What is Antisocial Personality Disorder?

He Antisocial personality disorder (TPA) is a type of mental condition characterized by the person exhibiting destructive behavior and having little respect for social norms.

The person's way of thinking, his perception of situations and his way of relating to others is dysfunctional and destructive.

Usually people with this disorder have little regard for good and evil and often ignore the rights, feelings and desires of others.

Antisocial people tend to treat others with hardness, indifference, or manipulation.

Although they break the law or get into constant trouble, they show little guilt or remorse.

They can behave violently, lie, act impulsively, and have problems with drugs and alcohol.

All this causes people with this disorder are not able to lead a normal life and have responsibilities, such as having work, training or build a family.

Difference between antisocial personality disorder and psychopathy

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

Although the relationship between psychopathic personality and TPA is uncertain, the two syndromes do not overlap clearly.

These are the characteristics of psychopathy:

• They do not feel empathy By people, and in general, by living beings.
• Although often"charming,"they are unable to establish emotional bonds with other people.
• They are usually manipulative and they know how to gain the trust of others.
• Although they find it difficult to feel their emotions, they learn to show them.
• Therefore, they seem normal, they are not"rare".
• They normally lead a normal life, 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 so in a planned way.
• They are calm, meticulous and some very charismatic.
• They tend to be leaders.
• According to the specialist Robert Hare :"They look smart, but they really are not especially bright. Some of them, of course. And when they are intelligent they are more dangerous."

The symptoms of TPA can begin in adolescence and are evident in people in the 20 to 40 years.

In children, early signs of behavior such as cruelty to animals, bullying , Impulsiveness or social isolation.

Although considered a lifelong disorder, some symptoms (especially criminal behavior and use of drugs or alcohol) may decline over time. However, it is not known whether this reduction is due to age or to the 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.

It seems that personality disorders are a combination of genetic and environmental influences.

Hormones and neurotransmitters

Traumatic events can lead to disruption 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 APT is the Serotonin . A meta-analysis of 20 studies found low significant levels of 5-HIAA (indicating low levels of serotonin), 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 TPA can be seen 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 customs.

Environment

Some studies suggest that the social and family environment contribute to the development of antisocial behavior.

Parents who exhibit antisocial behaviors can pass them on to their children, who learn them by observation.

Brain Injury

Since 1980 some scientists have associated brain injuries, including Prefrontal cortex , With the inability to make moral 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 may affect the ability of the prefrontal cortex to interpret limbic system , Which could result in uninhibited signals manifested in aggressive behavior.

Antisocial personality subtypes according to Theodore Millon

The psychologist Theodore Millon Suggests 5 subtypes of TPA:

• Nomadic (Includes schizoid and avoidant features): feels gafe, failed, condemned. They are usually isolated or abandoned. They 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; Desires of revenge; Truculent, insensitive, without fear; Without fault.
• Penny pincher (Variant of pure pattern): feels intentionally rejected and private; Bad attitude, discontent; Envy, seek revenge, greed; More pleasure in taking than in having.
• Risk taker (Including histrionic characteristics): intrepid, adventurous, audacious, atrevid; Rash, reckless, impulsive, not paying attention; Unbalanced by risk; Pursues dangerous adventures.
• Reputation defender (Including narcissistic characteristics): needs to be regarded as infallible, unshakable, invincible, indomitable, formidable, inviolable; Defend their reputation with antisocial acts, aggressive leadership.

Diagnosis

When a health care professional thinks that a person can have TPA, he can usually perform a series of tests and medical tests to help determine the diagnosis:

• Physical exam : Is performed to rule out other problems that may cause the symptoms.
• Lab tests : May include, for example, a complete blood count or thyroid function check.
• Psychological evaluation : The mental health professional evaluates feelings, personal relationships, thoughts, family history, and behavioral patterns.

It is likely that a person with APT will not confirm their actual signs and symptoms. Family and friends can help give information.

