What is Antisocial Personality Disorder?
Antisocial personality disorder is attributed to someone who has an long term pattern of being reckless, manipulative and deceitful. They will have total disregard for the feelings and rights of other people and think nothing of violating them.
This disorder is a mental health condition that generally starts in childhood or adolescence and continues as an adult. Behaviors are often impulsive and irresponsible and lead to criminality.
Three and half percent of adults in the US, which equates to approximately 7.6 million, have this disorder. (1)
Antisocial personality disorder is also known as sociopathic personality disorder. (2)
Symptoms
People with this condition will not recognize the symptoms themselves. The symptoms generally become evident in childhood but only people over 18 years old can be diagnosed. These symptoms include: (3)
Failure to Comply to Social Norms
One clear sign of antisocial personality disorder is the complete lack of respect for what is right and wrong. They will break the law regardless of the consequences and will not feel guilty or remorseful. This can happen time and again because they don’t learn from their mistakes. (4)
Deceitfulness
Lying, manipulation and a total disregard for the truth are common traits of this disorder and very often this will be for the person’s own benefit or gain. They are able to sense vulnerabilities in others and manipulate them to get what they want. They can also appear quite charming and witty if it means they are going to get something out of it. (5)
Aggressiveness
People with this disorder will often be aggressive showing violence and hostility towards others. They are likely to have adverse reactions to situations in which they feel frustrated or provoked. (6)
Impulsiveness
Unlike most of us, the ability to control impulses is not present in people with antisocial behavior disorder.
They tend to act on the spur of the moment for immediate gratification without planning ahead. For example, they may steal a car just because they want to get home quickly rather than wait for a bus. (7)
Recklessness
Behaving in a manner with total disregard for safety of themselves or others is not uncommon. They will likely set fire to a building without wondering about the dire consequences. (8)
Irresponsibility
Irresponsibility in all aspects of daily life, especially in the workplace, is another trait of this disorder. People can feel that don’t have to answer to anyone but themselves and can do what they want regardless.
Even though people with this disorder are capable of appearing amenable they remain detached and will resist authority from anyone. (9)
Lack of Remorse
People with this disorder will be completely indifferent to any harm they cause others.
They will steal from or manipulate those closest to them and won’t think twice about the repercussions it will have. As long an action meets their own ends they simply don’t care about the outcome it can have on others.
They will also not feel sorry for their behavior under any circumstances. (10)
Low Morals
Moral guidelines society sets for us are generally not observed by sufferers of this disorder. They feel ethical standards which apply to the rest of us don’t relate to them. (11)
Lack of Empathy
Being empathetic means we are able to step into someone else’s shoes and see how they feel. This ability is lacking in people with antisocial personality disorder.
They have no idea how they are perceived and don’t care how their behavior affects other people’s feelings. As a result they can be cruel and may be socially awkward. (12)
Personal Relationships
In line with previous symptoms it follows suit that people with this disorder find it difficult to maintain close personal relationships. Due to their ability to display charm and wit they may form relationships easily however, sustaining them is a different matter.
Antisocial personality disorder poses a substantial risk for physical and psychological abuse in close interpersonal relationships. (13)
Stages
As with many psychological disorders there are no stages as such for this condition.
There are however guidelines set out around diagnosis. These criteria are symptom and history based.
There are two separate sets of criteria. The first set is for general for personality disorders and is defined as:
“an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the person’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment”. (14)
The second set is specific to antisocial personality disorder. We will look at those specific to this condition. (15)
Criteria A
There are seven individual symptoms that can be displayed within this criteria, they are: criminal behavior, deceitfulness, impulsiveness, aggression, recklessness, irresponsibility and lack of remorse.
Criteria B
A person must be at least 18 years old.
Criteria C
There is evidence of behavioral misconduct from the age of 15 years or less.
Criteria D
The antisocial behavior does not happen only during the course of schizophrenia or a manic episode.
For diagnosis a person will have a general personality disorder and display at least one of the traits in criteria A as well as the criteria B, C and D.
Treatment
This disorder is one of the most difficult personality disorders to treat. It is unlikely that someone with the condition will seek treatment of their own accord. They may only be diagnosed when ordered to undergo treatment by authorities after criminal events.
However, there are treatments available which can help manage the condition. It is possible that other conditions may coexist like anxiety or depression.
Psychotherapy
Cognitive Behavioral Therapy (CBT)
This talking therapy can be used to treat antisocial personality disorder. It aims to help people change the way in which they perceive themselves and others. It also aims to address their problems by altering the way they behave and think. (16)
Mentalization Based Therapy (MBT)
MBT is another talking treatment that targets the recognition and understanding of how a person’s mental state affects their behavior. (17)
Democratic Therapeutic Communities
This group therapy can be conducted in a prison, health or social care setting. It creates an environment which encourages the formation of close relationships within the group.
They learn to work as a democratic community taking responsibility for themselves and others. This in turn helps people to recognise their negative behaviours and learn how to deal with them. (18)
Medication
There is not much evidence around the use of medication being effective for treating antisocial personality disorder.
There are drugs that can be used to address some of the symptoms. They are generally psychiatric medications to treat conditions that can coexist with the disorder like anxiety, depression and mood swings. These include antidepressants, antipsychotics or mood-stabilizing medications.
A drug called phenytoin has been shown to help with aggressive and impulsive behavior. (19)
FAQ
What is antisocial personality disorder? Antisocial personality disorder is attributed to someone who has an long term pattern of being reckless, manipulative and deceitful. They will have total disregard for the feelings and rights of other people and think nothing of violating them.
What are the signs of antisocial personality disorder? A person with this disorder is reckless and impulsive. They have little or no regard for authority or how their behavior impacts on others. Deceitfulness, lies and manipulation are part of their everyday life even though they can appear quite charming and witty. At some point they will most likely have been arrested for criminal offenses.
How do you develop antisocial personality disorder? There is no definitive cause of this disorder but it is thought that genetic and environmental factors play a part. A child that has suffered trauma or abuse or had alcoholic or abusive parents can develop the condition. (20)
How are you diagnosed for antisocial personality disorder? Diagnosis is based on the symptoms displayed. You will have a general personality disorder and display at least one other trait associated with antisocial personality disorder. You must also have displayed misconduct from the age of 15 or younger. These traits should not be part of any other disorder like schizophrenia and you must be over 18 years old.
What is the best treatment for antisocial personality disorder? There are several psychotherapeutic treatments available for this disorder. Some medications may also help alleviate some of the symptoms. Your healthcare professional will discuss with you and decide what is best for you.
What are the long term complications of antisocial personality disorder? The long term effects of this disorder can affect every aspect of life. There are physical, psychological and social effects that can affect both the sufferer and those around them. The likelihood of addiction to alcohol or drugs and suicide is also increased. (21)
Is antisocial personality disorder considered a disability? This disorder is not considered a disability. However, there could be instances when you may be able to claim social security benefits. (22)
Is there a cure for antisocial personality disorder? There is no known cure for this disorder. The symptoms can be managed with therapy and/or medication.
Is antisocial personality disorder life threatening? This is not a life threatening condition but the reckless behavior or suicidal tendencies can result in death.
Summary
Antisocial personality disorder describes a person who has an long term pattern of being out of control, devious and deceitful. They have total disregard for the feelings and rights of other people and think nothing of violating them.
Whilst appearing charming and witty beneath lurks a manipulative character that will lie and cheat. They will also use whatever means necessary to exploit other people to get what they want. Furthermore, their behavior is impulsive and aggressive and chances are they have a criminal history.
Treatments are available to manage this condition however, the hardest challenge might be convincing someone that they need help in the first instance.