Multidimensional treatment for ASPD co-morbid with substance abuse: Efficacy of MET and CBT in a case study

Abstract

Background: This case study explores the assessment, diagnosis, and treatment of antisocial personality disorder (ASPD) in a 20-year-old female referred to as B.Q., who presented with comorbid substance abuse and high impulsivity.

Methods: Psychological assessments, including the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Barrat Impulsiveness Scale (BIS-11), and Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST), were administered to evaluate B.Q.'s psychological profile and substance abuse patterns. Being raped by 3 men in a suburb closer to the school was said to have precipitated Substance use. A multidimensional treatment approach incorporating Motivational Enhancement Therapy (MET) and Cognitive Behavioral Therapy (CBT) was employed.

Results: The findings underscore the significance of considering both personality traits and specific symptoms in the diagnosis and treatment of ASPD which remains one of the most poorly understood and understudied mental disorders in psychiatry and accounting for 2-5% of the general population as its diagnosis is complex, requires a comprehensive assessment of an individual's behavior patterns, personality traits, and history of conduct problems. The study demonstrates the effectiveness of a multidimensional treatment approach, with MET addressing ambivalence and CBT targeting thought pattern modification, mood improvement, and daily functioning. B.Q. exhibited substantial improvements in psychopathic traits and mood instability, as evidenced by reductions in Psychopathic Deviate scores from baseline (M = 46, T = 113) to T3 (M = 36, t = 82), and decreases in Hypomania scores from baseline (M = 36, T = 98) to T3 (M = 28, t = 72). Moreover, BIS-11 data revealed significant reductions in impulsivity dimensions from baseline (Total Impulsiveness: M = 71) to T3 (Total Impulsiveness: M = 27), indicating reduced impulsivity. ASSIST data indicated effective interventions for substance abuse, with substance use declining from T1 (Total Substance Use: M = 45) to T3 (Total Substance Use: M = 20).

Conclusion: These results provide valuable insights for clinical practice, emphasizing the importance of comprehensive assessments and tailored treatment plans for individuals with ASPD and comorbid substance abuse. Further research is recommended to validate and expand upon these findings, with a focus on long-term treatment outcomes and underlying neurobiological mechanisms of ASPD.