Ilhaam Shaik
INTRODUCTION: ANTISOCIAL PERSONALITY DISORDER
Antisocial Personality Disorder is also known as Sociopathy and Sociopathic Personality, . It is a mental disorder in which the person shows no regard for what is right and wrong and ignores the feelings and rights of others. Individuals suffering with Antisocial Personality Disorder manipulate or treat others harshly. They love breaking laws, are deceitful, aggressive, show no guilt or remorse and loyalty to anyone.
They lie, behave violently, and have problems with drug ans alcohol use. They usually can’t fulfill responsibilities that is related to family, work or school.
They could be defaulting in debts, being reckless, impulsive, fail to plan ahead and aware of their lies and misdeed.
Antisocial Personality Disorder falls under Cluster B of Personality Disorders which also includes Boderline Personality Disorder, Narcissistic Personality disorder and Histrionic Personality Disorder
HISTORY:
In the 19th century, Philipp Pinnel called individuals with such Antisocial Personality traits as violently insane but those who did not show cognitive symptoms of insanity.
In the year 1835, James Prichard called it as moral insanity. It was used after an angered aristocrat who whilped a horse, kicked a dog to death and threw a peasant to well.
COMPONENTS OF ANTISOCIAL BEHAVIOUR:
Presence of conduct disorder before the age of 15 which includes behaviour such as stealing, running away from home, aggression towards people and animals, theft, destruction of property, misbehaving with siblings etc.
Continuation of these behaviour traits in adulthood as well in the form of prostituition, pimping etc.
SIGNS ANE SYMPTOMS:
●No regard for what is right and wrong.
●Lying or deceit and exploiting others.
●Being disrespectful of others.
●Manipulating others for personal gain and pleasure.
●Arrogance
●Sense of superiority
●Repeated problems with law and criminal behaviour.
●Violating rights of others through dishonesty.
●Fail to plan ahead.
●Acting charming and witty.
●Stealing and fighting often.
●Lack of empathy.
●Lack of remorse or guilt of harming others.
●Unnecessary risk taking.
●Abusive and unhealthy relationships.
●Failure to show constancy and responsibility.
●Walk out of jobs, children and spouses.
●Reckless and impulse behaviour.
PREVALANCE:
More seen in younger men than older men.
People belonging to poor socio economic background.
Comorbidity with substance abuse.
DIAGNOSIS OF THE DISORDER IS BASED ON:
Psychological evaluation exploring feelings, thoughts, relationships, behaviour pattern, and family history.
Medical and Personal history.
Symptoms listed in DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) that is published by American Psychological Association.
Typically this disorder isn’t diagnosed before the age of 18 although some signs and symptoms may occur in childhood.
CAUSES:
Personality is the combination of thoughts, behaviour and emotions that makes everyone distinct. It’s the way people view, understand and relate to the outside world, as well as how they view themselves. Personality is formed during childhood, which is shaped through an interaction of inherited tendencies and environmental factors.
The exact causes are unknown but the suspected causes are:
●Genes may make you vulnerable along with life situations (Environment) like childhood experiences like physical and sexual abuse and childhood psychopathology.
●Peer relations and family dynamics.
●Changes in the way the brain functions.
RISK FACTORS:
●Childhood Conduct Disorder.
●Family history or Antisocial Personality Disorder.
●Family history of other mental disorders.
●Abuse during childhood.
●Unstable and chaotic family life.
COMPLICATIONS:
●Child and spouse abuse.
●Alcohol or substance use.
●Imprisonment
●Suicidal behaviour
●Having other mental health disorders.
●Poor socio economic background.
●Premature death due to violence.
DIAGNOSIS AND TREATMENT:
The DSM-5 diagnostic criteria for Antisocial Personality Disorder:
A pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three (or more) of the following:
●Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
●Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
●Impulsivity or failure to plan.
●Irritability and aggressiveness, often with physical fights or assaults.
●Reckless disregard for the safety of self or others.
●Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.
●Lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person.
●The individual is at least age 18 years.
●Evidence of conduct disorder typically with onset before age 15 years.
●The occurrence of antisocial behavior is not exclusively during schizophrenia or bipolar disorder.”
The disorder is hard to treat as the individuals suffering do not report it themselves while the others around them have to so close follow up over the long terms may help.
Behavioural therapy and Psychotherapy is known to help in individual and group settings. Psychotherapy (Talk Therapy) includes anger and voilence management, treatment for other mental conditions and treatment for alcohol or substance misuse.
There aren’t any medications for the disorder rather there are some for the symtoms associated with it such as anxiety, depression and aggression. Psychiatric medications like mood stabilizers is also used to treat symptoms like impulsive aggression.
COPING AND SUPPORT:
People suffering from Antisocial Personality Disorder make lives miserable of those around them without any feelings of guilt or remorse. People around them must also seek help and it gets distressing.
A counsellor or a mental health professional helps you to learn to set limits or boundaries and protect themselves from anger, aggression and violence that is common to Antisocial Personality Disorder. There are various coping strategies.
The family members and friends must seem help from professionals with adequate experience and training in managing Antisocial Personality Disorder. They may also suggest support groups for family and friends.
REFERENCES:
Pagán, C. N. (2014, March 25). Antisocial Personality Disorder. WebMD. https://www.webmd.com/mental-health/antisocial-personality-disorder-overview
Antisocial personality disorder – Symptoms and causes. (2019, December 10). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928
Harvard Health Publishing. (2019). Antisocial Personality Disorder. Harvard Health. https://www.health.harvard.edu/a_to_z/antisocial-personality-disorder-a-to-z
American Psychiatric Association. Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013;659-663.
NHS website. (2018, June 11). Antisocial personality disorder. Nhs.Uk. https://www.nhs.uk/conditions/antisocial-personality-disorder/
