Sufferers of antisocial or dissocial personality disorder, or APS for short, disregard social norms in their behavior and have little or no empathy. The behavior of affected persons cannot be changed by positive or negative reinforcement from the outside; on the contrary, punishment will trigger defiant reactions. Psychopathy is a severe form of antisocial/dissocial personality disorder.
What is dissocial personality disorder?
Antisocial personality disorder is a severe disorder that appears in childhood and adolescence with truancy, vandalism, and frequent lying. In adulthood, antisocial personality disorder becomes noticeable with physically aggressive behavior, financial problems, and social recklessness. Affected individuals of all ages are impulsive, risk-taking, easily irritable, and have a low frustration tolerance. Social bonding rarely occurs due to the lack of empathy, but affected individuals are good manipulators. It is interesting to note that, on the one hand, the disorder is associated with a high crime rate, but that, on the other hand, antisocial personality disorder can be a career driver according to studies. Depending on the state of research, one distinguishes antisocial personality disorder from psychopathic personality disorder, considers the latter to be an extreme case of APS, or refers to both as synonyms.
Causes
The causes of antisocial personality disorder are not well understood. However, an interaction of genetic and social factors can be assumed to cause the problem. The genetic factor has been demonstrated in twin studies; thus, the disorder occurs significantly more often in identical twins than in fraternal twins. Adoption studies with twins further proved that the genetic factor is only conditional, not triggering. Family problems in childhood, including a lack of love and attention, neglect and experiences of physical or emotional violence, and inadequately orienting educational standards, could be established in most affected individuals.
Symptoms, complaints, and signs
This disorder is associated with severe psychological complaints that have a very negative impact on the patient’s daily life and quality of life. In extreme cases, this can include suicidal thoughts and eventually suicide if the condition is not properly treated. In most cases, those affected by this disease appear aggressive and highly irritable. Especially in children, this disorder can therefore also significantly delay and restrict development. Many patients suffer from outbursts of rage or anger that occurs for no particular reason. It is not uncommon for a destructive rage to occur, so that patients may also hurt other people or destroy objects. Furthermore, complaints occur during contact with other people, whereby the affected persons show only few social skills. The capacity for empathy is also extremely reduced or non-existent in this disorder. Patients usually act selfishly, thinking only of their own well-being. Therefore, lying or concealment of various actions is common. The disease therefore also has a negative effect on the relationship with relatives or the partner of the affected person.
Diagnosis and course
The diagnosis in ICD10 and the more modern classification system DSM-IV shows significant differences, among other things, the DSM-IV specifies an age limit from 18 years and speaks it of antisocial, ICD10 of dissocial personality disorder. Psychiatrists more often use the DSM-IV for diagnosis, so the following is a brief overview of the diagnostic criteria mentioned there. 1. the affected person shows a strong pattern of disregarding the rights of others since the age of 15, here seven criteria are distinguished. 2. the diagnosis can only be made when the person concerned is 18 years old or older. 3. disturbed social behavior in the sense of dissociality occurred before the age of 15. 4. the antisocial behavior must not be episodically related to schizophrenia or mania. Few conclusions can be drawn about the course of antisocial personality disorder. It is important to note that dissocial behavioral problems in childhood are a sure indication of a later antisocial disorder.Further, it was found that antisocial behavior decreases with age and affected individuals become calmer in middle age.
When should you see a doctor?
Seeing a psychologist is definitely necessary for this condition. This can prevent further complications. In an emergency or in severe cases of this disease, it is also necessary to stay in a closed clinic. Above all, the parents and relatives of a patient must recognize the symptoms and offer or initiate treatment. As a rule, a doctor must be consulted when the affected person shows aggressiveness and outbursts of anger. Similarly, the patient has little social skills and cannot properly assess his actions and behavior. The affected person also completely lacks empathy. Furthermore, persistent lying may indicate the disease and should be examined by a physician. Especially in adolescents at the age of 15 years, these complaints can occur. Treatment for this disorder is usually provided by a psychologist. However, friends and relatives of the patient can also significantly contribute to a positive course of the disease.
