AntiSocial Personality Disorder

The AntiSocial Personality Disorder is an official psychiatric diagnosis of a personality disorder.

Characteristics

The key factor in people with the AntiSocial Personality Disorder is the limited types of emotions experienced. The lacking is central in understanding the complete apathy towards the suffering of others. It is believed that daredevil behaviour and dangerous substance abuse is an attempt to transcend the lack of emotions. It is also believed that rage and anxiety are the only emotions that is common between those with the disorder and those without.

Through Freudian Psychoanalysis, this disorder can be assessed as the overpowering of the superego (responsible for conscious and moral behaviour) by the id (desire) and the ego (self).

A common misconception is that many of the individuals diagnosed with antisocial personality disorder can be found in prisons. Being a criminal does not necesarily mean that the person has an AntiSocial Personality disorder nor does it mean that one with the disorder is a criminal. Because of this the PCL-R tests, which rely on testing for the disorder based on criminal activity, has come into question. It is even hypothesized that many over-achievers may also have the disorder.

Research has shown that individuals with antisocial personality disorder are indifferent to the possibility of physical pain or many punishments, and show no indications that they experience fear when so threatened. This may explain their apparent disregard for the consequences of their actions, and their lack of empathy with the suffering of others. Although it is agreed upon by most psychiatrists that antisocial personality disorder is almost impossible to treat, there is some evidence that shows that they respond to impersonalized loss.

Diagnosis

Diagnostic criteria (DSM-IV-TR)

The Diagnostic and Statistical Manual of Mental Disorders, a widely used manual for diagnosing mental and behavioral disorders, defines antisocial personality disorder as a pervasive pattern of disregard for and violation of the rights of others occurring since age 15, as indicated by three (or more) of the following:

• failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
• deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
• impulsivity or failure to plan ahead
• irritability and aggressiveness, as indicated by repeated physical fights or assaults
• reckless disregard for safety of self or others
• consistent irresponsibility, as indicated by repeated failure to sustain steady work or honor financial obligations
• lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

The manual lists the following additional necessary criteria:

• the individual is at least age 18 years.
• there is evidence of conduct disorder with onset before age 15 years.
• the occurrence of antisocial behavior is not exclusively during the course of Schizophrenia or a Manic Episode.

A mnenomic to remember the traits is Corrupt:

C - cannot follow law O - obligations ignored R - remorseless R - recklessness U - underhandedness P - planning deficit T - temper

Diagnostic criteria (ICD-10)

Chapter V of the tenth revision of the International Classification of Diseases offers a set of criteria for diagnosing the related construct of dissocial personality disorder.

Dissocial Personality Disorder (F60.2), usually coming to attention because of a gross disparity between behaviour and the prevailing social norms, and characterized by:

• callous unconcern for the feelings of others;
• gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations;
• incapacity to maintain enduring relationships, though having no difficulty in establishing them;
• very low tolerance to frustration and a low threshold for discharge of aggression, including violence;
• incapacity to experience guilt or to profit from experience, particularly punishment;
• marked proneness to blame others, or to offer plausible rationalizations, for the behaviour that has brought the patient into conflict with society.

There may also be persistent irritability as an associated feature. Conduct disorder during childhood and adolescence, though not invariably present, may further support the diagnosis.

Potential warning signs

Though Antisocial personality disorder cannot be formally diagnosed before age 18, three warning signs, known as the MacDonald Triad, can be found in some children. These are:

1. a longer-than-usual period of bedwetting
2. cruelty to animals
3. pyromania

Obviously, not all children who exhibit these signs grow up to develop anti-social personality disorder, but these signs are found in significantly higher proportions than in the general population.

A child who shows signs of anti-social personality disorder will be diagnosed as having either conduct disorder or oppositional defiant disorder. Not all of these children will grow up to develop anti-social personality disorder.

Sources

• Cooke D. J., Michie C. "Refining the construct of psychopathy: Towards a hierarchical model." Psychological Assessment 13 (2): 171-188, 2001.
• Petronix., "The Sociopathic Bible". E-Book, Sociopathic.net 1-26, 2005.
• Myers, David G. Psychology. 7th ed. Worth, 2003.

External links

• Profile of a Sociopath?