By Steve Bressert, Ph.D.
Antisocial personality disorder is a disorder that is characterized by a long-standing pattern of disregard for other people’s rights, often crossing the line and violating those rights. A person with antisocial personality disorder (APD) often feels little or no empathy toward other people, and doesn’t see the problem in bending or breaking the law for their own needs or wants.
The disorder usually begins in childhood or as a teen and continues into a person’s adult life. Antisocial personality disorder is often referred to as psychopathy or sociopathy in popular culture. However, neither psychopathy nor sociopathy are recognized professional labels used for diagnosis. Individuals with Antisocial Personality Disorder frequently lack empathy and tend to be callous, cynical, and contemptuous of the feelings, rights, and sufferings of others. They may have an inflated and arrogant self-appraisal (e.g., feel that ordinary work is beneath them or lack a realistic concern about their current problems or their future) and may be excessively opinionated, self-assured, or cocky.
They may display a glib, superficial charm and can be quite voluble and verbally facile (e.g., using technical terms or jargon that might impress someone who is unfamiliar with the topic).
Lack of empathy, inflated self-appraisal, and superficial charm are features that have been commonly included in traditional conceptions of psychopathy and may be particularly distinguishing of Antisocial Personality Disorder in prison or forensic settings where criminal, delinquent, or aggressive acts are likely to be nonspecific.
These individuals may also be irresponsible and exploitative in their sexual relationships.
A personality disorder is an enduring pattern of inner experience and behavior that deviates from the norm of the individual’s culture. The pattern is seen in two or more of the following areas: cognition; affect; interpersonal functioning; or impulse control.
The enduring pattern is inflexible and pervasive across a broad range of personal and social situations. It typically leads to significant distress or impairment in social, work or other areas of functioning. The pattern is stable and of long duration, and its onset can be traced back to early adulthood or adolescence.
Symptoms of Antisocial Personality Disorder
Antisocial personality disorder is diagnosed when a person’s pattern of antisocial behavior has occurred since age 15 (although only adults 18 years or older can be diagnosed with this disorder) and consists of the majority of these symptoms:
- 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
There should also be evidence of Conduct Disorder in the individual as a child, whether or not it was ever formally diagnosed by a professional.
Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes and maturation. According to the DSM-5, antisocial personality disorder cannot be diagnosed in people younger than 18 years old.
Antisocial personality disorder is 70 percent more prevalent in males than females. According to research, the 12-month prevalence rate of this disorder is between 0.2 and 3.3 percent in the general population. Like most personality disorders, antisocial personality disorder typically will decrease in intensity with age, with many people experiencing few of the disorder’s symptoms by the time they are in the 40s or 50s.
How is Antisocial Personality Disorder Diagnosed?
Personality disorders such as antisocial personality disorder are typically diagnosed by a trained mental health professional, such as a psychologist or psychiatrist.
Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment.
There are no laboratory, blood or genetic tests that are used to diagnose antisocial personality disorder. Many people with antisocial personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life.
This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events. A diagnosis for antisocial personality disorder is made by a mental health professional comparing your symptoms and life history with those listed here. They will make a determination whether your symptoms meet the criteria necessary for a personality disorder diagnosis.
Causes of Antisocial Personality Disorder
Researchers today don’t know what causes antisocial personality disorder. There are many theories, however, about the possible causes of antisocial personality disorder.
Most professionals subscribe to a biopsychosocial model of causation — that is, the causes of are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important. If a person has this personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.
Treatment of Antisocial Personality Disorder
Treatment of antisocial personality disorder typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder.
Medications may also be prescribed to help with specific troubling and debilitating symptoms.
Bressert, S. (2016). Antisocial Personality Disorder Symptoms. Psych Central. Retrieved on July 2, 2016, from http://psychcentral.com/disorders/antisocial-personality-disorder-symptoms/
By Doré E. Frances, PhD -Teens with conduct disorders and antisocial personality conditions are more resistant to authority figures and possible treatment options offered.
What this means is that traditional means of eliciting positive behaviors might be harder to accomplish with teens with CD. Difficult maybe, however, not impossible.
Studies and researchers suggest a combination of individual and family/group therapies aimed at developing problem-solving and interpersonal skills. Often these teens do not know how to properly interact with others (or choose not to), so therapies that involve peers and how to function in different situations may prove helpful. Families especially can have a hard time in dealing with conduct disorder. Parents or siblings may become fearful or anxious around the antisocial teen, unsure if the adolescent will respond harshly or violently. Having family-centered therapy helps both parties to discuss the issue at hand and construct ways in which the parents, siblings, and the affected teen can cope.
Similarly, it may be the parents who need a behavioral adjustment as well. Not knowing how to react to a child with CD or other antisocial behaviors can trigger frustration, nervousness, anger, or violent outbursts. In other cases, parents can avoid the child altogether.
In parental management therapy, it’s important to know that in order for a teen to change, the parent may need to change as well. Sometimes the most longstanding outcomes are a result of the parents working together with the child, with both parties understanding the importance of change. Cognitive behavioral therapy can help to develop skills that foster independence and critical thinking. Considering that antisocial behavior may in part be brought on by an adolescent trying to alter his/her environment, teaching a teen these skills may make them feel more in control of their surroundings and thus, more at ease. Many therapies focus on these skills as well as those that promote social and communicative behavior.
Learning how to express emotions in a healthy way, nurturing one’s cognitive and emotional development, and feeling supported can make a huge difference in how an adolescent responds and acts.While no one can ever predict the outcome of treatment and how it relates to antisocial behaviors in the future, getting assistance now can mean a world of difference for you, your teen, and your family. Without treatment, these already stressful actions can escalate into long-term problems. When you feel troubled by your teen’s behavior and suspect a more serious problem, please call Horizon Family Solutions.
We understand the importance of family and value your child’s health. Call now.