What is Antisocial Personality Disorder?
When
a person is diagnosed with Antisocial Personality Disorder it means that a
professional has determined that they have an ongoing pattern of manipulating,
exploiting, or violating the rights of others. In general, Personality Disorders are ways
that clinicians diagnose Personality patterns that are pervasive and
inflexible, they represent distorted ways in which the person perceives themselves, others and the world. With an Antisocial Personality Disorder diagnosis, a clinician is saying clearly that this person has a blatant disregard
for other people and that they repeatedly violate the rights of others through
things they say, things they do and the choices they make. People with Antisocial Personality Disorder have an impoverished moral sense or conscience, they are beyond just missing a "sensitivity chip" they are calculated, cold, intending to harm and intending to get away with the harm they cause. These are people who don’t care about anyone truly unless someone is able to further their pathetic manipulation of others. Once generally thought of to be behavior exclusively of criminals the diagnosis has evolved to be a predominantly immoral personality that can impact anyone and be found anywhere. On the surface they may actually appear quite normal, pleasant, even socially appropriate, but underneath that facade is a person who on a daily basis is engaging in thoughts, feelings and/or activities that most people would find morally repugnant.
These people are violent, deceptive and greedy. They seek out others only for their own benefit and have little to no empathy for the quality of others lives unless their presence serves them.
The
symptoms (or Characteristic Behaviors) for Antisocial Personality Disorder (ASPD) consists of the majority of the following:
- Failure to conform to social norms with respect to lawful behaviors as
indicated by repeatedly performing acts that are grounds for arrest.
- The traditional method for
diagnosis relied heavily on identifying that the person had an actual arrest history as the diagnosis is contingent on a person meeting the criteria for Conduct Disorder with a childhood onset or an adolescent onset *. However most clinicians today recognize that it is far more important to do an extensive history that includes but is not limited to: interpersonal relationships (social, sexual, peer, and family), education history, interaction with authorities, drug use, experience with animals, work experience and general method of navigating conflict, to assess whether the person failed to conform to social norms with regards to lawful behavior. People behave in illegal and immoral ways every day. The significance as to whether or not they were caught or held responsible by others has become irrelevant for assessment.
- Deceitfulness, as indicated by repeated lying, use of aliases, or
conning others for personal profit or pleasure.
- Deceitfulness can be
demonstrated in many forms. The concept
of lying excessively even if just to make it appear to others that one is a
better person than they are is an Antisocial Personality trait. We all want others to think well of us, but people with ASPD are excessively deceitful and their lies are purposeful and without remorse. They are almost unable to be authentic in any manner as their entire methodology of navigating the world is orchestrated by the desire to not allow anyone to know their true self. They take great pleasure in lying to others so much so that the act of lying becomes more common than telling the truth. They are highly skilled at deception. In times where the person must achieve a goal their lying becomes so profuse and frequently so convincing that others around them can't imagine that they are possibly untruthful. They lie with conviction. They lie to who they know will accept their lies. They lie to anyone they need to fulfill whatever scenario they want others to accept. Part of their lying has a Narcissistic basis. While some with ASPD will appear not to care about others opinions at all, the vast majority have overlapping Narcissism and their lies are heavily expelled in order to force others to see them in a good light. In Antisocial Personality Disorder, we see people who are frequently conning
others. The con itself is pleasurable and
the outcome of the con usually profitable be it by money, status, or acceptance. These are the men and women who kill their spouses or hide multiple spouses, the financial analysts and brokers who scam innocent people into relinquishing their nest eggs, these are the children who manipulate their elderly parents for extensive inheritances, and the people who run from the law, run from responsibility and run from anything that might connect them personally to the horrible acts they have participated in.
- Impulsivity or failure to plan ahead.
- People with Antisocial
Personality Disorder are impulsive. They
do things and say things without giving thorough thought as to what the
consequences will be and that is because they do not care about
consequences. In their mind they will be
able to escape consequences. Traditionally, people with ASPD do have the ability to execute
master plans but they have difficulty evaluating the long term affects of their plan. They care greatly about short term gain and if they can achieve long term it would be celebrated but in general it is a moment by moment decision of satisfaction. They are the criminals we as a society know all too well but they are also the neighbors who hide many secrets. While it is stated that they do not plan
ahead, this is meant to refer to the person being unable to curb
impulses when in the moment, not necessarily to drifters or gypsy like
personalities whom strategic planning is a challenge. An impulsive crime may be pursued but they lack awareness that this might lead to a potential life in jail sentence.
An impulsive abandonment may be made but they lack an awareness of the experience they might have if it means a potential lifetime without
that person. An impulsive walk out of place of employment may feel satisfying and empowering but they lack an awareness that this might lead to financial ruin, loss of a home or even a record on their resume. In short, they make impulsive decisions frequently done in anger and fail to execute the thought one needs to insure the decision does not result in long term undesired effects.
