What Is Antisocial Personality Disorder?

Antisocial Personality Disorder

Antisocial personality disorder, also called sociopathy, is a type of personality disorder that is characterized by irresponsible, criminal, and impulsive behavior. A person with antisocial personality disorder is often reckless, dishonest, and manipulative with no regard for other people's feelings. 

This disorder is similar to other types of personality disorder on the spectrum since its severity may range from infrequent bad behavior to repeated law-breaking and criminal acts. Individuals with psychopathy have a severe form of antisocial personality disorder. 

Patterns of dangerous and harmful behavior are regarded as psychopathic or sociopathic. Much debate has been made about the description of these behaviors. When describing psychopaths, they tend to have a complete lack of conscience about other people, whereas sociopaths are mainly described as having an extremely wrong conscience. 

Experts describe people with this disorder as stone cold when it comes to other people's rights. The common complications of this disorder are alcoholism, drug abuse, and imprisonment. Even though people with this disorder may appear nice on the outside, they are more likely to be aggressive, irresponsible, and irritable on the inside. Because of their manipulative tendencies, it is quite difficult to tell whether they are telling the truth or not. They also tend to have a number of somatic complaints as well as suicide attempts. 

The disorder is more prevalent in males than in females with the highest prevalence in men with drug or alcohol abuse and those who are imprisoned or other forensic settings. 

Antisocial personality disorder is much more common in males than in females. The highest prevalence of antisocial personality disorder is found among males who abuse alcohol or drugs or who are in prisons or other forensic settings.

Causes 

Although the main cause of antisocial personality disorder is unknown, genes may make people more susceptible to develop the disorder, as well as certain life situations or events that may trigger its development. Another possible cause may be the changes in a person's brain function during brain development. 

Risk Factors

Below are factors that tend increase a person's risk of developing an antisocial personality disorder:

• A conduct disorder diagnosis during childhood
• A family history of the disorder, other personality disorders, or psychiatric disorders
• Childhood abuse or neglect 
• Growing up in a violent, unstable, and chaotic household

Men are also more prone to developing antisocial personality disorder than women. 

Signs and Symptoms

At least three of the following signs and symptoms should be present to diagnose antisocial personality disorder:

• Repetitive involvement in behaviors that are ground for arrest such as repeatedly breaking laws
• A failure of planning or thinking ahead
• Repeatedly cheats on relationships (telling lies, using others to gain profit or pleasure, and using false names)
• The tendency to show aggressiveness, anger, hostility, irritability, getting into frequent physical fights, and assaulting others repeatedly.
• Lack of self-control
• Lack of concern for other people's safety 
• Being irresponsible such as not being able to keep up with financial obligations, unable to develop a pattern of good habits, a lack of guilt for wrongdoings, and a disregard for other people's rights

Diagnosis

In most cases, people with antisocial personality disorder do not believe that they need help. However, they may seek help when they experience other symptoms, such as anxiety, depression, and violent outbursts, or for substance abuse treatment. It may be difficult for a person with antisocial personality disorder to provide specific signs and symptoms, so with permission, friends and family may be able to help when it comes to providing such information. 

After evaluating and ruling out other medical problems, healthcare providers may refer people with the disorder to mental health professionals to help provide further evaluation. A diagnosis of antisocial personality disorder is usually based on the following:

• Personal and family medical history
• Psychological testing that can help recognize behavior patterns as well as explore feelings, thoughts, and relationships
• Symptoms according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

Although the disorder is not usually diagnosed before 18 years old, the signs and symptoms of the disorder may occur during the early teenage years or childhood. Before reaching the age of 15, symptoms of conduct disorder may occur. Long-term outcomes may be improved when antisocial personality disorder is early identified. 

Treatment

Antisocial personality disorder can be difficult to treat, but some people find long-term treatment with a regular follow-up plan beneficial. Treatment may also vary and depend on the individual's specific condition or situation, symptoms, and cooperativeness in treatment. Treatment may include:

Psychotherapy

It is also called as talk therapy, which may be used for the treatment of antisocial personality disorder. This type of therapy may include treatment for substance abuse, management of anger and violent behavior, and treatment for other mental disorders. However, psychotherapy may not work if a person has severe symptoms along with the refusal to admit his or her contribution to creating serious problems. 

Medications

The Food and Drug Administration (FDA) has not approved specific medications for the treatment of antisocial personality disorder. However, healthcare providers may prescribe medications for certain associated conditions, such as depression, anxiety, and aggression. Drugs are often cautiously prescribed to avoid potential abuse or misuse.

• Clozapine - This is an antipsychotic medication that has shown promising results in men with antisocial personality disorder.

• Lithium and Carbamazepine - These drugs may help control impulsive behavior and aggression in people with antisocial personality disorder.

• Selective Serotonin Reuptake Inhibitors (SSRIs) - SSRIs may help improve the symptoms of general personality disorders, including anger. 

Democratic Therapeutic Communities (DTC)

There is evidence that community-based programs are an effective long-term treatment method for individuals with antisocial personality disorder. These programs are even increasingly becoming popular in prisons. 

Democratic therapeutic communities is a social therapy method that focuses on people's risk of offending and violent behavior, including their psychological and emotional needs. This type of therapy is usually based on small to large therapy groups. It often focuses on issues in the community and creating a good environment for both prisoners and staff. Vocational work and education may also be included as opportunities.  

The length of treatment would take 18 months for people to practice certain changes and put their knowledge and skills into practice. Self-motivation is one of the key factors in this type of therapy. An example would be the willingness of a person to work and be a part of a community, group participation, and participation in the democratic process. 

Complications

Below are some problems and complications of antisocial personality disorder:

• Drug or alcohol abuse
• Gang involvement or participation
• Homelessness or low socioeconomic status
• Premature death as a result of violence
• Suicidal or homicidal tendencies
• Spouse or child abuse/neglect
• Imprisonment
• Other mental health concerns such as depression or anxiety

Outlook

The success of treatment is often affected by a person's lack of connection between behavior and feelings. Treatment may only be sought after the referral of the legal system since people with the disorder hardly seek treatment on their own.

There is also limited effective treatment for the disorder because of patients not trusting their therapist and authority figures. Due to these factors, the outlook tends to be poor. However, criminal and aggressive behavior tend to decline as people with antisocial personality disorder age.