November 2020
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Without a co‐occurring psychiatric illness, people diagnosed with antisocial personality disorder (ASPD) would not be subject to involuntary inpatient hospitalization. This chapter explains why ASPD does not and should not qualify for civil commitment, and analyzes the question of whether it should qualify for the lesser intrusion of preventive outpatient commitment. Civil commitment deprives the individual of the fundamental constitutional liberty in freedom from external restraint. Preventive outpatient commitment does not present the massive curtailment of liberty produced by involuntary hospitalization. However, it does constitute an invasion of constitutionally protected liberty. Without the full cooperation of the psychopathic individual and a genuine desire to change, it is unlikely that forced outpatient treatment will be effective. Thus, psychotherapeutic and cognitive behavioral interventions for those with ASPD would seem to be effective only to the extent the individual is motivated to change and cooperates fully in the therapeutic process.