A key factor for diagnosis is how the person relates to others. Someone with TPA probably has 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 comes from the age of 15, as indicated by three (or more) of the following items:

1. Failure to adapt to social norms in regard to legal behavior, as indicated by repeatedly perpetrating acts that are grounds for detention.
2. Dishonesty, indicated by lying repeatedly, using an alias, defrauding others for personal gain or pleasure.
3. Impulsivity or inability to plan for the future.
4. Irritability and aggressiveness, indicated by repeated physical fights or aggressions.
5. Reluctant unconcern for your safety or that of others.
6. Persistent irresponsibility, indicated by the inability to keep a job with constancy or to take care of economic obligations.
7. Lack of remorse, as indicated by the indifference or justification of having damaged, mistreated or robbed others.

B) The subject is at least 18 years old.

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

D) Antisocial behavior does not appear exclusively in the course of schizophrenia or a manic episode.

ICD-10

According to the CIE ( 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 take advantage of experience, in particular punishment.
5. Marked willingness to blame others or to offer plausible rationalizations for the behavior that has led the person in conflict with society.

Comorbidity

The following conditions normally coexist with the TPA:

• Anxiety disorders .
• Depressive disorder .
• Substance use disorders.
• Somatization disorder .
• Attention Deficit Hyperactivity Disorder .
• Boundary personality disorder .
• Histrionic Personality Disorder .
• Narcissistic Personality Disorder .

Treatment

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

However, long-term treatment is necessary to achieve normal functioning.

In addition, 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 can not admit that he or she contributes to their problems.

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

Medication

There is no medication specifically approved to treat TPA.

However, several types of psychiatric medication can help control the aggressiveness and other associated conditions.

These drugs may be: Antidepressants , Mood stabilizers and Antipsychotics . They should be prescribed with care because they can be misused.

Family Training

People living with people with APD may need help. Mental health professionals can teach skills to learn to set boundaries and protect yourself from aggression, violence, and hate.

Risk factor's

Certain factors appear to increase the risk of developing TPA:

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

Complications

The complications and consequences of TPA may be:

• Participate in criminal gangs.
• Aggressive behavior or physical violence.
• Risk behavior.
• Abuse of children.
• Substance abuse .
• Problems with betting.
• 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 safe way to prevent this personality disorder, although children at risk of developing it can be identified and offer early intervention.

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

• Abuse of other children.
• Conflicts with family members or authority figures.
• Steal.
• Cruelty with 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 TPA.

And what experiences do you have with antisocial personality disorder?

References

1. American Psychiatric Association (2000). "Diagnostic criteria for 301.7 Antisocial Personality Disorder". BehaveNet. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Retrieved 8 July 2013.
2. Dissocial personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10).
3. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision.
4. Millon, Theodore - Personality Subtypes. Millon.net. Retrieved on 7 December 2011.
5. "Antisocial personality disorder". Mayo Foundation for Medical Education and Research. 13 July 2013. Retrieved 25 October 2013.
6. Sutker, Patricia B., and Albert N. Allain, Jr."Antisocial Personality Disorder."Comprehensive Handbook of Psychopathology. Vol. III. : Springer US, 2002. 445-90. Google Scholar. Web. 13 March 2013.
7. Gatzke L.M, Raine A. (2000). Treatment and Prevention Implications of Antisocial Personality Disorder [1] Current Science Inc. Department of Psychology, University of Southern California. 2: 51-55.
8. "Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion". Robert D. Hare, PhD Psychiatric Times. Vol. 13 No. 2. 1 February 1996.
9. Moore TM, Scarpa A, Raine A. (2002). "The meta-analysis of serotonin metabolite 5-HIAA and antisocial behavior". Aggressive Behavior. 28 (4): 299-316. Doi: 10.1002 / ab.90027.
10. "Protect - Watch Your Head". The Franklin Institute Online. The Franklin Institute. 2004. Retrieved 10 July 2013.