Antisocial Personality Disorder…being aware of the signs

 

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Antisocial personality disorder is a chronic mental condition in which a person’s ways of perceiving situations, thought process and empathizing with others can be dysfunctional. A lot of people with antisocial personality disorder generally have trouble understanding right from wrong. They typically disregard any concerns, consequences, and feelings of other people’s concerns. People with antisocial personality disorder have very persuasive traits. They can be very passive aggressive and manipulating to others. They may disregard how they treat others. Sometimes they do not understand they are conflicting mental pain amongst society because they are unaware of sympathizing emotions. They may also be involved with drugs, alcohol, violent behavior and have issues with interpersonal relationships. People with this disorder may violate the law, and have no remorse with being in trouble. Not all people with this disorder are necessarily violent.

The DSM IV states the following,

“ANTI-SOCIAL PERSONALITY DISORDER DSM IV 301.70

EXPLANATION

Individuals with an Antisocial Personality Disorder show a lack of concern toward the expectations and rules of society and usually frequently become involved in at least minor violations of the rules of society and the rights of others.  A popular term for this type of individual is “sociopath”.  Although the diagnosis is limited to those persons over eighteen years of age, it usually involves a history of antisocial behavior before the age of fifteen.  The individual often displays a pattern of lying, truancy, delinquency, substance abuse, running away from home and may have difficulty with the law.  As an adult, the person often commits acts that are against the law and/or fails to live up to the requirements of a job, financial responsibility, or parenting responsibilities.  They tend to have difficulty sustaining a long term marital relationship and frequently are involved in alcohol and drug abuse. 

SYMPTOMS

The signs and symptoms include:

  1. Lack of concern regarding society’s rules and expectations.
  2. Repeated violations of the rights of others.
  3. Unlawful behavior.
  4. Lack of regard for the truth
  5. In parents, neglect or abuse of children.
  6. Lack of a steady job.  Frequent job changes through quitting and/or being fired
  7. Tendencies toward physical aggression and extreme irritability.

TREATMENT

Currently, there is no widely accepted effective method of treating sociopathic personality types.  They tend to be very manipulative during treatment and tend to lie and cover up personal faults in themselves and have little insight into their behavior patterns.  They tend to exhibit short-term enthusiasm for treatment, particularly after an incident which has brought them into contact with society or the law, however, once this anxiety is relieved and reduced, they frequently drop out of treatment and fall back into the same sociopathic patterns that brought them into treatment initially.  In most cases, the prognosis remains unfavorable throughout the individual’s life-span.

An Antisocial Personality Disorder is not just a medical term for criminality.  It describes a long term pervasive personality disorder that is very resistant to treatment.  Suicide, alcoholism, vagrancy, social isolation are common among these individuals, but there is a remarkable lack of anxiety or depression for situations in which these emotions are usually expected.  In spite of their run-ins with the law, they usually present a very charming and normal facade.  Dynamically, these individuals remain fixed in earlier levels of development.  Usually there is parental rejections and/or indifference and needs for satisfaction and security are not met.  As a result, psychoanalytic theory holds that the ego which controls impulses between conscience and impulses is underdeveloped.  Behavior is usually id directed due to this lack of ego strength, a result is a need for immediate gratification.  An immature superego allows the individual to pursue gratification regardless of the means and without experiencing any of the feelings of guilt. Functioning has been implicated as an important doctrine in determining whether an individual develops this disorder.  Usually the following circumstances are predisposed factors:

  1. Absence of parental discipline.
  2. Extreme poverty.
  3. Removal from the home.
  4. Growing up without parental figures of both sexes.
  5. Erratic, inconsistent discipline.
  6. Being “rescued” each time the person is in trouble and never having to suffer the consequences of his own behavior.
  7. Maternal deprivation and lack of an appropriate “attachment”.

This problem is much more prevalent in males than females.  If present in females, it usually occurs at the onset of puberty.  In males the onset is usually earlier on in childhood.  Behaviors can diminish somewhat after the age of thirty when the individual seems to “mellow out” and learns more effective ways of staying within the system.  Clients tend to be very manipulative and lack motivation for change.  They very rarely seek therapy voluntarily and they are usually forced into therapy through some involvement with the law or other aspects of their life.  History also reveals significant impairment in social, marital, and occupational functioning.  Therapists relate that these clients tend to lack emotional attachment to others.  They tend to be personable, charming, and engaging and are usually above average in intelligence.  This demeanor, however, is often a pretense intended to deceive others and facilitate the exploitation of others.  Emotional reactions tend to be extreme and these individuals tend to lack concern for other people’s feelings, be preoccupied with their own interests, and tend to have grandiose expressions of their own importance.  Insight and judgment are usually poor as is their responsiveness to therapy.  Therapy should focus on helping the individual develop a trusting relationship with other significant people in their lives; children, spouses, etc.  The client also needs to learn healthy ways to deal with anxiety and learn to postpone or defer gratification of impulses as a positive step toward developing a more mature and socially more positive way of interacting with others. Focus should also be on promoting development of alternate constructive methods of interacting with others rather than manipulation for self gain. Progress should be measured in terms of self control and use of appropriately assertive rather than aggressive behaviors to gain desired responses.   Anxiety and frustration also need to be recognized and diminished and the client also needs to focus on appropriate means of management of these two emotions which tend to cause the greatest conflict with authority and others.  Response to therapy is usually very poor, tends to be long term.  However, most of these clients do discontinue therapy prematurely and only remain if forced or coerced which further complicates treatment.” 

(http://www.accg.net/antisocial.htm)

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