Treatment and therapy
Problematic in the treatment of antisocial personality disorder is that any therapy requires the patient to be suffering. Only when this is present will a patient decide to undergo therapy and actively cooperate in his or her recovery. Antisocial personalities, however, have no suffering pressure. On the contrary, they feel comfortable with themselves and tend to get angry with those who do not understand them, i.e. mostly their fellow human beings. Sufferers do not understand why their lives should become easier if they comply with social and legal norms. Family and physicians should nevertheless show empathy and train the affected person to develop empathy. Another therapy option is to practice impulse and affect control. However, if the affected persons are ready for therapy and find a psychotherapist or psychiatrist who classifies them as capable of therapy and wants to work with them. Thus, the combination of highly structured behavioral therapy and psychotropic drug administration promises the greatest success. Both address the impulse control factor, because the emotional and empathic incapacity seem to be biologically determined and therefore incurable. However, encouragement of empathy can be attempted.
Outlook and prognosis
Dissocial personality disorder is not curable, but the affected person can learn to cope with the consequences of this personality disorder and lead a largely normal life. Affected persons need psychological care for years, which can be difficult because they often do not feel any pressure to suffer for a long time. Those around them urge them to see a psychologist, which is not a good prerequisite for a lasting improvement in their dealings with others and their own position in society. If professional help is sought early in life, the chances are better that the affected person will learn to deal with his personality disorder in a way that allows him to integrate into society without attracting attention. The longer a dissocial personality disorder is allowed to develop, the more likely it is that sufferers will get into social difficulties as a result. For example, they are particularly at risk of carrying out criminal acts. This can be avoided with timely psychological help. Discontinuation of therapy that has already begun and is voluntary is not uncommon with dissocial personality disorder, which worsens the affected person’s prospects of leading a normal life. Furthermore, persons with dissocial personality disorder have an increased risk of suicide, although they do not necessarily suffer from depression. Rather, this is due to an increased awareness of risk, but is still a risk factor for them.
Prevention
There is only one means of preventing antisocial personality disorder: a loving, confidence-inspiring and orienting parental home. If this cannot be provided, early therapy should be given at the first signs of dissocial behavior in order to halt or at least mitigate the progression to antisocial personality disorder.
Aftercare
With this personality disorder and psychopathy, there are usually very few or no options and measures of aftercare available to the affected person.The affected person is primarily dependent on a quick and early detection of this disease, so that it does not come to further complications and also not to a worsening of the complaints. The earlier the personality disorder and psychopathy are recognized, the better the further course of the disease usually is, although a complete cure cannot always be guaranteed. It is also important that the relatives and friends of the affected person also deal with this disease and inform themselves about the disease, so that no wrong behavior is carried out. As a rule, the person affected by the personality disorder and psychopathy is dependent on a visit to a psychologist and furthermore also on taking medication. It is necessary to pay attention to a correct dosage with a regular intake in order to relieve the symptoms permanently. The visits to the psychologist should also be carried out regularly. As a rule, the personality disorder and psychopathy does not reduce the life expectancy of the affected person.
What you can do yourself
Self-treatment for a mental disorder is difficult in principle. Often, sufferers are unaware of their disorder themselves or deny it. However, treatment can only be successful if the patient actively participates in it. Moreover, mental illnesses cannot be cured by self-treatment. Only supportive measures can contribute to a faster healing. In most cases, relatives and friends are the first to recognize an existing problem. They should actively seek discussion. If the affected person is ready for therapy, he or she must participate in it consistently. In addition, the offer of a professionally accompanied self-help group can be taken up. The basis is formed by exercises for impulse and affect control as well as further behavioral training. These should also be repeated at home with familiar people. This requires constant support from the patient’s social environment. There is often no alternative to the supplementary use of medication. These must also be taken constantly. If the therapy progresses successfully, patients can also choose other methods that give them inner stability. Autogenic training or yoga are one possibility. If the first signs of a lack of impulse control already appear in children, treatment should be started at an early stage. Here, the accompanying educators are also called upon to give parents advice. A stable and loving home provides the best support.
