Antisocial Personality Disorder

Antisocial personality disorder is a pattern of socially irresponsible, deceitful, and exploitative behavior in the absence of guilt, also known as sociopathy or psychopathy. It begins in childhood or early adolescence and is manifested by disturbances in many areas of life.

Antisocial personality disorder is usually a lifelong disorder that begins in childhood and is fully manifested by a person in their late 20s or early 30s. This extreme behavioral disorder is developed by a small percentage of children with conduct disorder whose behavior does not improve as they mature. Antisocial personality disorder is only diagnosed in people over age 18. The symptoms are similar to those of conduct disorder, and the criteria for diagnosis include the onset of conduct disorder before the age of 15. About 3% of males and 1% of females develop antisocial personality disorder.

The adult with antisocial personality disorder displays at least three of the following behaviors:

An individual diagnosed with antisocial personality disorder cannot express a range of feelings. Contempt for others may be the dominant expression. This striking lack of personal affect and empathy is oddly combined with an inflated sense of self-worth. Often antisocial personalities or sociopaths have a superficial charm that masks their inner apathy. They may mimic others’ mannerisms or expressions of feeling without actually experiencing feelings themselves. Many psychologists have linked antisocial personality disorder to a childhood history of physical or sexual abuse, to neurological disorders (often undiagnosed), and to low IQ. Children of a parent with an antisocial personality disorder or substance abuse problem are more likely to develop the disorder. Antisocial personality disorder is associated with low socioeconomic status and urban settings. The antisocially disordered person may be poverty-stricken, homeless, a substance abuser, or have an extensive criminal record. However, these external factors do not completely explain the personality type.

Individuals with antisocial personality disorder are unresponsive to any form of treatment. People with this disorder are seen in the prison population. Although there are medications available that may quell some of the symptoms of the disorder, noncompliance or abuse of the drugs prevents their widespread use. The most successful treatment programs are long-term, structured residential settings in which the patient systematically earns privileges as behavior is modified. Some form of dynamic psychotherapy is usually given along with the behavior modification. The therapist's primary task is to establish a relationship with the patient, who has thus far typically had very few relationships and is unable to trust, fantasize, feel, or learn. Some adults are able to understand that they exist on a spectrum of antisocial behavior and learn appropriate ways to treat family and others.

See also Abnormal psychology ; Criminal profiling .

Resources

BOOKS

Black, D. W. Bad Boys, Bad Men: Confronting Antisocial Personality Disorder. Oxford, UK: Oxford University Press, 2013.

Thomas, Christopher R., and Kayla Pope. The Origins of Antisocial Behavior: A Developmental Perspective. Oxford, UK: Oxford University Press, 2013.

ORGANIZATIONS

Antisocial and Violent Behavior Branch, Division of Biometry and Applied Sciences, National Institute of Mental Health, 18-105 Parklawn Bldg., 5600 Fishers Lane, Rockville, MD, 20857, (301) 443-3728.