Antisocial Personality Disorder Symptoms, Causes

The antisocial personality disorder (APD) is a type of mental condition characterized in that the person shows destructive behavior and has little respect for social norms. The person's way of thinking, their perception of situations and their way of relating to others is dysfunctional and destructive.

Typically, people with this disorder have little regard for right and wrong and often disregard the rights, feelings, and wishes of others. Antisocial people tend to treat others harshly, indifferently, or manipulating them. Even if they break the law or get in constant trouble, they show little guilt or remorse.

They may behave violently, lie, act impulsively, and have problems with drugs and alcohol. All this causes that people with this disorder are not able to lead a normal life and have responsibilities, such as having a job, training or building a family.

Article index

• 1 Difference between antisocial personality disorder and psychopathy
• 2 Symptoms
• 3 Causes of antisocial personality
• 4 Subtypes of antisocial personality
• 5 Diagnosis
  • 5.1 Diagnostic criteria according to DSM-IV
  • 5.2 ICD-10
• 6 Comorbidity
• 7 Treatment
• 8 Risk factors
• 9 Complications
• 10 Prevention
• 11 References

Difference between antisocial personality disorder and psychopathy

Although psychopathy is not a formally recognized mental disorder by the APA (American Psychiatric Association), it is considered a more severe form of antisocial personality disorder..

Although the relationship between psychopathic personality and APD is uncertain, the two syndromes do not clearly overlap. These are the characteristics of psychopathy:

• They do not feel empathy for people, and in general, for living beings.
• Although they are often "charming", they are unable to establish emotional bonds with other people.
• They tend to be manipulative and know how to gain the trust of others.
• Although it is difficult for them to feel emotions, they learn to show them.
• Therefore, they seem normal, they are not "rare".
• They usually lead normal lives, have good jobs, and are well educated..
• It is difficult to know if someone is a psychopath or not because they are very good at manipulating and pretending. 
• When they commit crimes (only a very small minority of psychopaths commit them), they do it in a planned way.
• They are calm, meticulous and some very charismatic. 
• They are usually leaders.
• According to specialist Robert Hare: “They seem smart, but they're not really especially bright. Some yes, of course. And when they are intelligent they are more dangerous ".

Symptoms

The characteristic signs and symptoms of APD are:

• Lying constantly to deceive others.
• Using the charm to manipulate other people.
• Intense egocentricity, sense of superiority, or exhibitionism.
• Recurring difficulties with the law.
• Repeatedly violating the rights of others by using bullying or dishonesty.
• Child abuse or neglect.
• Impulsiveness, aggressiveness, hostility, irritability, agitation.
• Lack of empathy for others and lack of remorse for hurting others.
• Dangerous or risky behaviors.
• Poor or abusive relationships.
• Inability to learn from negative consequences of behavior.
• Tendency to use drugs or alcohol.

Symptoms of APD can begin in adolescence and are evident in people in their 20s to 40s. In children, early signs can be observed in behaviors such as: cruelty towards animals, bullying, impulsivity or social isolation.

Although it is considered a lifelong disorder, some symptoms (especially criminal behavior and drug or alcohol use) can decrease over time. However, it is not known whether this reduction is due to age or awareness of the consequences of negative behavior.

Causes of antisocial personality

Personality is a combination of thoughts, emotions, and behaviors that make each person unique. Personality disorders appear to be a combination of genetic and environmental influences.

Hormones and neurotransmitters

Traumatic events can lead to the interruption of the normal development of the central nervous system, which generates a release of hormones that can change the normal pattern of development.

Criminals who have committed violent crimes tend to have higher levels of testosterone in their blood.

One of the neurotransmitters that have been studied in people with TPA is serotonin. A meta-analysis of 20 studies found significant low levels of 5-HIAA (indicating low serotonin levels), especially in people younger than 30 years..

Some studies have found a relationship between monoamine oxidase A and antisocial behavior, including TPA, in abused children. 

Cultural differences

Cultural norms differ significantly, and therefore disorders such as APD can be viewed differently depending on the country.

Robert Hare has suggested that the increase in TPA that has been reported in the United States may be related to changes in cultural mores..

Atmosphere

Some studies suggest that the social and family environment contribute to the development of antisocial behavior. Parents who display antisocial behaviors can pass them on to their children, who learn them by observation.

Brain injuries

Since 1980 some scientists have associated brain injuries, including damage to the prefrontal cortex, with the inability to make morally and socially acceptable decisions. Children with early damage to the prefrontal cortex may not develop moral or social reasoning.

On the other hand, damage to the amygdala can affect the ability of the prefrontal cortex to interpret feedback from the limbic system, which could result in uninhibited signals that manifest in aggressive behaviors.

Antisocial personality subtypes

Psychologist Theodore Millon suggests 5 subtypes of APD:

• Nomadic (includes schizoid and avoidant characteristics): feels jinx, failed, condemned. They are usually isolated or abandoned. May show resentment and anger at the slightest provocation.
• Malicious (includes sadistic and paranoid characteristics): belligerent, spiteful, vicious, evil, brutal, resentful; anticipates betrayal and punishment; wishes for revenge; gruesome, insensitive, fearless; no fault.
• Penny pincher (variant of the pure pattern): you feel intentionally rejected and deprived; bad attitude, discontent; envy, seek revenge, greed; more pleasure in drinking than in having.
• Risk taker (including histrionic characteristics): fearless, adventurous, audacious, daring; reckless, reckless, impulsive, inattentive; unbalanced by risk; chase dangerous adventures.
• Reputation defender (including narcissistic characteristics): needs to be considered as infallible, unshakable, invincible, indomitable, formidable, inviolable; defend their reputation with antisocial acts, aggressive leadership.

