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

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

Open Access
|Feb 2026

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 analysed 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.

Language: English
Page range: 49 - 62
Submitted on: Dec 2, 2025
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Accepted on: Feb 6, 2026
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Published on: Feb 17, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: Volume open

© 2026 Ahmed Rady, Celia Rupaire, Manuel Bermejo, Jerome Lacoste, published by International Platform on Mental Health
This work is licensed under the Creative Commons Attribution 4.0 License.