Antisocial Personality Disorder (ASPD), sometimes called sociopathy, is a mental disorder in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior.
The Diagnostic and Statistical Manual of Mental Disorders (DSM 5 - TR) classifies ASPD as a “Cluster B” or “erratic” illness, comparable in symptoms to borderline, narcissistic, and histrionic personality disorders. The DSM restricts the diagnosis of ASPD to individuals who are at least 18 years of age but who have experienced antisocial tendencies before age 15. Symptoms tend to surface during a person’s late teenage years and early twenties, however they can also improve on their own by the time the individual is in their forties.
For forensic nurses, it is important to remember that individuals with antisocial personality disorder often violate the law, becoming criminals. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. Because of these characteristics, people with this disorder typically can't fulfill responsibilities related to family, work, or school.
Although the causes of ASPD are highly disputed, research has found that antisocial behavior is linked to abnormalities in the chemistry and anatomy of the human brain. Low levels of the neurotransmitter serotonin and maldevelopment of limbic and septal brain regions are believed to affect judgement, planning, and impulse control in ASPD sufferers. Furthermore, environmental factors, including low socio-economic status, low education levels, and familial lifestyle, contribute to the onset of ASPD. Criminal behavior is frequently associated with ASPD, and it is believed that 40 to 70 percent of the prison population meets the criteria for this diagnostic category - compared to the 1 to 3 percent in the general population. Although there may not be a clear explanation for why some people turn to crime, researchers have now found are some overarching risks and manifestations that are common among those persons with a diagnosis of ASPD as noted in the Fast Facts below:
Fast Facts:
Causes
Personality is the combination of thoughts, emotions and behaviors that makes everyone unique. It's the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.
The exact cause of antisocial personality disorder isn't known, but:
· Genes may make you vulnerable to developing antisocial personality disorder — and life situations may trigger its development
· Changes in the way the brain functions may have resulted during brain development
Risk factors
Certain factors seem to increase the risk of developing antisocial personality disorder, such as:
· Diagnosis of childhood conduct disorder
· Family history of antisocial personality disorder or other personality disorders or mental health disorders
· Being subjected to abuse or neglect during childhood
· Unstable, violent or chaotic family life during childhood
· *Men are at greater risk of having antisocial personality disorder than women are.
Antisocial personality disorder signs and symptoms may include:
· Disregard for right and wrong
· Persistent lying or deceit to exploit others
· Being callous, cynical and disrespectful of others
· Using charm or wit to manipulate others for personal gain or personal pleasure
· Arrogance, a sense of superiority and being extremely opinionated
· Recurring problems with the law, including criminal behavior
· Repeatedly violating the rights of others through intimidation and dishonesty
· Impulsiveness or failure to plan ahead
· Hostility, significant irritability, agitation, aggression or violence
· Lack of empathy for others and lack of remorse about harming others
· Unnecessary risk-taking or dangerous behavior with no regard for the safety of self or others
· Poor or abusive relationships
· Failure to consider the negative consequences of behavior or learn from them
· Being consistently irresponsible and repeatedly failing to fulfill work or financial obligations
Adults with antisocial personality disorder typically show symptoms of conduct disorder before the age of 15. Signs and symptoms of conduct disorder include serious, persistent behavior problems, such as:
· Aggression toward people and animals
· Destruction of property
· Deceitfulness
· Theft
· Serious violation of rules
· Although antisocial personality disorder is considered lifelong, in some people, certain symptoms — particularly destructive and criminal behavior — may decrease over time. But it's not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.
Consequences and Challenges of antisocial personality disorder potentially include:
· Spouse abuse or child abuse or neglect
· Problems with alcohol or substance use
· Being in jail or prison
· Homicidal or suicidal behaviors
· Having other mental health disorders such as depression or anxiety
· Low social and economic status and homelessness
· Premature death, usually as a result of violence
· Prevention
Final Thoughts
There's no absolute way to prevent antisocial personality disorder from developing in those at risk. Because antisocial behavior is thought to have its roots in childhood, forensic nurses, parents, and teachers may be able to spot early warning signs. It may help to try to identify those most at risk, such as children who show signs of conduct disorder, and then offer early intervention.
thanks Paul !!!