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Week 7 Controversy Associated with Personality and Paraphilic Disorders
Christa M. Smith
College of Nursing-PMHNP, Walden University
PRAC 6675: PMHNP Care Across the Lifespan I
Dr. Nataliya Ishkova
October 12th, 2025
, 2
Antisocial Personality Disorder (ASPD) is one of the most debated mental health disorders,
characterized by persistent patterns of disregard for others' rights, impulsivity, and a lack of
remorse (Fisher et al., 2024). The controversies surrounding ASPD stem from its complex
nature and the challenges it poses for diagnosis and treatment. Critics frequently debate the
definition and boundaries of the disorder, questioning whether some individuals genuinely have a
personality disorder or if they are merely displaying extreme maladaptive behaviors. This debate
becomes especially heated when the behaviors of people with ASPD overlap with criminal
activity, which fuels stigma and fear.
Professional Beliefs: I believe ASPD is a real and treatable disorder, but it requires specialized
methods. Mental health professionals often debate their opinions about ASPD. Some view it as a
neurodevelopmental disorder mainly caused by genetics, while others emphasize environmental
factors like trauma and early childhood experiences (Choy & Raine, 2024). No matter the
perspective, everyone agrees that people with ASPD can show a wide range of behaviors, which
makes treatment more challenging. Understanding these differences is key to effectively working
with clients who display ASPD traits.
Maintaining a therapeutic relationship with a patient who has ASPD requires a tailored
approach. Setting and upholding boundaries is essential in this process. Providers need to
recognize the patient's manipulative tendencies and establish firm yet fair limits, while fostering
a safe environment that encourages open communication (Aerts et al., 2023). Building trust can
be challenging since individuals with ASPD may show little respect for the therapeutic
relationship. Consistent communication and active listening are vital for establishing trust and
reliability. Additionally, using motivational interviewing can encourage engagement and help
individuals gain insight into their behaviors, even if they have limited self-awareness or capacity
Week 7 Controversy Associated with Personality and Paraphilic Disorders
Christa M. Smith
College of Nursing-PMHNP, Walden University
PRAC 6675: PMHNP Care Across the Lifespan I
Dr. Nataliya Ishkova
October 12th, 2025
, 2
Antisocial Personality Disorder (ASPD) is one of the most debated mental health disorders,
characterized by persistent patterns of disregard for others' rights, impulsivity, and a lack of
remorse (Fisher et al., 2024). The controversies surrounding ASPD stem from its complex
nature and the challenges it poses for diagnosis and treatment. Critics frequently debate the
definition and boundaries of the disorder, questioning whether some individuals genuinely have a
personality disorder or if they are merely displaying extreme maladaptive behaviors. This debate
becomes especially heated when the behaviors of people with ASPD overlap with criminal
activity, which fuels stigma and fear.
Professional Beliefs: I believe ASPD is a real and treatable disorder, but it requires specialized
methods. Mental health professionals often debate their opinions about ASPD. Some view it as a
neurodevelopmental disorder mainly caused by genetics, while others emphasize environmental
factors like trauma and early childhood experiences (Choy & Raine, 2024). No matter the
perspective, everyone agrees that people with ASPD can show a wide range of behaviors, which
makes treatment more challenging. Understanding these differences is key to effectively working
with clients who display ASPD traits.
Maintaining a therapeutic relationship with a patient who has ASPD requires a tailored
approach. Setting and upholding boundaries is essential in this process. Providers need to
recognize the patient's manipulative tendencies and establish firm yet fair limits, while fostering
a safe environment that encourages open communication (Aerts et al., 2023). Building trust can
be challenging since individuals with ASPD may show little respect for the therapeutic
relationship. Consistent communication and active listening are vital for establishing trust and
reliability. Additionally, using motivational interviewing can encourage engagement and help
individuals gain insight into their behaviors, even if they have limited self-awareness or capacity
