Personality Disorder Support Community

Personality Disorder Support Community

Antisocial Personality Disorder


Antisocial Personality Disorder (ASPD) is a mental health condition characterised by persistent thoughts, emotions and behaviours that may be harmful to, or violate the rights of, other people. It is only diagnosed in adults (over 18) but usually stems from childhood, and individuals must have displayed some symptoms of Conduct Disorder (e.g. vandalising, lying, truancy) before the age of 15 for an official diagnosis.

Antisocial individuals may:

  • Disregard rules and expectations in society.

  • Persistently lie.

  • Have poor or abusive relationships.

  • Violate of the rights of others.

  • Engage in unlawful behaviour.

  • Have a lack of regard for the truth.

  • Be physically aggressive.

  • Be extremely irritable.



Criteria outlined by the DSM IV or the ICD-10 are used to diagnose ASPD.

For the DSM IV, the diagnostic criteria are as follows:

  1. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following:

    1. Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest.

    2. Deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure.

    3. Impulsiveness or failure to plan ahead.

    4. Irritability and aggressiveness as indicated by repeated physical fights or assaults.

    5. Reckless disregard for safety of self or others.

    6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations.

    7. Lack of remorse as indicated by being indifferent to or rationalising having hurt, mistreated, or stolen from another.


  2. The individual is at least age 18 years.

  3. There is evidence of conduct disorder with onset before age 15 years.

  4. The occurrence of antisocial behaviour is not exclusively during the course of schizophrenia or a manic episode.



The ICD-10 lists criteria for a similar disorder called Dis-social Personality Disorder which is an umbrella term for Amoral, Antisocial, Psychopathic, or Sociopathic Personality Disorders.

It is characterised by at least 3 of the following:

  1. Callous unconcern for the feelings of others.

  2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.

  3. Incapacity to maintain enduring relationships, though having no difficulty in establishing them.

  4. Very low tolerance to frustration and a low threshold for discharge of aggression including violence.

  5. Incapacity to experience guilt or to profit from experience, particularly punishment.

  6. Markedly prone to blame others or to offer plausible rationalisations for the behaviour that has brought the person into conflict with society.



Cause of ASPD

The causes of ASPD are unknown but several external factors are believed to contribute including lack of discipline, extreme poverty, maternal deprivation, and lack of an appropriate “attachment”. It’s also thought that people with ASPD may have potential genetic vulnerability that can lead to the disorder being triggered by life situations.

Diagnosing ASPD

If you believe that you or a family member may have ASPD, you will have to be referred to a mental health professional by your GP. They may also perform tests first to rule out any physical illness that may be causing the behaviour. Diagnosis can be a long process, especially due to the nature of this disorder where the individual may lie or provide inaccurate accounts of their symptoms.

Treatment

People with ASPD rarely seek treatment as they may not want or feel they need it. They may seek out therapy for other reasons such as relationship problems, drug or alcohol abuse, or depression. They might also be ordered to have treatment by courts, or made to by family members. ASPD sufferers may be given Psychotherapy that focus on the individual learning to understand about the disorder and the consequences their behaviour may have in order to learn how to control it. Stress and anger management skills might also be taught, and a number of psychiatric medications can be used to treat symptoms.

Millon's Subtypes

The Covetous Antisocial is the ‘purest’ type, though it combines Narcissistic traits. They are driven by dissatisfaction with what they have in life. This subtype are often jealous of others, feeling that they haven’t been given the things that they deserve, and want to take what they feel is rightfully theirs without ever achieving a feeling of fulfilment.

The Reputation-defending Antisocial also has Narcissistic features, which leads them with a need to be seen as invincible by others. They do not respond lightly to criticism or insults. they must be recognised for the important individuals they feel they are and never treated with indifference.

The Risk-taking Antisocial has Histrionic traits, and likes to be seen as fearless in the face of danger. They actively seek out hazardous situations, enjoy taking risks, and are unfazed by potentially serious injuries. They are impulsive, reckless, and thrill seeking.

The Nomadic Antisocial combines Schizoid and Avoidant features. This type could be seen as far from the aggressive and antagonistic individual most people picture when confronted with the idea of ASPD. Feeling rejected and self-pitying, this subtype tend to detach themselves from the society they believe has cast them aside.

The Malevolent Antisocial has both Paranoid features, which leads them to anticipate betrayal; and Sadistic features, which causes them to act on their perceived mistreatment. They are resentful of others, ruthless in their actions, and do not feel guilt or fear of punishment.

© PDChat 2013

References:

Antisocial Personality Disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)

Dis-social Personality Disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)

Millon, Theodore (2006). "Personality Subtypes Summary”. The Official Website for Theodore Millon, Ph.D., D.Sc.. DICANDRIEN, Inc. http://millon.net/taxonomy/summary.htm.

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