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Antisocial Personality Disorder
The term "anti-social" is used to describe people who choose to be alone and resist spending a significant amount of time with those around them. However, "asocial" more accurately describes this lack of involvement in social activity. Asocial describes a general lack of interest in society and interaction with people, but it does not imply a person holds particular ill will or malicious intent against others. However, when a "personality disorder" term is added to the word "antisocial," it changes the whole meaning of it and becomes something different and more complex disorder. It extends beyond a general distaste or avoidance of community and society.
What is Antisocial Personality Disorder?
These antisocial personality traits differ greatly from those suffering from the disorder. An individual's personality is what usually distinguishes them from others, and it is composed of various psychological traits or characteristics that determine an individual's preferences and behavioral style. Two major factors influencing a person's personality are inherited traits and the environment (nature and nurture). When a person's personality is involved in activities that demand high risk or involve a criminal act, that individual is said to suffer from an antisocial personality disorder.
Defining Antisocial Personality Disorder
An antisocial personality disorder is a severe personality disorder that requires immediate treatment. People that match the criteria for ASPD are often hostile toward others. It is a rigid, dysfunctional cognitive process in an individual who violates, manipulates, and exploits other people's rights and harms others through their aggression and impulsive behavior. They lack remorse and do not believe that there is any problem with their behavior. People with antisocial personality disorder lie and commit fraud despite being charming, clever, and fun to be with. The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classifies the ten personality disorders into clusters A, B, and C. Antisocial personality disorder falls into cluster b along with borderline, narcissistic, and histrionic personality disorders. Research has shown that people with antisocial personality disorders are believed to be violent, evil, dangerous, and impossible to treat. The newer diagnosis system includes related but not identical conditions in antisocial personality disorder, psychopathy, and sociopathy. These terms are not used to describe ASPD, but traits of it may overlap with those of sociopaths and psychopaths. There has been a long fascination with serial killers like Ted Bundy, also known as the psychopath. Popular fictional characters exemplify the traits of psychopathy, which makes the viewers form an attachment to their character and charm.
A psychopath is a term used to define people whose harmful actions toward other individuals tend to be a result of manipulation and cunningness. They act out empathy for others rather than feeling those emotions themselves. They are charismatic and charming. A psychopath is a severe form of antisocial personality disorder. Sociopaths, however, can form close connections with others but still violate social norms. They tend to be easily agitated and are more impulsive than people with psychopath traits.
Complications in ASPD
The only personality disorder that cannot be diagnosed in childhood or before the age of 18 is antisocial personality disorder. People with this disorder are usually diagnosed with conduct disorder. Children diagnosed with conduct disorder may ignore the rules, bully others, lie or steal. The symptoms and signs can overlap with other conditions such as attention deficit hyperactivity disorder, depression, etc. Children diagnosed and treated earlier may not develop disorders in adulthood, whereas the continued behavior turns into an antisocial personality disorder. Individuals with it may disregard consequences and refuse to take responsibility for their course of action. A person with an anti-social personality disorder is at a higher risk of developing viral infections and sexually transmitted diseases, which come along with the high risk-taking acts. They also have an increased mortality rate due to traumatic incidence, injuries, homicides, accidents, and suicides.
Research suggests that about 1–4% of the general population fall under the umbrella of antisocial personality disorder in their lifetime. It has been found that males are 3 to 5 times more likely to be diagnosed with ASPD than females. The gender distribution includes 6% of men and 2% of women in the general population diagnosed with ASPD. Substance abuse is positively correlated, and education and intelligence negatively correlate with ASPD diagnosis.
Factors Contributing to the Cause
There is no single cause for ASPD, but factors such as the following may increase the risk of developing this disorder −
Chemical factors such as unusual levels of serotonin
Environmental factors such as trauma or abuse in early childhood
Genetics factor can predispose individuals
Lifestyle factors such as substance abuse
Signs and Symptoms
An anti-social personality disorder's diagnosis is based on psychological evaluation, which generally includes exploring an individual's feelings, thoughts, relationships, and behavior patterns along with a personal and family medical history of that individual and at least one symptom from the following pattern. These may be seen in an individual in a given period of 12 months −
- Acting rashly
- Manipulate or deceive others
- Lack of empathy
- Lack of remorse for their behavior
- Violate or break the law
- Physical anger or aggressive behavior
Per the DSM 5 criteria, the diagnosis of antisocial personality disorder focuses on behaviors usually related to Criminal actions. Research shows concerns around this have been raised that sometimes diagnosis may be misinterpreted to individuals from low socioeconomic or urban settings in which Antisocial behavior may be a part of their protective living strategy; therefore, this disorder prevalence may have been overstated.
The term differential diagnosis means distinguishing between various conditions with similar symptoms. Certain disorders mimic antisocial personality disorder, so making the right diagnosis is important. These disorders include:
Treatment for antisocial personality disorder is difficult for several reasons. Namely, people rarely seek treatment on their own as they do not believe there is something wrong with them or others who receive treatment, only when they have legal action taken against them. In such conditions, individuals are not usually responsive to punishment. Therefore, it is best to have the right diagnosis at the right time.
Cognitive behavioral therapy has effectively changed maladaptive cognitive patterns into organized and healthy behaviors. It helps to gain insight into an individual's behavior and cognitive processes. Group therapy, family therapy, and mentalization-based therapy are also included in the treatment process.
Such as anti-anxiety medications, anti-depressants, antipsychotics, and mood stabilizers may be used and prescribed in the treatment course.
Individuals with antisocial personality disorder have been shown to be dysfunctional in various areas of life, making it difficult to cope with current living situations. Seeking a mental health professional and support from the family is helpful, along with learning skills to set boundaries to protect themselves from anger, violence, and common symptoms of antisocial personality disorder. Successful treatment and coping strategies can improve the well-being and quality of life of an individual suffering from anti-social personality disorder and positively impact their lives.
Individuals with antisocial personality disorder have a poor sense of morality and ethics. They are aggressive, impulsive, and involve themselves in high-risk activities, even criminal activities such as fraud or gambling. People with ASPD do not feel guilty or lack empathy for others. Treatment is aimed at reducing their impulsive and high-risk activities, along with a change in their actual behavior. This helps to increase their wellbeing and overall quality of life. It is critical to obtain the correct diagnosis as soon as possible in order to avoid any other complications associated with social personality disorder.
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