- Irritability and aggressiveness, as indicated by repeated physical
fights or assaults.
- People with Antisocial
Personality Disorder are aggressive physically.
They tend to engage in violence when words would do, tend to yell, when
discussion could occur and they tend to feel incredibly entitled to be abusive
with whomever they choose whenever they choose. They lack a certain emotional intelligence and rely on primitive ways to handle their frustrations. Differences in gender and age impact how a person with ASPD expresses this criterion as well as time of onset as those with adolescent onset* show a marked decrease in traditional violence symptoms but can frequently develop into more aggressive people later in life. Alternatively, some people tend to get more withdrawn and irritable later in life perhaps because they lack the physical ability to express their frustrations as they had in the past. They are moody people who put on great facades with many people but internally are like a volcano ready to erupt at any moment.
- Reckless disregard for safety of self or others.
- With
Antisocial Personality Disorder, a person takes what they want when they
want without regard for how their actions may harm themselves or others. The covet the prize and dismiss the body counts. Like the Narcissist, they care mostly for themselves and will go out of their way to insure their needs are met (which involve the safety of their lives: stability, financial security, status, etc.). This particular criteria is not about the Antisocial displaying a disregard for their personal safety, it is simply a safety for themselves to not receive negative punishment. These are the pathological
criminals who commit first-degree murder because their rage at the victim is simply overwhelming but they are also the arrogant drug
dealer who justifies the lives he/she ruins or the teacher who takes sexual advantage
of a student and even the family members who allow atrocities to occur against
one another in order to protect their own interpersonal standing and security. They are innately cowards and if at all possible will delegate out their antisocial acts, but if they must put others at risk (physical, emotional, financial, etc.) they will gladly do so while justifying their behavior. They are thrill seekers people who use others for their thrills. They are the people who can damage lives without regard to how it will
affect those who care about them. They
are entitled, massively entitled to do what they want and to whomever they
want.
- Consistent irresponsibility, as indicated by repeated failure to sustain
consistent work behavior or honor financial obligations.
- Because people with Antisocial Personality Disorder ultimately lack impulse control, they are highly irresponsible and will be reckless with their work and financial obligations. People with this criteria again have a large overlap with Narcissistic Personality Disorder. They have a tremendous lack of gratitude, strong sense of entitlement and no remorse when they have taken advantage of others kind nature. The irresponsibility they demonstrate can be seen early on as they believe they are deserving of more, angry that others are withholding, and this inner rage of entitlement allows them to be reckless usually knowing that there will be some poor sucker coming their way that they can manipulate into saving them. Many of them tend to move from job to job but mostly because they cause ruin within their employment and can easily be fired. Those who decide to go into their own business frequently find naive benefactors who they can repeatedly scam with lies into continuing to support them. Those that try it completely on their own may be the type who move from house to house, city to city, carefully and purposefully manipulating others and staying one foot ahead of anyone trying to catch them.
- Lack of remorse, as indicated by being indifferent to or rationalizing.
- Because of their very low or absent capacity for remorse, individuals with ASPD often lack sufficient motivation and fail to see the costs associated with antisocial acts. They may only artificially simulate the expressions of remorse rather than truly experience remorse: they can be seductively charming and dishonest, and may manipulate those around them in order to maintain their trust so that they can continue their antisocial acts. Like the Narcissist, people with Antisocial Personalities are obsessed only with themselves and are willing to do anything necessary to maintain the idealized image they have presented. One of the absolute hallmarks in Antisocial Personality Disorder
is a lack of remorse and a very obvious response of indifference or
rationalization. In a true psychopath,
there is this almost tangible indifference to others even when grave harm has
occurred as a result of their actions.
In others who are less criminal but equally pathological, they care greatly about
how other people perceive them which leads them to take great steps to insure that
others will not become aware of their behavior.
These particular people rationalize their horrid acts. You will frequently hear benign comments such
as “they made me do it” to overt lies suggesting acts never occurred. They tend to apply a plethora of defensive mechanisms to maintain a space between their actions and those behaviors they want people to believe. They always have a story and it is never based truly in reason or fact. They take advantage of the fact that people do not want to believe in evil and will choose to accept good if it is presented as a possibility. An astute person will notice their rationalization and not find it a possibility. For these people, the wrath of the Antisocial Person can be filled with hate, revenge and attempts to annihilate. It doesn’t matter if they are rationalizing their drunken fist fight, stealing money, hitting a sibling or abandoning their grandchild, these people
will always have an excuse.
-
It has an onset in adolescence or early adulthood, is stable over time,
and leads to personal distress or impairment and impacts those around them.
