Mindfulness, alexithymia, and empathy moderate relations between trait aggression and antisocial personality disorder traits

Antisocial personality disorder (ASPD) has long been described focusing exclusively on behavioral features, like aggression. Although the role of mentalizing for aggression is well established, research on the role of mentalizing in ASPD remains limited. The present study examined the independent and interactive effects of mentalizing abilities and aggression in predicting ASPD traits in a violent male offender sample (N = 403). Participants completed self-report measures of ASPD traits, and a comprehensive assessment of mentalizing skills including measures of mindfulness, empathy, and alexithymia. Above and beyond the main effect of aggression, mindfulness, alexithymia, and empathy significantly explained an incremental amount of variance in ASPD traits in separate regression analyses. Further, mindfulness, alexithymia, and empathy significantly interacted with aggression in predicting ASPD scores. Findings suggest that among offenders with better mentalizing, aggression was significantly more strongly related to ASPD traits, indicating that at higher levels of mentalizing, only participants who also had higher levels of aggression scored higher on ASPD traits. Conversely, among offenders with poorer mentalizing, the positive association between aggression and ASPD traits was significantly weaker, indicating that poor mentalizing alone was sufficient to have high levels of ASPD traits (and aggression). Findings suggest that in some instances, mentalizing may not have a protective role on ASPD in the presence of very high levels of aggression. However, among offenders with poor mentalizing, treatments targeting aggression may not be successful in reducing ASPD traits. Interventions that aim at improving mentalizing may ultimately be more effective to treat aggression and ASPD among offenders