Stout, M. (2005). The sociopath next door: the ruthless versus the rest of us. New York: Broadway Books.

Reviewer:
Dina Eledge

Curricular Areas:
Assessment, Counselor Education, Helping Relationships/Counseling Theory, Rehabilitation Counseling

Subject Headings:
Family dynamics, Personality disorders, Prison, Relationships, Substance abuse-alcohol, Substance abuse-drugs

Review:
Individuals with antisocial personality disorder have a unique set of symptoms and behavior patterns that not only affect their own lives, but the lives of others they come in contact with. It is the potential danger faced by those who come into contact with these individuals that makes this disorder particularly dark and disturbing. Stout (2005) calls antisocial personality disorder (APD) "A non-correctable disfigurement of character that is now thought to be present in about 4 percent of the population.” Throughout this book, readers learn how to identify individuals who suffer from APD - also called sociopaths. One of the key characteristics of someone with this disorder is a complete absence of conscience. They can do anything at all without any shame, remorse or guilt. Other traits are poor judgment, failure to learn from experience, extreme egocentricity, incapacity for love, a lack of emotional responsiveness to others, impulsivity, insincerity, and superficial charm.

Antisocial Personality Disorder is commonly misdiagnosed and misunderstood. Clinicians often confuse this disorder with criminal behavior not associated with a personality disorder. The rate of co-morbidity is high and can present specific behavioral and prognostic challenges, depending upon the other condition. Treatment is tricky with these individuals, because the individual rarely comes to terms with the disorder, often blaming others for their behavior and predicament. However, there are a few options. CBT can help the individual begin to change maladaptive thought patterns in their relationships with others. Behavioral therapy might also be helpful in targeting and modifying the negative behavior. Antidepressants are sometimes prescribed to offset depression caused by the life circumstances often present in individuals with this disorder. Mood stabilizers may also help control some of the rage and anger these clients feel.

Since the prevalence and severity of Antisocial Personality Disorder is likely to be greater among incarcerated samples, this book is a must-read for forensic counselors in training and anyone interested in working with clients with personality disorders.