- The modern clinician knows that a person with Antisocial Personality Disorder is no longer exclusively the career criminal. This, like all personality disorders, are seen now more on a spectrum with the most significantly pathological being the emotionally barren mass murderer to the quite neighbor who happens to take secret pleasure in terrorizing their family. We look for signs in childhood that would reveal the most significant pathology. In those children under 10 who demonstrate pathology it is almost certain that they have been victims of severe child abuse, however in older children, we see a shift in personality where an adolescent isn't fitting in quite well. They may isolate themselves in groups or be loners. But there is an attitude towards the world that is defiant and entitled. There may be elevated expectations from the child to parents or peers, or the start of deviant liar for status or monetary gain. In adulthood, when a clinician may not be told the accurate childhood history, we look for overt signs of manipulation, a detachment from things that normally would breed attachment and a lack of empathy or remorse for situations or people whom they may have harmed or conned. When we evaluate the person for the criteria and they meet it, a clinician will tend to start digging deeper and see the many ways they may have masked their true Antisocial Nature.
* In Antisocial Personality Disorder with Adolescent-Onset, one will not see any criteria characteristic of
Conduct Disorder prior to age 10. These
children, or young adults as they should be called, tend to have substantially
less or no aggressive behaviors and more normative peer relationships. However, in the company of others such as family,
school authorities and friends, they frequently display distinct qualities that
can be quite subtle and overlooked. They
will be more manipulative than violent and more societal appropriate than
deviant. The range in this group can be
enormous. A distinction for this subtype compared to the Childhood-Onset
subtype is that they are more directly influenced by life experiences. During adolescence, this subtype will evolve and
alter in motivation and may not even develop Antisocial Personality Disorder
but merely the spectrum characteristics whereas the Childhood-Onset maintains a
similar motivation from childhood to adulthood and without intervention is
almost certain to develop Antisocial Personality Disorder.
Personality
functioning manifest
by:
The following explain the areas of functioning impacted by a person with Antisocial Personality Disorder.
Impairments in self functioning:
* Identity: Ego-centrism; self-esteem derived from personal gain, power, or pleasure.
*Self-direction: Goal-setting based on personal gratification; absence of prosocial internal
standards
Impairments in interpersonal functioning:
*Lack Empathy-Lack of concern for feelings and/or the needs or suffering of others. Lack of remorse after mistreatment or hurting another.
*Lack of true intimacy - use of others to exploit, use of deceit and coercion, use of domination to control others
a. Pathological personality
traits in the
following domains:
*Antagonism - Manipulativeness:
Frequent use of subterfuge to influence or control others; use of seduction,
charm, glibness, or ingratiation to achieve one„s ends.
*Deceitfulness: Dishonesty and fraudulence; misrepresentation of self;
embellishment or fabrication when relating events.
*Callousness: Lack of concern for feelings or problems of others; lack of guilt
or remorse about the negative or harmful effects of one„s actions on others;
aggression; sadism.
*Hostility: Persistent or frequent angry feelings; anger or irritability in
response to minor slights and insults; mean, nasty, or vengeful behavior.
Disinhibition, characterized by:
*Irresponsibility: Disregard for – and failure to honor – financial and other
obligations or commitments; lack of respect for – and lack of follow through on
– agreements and promises.
*Impulsivity: Acting on the spur of the moment in response to immediate stimuli;
acting on a momentary basis without a plan or consideration of outcomes;
difficulty establishing and following plans.
The International Classification of Disease ICD-10
Has a diagnosis called Dissocial Personality disorder.
This is an overlap of Antisocial Personality Disorder with some elements of Narcissistic Personality traits. It falls under a medical diagnosis and serves as a means to describe people who at their core do not feel responsible for their actions. Although traditional diagnosis of Mental disorders have fallen under the realm of DSM et al., this allowance for a medical diagnosis offers a broader charcterization of the disirder and could provide complimentary medical assessment as the diagnoses evolves.
It is characterized by at least 3 of the
following:
Callous
unconcern for the feelings of others;
Gross
and persistent attitude of irresponsibility and disregard for social norms, rules, and
obligations.
Incapacity
to maintain enduring relationships, though having no difficulty in establishing
them.
Very
low tolerance to frustration and a low threshold for discharge of aggression including but not limited to violence
Incapacity
to experience guilt, any real sense of true remorse
and have a failure to profit from experience, particularly punishment.
Marked
readiness to blame
others or to offer plausible rationalizations
for the behavior that has brought the person into conflict with society or others.
The
ICD states that this diagnosis includes:
"amoral, antisocial, asocial,
psychopathic, and sociopathic personality".
I've seen this and I cannot agree more with the description.
(All rights reserved. January 27, 2014)