About antisocial personality disorder

What is antisocial personality disorder?

A personality disorder (PD) is a persistent pattern of thoughts, feelings, and behaviors that is significantly different from what is considered normal within the person's own culture.

  • Personality disorders are grouped into clusters A, B, and C based on the dominating symptoms.
  • Antisocial personality disorder is specifically a pervasive pattern of disregarding and violating the rights of others and may include symptoms such as breaking laws, frequent lying, starting fights, lack of guilt and taking personal responsibility, and the presence of irritability and impulsivity.
  • Psychopathy is considered to be a more severe form of antisocial personality disorder. Specifically, in order to be considered a psychopath, an individual must experience a lack of remorse or guilt about their actions in addition to demonstrating antisocial behaviors.
  • Psychopaths tend to be highly suspicious or paranoid, even in comparison to individuals with antisocial personality disorder, which tends to lead the psychopathic person to interpret all aggressive behaviors toward them as being arbitrary and unfair.
  • Antisocial personality disorder is likely the result of a combination of biologic/genetic and environmental factors.
  • Some theories about the biological risk factors for antisocial personality disorder include dysfunction of certain genes, hormones, or parts of the brain.
  • Diagnoses often associated with antisocial personality disorder include substance abuse, attention deficit hyperactivity disorder (ADHD), and reading disorders.
  • Theories regarding the life experiences that put people at risk for antisocial personality disorder include a history of childhood physical, sexual, or emotional abuse; neglect, deprivation, or abandonment; associating with peers who engage in antisocial behavior; or having a parent who is either antisocial or alcoholic.
  • Since there is no specific definitive test that can accurately assess the presence of antisocial personality disorder, health-care professionals conduct a mental-health interview that looks for the presence of antisocial symptoms. If the cultural context of the symptoms is not considered, antisocial personality disorder is often falsely diagnosed as being present.
  • Research indicates ethnic minorities tend to be falsely diagnosed as having antisocial personality disorder, inappropriately resulting in less treatment and more punishment for those individuals.
  • Although antisocial personality disorder can be quite resistant to treatment, the most effective interventions tend to be a combination of firm but fair programming that emphasizes teaching the antisocial personality disorder individuals skills that can be used to live independently and productively within the rules and limits of society.
  • While medications do not directly treat the behaviors that characterize antisocial personality disorder, they can be useful in addressing conditions like depression, anxiety, and mood swings that co-occur with this condition.
  • If untreated, people with antisocial personality disorder are at risk for developing or worsening a myriad of other mental disorders. Antisocial personality disorder individuals are also at risk for self-mutilation or dying from homicide or suicide.
  • Many people with antisocial personality disorder experience a remission of symptoms by the time they reach 50 years of age.

Cluster A personality disorders are those that include symptoms of social isolation, and/or odd, eccentric behavior. These disorders include

  • paranoid personality disorder,
  • schizotypal personality disorder,
  • schizoid personality disorder.

Cluster B personality disorders are those that include symptoms of dramatic or erratic behaviors (counter-social behaviors). These personality disorders include

  • antisocial personality disorder,
  • borderline personality disorder,
  • histrionic personality disorder,
  • narcissistic personality disorder.

Cluster C personality disorders are dominated by difficulties with anxiety and inhibited behavior. These disorders are referred to as and include

  • avoidant personality disorder,
  • dependent personality disorder,
  • obsessive compulsive personality disorder (OCD).

What are the symptoms for antisocial personality disorder?

Antisocial personality disorder signs and symptoms may include:

  • Disregard for right and wrong
  • Persistent lying or deceit to exploit others
  • Being callous, cynical and disrespectful of others
  • Using charm or wit to manipulate others for personal gain or personal pleasure
  • Arrogance, a sense of superiority and being extremely opinionated
  • Recurring problems with the law, including criminal behavior
  • Repeatedly violating the rights of others through intimidation and dishonesty
  • Impulsiveness or failure to plan ahead
  • Hostility, significant irritability, agitation, aggression or violence
  • Lack of empathy for others and lack of remorse about harming others
  • Unnecessary risk-taking or dangerous behavior with no regard for the safety of self or others
  • Poor or abusive relationships
  • Failure to consider the negative consequences of behavior or learn from them
  • Being consistently irresponsible and repeatedly failing to fulfill work or financial obligations

Adults with antisocial personality disorder typically show symptoms of conduct disorder before the age of 15. Signs and symptoms of conduct disorder include serious, persistent behavior problems, such as:

  • Aggression toward people and animals
  • Destruction of property
  • Deceitfulness
  • Theft
  • Serious violation of rules

Although antisocial personality disorder is considered lifelong, in some people, certain symptoms — particularly destructive and criminal behavior — may decrease over time. But it's not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.

When to see a doctor

People with antisocial personality disorder are likely to seek help only at the urging of loved ones. If you suspect a friend or family member may have the disorder, you might gently suggest that the person seek medical attention, starting with a primary care physician or mental health professional.

What are the causes for antisocial personality disorder?

Personality is the combination of thoughts, emotions and behaviors that makes everyone unique. It's the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

The exact cause of antisocial personality disorder isn't known, but:

  • Genes may make you vulnerable to developing antisocial personality disorder — and life situations may trigger its development
  • Changes in the way the brain functions may have resulted during brain development

What are the treatments for antisocial personality disorder?

Another very common question asked is, can antisocial personality disorder be cured? While it can be quite resistant to change, research shows there are a number of effective treatments for this disorder. For example, teenagers who receive therapy that helps them change the thinking that leads to their maladaptive behavior (cognitive behavioral therapy) have been found to experience a significant decrease the incidence of engaging in repeat antisocial behaviors.

On the other hand, attempting to treat antisocial personality disorder like other conditions is not often effective. For example, programs that have tried to use a purely reflective (insight-oriented) approach to treating depression or eating disorders in people with antisocial personality disorder often worsen rather than improve outcomes in those individuals. In those cases, a combination of firm but fair programming that emphasizes teaching individuals with antisocial personality disorder the skills that can be used to live independently and productively within the rules and limits of society has been the more effective treatment for this condition.

While medications do not directly treat the behaviors that characterize antisocial personality disorder, they can be useful in addressing conditions that co-occur with this condition. Specifically, depressed or anxious individuals who also have antisocial personality disorder may benefit from antidepressants, and those who exhibit impulsive anger may improve when given mood stabilizers.

What are the risk factors for antisocial personality disorder?

Certain factors seem to increase the risk of developing antisocial personality disorder, such as:

  • Diagnosis of childhood conduct disorder
  • Family history of antisocial personality disorder or other personality disorders or mental illness
  • Being subjected to abuse or neglect during childhood
  • Unstable, violent or chaotic family life during childhood

Men are at greater risk of having antisocial personality disorder than women are.

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