Bad Boys, Bad Men: Confronting Antisocial Personality Disorder [Paperback]

"My goal," writes Donald Black, at the beginning of Bad Boys, Bad Men "is to educate readers about a serious but underappreciated health problem." This is the core of the book: an attempt to identify and describe a psychiatric disorder that goes undiagnosed in the vast majority of cases of anti-social men. Based on the study of men treated at the University of Iowa Psychiatric Hospital between 1945 and 1970, Bad Boys, Bad Men explores the connection between conduct disorder in boys and the chaotic lives of the men Black describes as "anti- social". The key to that connection is pattern: the anti-social does not break the occasional social rule but lives in a state of constant resistance to authority and norm--with predictable results in terms of economic, psychological and emotional poverty. Cautious when it comes to causes--some combination of gene and environment is proposed--Black is clear that the crucial predictor of ASP is conduct disorder in childhood. Aiming at the general reader, as well as professionals, he traces the common themes of ASP through his subjects' lives: chaotic childhoods, abuse, unemployment, addiction, violence and, sometimes, murder. More problematically, he supports the topical claim that ASP is a "lurking threat" to the fabric of cultural life through a wide range of high-profile cases of violence and murder: among others, Saddam Hussein, O.J. Simpson, John Gacy. But are these men really comparable? And how do you start to separate ASP as a specific disorder from the apparent prevalence of ASP symptoms?: that's the problem, and challenge, of this contribution to the study of criminal behaviour. --Vicky Lebeau --This text refers to the Hardcover edition.

"Clearly written, informative, and filled with intriguing stories of real people....Tells us what we need to know about antisocial personality disorder. A wonderful book."--John M. Oldham, MD, Columbia University

Whether called black sheep, sociopaths, felons, conmen, or misfits, some men break all the rules. They shirk everyday responsibilities, abuse drugs and alcohol, take up criminal careers, and lash out at family members. In the worst cases, they commit rape, murder, and other acts of extreme violence as though they lack a conscience. What makes these men - men we all know, whether as faces from crime reports or as people close to us - behave the way they do? Bad Boys, Bad Men examines the mysterious mental condition that underlies this lifelong penchant for bad behaviour. Psychiatrist and researcher Donald W. Black, M.D., draws on case studies, scientific data, and current events to explore antisocial behaviour and to chart the history, nature, and treatment of a misunderstood disorder that effects up to seven million Americans. Black shows that the condition psychiatrists call antisocial personality disorder, or ASP, is not a myth but a very real problem that causes more pain to individuals and society than many commonly recognized psychiatric illnesses. New evidence from genetics and neuroscience supports the long-held notion that extreme cases of antisocial behaviour are tied to biologic causes and that some people are simply born bad. Bad Boys, Bad Men summarizes recent advances in genetics, brain imaging and psychophysiologic research that shed light on ASP. The disorder's impact spans every society and is linked to a host of social problems, including crime, domestic violence, drug abuse, and neglected children. Black argues that any attempt to counter these problems requires confronting ASP and that some of today's high-profile crimincal cases may be rooted in this perplexing disorder. In Bad Boys, Bad Men Black describes the warning signs that predict which troubled children are more likely to become dangerous adults. The books details the slow progress towards treatment for ASP, discusses the role of the criminal justice system in dealing with the disorder, and offers advice for individuals and families affected by it. Drawing on the author's research into the progression of ASP, Bad Boys, Bad Men introduces people like Ernie, the quintessential juvenile delinquent who had an incestuous relationship with his mother and descended into crime and alcoholism; Ed, the charming con man whoe wealthy parents tried to bail him out at every turn; Paul, an exhibitionist who sex offenses were only the beginning of his problems; and John Wayne Gacy, the notorious serial killer whose lifelong pattern of misbehaviour escalated to the rape and murder of more than 30 young men and boys. These compelling cases read like medical detective stories, as Black tries to separate the lies these men tell from the facts of their lives. For people with ASP, life becomes an opportunity to grab what they can without remorse or concern for the consequences of their actions. In depicting the antisocial personality, Bad Boys, Bad Men underscores the fundamental human need for conscience and social order. Though Bad Boys, Bad Men is written for general audience, its summary of the psychiatric literature makes it suitable for readers already familiar with the topic. It will be of interest to psychiatrists, psychologists, criminologists, social workers, victims of crime and domestic abuse, and anyone else interested in understanding social behaviour.

EXAMINING THE MYSTERIOUS PENCHANT FOR BAD BEHAVIOR
We see them on the evening news, read about them in newspapers. Some of us may even know them personally. They are sociopaths, felons, conmen, or misfits, men who break all the rules. In the worst cases, they commit rape, murder, and other acts of extreme violence as though they lack a conscience. What makes these men behave they way they do?

This book examines the mental condition characterized by a serial pattern of bad behavior. In doing so, it provides a framework to help explain much of what is wrong in our society. Drawing on case studies, scientific data, and current events, Black shows how antisocial personality disorder, or ASP, is not a myth, but a very real problem that causes more pain to individuals and society than many commonly recognized psychiatric disorders. ASP effects up to seven million Americans, spans every level of society, and touches almost every family and community. Black implicates ASP in a host of social problems, including crime, domestic violence, drug abuse, and neglected children. The disorder plays a role in many of today’s high profile crimes. New evidence from genetics and neuroscience supports the long-held notion that extreme cases of antisocial behavior are tied to biological causes and that some people are simply born bad.

Bad Boys, Bad Men introduces men who show the disorder’s devastating consequences, and its progression through life starting in early childhood. Black not only describes the warning signs that predict which children are more likely to become dangerous adults, but also details progress towards treatment for ASP, discusses the role of the criminal justice system, and offers advice to individuals and families affected by it.-

Contents: A Lurking Threat: Antisocial Personality Disorder and Society; Searching for Answers: The Evolving Psychiatric View of Antisocial Personality Disorder; Bad Boys to Bad Men: The Symptoms of Antisocial Personality Disorder; Naming the Problem: The Diagnosis of Antisocial Personality Disorder; Divergent Paths: The Naturla History of Antisocial Personality Disorder; Seeds of Despair: The Causes of Antisocial Personality Disorder; Overcoming Antisocial Personality Disorder: Options for treatment; Power and Pretense: The Hidden Antisocials; The Antisocial Murderer: Gacy and Others; Antisocial Personality Disorder and Families: Finding Ways to Cope; Epilogue: Dispelling the Myths; Recommended Reading. --This text refers to the Hardcover edition.

Donald W. Black, M.D., is Professor of Psychiatry at the University of Iowa College of Medicine in Iowa City. A graduate of Stanford University and the University of Utah School of Medicine, he has received numerous awards for teaching, research, and patient care, and is listed in "Best Doctors in America." He writes extensively for professional audiences, and his work has been featured on 20/20, Dateline, and 48 Hours. C. Lindon Larson is a writer and editor and lives in Iowa City.