Cochrane · systematic review · CD007668
Psychological interventions for antisocial personality disorder
Gibbon, S, Khalifa, NR, Cheung, NH-Y, et al. · Cochrane Database of Systematic Reviews · 2020 · Cochrane Library
Developmental, Psychosocial and Learning ProblemsAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
41
current version
GRADE rated
13
No studies
28
Included studies
NR
No studies 28 · 68.3%Ungraded 0 · 0%Very low 11 · 26.8%Low 2 · 4.9%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Cognitive behaviour therapy + treatment‐as‐usual versus treatment‐as‐usual alone for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression (any act of physical aggression) Assessed by: number reporting any act of physical aggression Cognitive behaviour therapy + treatment‐as‐usual vs treatment‐as‐usual alone | OR 0.92 [0.28, 3.07] | 1 study · 52 participants | Low Downgraded: risk of bias, imprecision |
Reconviction Cognitive behaviour therapy + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | NR | No studies |
Global state/functioning Cognitive behaviour therapy + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | NR | No studies |
Social functioning Assessed by: Social Functioning Questionnaire (range of possible scores = 0‐24; higher score = poorer outcome) Timing of assessment: 12 months Cognitive behaviour therapy + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | 1 study · 39 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Cognitive behaviour therapy + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | NR | No studies |
Impulsive lifestyle counselling + treatment‐as‐usual versus treatment‐as‐usual alone for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression: trait Assessed by: Buss‐Perry Aggression Questionnaire ‐ Short Form (12 items rated on 5‐point Likert scale ranging from extremely uncharacteristic (1) to extremely characteristic (5); range = 12‐60; high score = poor outcome) Timing o... Impulsive lifestyle counselling + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | 1 study · 118 participants | Very low Downgraded: risk of bias, imprecision |
Reconviction Impulsive lifestyle counselling + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | NR | No studies |
Global state/functioning Impulsive lifestyle counselling + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | NR | No studies |
Social functioning Impulsive lifestyle counselling + treatment‐as‐usual vs treatment‐as‐usual alone | no estimate extracted | NR | No studies |
Adverse events: death Assessed by: number of participant deaths between a 3‐ and 9‐month Impulsive lifestyle counselling + treatment‐as‐usual vs treatment‐as‐usual alone | OR 0.4 [0.04, 4.54] | 1 study · 142 participants | Very low Downgraded: risk of bias, imprecision |
Adverse events:incarceration Assessed by: incarceration between a 3‐ and 9‐month Impulsive lifestyle counselling + treatment‐as‐usual vs treatment‐as‐usual alone | OR 0.7 [0.27, 1.86] | 1 study · 142 participants | Very low Downgraded: risk of bias, imprecision |
Contingency management + standard maintenance versus standard maintenance alone for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression Contingency management + standard maintenance vs standard maintenance alone | no estimate extracted | NR | No studies |
Reconviction Contingency management + standard maintenance vs standard maintenance alone | no estimate extracted | NR | No studies |
Global state/functioning Contingency management + standard maintenance vs standard maintenance alone | no estimate extracted | NR | No studies |
Social functioning Assessed by: adjusted composite scores on the Family/Social domain of the Addiction Severity Index (composite scores range from no problems (0) to severe problems (1); higher score = worse outcome) Timing of assessment: 6 months Contingency management + standard maintenance vs standard maintenance alone | no estimate extracted | 1 study · 83 participants | Low Downgraded: risk of bias, imprecision |
Adverse events Contingency management + standard maintenance vs standard maintenance alone | no estimate extracted | NR | No studies |
'Driving whilst intoxicated' programme + incarceration versus incarceration alone for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression 'Driving whilst intoxicated' programme + incarceration vs incarceration alone | no estimate extracted | NR | No studies |
Reconviction (for drink‐driving) Assessed by: Cox regression of re‐arrest rates over 24 months Timing of assessment: 24 months 'Driving whilst intoxicated' programme + incarceration vs incarceration alone | HR 0.56 | 1 study · 52 participants | Very low Downgraded: risk of bias, imprecision |
Global state/functioning 'Driving whilst intoxicated' programme + incarceration vs incarceration alone | no estimate extracted | NR | No studies |
Social functioning 'Driving whilst intoxicated' programme + incarceration vs incarceration alone | no estimate extracted | NR | No studies |
Adverse events 'Driving whilst intoxicated' programme + incarceration vs incarceration alone | no estimate extracted | NR | No studies |
Schema therapy versus treatment‐as‐usual for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression Schema therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Reconviction Assessed by: number of participants documented to have recidivated (documented as a global negative outcome) Timing of assessment: over the 3 years Schema therapy vs treatment‐as‐usual | OR 2.81 [0.11, 74.56] | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Global state/functioning Schema therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Social functioning Assessed by: mean number of days until unsupervised leave grantedb Timing of assessment: over the 3 years Schema therapy vs treatment‐as‐usual | no estimate extracted | 1 study · 30 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Assessed by: number of participants with a global negative outcome (e.g. dropping out of therapy, recidivism or being transferred to another facility due to poor treatment response) overall Timing of assessment: over the 3 years Schema therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Social problem‐solving therapy + psychoeducation versus treatment‐as‐usual for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression Social problem‐solving therapy + psychoeducation vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Reconviction Social problem‐solving therapy + psychoeducation vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Global state/functioning Social problem‐solving therapy + psychoeducation vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Social functioningAssessed by: Social Functioning Questionnaire (8 items rated on 4‐point scale; anchors vary across items; high score = poor outcome) Timing of assessment: 6 months Social problem‐solving therapy + psychoeducation vs treatment‐as‐usual | no estimate extracted | 1 study · 17 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Adverse events Social problem‐solving therapy + psychoeducation vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Dialectical behaviour therapy versus treatment‐as‐usual for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression Dialectical behaviour therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Reconviction Dialectical behaviour therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Global state/functioning Dialectical behaviour therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Social functioning Dialectical behaviour therapy vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Adverse events (self‐harm) Assessed by: mean number of self‐harm days in past 2 months Timing of assessment: 2 months Dialectical behaviour therapy vs treatment‐as‐usual | no estimate extracted | 1 study · 14 participants | Very low Downgraded: risk of bias, imprecision |
Psychosocial risk management ('Resettle' programme) versus treatment‐as‐usual for antisocial personality disorder
Population: adults with antisocial personality disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Aggression Psychosocial risk management ('Resettle' programme) vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Reconviction: total number of official offences recorded (higher number = worse outcome) Timing of the assessment: 1 year after release from prison Psychosocial risk management ('Resettle' programme) vs treatment‐as‐usual | no estimate extracted | 1 study · 35 participants | Very low Downgraded: risk of bias, imprecision |
Global state/functioning Psychosocial risk management ('Resettle' programme) vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Social functioning Psychosocial risk management ('Resettle' programme) vs treatment‐as‐usual | no estimate extracted | NR | No studies |
Adverse events: death during the study period Timing of assessment: 2 years after release from prison Psychosocial risk management ('Resettle' programme) vs treatment‐as‐usual | OR 0.89 [0.05, 14.83] | 1 study · 35 participants | Very low Downgraded: risk of bias, imprecision |