Antisocial Personality Disorder: What is it?

Many may hear the term "psychopath" and "sociopath" used loosely throughout the media. Some may even immediately think of infamous serial killers such as Ted Bundy or Jeffrey Dahmer, but the terms psychopath and sociopath aren't medical terms. Instead, someone would be diagnosed with antisocial personality disorder (ASPD). Before explaining what ASPD is, we must understand that ASPD is a chronic mental health disorder that cannot be cured but can be treated. ASPD is not just a trait that some people have. It is a personality disorder that needs diagnosis and treatment by a doctor.

WHAT IS ASPD?

ASPD is a personality disorder in which a person may often disregard and violate the rights of others while also having difficulty understanding right from wrong. People with ASPD may come across as uncaring, unremorseful, and rash. However, they may also come across as charming, fun, and pleasurable to be around when first met. Those with ASPD are more likely to give in to impulsive urges, such as criminal or violent behavior due to the symptoms characterized by having ASPD.

Those with ASPD may have a pattern of lying and manipulation and a tendency to engage in risky behavior. Like many disorders, ASPD can range in severity from the stereotypical definition of a "psychopath" to manageable yet still impulsive. Unlike many other disorders, ASPD begins in early childhood all the way to adulthood. Additionally, to be diagnosed with ASPD, an individual must have had symptoms before the age of 15.

ASPD is part of cluster B of the ten personality disorders. Those in cluster B are described as being dramatic and erratic. Those in cluster B are also unpredictable in behavior. This inconsistent behavior can affect many people, not just individuals with ASPD. In fact, ASPD can become so severe that it affects all parts of someone's life. Due to their lack of remorse, the harm they do to others prevents long-term relationships and may even prevent being able to have a job. This disregard for others leads to dangerous behavior, which poses a risk for the individual with ASPD and those around them. Due to their tendency to engage in harmful behavior, we associate those with ASPD with criminal activity. However, with the correct, long-term treatment, this can be prevented. In fact, some with ASPD do not engage in illegal activity at all.

Those with ASPD can be manipulative and exploit others for their own benefit and pleasure. They may be irresponsible in several aspects of their lives, including financial, professional, and personal. This can manifest in a sudden decision to move cities and spend a large amount of money on unneeded things. Those with ASPD may engage in risky behavior and have a short temper leading to aggressiveness and physical violence. People with ASPD experience no remorse for their actions or may have extreme difficulty doing so and may attempt to rationalize their behavior toward others. This rationalization could be telling themselves that they're just protecting themselves or saying that the person they hurt deserved it. Some with ASPD may also be overly confident and narcissistic in action and self-opinion.

SYMPTOMS OF ASPD

In childhood, those with ASPD must have been diagnosed with conduct disorder before reaching the age of 15. Children with conduct disorder may bully others and be seen as deceitful and destructive by their peers. Additionally, children and minors cannot be diagnosed with ASPD.

According to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013), three or more of the following criteria are needed to diagnose someone with ASPD:

"A. 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 behaviors, as indicated by repeatedly performing acts that are grounds for arrest.

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

3. Impulsivity 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 behavior or honor financial obligations.

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

B. The individual is at least age 18 years.

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

D. The occurrence of antisocial behavior is not exclusively during the course of

schizophrenia or bipolar disorder.”

Those with ASPD have difficulty feeling empathy for others and cannot form long-term relationships. Many relationships are short-lived because others may feel hurt by the individual's actions. Additionally, ASPD is also characterized by having difficulty being aware of themselves and their actions. This means that many of those living with ASPD have no idea their behavior hurts others.

Although a common symptom of ASPD is indeed aggressiveness, many individuals with ASPD aren't criminals.

Additionally, those with ASPD are at a higher risk of substance abuse.

CAUSES OF ASPD

The main causes for ASPD are relatively unknown but believed to be a mix of genetics and environment. Contributing factors to the development of ASPD are:

• Having an immediate family member who has or had ASPD

• Substance abuse

• Child abuse

• Neglectful or alcoholic parents

Children raised in an unhealthy household by a parent exhibiting behaviors common in ASPD are at an increased risk of repeating these behaviors.

REFERENCES

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