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antisocial personality disorder

Alternative Names 
psychopathic personality disorder , sociopathic personality disorder

Definition
Antisocial personality disorder is a personality disorder defined by continuous and long-term antisocial behaviour. Early childhood signs include lying, stealing, fighting, and missing school. Before age 15, disrespect for others and violation of other's rights are signs of the disorder. Problems in adolescence can be early or aggressive sexual behaviour. Also, excessive drinking and illicit drug use can occur. These problems continue into adulthood. The diagnosis is not made until the person is over 18.

What are the signs and symptoms of the condition? 
Individuals with antisocial personality disorder may seem cold and insensitive. Or they can seem charming, but cunning and insincere. They tend to view relationships only in terms of what can be gained.

People with the disorder may think that it is reasonable to manipulate or deceive others to get what they want. As a result, these individuals tend to have a general disregard for rules, laws and customs. They assume that these rules and laws do not apply to them. This causes frequent problems at work or with the law.

There tends to be little or no sense of guilt about the harm or pain these individuals cause others. They have a difficult time with responsibility and honesty. This causes problems in relationships and employment. Other symptoms include:
  • impulsiveness
  • lack of conformity to social norms involving rules, regulations and laws.
  • general lack of regard for consequences of behaviour.
  • lack of empathy.
  • lack of honesty.
  • irritability, aggressiveness and/or violent behaviour.
  • disregard for safety and responsibility.
  • lack of conscience or remorse.


What are the causes and risks of the condition? 
The specific causes of antisocial personality disorder are not known. The disorder occurs much more often in people who have an antisocial biological parent. As a result, biological and genetic factors are thought to play a significant role. Additionally, the disorder is four times more common in men than in women.

Frequent exposure to criminal behaviour and substance abuse is thought to contribute to the development of the disorder. Children raised in a chaotic, neglectful, harsh and abusive environment are also at higher risk.

How is the condition diagnosed? 
A doctor makes the diagnosis based on the symptoms and behaviours of the individual. In addition, psychological testing is sometimes used to diagnose antisocial personality disorder.

What are the long-term effects of the condition? 
Individuals with this disorder usually have long-term problems in relationships with others. A repeated pattern of job and legal problems is often seen.

What are the treatments for the condition? 
Psychotherapy is the primary treatment for this disorder. Medications may also help reduce specific symptoms such as mood swings and irritability. Medications, however, are used only in addition to psychotherapy.

Individuals with antisocial personality disorder rarely seek treatment. Instead, they are pressured into treatment by family members, or employers. Treatment may be ordered by the court. Because the person with antisocial personality disorder does not understand his or her problem, treatment is very difficult. Effective therapy is limited, but behavioural approaches can be helpful. These types of approaches help the person make a connection between feelings and actions. Many individuals with this disorder have not had made emotional connection in a relationship. Therefore, a therapeutic relationship between the individual and doctor is critical.

Author: Ann Reyes, Ph.D.
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 25/04/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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