Mental Health

Melissa Greener
Placement four

Anti-Social Personality Disorder

To understand antisocial personality disorder (ASPD or APD), it is necessary to learn what having any personality disorder involves. As defined by the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV-TR, 2000), a personality disorder (PD) is a persistent pattern of thoughts, feelings, and behaviours that is significantly different from what is considered normal within the person 's own culture.

Antisocial personality disorder is specifically a pervasive pattern of disregarding and violating the rights of others. Diagnostic criteria for this disorder state that this pattern must include at least three of the following specific signs and symptoms:

• Lack of conforming to laws, as evidenced by repeatedly committing crimes

• Repeated deceitfulness in relationships with others, such as lying, using false names, or conning others for profit or pleasure

• Failure to think or plan ahead (impulsivity)

• Tendency to irritability, anger, and aggression, as shown by repeatedly assaulting others or getting into frequent physical fights

• Disregard for personal safety or the safety of others

• Persistent lack of taking responsibility, such as failing to establish a pattern of good work habits or keeping financial obligations

• A lack of feeling guilty about wrong-doing

Although there are no clear biological causes for this disorder, research on the possible biologic risk factors for developing antisocial personality disorder indicates that, in those with antisocial personality disorder, the part of the brain that is primarily responsible for learning from one 's mistakes and for responding to sad and fearful facial expressions (the amygdala) tends to be smaller and respond less robustly to the happy, sad, or fearful facial expressions of others. That lack of response may have something to do with the lack of empathy that antisocial individuals tend to have with the feelings, rights, and suffering of others.

Psychopathy is considered to be a more severe form of antisocial personality disorder. Specifically, in order to be considered a psychopath, an individual must experience a lack of remorse or guilt about their actions in addition to demonstrating antisocial behaviours.

Although antisocial personality disorder can be quite resistant to treatment, the most effective interventions tend to be a combination of firm but fair programming that emphasizes teaching the antisocial personality disorder individuals skills that can be used to live independently and productively within the rules and limits of society.

While medications do not directly treat the behaviours that characterize antisocial personality disorder, they can be useful in addressing conditions like depression, anxiety, and mood swings that co-occur with this condition.

If untreated, people with antisocial personality disorder are at risk for developing or worsening a myriad of other mental disorders. Antisocial personality disorder individuals are also at risk for self-mutilation or dying from homicide or suicide.

The National Institute of Clinical Excellence (NICE, 2012) state that anti-social personality disorder is usually not diagnosed before the age of 18. however, characteristics of the disorder can be recognised in children with conduct disorders. NICE therefore advocates that early treatment for children with conduct disorders may help to prevent anti-social personality disorder from developing later.

NICE further suggest that those working with children with conduct disorders/anti-social personality disorders, should recognise that a positive and rewarding approach will have better long-term outcomes; cognitive problem – solving skills should be considered for those aged 8 years and over: to prevent people with anti-social personality disorder from re-offending, they should be offered group based cognitive and behavioural interventions such as those focussed on reasoning and rehabilitation.

References

NICE (2009) New NICE guidelines set to improve treatment and management of people with anti-social personality disorder. Available at: http://www.nice.org.uk/media/187/2B/2009004AntisocialPersonalityDisorder.pdf (Accessed 28/06/12).

MedicineNet.com (2012) Anti-Social Personality Disorder Available at: http://www.medicinenet.com/antisocial_personality_disorder/page4.htm (Accessed 29/06/12).

References: NICE (2009) New NICE guidelines set to improve treatment and management of people with anti-social personality disorder. Available at: http://www.nice.org.uk/media/187/2B/2009004AntisocialPersonalityDisorder.pdf (Accessed 28/06/12). MedicineNet.com (2012) Anti-Social Personality Disorder Available at: http://www.medicinenet.com/antisocial_personality_disorder/page4.htm (Accessed 29/06/12).