Antisocial Personality Disorder
Rule breaking, angry, contemptuous
Information about Antisocial Personality Disorder – its presentation, symptoms and treatment.
Beliefs, emotions and behaviour:
A person with this personality will feel that they are entitled to break the rules. They may view others as easily manipulated and with contempt. They perceive themselves as better than others.
Missing Interpersonal Ability:
Empathy, Sociability
Such an individual is likely to show both instrumental and reactive (emotional) aggression and attempt to control others to do things for them. They are seen as lacking empathy and feel the need to be dominant over others. Creation of fear can be used as a mechanism to keep themselves safe. They are likely to have a criminal history with a range of crimes.
Antisocial Personality Disorder is linked to these other disorders:
- Psychopathy
- Conduct Disorder/ ADHD
- Substance Misuse disorders
I am a loner, strong, independent
Beliefs about self
Others are vulnerable and there to be exploited
Beliefs about others
The world is a threatening place
Beliefs about the world
Connor was bought up by his mother, who remarried when he was 5. He describes how he feels that he was never wanted by his mother and that he was seen as a bad reminder of her old life. At school he was disruptive and found it hard to concentrate, being expelled at age 7 for attempting to set fire to the gym. He started to use alcohol and cannabis at age 10 with friends when they would steal from back gardens and cars to get money. Connor was seen as the ‘ring leader’.
As he grew older he started to deal drugs, and would become involved in robberies and steal cars. He said he did this for the ‘buzz’ rather than for money. He is involved with a local gang and has convictions for GBH, having spent time in prison. Connor has had a number of girlfriends, often at the same time, but is controlling and aggressive within these meaning they do not last long. He has tried to work, but finds it boring and gets angry quickly when ‘told what to do’.
example presentation
DSM V Criteria:
According to the DSM-5, the main criteria for ASPD are:
A. Disregard for and violation of others rights since age 15, as indicated by one of the seven sub features:
- Failure to obey laws and norms by engaging in behaviour which results in criminal arrest, or would warrant criminal arrest
- Lying, deception, and manipulation, for profit or self-amusement,
- Impulsive behaviour
- Irritability and aggression, manifested as frequently assaults others, or engages in fighting
- Blatantly disregards safety of self and others,
- A pattern of irresponsibility and
- Lack of remorse for actions
The other diagnostic Criterion are:
B. The person is at least age 18,
C. Conduct disorder was present by history before age 15
D. and the antisocial behaviour does not occur in the context of schizophrenia or bipolar disorder
Treatment for Antisocial Personality Disorder
The NICE guidelines for this disorder state that cognitive and behavioural therapies should be offered. These can include interventions that focus on impulsivity, interpersonal difficulties, substance misuse and antisocial behaviour. Therapies including mentalisation based therapy (MBT) and Schema therapy have also started to develop an evidence base for treating ASPD.
Guidelines state that medication should be used to treat associated problems, including depression and anxiety. However, medication is not routinely recommended for Antisocial Personality Disorder.
