BACKGROUND: Antisocial personality disorder (AsPD) is associated with a wide range of disturbance including persistent rule-breaking, criminality, substance misuse, unemployment, homelessness and relationship difficulties. OBJECTIVES: To evaluate the potential beneficial and adverse effects of pharmacological interventions for people with AsPD. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library 2009, Issue 3), MEDLINE (1950 to September 2009), EMBASE (1980 to 2009, week 37), CINAHL (1982 to September 2009), PsycINFO (1872 to September 2009) , ASSIA (1987 to September 2009) , BIOSIS (1985 to September 2009), COPAC (September 2009), National Criminal Justice Reference Service Abstracts (1970 to July 2008), Sociological Abstracts (1963 to September 2009), ISI-Proceedings (1981 to September 2009), Science Citation Index (1981 to September 2009), Social Science Citation Index (1981 to September 2009), SIGLE (1980 to April 2006), Dissertation Abstracts (September 2009), ZETOC (September 2009) and the metaRegister of Controlled Trials (September 2009). SELECTION CRITERIA: Controlled trials in which participants with AsPD were randomly allocated to a pharmacological intervention and a placebo control condition. Two trials comparing one drug against another without a placebo control are reported separately. DATA COLLECTION AND ANALYSIS: Three review authors independently selected studies. Two review authors independently extracted data. We calculated mean differences, with odds ratios for dichotomous data. MAIN RESULTS: Eight studies met the inclusion criteria involving 394 participants with AsPD. Data were available from four studies involving 274 participants with AsPD. No study set out to recruit participants solely on the basis of having AsPD, and in only one study was the sample entirely of AsPD participants. Eight different drugs were examined in eight studies. Study quality was relatively poor. Inadequate reporting meant the data available were generally insufficient to allow any independent statistical analysis. The findings are limited to descriptive summaries based on analyses carried out and reported by the trial investigators. All the available data were derived from unreplicated single reports. Only three drugs (nortriptyline, bromocriptine, phenytoin) were effective compared to placebo in terms of improvement in at least one outcome. Nortriptyline was reported in one study as superior for men with alcohol dependency on mean number of drinking days and on alcohol dependence, but not for severity of alcohol misuse or on the patient's or clinician's rating of drinking. In the same study, both nortriptyline and bromocriptine were reported as superior to placebo on anxiety on one scale but not on another. In one study, phenytoin was reported as superior to placebo on the frequency and intensity of aggressive acts in male prisoners with impulsive (but not premeditated) aggression. In the remaining two studies, both amantadine and desipramine were not superior to placebo for adults with opioid and cocaine dependence, and desipramine was not superior to placebo for men with cocaine dependence. AUTHORS' CONCLUSIONS: The body of evidence summarised in this review is insufficient to allow any conclusion to be drawn about the use of pharmacological interventions in the treatment of antisocial personality disorder. Language: en

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Psychological interventions for antisocial personality disorder

Cognitive distortions and blame attribution in sex offenders against adults and children

Introduction: Rethinking Subjectivity

People with experience as mental health clients, mental health nurses, writers and other professionals have used literature to benefit mental health service users in various ways. These include expressive writing, as well as applications in psychotherapy and counselling and to deal with specific problems and symptoms. In addition, therapeutic story-telling, bibliotherapy and poetry therapy have been used. Various benefits have been described, but some accounts do not include evidence of clinical effectiveness. However, positive treatment outcomes have been reported in research papers and other literature, with particular evidence of clinical effectiveness in some studies of bibliotherapy, therapeutic writing and poetry therapy. Further work is needed to clarify and measure the effectiveness of various expressive and therapeutic uses of literature. The authors also recommend collaboration among practitioners and the need for supporting evidence for proposals for increased resources in this field.

Fiction, poetry and mental health: expressive and therapeutic uses of literature.

I ask a reader to look at these sentences. They describe a familiar experience of most, if not all writers. What is of interest to me here, however, are those words I have marked in bold typeface. I wish to draw your attention to the physicality of those words I am poised physically and metaphorically; waiting for creative inspiration while also ‘inspiring’ (i.e. taking an inward breath); trying to squeeze out the words like play dough from my hands; the pain of writing. These are words of and about the body used metaphorically to express subjective experience. It seems that, not surprisingly since we live in and through our bodies, the use of ‘body metaphors’ to describe our experience is extremely common and as I will later discuss, it is often difficult to find means to describe subjective experience without their use. In this article I want to examine this closely and in doing so I will be relying heavily on the work of George Lakoff and Mark Johnson (1999). Their ideas about what they call ‘the embodied mind’ are, I will suggest, highly relevant to dramatherapy practice.

