Antisocial Personality Disorder (ASPD) is a mental disorder where a person shows no regard for right or wrong and is not concerned with the feelings or rights of other people. Someone with this disorder will manipulate, antagonise and treat others with indifference. They show no remorse or guilt for the actions and behaviour.
In order to be diagnosed with ASPD, a person must be at least 18 years of age and shown signs of a Conduct Disorder before the age of 15. A Conduct Disorder is a repetitive patter of behaviour that violates the rights, wishes, and feelings of others. The pattern continues to adulthood but on a larger scale. Rules and norms are disgarded, and the person may violate the law, or have drug and alcohol problems. It becomes difficult for them to fulfill responsibilities and commitments.
Antisocial behaviour is not limited to episdoes of mania with Bipolar Disorder, or being unwell from other mental illness. The behaviour exists outside of these periods.
In the past, this disorder was known as Sociopathy, Psychopathy or Dissocial Personality Disorder.
Symptoms
There are several warning signs and symptoms that may indicate a person has Antisocial Personality Disorder. A majority of these symptoms would lead to a diagnosis of ASPD.
Deceitfulness
People with ASPD are often experienced by others as deceitful, constantly lying, manipulating, or conning others in order to gain personal satisfaction or pleasure. These behavours could be accompanied by extreme but superficial charm. They show a lack of empathy, and a lack of guilt or remorse for their behaviours.
Non Conformity
The person may show no respect for the law and have no boundaries. They may repeatedly perform acts that lead to arrest or cause harm to others.
Impulsivity
People with ASPD might act impuslively and in the spur of the moment without any consideration of how their actions would impact themselves or others. The lack of planning ahead might lead to sudden changes in jobs, personal relationships etc.
Aggression
Someone diagnosed with this disorder often behaves in an irritable and aggressive manner. They might be physically abusive towards family members, such as a wife and/or children. They may also display disregard for their own safety, as well as that of others. They can often engage in reckless driving or in sexual behaviours or substance abuse with high risk of harm to self or others.
Irresponsibility
Consistent and extreme irresponsibility could also be present in people presenting with ASPD. This might include failing to care for a child by either not paying child support; not providing adequate standards of hygiene; or not ensuring that the child is in the care of another adult if the primary carer is not able to be present. Relationships may suffer and there is an inability to maintain work or financial commitments.
Causes and Development
The exact causes for developing ASPD are still unclear. Most professionals believe that causes are biological and genetic, as well as early social factors and interactions with family, friends and other children. It is a complex disorder that must be diagnosed by a mental health professional based on symptoms and past history.
Other psychosocial factors in early childhood could also contribute to the development of this disorder. Some factors include but are not limited to a childhood diagnosis of Conduct Disorder, a family history of ASPD, childhood abuse or neglect, an unstable, violent or disordered childhood, and poor social contact. ASPD is more commonly diagnosed in men than women. It is likely that symptoms will decrease in intensity by the age of 40 or 50.
What Help is Available?
It is difficult to treat this disorder because people with ASPD rarely seek treatment, as they do not think that there is anything wrong with the way they behave. When treatment is given, it is usually when individuals have entered the Corrective Services System and are forced to participate in treatment.
Medication
No medication is known to be helpful in the treatment of this disorder. However, some medication might be useful in order to manage some of the symptoms. The types of medication prescribed could include antidepressants, antipsychotics or mood stabilizers.
Medication must be prescribed with caution because of the potentiality of people living with this disorder to misuse drugs.
Psychotherapy
Talk therapy could be helpful for people with ASPD. It may include anger and violence management, substance abuse treatment and treatment for other mental health conditions.
Group therapy might be more useful than individual therapy, especially if the group facilitator is a peer, and not seen as an authority figure which is the way professional therapists are perceived to be.
What can I do to help a loved one with ASPD?
- Talk to someone
- If you are concerned that someone you know is showing signs of Antisocial Personality Disorder, it is important to seek help from a skilled mental health professional. A professional specialised in working with this disorder could be helpful in teaching skills to handle the aggression, violence and/or manipulative, conning behaviors which are so characteristic of this disorder. It is important to seek help if you are concerned about a loved one’s behavior or if you feel any danger from this person’s actions.
- Contact the Mental Health Information Service on 1300 794 991 for information about services in your area
- Speak to your local doctor (GP)
- Contact the Australian Psychological Society (APS) on 1800 333 947 for referral to a psychologist in your area
- If you live in NSW, seek services in your local area using the Way Ahead Directory www.directory.wayahead.org.au
References
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5), American Psychiatric Publishing: Washington DC, USA.
American Psychiatric Association (2005). Diagnostic and Statistical Manual of Mental Disorders (DSM-4 TR), American Psychiatric Publishing: Washington DC, USA.
Castillo, R.J. (1997). Culture and Mental Illness: A Client-Centred Approach. Pacific Grove, CA: Brooks/Cole.
D.Robinson (2003). The Personality Disorders Explained, Rapid Psychler Press, USA