Naming the Problem

This chapter details the process of diagnosis and assessment of antisocial personality disorder (ASPD). The first step in evaluating patients is to construct an accurate history through a careful interview. Because lab tests, x-rays, and brain scans have little, if any, diagnostic value—aside from their capacity to rule out medical problems—the patient’s history is the most important basis for diagnosing ASPD. The chapter then considers mental status examination (MSE), the psychiatrist’s equivalent of the physical examination, and personality and cognitive testing. When the history has been pieced together, the time comes to consider potential explanations for the patient’s chief complaint and current problems, a process that results in the differential diagnosis, a set of possibilities ranked from most to least probable. Ultimately, psychiatric diagnosis carries several important functions and can help guide troubled patients to make important changes in their life.