Case Study 18-1: Comprehensive Assessment of a Patient With Antisocial Personality Disorder

James is a 27-year-old Caucasian male who presented at interview with expansive mood. Affect was friendly, engaging, and initially appropriate to words. He appeared well groomed, tall, and very muscular, wearing clean, expensive name-brand athletic wear, jeans, and sneakers. He was tanned, with large dark eyes and long eyelashes, highlighted by a single, blackish-blue, teardrop-shaped tattoo under one eye. (Interviewer aware that literature shows that some gang members have one tattooed teardrop under their eye as a symbol for each person's life they have taken.) James reported that last month he had been court ordered to go to counseling but skipped a few appointments, as he believed he knew more about life than the counselor. In a matter-of-fact way, he stated that because he missed counseling and had a fight with the mother of his 4-year-old son, he was arrested. He then presented as very remorseful, with intrusive eye contact, and stated, "The judge told me I had to resume counseling, so I'm ready to work on improving myself." He then leaned forward in his chair and stated, "I was in a gang for awhile but I gave up that life for the sake of my son."