The term Antisocial Personality Disorder or ASPD for short, refers to a chronic mental condition involving a pattern of disregard for the rights of others including the violation of other’s rights. Deceit and manipulation are common features of this personality disorder.
Personality disorders refer to mental health conditions related to the way a person feels, thinks, perceives or relates to others. Antisocial personality disorder is a pretty difficult personality disorder as the behavior of people with this disorder might be irresponsible, manipulative, impulsive, reckless, and indifferent to other’s feelings. Most often this personality disorder will lead to criminal behavior.
In DSM 5 it is included in cluster B, called emotional, dramatic and erratic cluster. The disorders in cluster B are characterized by problems with emotional regulation and impulse control.
This cluster also includes disorders such as Histrionic Personality Disorder, Narcissistic Personality Disorder, Borderline Personality Disorder and of course Antisocial Personality Disorder.
In ICD 10 it appears under the name of Dissocial Personality Disorder. The criteria are similar in both manuals (ICD – 10 and DSM – V) but not identical.
In both manuals it is mentioned that the antisocial personality disorder was often referred to as sociopathy or psychopathy and it might include psychopathy and sociopathy. But the two terms are not recognized or used by professionals to label diagnostics of antisocial personality disorder.
The diagnostic criteria for antisocial personality disorder were based on the work of Hervey Cleckley on psychopathy. Anyway there were critics who argued that as long as the criteria are not exactly the same, the antisocial personality disorder and psychopathy cannot be treated the same way.
Psychopathy is described as a personality disorder defined by traits that includes diminished ability for remorse, antisocial behavior and poor behavioral controls.
Most often psychopathy traits are measured using PCL-R (Psychopathy Checklist Revised), developed by Canadian researcher Robert D. Hare. Psychopathy diagnosis appears nowhere in the DSM or ICD though sometimes distinctions between the antisocial personality disorder and psychopathy or sociopathy are stated.
The spectrum of severity of antisocial personality disorder might range from a mild form that includes occasional bad behavior to a more severe version where the people with the disorder commit serious crimes and break the law repeatedly.
Robert Hare insists that his PCL-R is better than ASPD when it comes to predicting future violence and criminality though ASPD diagnosis covers twice or even three times more prisoners than psychopathy diagnosis.
In DSM – V psychopathy was proposed as an alternative model of ASPD, called Alternative DSM – 5 Model for Personality disorder. It is a diagnosis of ASPD with psychopathic features and it is described as the lack of fear or anxiety and bold interpersonal style that could mask fraudulence.
Five Subtypes Of ASPD Were Proposed By Theodore Millon:
- Nomadic – with avoidant and schizoid features.
- Malevolent – with paranoid and sadistic features.
- Covetous – feels deprived and denied and finds more pleasure in taking than having.
- Risk-taking – with histrionic features.
- Reputation defending – with narcissistic features.
- Male are more likely to be diagnosed with ASPD than women and people with ASPD are at higher risk of a violent death.
Also There Are Few Disorders That Are Very Likely To Coexist With ASPD Including:
- Anxiety disorders.
- Impulse control disorders.
- Depressive disorders.
- Borderline personality disorder.
- Narcissistic personality disorder.
- Somatization disorder.
- Substance related disorders.
- Sadistic personality disorder.
- Histrionic personality disorder.
The factors that might cause ASPD include imbalance between levels of testosterone, cortisol and serotonin. The three substances aforementioned seem to be important regulators of social aggression.
Other factors might include head injury, limbic neural maldevelopment, home and social environment or even cultural influences. Also there are scientists who think the ASPD might be inherited.
The ASPD should be diagnosed only by a trained psychiatrist and in order to understand this disorder people should seek the specialist help of a psychiatrist.
The treatment for ASPD is really difficult as the patient lacks remorse and the symptoms include deceitfulness. The most common treatment for ASPD are psychotherapy and cognitive behavioral therapy.