ANTISOCIAL PERSONALITY DISORDER: SYMPTOMS, CAUSES - GEOGRAFÍA - 2025

The antisocial personality disorder (TPA) is a type of mental condition characterized because the person shows destructive behavior and has little respect for social norms. The way of thinking of the person, his perception of situations and his way of relating to others is dysfunctional and destructive.

Typically, people with this disorder have little regard for right and wrong and often disregard the rights, feelings, and wishes of others. Antisocial people tend to treat others harshly, indifferently, or manipulating them. Even if they break the law or get in constant trouble, they show little guilt or remorse.

They can behave violently, lie, act impulsively, and have problems with drugs and alcohol. All this causes that people with this disorder are not able to lead a normal life and have responsibilities, such as having a job, training or building a family.

Difference between antisocial personality disorder and psychopathy

Although psychopathy is not a formally recognized mental disorder by the APA (American Psychiatric Association), it is considered a more severe form of antisocial personality disorder.

Although the relationship between psychopathic personality and APD is uncertain, the two syndromes do not clearly overlap. These are the characteristics of psychopathy:

• They do not feel empathy for people, and in general, for living beings.
• Although they are often "charming," they are unable to bond emotionally with other people.
• They tend to be manipulative and know how to earn the trust of others.
• Although it is difficult for them to feel emotions, they learn to show them.
• Therefore, they seem normal, they are not "weird".
• They usually lead normal lives, have good jobs, and are well educated.
• It is difficult to know if someone is psycho or not because they are so good at manipulating and pretending.
• When they commit crimes (only a very small minority of psychopaths commit them), they do it in a planned way.
• They are calm, meticulous and some are very charismatic.
• They are usually leaders.
• According to specialist Robert Hare: “They look smart, but they're not really especially bright. Some yes, of course. And when they are intelligent they are more dangerous ”.

Symptoms

The characteristic signs and symptoms of APD are:

• Constantly lying to deceive others.
• Using charm to manipulate other people.
• Intense egocentricity, sense of superiority or exhibitionism.
• Recurring difficulties with the law.
• Repeatedly violating the rights of others by using intimidation or dishonesty.
• Child abuse or neglect.
• Impulsiveness, aggressiveness, hostility, irritability, agitation.
• Lack of empathy for others and lack of remorse for hurting others.
• Dangerous or risky behaviors.
• Poor or abusive relationships.
• Inability to learn from the negative consequences of behavior.
• Tendency to use drugs or alcohol.

Symptoms of APD can begin in the teens and are evident in people in their 20s to 40s. In children, early signs can be observed in behaviors such as: cruelty towards animals, bullying, impulsivity or social isolation.

Although it is considered a life-long disorder, some symptoms (especially criminal behavior and drug or alcohol use) may decrease over time. However, it is not known whether this reduction is due to age or to an awareness of the consequences of negative behavior.

Causes of antisocial personality

Personality is a combination of thoughts, emotions, and behaviors that make each person unique. It seems that personality disorders are a combination of genetic and environmental influences.

Hormones and neurotransmitters

Traumatic events can lead to the interruption of the normal development of the central nervous system, which generates a release of hormones that can change the normal pattern of development.

Criminals who have committed violent crimes tend to have higher levels of testosterone in their blood.

One of the neurotransmitters that have been studied in people with TPA is serotonin. A meta-analysis of 20 studies found significant low levels of 5-HIAA (indicating low serotonin levels), especially in people younger than 30 years.

Some studies have found a relationship between monoamine oxidase A and antisocial behavior, including TPA, in abused children.

Cultural differences

Cultural norms differ significantly, and therefore disorders like APD can be viewed differently depending on the country.

Robert Hare has suggested that the increase in APR that has been reported in the United States may be related to changes in cultural mores.

Ambient

Some studies suggest that the social and family environment contribute to the development of antisocial behavior. Parents who display antisocial behaviors can pass them on to their children, who learn them by observation.

Brain injuries

Since 1980 some scientists have associated brain injuries, including damage to the prefrontal cortex, with the inability to make morally and socially acceptable decisions. Children with early damage to the prefrontal cortex may not develop moral or social reasoning.

On the other hand, damage to the amygdala can affect the prefrontal cortex's ability to interpret feedback from the limbic system, which could result in uninhibited signals that manifest in aggressive behaviors.

Antisocial personality subtypes

Psychologist Theodore Millon suggests 5 subtypes of APD:

• Nomad (includes schizoid and avoidant characteristics): feels jinx, failed, condemned. They are usually isolated or abandoned. They can show resentment and anger at the slightest provocation.
• Malevolent (includes sadistic and paranoid characteristics): belligerent, spiteful, vicious, evil, brutal, resentful; anticipates betrayal and punishment; wishes for revenge; truculent, insensitive, fearless; without guilt.
• Miser (variant of the pure pattern): feels intentionally rejected and private; bad attitude, discontent; envy, seek revenge, greed; more pleasure in taking than in having.
• Risk taker (including histrionic characteristics): intrepid, adventurous, fearless, daring; reckless, reckless, impulsive, inattentive; unbalanced by risk; chase dangerous adventures.
• Defender of reputation (including narcissistic characteristics): needs to be considered as infallible, unshakable, invincible, indomitable, formidable, inviolable; they defend their reputation with antisocial acts, aggressive leadership.

