal nutrition,
drug abuse and smoking by the pregnant mother or birth complications
that rob the child's brain of oxygen are a few such factors.
The word treatment may even have limited value when
applied to ASP, as it suggests a patient who is suffering and
seeking a cure. Most antisocials are not suffering in the usual
sense. They may see no reason to abandon their ways and
may even enjoy their escape from obligations, their
impulsivity, and their freedom from guilt.
Many antisocials have a history of childhood ADD, a condition with
effects that can linger into adulthood. Childhood ADD is characterized
by impulsiveness, hyperactivity, and inability to sustain attention, and its
symptoms overlap with those of conduct disorder.
As long as antisocial behavior is regarded as the product of bad
upbringing, social and economic deprivation, and other environmental
factors, families are more likely to help... antisocials hide from the world
and from themselves.
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