Antisocial Personality Disorder

By Isabella Cerase


What Is It?

Personality disorders represent “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture” per the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5); it is a mental disorder in which is present an unhealthy pattern of thinking, functioning, and behaving. Antisocial personality disorder (ASPD), like other personality disorders, is a longstanding pattern of behavior and experience that limit functioning and causes distress.


By definition, people with antisocial personality disorder don't follow society's norms, are intimidating in relationships, and are inconsiderate of the rights of others; people with this type of personality can be impulsive, reckless, and sometimes violent and may take part in criminal activity but if they do, they are not sorry for their hurtful deeds. (Harvard Health Publishing, 2019). This disorder is far more common and more apparent in men than women, with men 3 to 5 times more likely of being diagnosed with ASPD than females, with 6% men and 2% women within the general population (Fisher & Manassa Hany, 2019).


Symptoms

According to the American Psychology Association, manifestations include repeated violations of the law, exploitation of others, deceitfulness, impulsivity, aggressiveness, reckless disregard for the safety of self and others, and irresponsibility, accompanied by lack of guilt, remorse, and empathy. ASPD seem to be products of a strong genetic disposition interacting with a variety of environmental contributions. (Derefinko & Widiger, 2008) A role model or parent with ASPD will more likely lead to antisocial behavior growing up.




Like other types of personality disorder, antisocial personality disorder is on a spectrum, which means it can range in severity from occasional bad behavior to repeatedly breaking the law and committing serious crimes. ASPD is closely related with the diagnosis of psychopathy. Criminal behavior is a key feature of antisocial personality disorder, and there is a high risk that someone with the disorder will commit crimes and be imprisoned at some point in their life. Men with antisocial personality disorder have been found to be 3 to 5 times more likely to misuse alcohol and drugs than those without the disorder and have an increased risk of dying prematurely. People with antisocial personality disorder are also more likely to have relationship problems during adulthood and be unemployed and homeless (NHS Choices, 2019).



Treatment

A diagnosis can only be made if the person is aged 18 years or older and at least 3 of the criteria needed. Antisocial personality disorder is the only personality disorder that is not diagnosable in childhood. Before the age of 18, the patient must have been previously diagnosed with conduct disorder (CD) by the age of 15 years old to justify diagnostic criteria for ASPD (DSM-5, American Psychiatric Association, 2013).


Behavior can improve overtime with therapy. Therapy may include, for example, anger and violence management, treatment for alcohol or substance misuse, and treatment for other mental health conditions. But psychotherapy is not always effective, especially if symptoms are severe; There are no medications specifically approved by the Food and Drug Administration to treat antisocial personality disorder.


Doctors may prescribe medications for conditions sometimes associated with antisocial personality disorder, such as anxiety or depression, or for symptoms of aggression. Certain drugs are usually prescribed cautiously because they have the potential for misuse (Antisocial personality disorder - Diagnosis and treatment - Mayo Clinic, 2017).


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