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HomeTopicsPersonality DisordersAntisocial
Antisocial Personality Disorder: I Don't Care!Antisocial personality disorder is one of the most violent and aggressive of the various personality disorders. Also known as psychopathic personality or sociopathic personality disorder, antisocial personality disorder describes a complete disregard for the rights, feelings, or safety of others. The terms sociopath and psychopath are both used to describe someone with antisocial personality disorder. Prevalence and Causes of Antisocial Personality DisorderAntisocial personality disorder appears in 3.6 percent of the adult US population, or approximately 7.6 million people. The condition appears to be more common in men than women, although this may be because the male sociopath is more likely to receive a diagnosis.
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Sociopath or Psychopath? |
Causes of Antisocial Personality Disorder: What Makes a Psychopath?
The exact causes of antisocial personality disorder are unknown, although researchers have some clues. Genetics may play a role in whether a person becomes a psychopath, as the children of parents with antisocial personality disorder appear to be more at risk for the disorder. However, whether this suggests an environmental or genetic cause is unclear.
Sociopaths often have histories of childhood abuse. Many have parents who abused alcohol or other substances. None of these possible causes, however, can explain the development of all sociopaths.
Antisocial Personality Disorder Symptoms
Central to antisocial personality disorder is a disregard for the rights of others and a willingness to violate those rights. Antisocial personality disorder does not so much have symptoms as a set of characteristics and tendencies. A psychopath may:
- engage in violent acts and fights
- feel no guilt or remorse for his or her actions
- have no concern for individual safety or the safety of others
- lie or deceive consistently
- regularly break the law
- steal.
Sociopaths are often angry and their self-interest makes many of them arrogant. Despite this, some people with antisocial behavior disorder can appear charming or flattering. This charm is not sincere, however, the psychopath simply uses charm as a tool to manipulate people to achieve his or her own ends.
How the Psychopath Perceives Himself
Psychopaths perceive themselves as different from the general population, but they don't believe this as a problem. The sociopath views himself as superior to other people, and disdains social conventions. People are only valued if they offer something the psychopath needs, and then only for as long as it is needed.
Diagnosing Antisocial Personality Disorder
Antisocial personality disorder is not as difficult to diagnose as some personality disorders, but for a sociopath to willingly seek out treatment is highly unlikely. Many cases of antisocial personality disorder only come to medical attention when the person seeks medical attention by a court of law. In such cases, the psychopath can be expected to resist both diagnosis and treatment.
For a diagnosis of antisocial personality disorder, a childhood diagnosis of conduct disorder is required (or evidence that the person met the diagnostic criteria for conduct disorder as a child). In addition, the DSM-IV states that at least three of the following be present for an antisocial personality disorder diagnosis:
For a diagnosis of antisocial personality disorder, a childhood diagnosis of conduct disorder is required (or evidence that the person met the diagnostic criteria for conduct disorder as a child). In addition, the DSM-IV states that at least three of the following be present for an antisocial personality disorder diagnosis:
- failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
- deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
- impulsivity or failure to plan ahead
- irritability and aggressiveness, as indicated by repeated physical fights or assaults
- reckless disregard for safety of self or others
- consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
- lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
From the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. American Psychiatric Association, 1994.
Like many other personality disorders, antisocial personality disorderhas symptoms that can be explained by the presence of other conditions, and these conditions must be ruled out during diagnosis. Such conditions include manic episodes and schizophrenia, as well as other personality disorders, including:
- narcissistic personality disorder
- histrionic personality disorder
- borderline personality disorder
- paranoid personality disorder.
Substance abuse can cause delusions that mimic antisocial personality disorder, and this poses a special problem when diagnosing a potential sociopath. For, while substance abuse could be the cause of sociopathic symptoms, people with antisocial personality disorder are fifteen percent more likely to develop substance abuse problems than the rest of the population.
Complications of Antisocial Behavior
The most common complication faced by people with antisocial personality disorder is incarceration and frequent conflicts with the law. As noted previously, high percentages of sociopaths are found in correctional facilities.