Diagnosis

When a healthcare professional thinks a person may have APD, they can usually carry out a series of medical tests and examinations to help determine the diagnosis:

• Physical exam: This is done to rule out other problems that may cause symptoms.
• Laboratory tests: can include for example a complete blood count or a thyroid function check.
• Psychological evaluation: The mental health professional evaluates feelings, personal relationships, thoughts, family history, and patterns of behavior.

A person with APD may not confirm their actual signs and symptoms. Family and friends can help provide information.

A key factor in the diagnosis is how the person relates to others. Someone with APD probably has a poor understanding and empathy for other people's feelings and thinking.

Diagnostic criteria according to DSM-IV

A) A general pattern of contempt and violation of the rights of others that occurs from the age of 15, as indicated by three (or more) of the following items:

1. Failure to conform to societal norms regarding legal behavior, as indicated by repeatedly committing acts that are grounds for arrest.
2. Dishonesty, indicated by repeatedly lying, using an alias, or defrauding others for personal gain or pleasure.
3. Impulsiveness or inability to plan for the future.
4. Irritability and aggressiveness, indicated by repeated physical fights or assaults.
5. Reckless disregard for your safety or that of others.
6. Persistent irresponsibility, indicated by the inability to maintain a job with constancy or to assume financial obligations.
7. Lack of remorse, as indicated by indifference or justification for having harmed, mistreated or stolen from others.

B) The subject is at least 18 years old.

C) There is evidence of a conduct disorder that begins before the age of 15 years.

D) Antisocial behavior does not appear exclusively during a schizophrenia or a manic episode.

ICD-10

According to the ICD (International Classification of Diseases), antisocial personality disorder is characterized by at least 3 of the following:

1. Indifference to the feelings of others.
2. Persistent attitude of irresponsibility and disregard for social norms and obligations.
3. Low tolerance for frustration and low threshold for the discharge of aggression, including violence.
4. Inability to experience guilt or to profit from the experience, particularly from punishment.
5. Marked willingness to blame others or to offer plausible rationalizations for behavior that has brought the person into conflict with society.

Comorbidity

The following conditions normally coexist with TPA:

• Anxiety disorders.
• Depressive disorder.
• Substance use disorders.
• Somatization disorder.
• Attention deficit hyperactivity disorder.
• Borderline personality disorder.
• Histrionic personality disorder.
• Narcissistic personality disorder.

Treatment

TPA is difficult to treat; people with this disorder usually do not want to be treated or think they need it.

However, in order for them to function normally, long-term treatment is necessary.

Also, these people may need treatment for other conditions such as substance abuse, depression, or anxiety.

The best treatment or combination of treatments depends on the individual situation of each person or the severity of the symptoms.

Psychotherapy

Psychotherapy is not always effective, especially if the symptoms are severe and the person cannot admit that he or she contributes to their problems.

It can be given in individual sessions, in groups, with family or even with friends.

Medication

There is no specially approved medication to treat TPA. However, various types of psychiatric medication can help control aggression and other associated conditions.

These drugs can be: antidepressants, mood stabilizers and antipsychotics. They must be prescribed with care because they can be misused.

Family training

People who live with people with APD may need help. Mental health professionals can teach skills to learn to set limits and protect yourself from aggression, violence, and hatred.

Risk factor's

Certain factors seem to increase the risk of developing APD:

• Diagnosis of conduct disorder in childhood or adolescence.
• Family history of APD or other personality disorder or mental illness.
• Having suffered physical, sexual or verbal abuse during childhood.
• Chaotic and unstable life during childhood.
• Having gone through traumatic divorces during childhood.
• History of substance abuse in parents or other family members.
• Men are at higher risk.

Complications

The complications and consequences of TPA can be:

• Participate in criminal gangs.
• Aggressive behavior or physical violence.
• Risky behavior.
• Child abuse.
• Substance abuse.
• Gambling problems.
• Go to jail.
• Problems with personal relationships.
• Occasional periods of depression or anxiety.
• Problems at school and work.
• Low socioeconomic status.
• Loss of housing.
• Early death.

Prevention

There is no sure way to prevent this personality disorder, although children at risk of developing it can be identified and early intervention offered.

Although APD is not usually diagnosed before the age of 18, children at risk may show some behavioral or aggressive symptoms:

• Mistreat other children.
• Conflicts with family members or authority figures.
• Steal.
• Cruelty to people and animals.
• Vandalism.
• Use of weapons.
• Lying repeatedly.
• Poor school performance.
• Participation in bands.
• Escape from home.

Early discipline, social skills training, family therapy, and psychotherapy can help reduce the risk of developing ASD.

References

1. Dissocial personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10).
2. Millon, Theodore - Personality Subtypes. Millon.net. Retrieved on 7 December 2011.
3. "Antisocial personality disorder". Mayo Foundation for Medical Education and Research. July 13, 2013. Retrieved October 25, 2013.
4. "Protect - Watch Your Head". The Franklin Institute Online. The Franklin Institute. 2004. Retrieved July 10, 2013.