Diagnosis

When a healthcare professional thinks that a person may have APD, they can usually carry out a series of medical tests and examinations to help determine the diagnosis:

• Physical exam- Done to rule out other problems that may cause symptoms.
• Lab tests: can include for example a complete blood count or a thyroid function check.
• Psychological evaluation- Mental health professional assesses feelings, personal relationships, thoughts, family history, and behavior patterns. 

A person with APD may not confirm their actual signs and symptoms. Family and friends can help give information.

A key factor in the diagnosis is how the person relates to others. Someone with APD probably has a poor understanding and empathy for the feelings and way of thinking of others. 

Diagnostic criteria according to DSM-IV

A) A general pattern of contempt and violation of the rights of others that occurs from the age of 15, as indicated by three (or more) of the following items:

1. Failure to conform to social norms regarding legal behavior, as indicated by repeated acts that are grounds for arrest.
2. Dishonesty, indicated by repeatedly lying, using an alias, cheating others for personal gain or pleasure.
3. Impulsiveness or inability to plan for the future.
4. Irritability and aggressiveness, indicated by repeated physical fights or assaults.
5. Reckless disregard for your safety or that of others.
6. Persistent irresponsibility, indicated by the inability to maintain a job consistently or to assume financial obligations.
7. Lack of remorse, as indicated by indifference or justification for having harmed, mistreated, or stolen from others.

B) The subject is at least 18 years old.

C) There is evidence of a conduct disorder that begins before the age of 15.

D) Antisocial behavior does not appear exclusively during a schizophrenia or a manic episode.

ICD-10

According to the ICD (International Classification of Diseases), antisocial personality disorder is characterized by at least 3 of the following:

1. Indifference to the feelings of others.
2. Persistent attitude of irresponsibility and disregard for social norms and obligations.
3. Low tolerance for frustration and low threshold for the discharge of aggression, including violence.
4. Inability to experience guilt or to profit from the experience, particularly punishment.
5. Marked willingness to blame others or to offer plausible rationalizations for behavior that has brought the person into conflict with society.

Comorbidity

The following conditions typically coexist with TPA:

• Anxiety disorders.
• Depressive disorder.
• Substance use disorders.
• Somatization disorder.
• Attention deficit hyperactivity disorder.
• Borderline personality disorder.
• Histrionic personality disorder.
• Narcissistic personality disorder.

Treatment

TPA is difficult to treat; people with this disorder usually do not want to be treated or think they need it.

However, in order for them to function normally, long-term treatment is necessary..

Also, these people may need treatment for other conditions such as substance abuse, depression, or anxiety..

The best treatment or combination of treatments depends on the particular situation of each person or the severity of the symptoms.

Psychotherapy

Psychotherapy is not always effective, especially if the symptoms are severe and the person cannot admit that he or she contributes to their problems..

It can be given in individual sessions, in groups, with family or even with friends.

Medication

There is no specially approved medication to treat TPA. However, various types of psychiatric medication can help control aggression and other associated conditions..

These drugs can be: antidepressants, mood stabilizers and antipsychotics. They must be prescribed with care because they can be misused.

Family training

People who live with people with APD may need help. Mental health professionals can teach skills to learn to set limits and protect yourself from aggressiveness, violence, and hatred..

Risk factor's

Certain factors seem to increase the risk of developing APD:

• Diagnosis of conduct disorder in childhood or adolescence.
• Family history of APD or other personality disorder or mental illness.
• Having suffered physical, sexual or verbal abuse during childhood.
• Chaotic and unstable life during childhood.
• Having been through traumatic divorces during childhood.
• History of substance abuse in parents or other family members.
• Men are at higher risk.

Complications

The complications and consequences of APD can be:

• Participate in criminal gangs.
• Aggressive behavior or physical violence.
• Risky behavior.
• Child abuse.
• Substance abuse.
• Gambling problems.
• Go to jail.
• Problems with personal relationships.
• Occasional periods of depression or anxiety.
• Problems at school and work.
• Low socioeconomic status.
• Loss of housing.
• Early death.

Prevention

There is no sure way to prevent this personality disorder, although children at risk of developing it can be identified and early intervention offered.

Although APD is not usually diagnosed before the age of 18, children at risk may show some behavioral or aggressive symptoms:

• Abuse of other children.
• Conflicts with family members or authority figures.
• Steal.
• Cruelty to people and animals.
• Vandalism.
• Use of weapons.
• Lying repeatedly.
• Poor school performance.
• Participation in bands.
• Escape from home.

Early discipline, social skills training, family therapy, and psychotherapy can help reduce the risk of developing ASD..

And what experiences do you have with antisocial personality disorder??

References

1. Dissocial personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10).
2. Millon, Theodore - Personality Subtypes. Millon.net. Retrieved on 7 December 2011.
3. "Antisocial personality disorder". Mayo Foundation for Medical Education and Research. July 13, 2013. Retrieved October 25, 2013.
4. "Protect - Watch Your Head". The Franklin Institute Online. The Franklin Institute. 2004. Retrieved July 10, 2013.