Substance abuse is a common problem among psychopaths: 75 percent of diagnosed psychopaths abuse alcohol, and up to 50 percent abuse other substances. Both due to substance abuse and symptoms of antisocial personality disorder, many sociopaths experience panic attacks, tension, and anxiety problems.
Suicide attempts are much higher among psychopaths than the general population. While the general population's suicide rate is one percent, people with antisocial personality disorder have a suicide rate of five percent.
Suicide attempts are much higher among psychopaths than the general population. While the general population's suicide rate is one percent, people with antisocial personality disorder have a suicide rate of five percent.
Treatment of Antisocial Personality Disorder
Treatment is problematic, as the psychopath is likely to resist. Medications are not generally advised, as the sociopath will either not take the medication, or, in many cases, abuse it or try to manipulate the physician into prescribing specific drugs.
Therapy has been used to treat antisocial behavior, with limited success. Group therapy at the outset is not recommended, given the sociopath's preferences for confrontational and manipulative interaction. Intensive, long-term, inpatient treatment has been shown to be successful if the patient is cooperative. Spread over the course of years, inpatient treatment of antisocial personality disorder is expensive, but much less expensive and more effective than incarceration.
Ultimately, time appears to be the best treatment for antisocial personality disorder. Symptoms are more noticeable in the sociopath's early twenties, and by the time a sociopath reaches his or her forties symptoms tend to be less noticeable. It is unclear whether this means antisocial personality disorder symptoms diminish with age, or whether age prevents the psychopath from acting as he or she would when younger.
Resources
American Psychiatric Association. Diagnostic criteria for 301.7: Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. American Psychiatric Association, Washington, DC, 1994.
Ekleberry, S. (2000). Dual diagnosis and the antisocial personality disorder.
Kelly, D. (nd). Antisocial personality disorder.
Long, P. (nd). Antisocial personality disorder.
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2004, August 2). Landmark survey reports on the prevalence of personality disorders in the United States. NIH News.
National Library of Medicine. (updated 2003). Antisocial personality disorder. MedlinePlus Medical Encyclopedia.
National Mental Health Association. (2003). Substance abuse: Dual diagnosis.Mental Health Fact Sheets.
Therapy has been used to treat antisocial behavior, with limited success. Group therapy at the outset is not recommended, given the sociopath's preferences for confrontational and manipulative interaction. Intensive, long-term, inpatient treatment has been shown to be successful if the patient is cooperative. Spread over the course of years, inpatient treatment of antisocial personality disorder is expensive, but much less expensive and more effective than incarceration.
Ultimately, time appears to be the best treatment for antisocial personality disorder. Symptoms are more noticeable in the sociopath's early twenties, and by the time a sociopath reaches his or her forties symptoms tend to be less noticeable. It is unclear whether this means antisocial personality disorder symptoms diminish with age, or whether age prevents the psychopath from acting as he or she would when younger.
Resources
American Psychiatric Association. Diagnostic criteria for 301.7: Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders, 4th Edition. American Psychiatric Association, Washington, DC, 1994.
Ekleberry, S. (2000). Dual diagnosis and the antisocial personality disorder.
Kelly, D. (nd). Antisocial personality disorder.
Long, P. (nd). Antisocial personality disorder.
National Institute on Alcohol Abuse and Alcoholism (NIAAA). (2004, August 2). Landmark survey reports on the prevalence of personality disorders in the United States. NIH News.
National Library of Medicine. (updated 2003). Antisocial personality disorder. MedlinePlus Medical Encyclopedia.
National Mental Health Association. (2003). Substance abuse: Dual diagnosis.Mental Health Fact Sheets.
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- BPD: Borderline Personality Disorder
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- Narcissism and Narcissistic Personality Disorder: Placing Self First
- Obsessive Compulsive Personality Disorder: Don't Break the Rules!
- Paranoid Personality Disorder and Paranoid Schizophrenia
- Schizoid Personality Disorder: Self-Imposed Social Isolation
- Schizotypal Personality Disorder: Mild Schizophrenia?
