Dissocial personality disorder: Description
Dissocial personality disorder, also called antisocial personality disorder by experts, is a severe and potentially dangerous disorder. Some sufferers are so irritable that even a minor disagreement can incite them to commit an act of violence.
A dissocial personality disorder is already noticeable in childhood and adolescence. The affected children torture animals or bully their classmates. Even as adults, they appear callous towards their fellow human beings. They are not afraid of consequences for their often irresponsible behavior. Even punishment does nothing to change their conviction that they are in the right – on the contrary: in their view, the victims of the attacks are often to blame themselves. An extremely low to complete lack of empathy is characteristic of an antisocial personality disorder.
Partnerships are therefore another difficult area of life for those affected: As a rule, the relationships of people with antisocial personality disorder do not last long.
Dissocial personality disorder: frequency
In the general population, around three to seven percent of men and one to two percent of women have a dissocial personality disorder. This percentage is significantly higher in prisons. Among abusers in prison, for example, more than half have been diagnosed with a dissocial personality disorder. However, not everyone with a dissocial personality disorder commits crimes.
Special form of psychopathy
Psychopathy is an extreme form of dissocial personality disorder. Those affected are usually very good at hiding their antisocial attitude: at first glance, for example, they often appear charming and approachable. In reality, however, they manipulate their environment and have no feelings of guilt when they harm others or behave unlawfully.
Psychopathy is often difficult to recognize, even for experts. So far, it has not been possible to treat it adequately. In addition, those affected do not perceive themselves as needing treatment: They do not perceive their social behavior as disturbed.
You can read more about this particularly manipulative form of dissocial personality disorder in the article Psychopathy.
Dissocial personality disorder: symptoms
Diagnostic criteria
The diagnosis of “dissocial personality disorder” is made according to the International Classification of Mental Disorders (ICD-10) on the basis of the following symptoms:
Firstly, the general criteria for a personality disorder must be fulfilled. But what is a personality disorder? People with a personality disorder show character traits and behaviors that deviate significantly from social norms. Those affected are unable to adapt their behavior and come into conflict with their social environment.
Personality disorders develop as early as childhood. The full symptoms usually become apparent in early adulthood. It is important to distinguish whether the antisocial behavior is not the result of another mental disorder or brain damage.
On the other hand, at least three of the following characteristics and behaviors must apply for the diagnosis of “dissocial personality disorder”:
- The person concerned behaves callously and without concern for the feelings of others.
- They behave irresponsibly and disregard social norms, rules and obligations.
- He is unable to maintain lasting relationships, although he finds it easy to establish them.
- He has a low frustration tolerance and is quick to behave aggressively and violently.
- He tends to blame others or offers plausible explanations for his antisocial behavior.
Dissocial personality disorder: causes and risk factors
Dissocial personality disorder develops from a combination of biological factors and environmental influences. As it begins early in life, parents as role models and their parenting methods have a considerable influence on further development.
Dissocial personality disorder: biological causes
In identical twin pairs, dissocial personality disorder occurs more frequently in both siblings than in fraternal twins. This suggests that the risk of dissocial personality disorder is partly inherited.
The neurotransmitters in the brain also have a significant influence on behavior. For example, a low level of the happiness hormone serotonin is often associated with higher aggression.
Dissocial personality disorder: psychosocial causes
People with dissocial personality disorder often report traumatic experiences in their childhood (e.g. physical or psychological abuse). As a result of these experiences, those affected became insensitive to violence over time.
Certain family characteristics are also associated with later antisocial behavior. Children who have received little affection or whose parents already exhibit antisocial behavior are more likely to develop a dissocial personality disorder. Even if parents pay little attention to their children’s positive behavior but punish minor infractions excessively, they reinforce dissocial behavior. Children learn that they only receive attention when they misbehave. If they are well-behaved, however, they are neglected.
Many people with dissocial personality disorder were also not taught moral values in childhood. They did not learn from their parents what is right and what is wrong. As a result, they have not internalized any social norms. Even as children, they behave antisocially and aggressively towards people and animals. When they reach puberty, some embark on a criminal career. They steal, commit arson or other violations of the law.
Dissocial personality disorder: examinations and diagnosis
Even though the disorder often develops in childhood and adolescence, the diagnosis of “dissocial personality disorder” is usually only made from the age of 16. This is because children and adolescents are still undergoing major changes in their development.
Medical examinations
In order to rule out other causes of the deviant behavior, the doctor will carry out a number of medical examinations. Blood and urine will be analyzed to determine whether the behavior is due to drug use, for example. A computer tomography (CT) scan can rule out possible damage to the brain.
Antisocial personality disorder: test
Therapists and psychiatrists use questionnaires such as the Structured Clinical Interview (SKID) to diagnose dissocial personality disorder. The problem with diagnosing personality disorders is that those affected often know what the therapist wants to hear from them and answer accordingly. However, in order to obtain a realistic picture of the person, therapists often also ask relatives for information.
The therapist or psychiatrist could ask the following questions:
- Do you have the impression that you are easily irritable and quickly become aggressive?
- Do you feel bad when you hurt other people?
- Do you find it difficult to have long-term relationships?
Dissocial personality disorder: treatment
Dissocial personality disorder is difficult to treat. There are no medications that have been shown to be particularly effective for dissocial personality disorder. Nevertheless, doctors prescribe antidepressants and mood stabilizers, which in some cases contribute to an improvement in symptoms.
As part of cognitive behavioral therapy, the therapist tries to teach the sufferer to empathize with other people. However, if they do not have the basic prerequisites for this, they will not succeed in changing their perspective. In these cases, work can be done to help people with dissocial personality disorder learn to control their behavior better. This also involves them acquiring strategies in the course of therapy that help them get a better grip on impulsive and aggressive reactions.
The R&R program (Reasoning Rehabilitation Program) aims to improve self-control, social skills and problem-solving abilities, develop values and take responsibility for one’s own actions.
Dissocial personality disorder: course of the illness and prognosis
Experts believe that the best chances of success exist if dissocial behavior is discovered and treated in childhood. It is much more difficult to have a positive influence on full-blown dissocial personality disorder in adulthood. Initial progress in treating dissocial personality disorder has been made using a method in which the therapist teaches the patient that they can better exploit their potential by changing their behavior.
Overall, the lives of people with dissocial personality disorder often turn out badly: many of them repeatedly end up in prison. Only in middle age does the tendency towards antisocial behavior and criminality decrease. In addition, people with dissocial personality disorder are more often victims of violence. And they commit suicide more often.