PHILOSOPHY IN THE FLESH: the embodied mind and Dramatherapy

This imaginative psychotherapy considers the aim of the Aeolian Mode in releasing an individual's creative energy by freeing that person from the restrictive legacy of the past.

Mutative Metaphors in Psychotherapy: The Aeolian Mode

Vol 1. Mainly Theory- Dr Christopher Cordess and Dr Murray Cox. Introduction: Transference. 1. General 2. Forensic aspects: Counter-transference 1. - 2. Forensic aspects: Defence Mechanisms 1. General 2. In offender patients: Sociology and Psychotherapy: Adolescence: Theoretical aspects of working with psychosis: Theories of sexual development and offending: Theories of aggression: Victimology and PTSD: Research Methods: Vol 2. Mainly Practice - Dr Murray Cox and Dr Christopher Cordess: Introduction (to include reference to gender and race issues):What to expect from Forensc Psychotherapy: The centrality of Supervision: A. Working with out-patients: Individual psychotherapy: Group Psychotherapy: Supportive psychotherapy in Forensic Practice: The abused mentally impaired: Day Hospital treatment for Borderline and psychotic patients: Working with adolescent delinquents: B. Working in secure settings: Sex offending: Psychodynamic treatment in Regional Secure Units: The Forensic patient and the Therapeutic Community: Psychodynamics and the Special Hospital: A psychotherapist in prison: A review of research:Training.

Forensic Psychotherapy: Crime, Psychodynamics and the Offender Patient

Structuring the therapeutic process

Foreword, Jessica Kingsley. Remorse and Reparation: `To Double Business Bound' Dr Murray Cox. Section 1. Clinical Perspectives. 1. Reflections on Remorse in Forensic Psychiatry Dr Andrew S. Horne, Broadmoor Hospital. 2. The Aginbite of Inwit, or, The Varieties of Moral Experience Dr James Gilligan, Harvard University. 3. Necessary but not Sufficient: the Personal View of a Psychiatric Member of the Parole Board Dr David Tidmarsh, Parole Board. 4. Psychoanalytic Aspects of Remorse and Reparation Cleo van Velsen, Analyst. 5. A Defective Capacity to Feel Sorrow: Interferences to the Development of Remorse and Reparation Dr Leslie Sohn, The Maudsley Hospital. 6. Feelings of Guilt and the Attribution of Blame for Criminal Acts Dr Gisli Gudjonsson, Institute of Psychiatry. 7. Remorse for Being: Through the Lens of Learning Disability Professor Sheila Hollins, St George's Hospital Medical School. Section 2. Legal Perspectives. 1. Remorse and Rehabilitation John Harding, Inner London Probation Service. 2. Remorse and Reparation - a Judicial Perspective His Honour Henry Palmer. Section 3. Remorse and Reparation from Other Perspectives. 1. Remorse and Reparation: a Philosophical Analysis Dr Alan Thomas, King's College London. 2. The Most Dreadful Sentiment: a Sociological Commentary Baroness Cox and Dr Michael Borgeaud, University of North London. 3. Un-doing: Social Suffering and the Politics of Remorse Professor Nancy Scheper-Hughes, University of California. 4. Representations of Remorse and Reparation in Classical Greece Dr Douglas Cairns, University of Leeds. 5. Cases of Conscience in the Universe of Shakespeare's Plays: `Abhorring of Himselfe is a Recovering of Himselfe' Professor John Wilks, Okayama University. 6. Kierkegaard and Remorse: Remorse as an Existentialist Concern Alice Theilgaard and Bjarne Jacobsen, University of Copenhagen. Bibliogaphy.

Remorse and reparation

Preface to the 1988 Edition. Prologue. Acknowledgements. Synopsis. 1. Orientation: The Centre of Gravity. 2. Terms of Reference. 3. The Sense of Self. 4. The Therapist's Personal World. 5. Transference and Countertransference. 6. Empathy. 7. The Therapist Speaks. 8. The Patient Speaks. 9. Boundaries of Therapeutic Space. 10. Numbers within Therapeutic Space. 11. Compromise with Chaos (Borderline, Psychotic and Offender-Patients). Closure. Postscript. Suggested Further Reading. References. Subject Index. Supplementary Literary Index.

Murray Cox

Papers

Mutative Metaphors in Psychotherapy: The Aeolian Mode

Forensic Psychotherapy: Crime, Psychodynamics and the Offender Patient

Structuring the therapeutic process

Remorse and reparation

Structuring the therapeutic process: Compromise with chaos--the therapist's response to the individual and the group