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Antisocial Personality Disorder

Synonyms of Antisocial Personality Disorder

  • ASP

Disorder Subdivisions

  • No subdivisions found.

General Discussion

Antisocial personality disorder (ASP disorder) is a mental illness that usually becomes apparent during adolescence, before the age of fifteen. Symptoms usually include antisocial behavior in which there is little concern for the rights of others such as indifference to the moral or legal standards of the region or community. Behavior patterns usually include excessive drinking, fighting and irresponsibility. A key to the disorder is long lasting, persistent, manipulative, exploitive actions and manners that determinedly ignore others. For a diagnosis, some clinicians insist that the behavioral pattern be exhibited during childhood. Some clinicians believe that genetic makeup contributes to the cause of the disorder, but a detailed understanding of the cause remains elusive.

Symptoms

Most people with ASP disorder will, in early childhood, exhibit behaviors such as: lying, stealing, fighting, truancy, and resisting authority. By adolescence, affected individuals will have broken the law frequently and will willfully ignore their own safety and the safety of others; repeatedly lie, steal or brawl; and show neither guilt nor remorse for any or all anti-social behaviors.

By adulthood, a person with ASP disorder will have a history of legal problems, substance abuse problems, and/or sexual abuse problems. It should be noted that a person with ASP disorder may be charming, glib, persuasive and intimidating.

The behavior difficulties usually last into late adult life with markedly impaired capacity to sustain lasting, close, warm, and responsible relationships with family, friends, or sexual partners. The disorder may result in failure to become an independent, self-supporting adult. Disrespect for authority leads to problems with the law in most cases.

Causes

The cause of ASP disorder is unknown. There are many ideas and theories as to the cause of this disorder, but it continues to remain little understood. Some clinicians believe that there is not one cause but a complicated interaction of a variety of causes.

It may be caused by the absence of parental discipline in the home, extreme poverty, removal from the home, and growing up without parental figures of both sexes. Lack of educational achievement and the use of drugs may also be contributing causes of ASP disorder, as well as symptoms of the disorder. There may be predisposing factors to ASP disorder such as attention deficit disorder (ADD) and conduct disorder during the formative years before puberty.

Affected Populations

ASP disorder is thought to affect about three percent of American males and one percent of American females. Males are also affected at a much earlier age than females, usually during early childhood.

Related Disorders

Symptoms of the following disorders can be similar to those of antisocial personality disorder. Comparisons may be useful for a differential diagnosis:

Attention-deficit hyperactivity disorder (ADHD) usually starts before age 4, but may not be diagnosed until the child enters school. This disorder is characterized by a very short attention span, impulsiveness, and hyperactivity. Symptoms usually occur to varying degrees, depending on environmental factors. Symptoms typically get worse in situations requiring sustained attention, such as listening to a teacher in a classroom, attending meetings, or doing class assignments or chores at home. Signs of the disorder may be minimal or absent when a person with the disorder is receiving frequent reinforcement, in a very structured setting or in a one-to-one situation where there are no distractions. Often, symptoms improve with maturity, and adults with ADHD learn how to compensate for their handicap. (For more information on this disorder, choose "ADHD" as your search term in the Rare Disease Database.)

Substance abuse refers to the maladaptive behavior associated with regular use of a substance that can modify mood or behavior. The continued use of the substance (such as alcohol or drugs) when the user knows that the substance is causing addiction, causes social, occupational, psychological, or physical problems. The symptoms of addiction must persist for at least one month, or occur repeatedly over a longer period of time in order to be diagnosed as a substance abuse disorder.

Standard Therapies

Diagnostic Criteria
The general practice for making a diagnosis of ASP disorder is to observe an individual for three or more of the following characteristics. Among those characteristics is the failure to conform to social norms by repeatedly performing acts that are grounds for arrest. Deceitfulness, repeated lying, the use of aliases, or conning others for personal profit or pleasure are considered signs of ASP disorder as is impulsiveness and failure to plan ahead. Irritability and aggressiveness, especially when those behaviors result in repeated physical fights, assaults, and the reckless disregard for the safety of self or others are also chief characteristics. Other characteristics include a repeated failure to sustain work or honor financial obligations and a general lack of remorse or indifference for causing hurt or mistreatment to others. Most diagnosis criteria require the individual to be at least 18-years-old before a diagnosis is made. Additionally, the criteria asks that evidence of anti-social conduct before the age of 15 be present. Antisocial behavior should not be limited exclusively to the course of schizophrenia or a manic episode. It should be noted that at different junctures, these diagnostic criteria have been severely criticized, on many fronts, by various professional groups.

Treatment
Treatment of ASP disorder is challenging. Effective results occur in only a small proportion of cases. For many cases, psychological counseling or psychotherapy is the preferred treatment. In the more serious cases, psychiatric hospitalization may be necessary. Other treatment is symptomatic and supportive.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.

For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

A clinical study sponsored by the National Institute of Child Health and Human Development is currently (2004) evaluating antisocial behavior in families from one generation to the next. This study is part of the continuing Mauritius Child Health Project, which began by testing 1,795 three-year-old children on psychophysiological, behavioral, nutritional, and cognitive measures. The children from the original study are now adults. This study will re-test those adults, their previously untested spoused, and their children. Further information is available on the clinicaltrials.gov web site or by calling:

Kjetil Mellingen
(230) 453-9123

Organizations related to Antisocial Personality Disorder

References

TEXTBOOKS
Frances A. Chmn. Bd. eds. Diagnostic and Statistical Manual of Mental Disorders: DSM IV. 4th ed. American Psychiatic Association. Washington, DC; 1994:645-650.

Meloy JR. Antisocial Personality Disorder. In: Gabbard GO. ed. Treatment of Psychiatric Disorders. 2nd ed. American Pychiatric Association. Washington, DC; 1995:2273-90.

Perry JC. Vaillant GE. Personality Disorders. In: Kaplan HI, Sadock BJ. Eds. Comprehensive Textbook of Psychiatry/V. 5th ed. William & Wilkins. Baltimore, MD; 1989.

REVIEW ARTICLES
Goodman M, New A, Siever L. Trauma, genes, and the neurobiology of personality disorders. Ann N Y Acad Sci. 2004;1032:104-16.

Black DW, Blum N, Pfohl B, et al. Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. J Personal Disord. 2004;18:226-39.

MarkovitzPJ. Recent trends in the pharmacotherapy of personality disorders. J Personal Disord. 2004;18:90-101.

Paris J. Personality disorders over time: precursors, course and outcome. J Personal Disord. 2003;17:479-88.

Links PS, Gould B, Ratnayake R. Assessing suicidal youth with antisocial, borderline, or narcissistic personality disorder. Can J Psychiatry. 2003;48:301-10.

Hill J. Early identification of individuals at risk for antisocial personality disorder. Br J Psychiatry Suppl. 2003;44:S11-14.

Sher KJ, Trull TJ. Substance use disorder and personality disorder. Curr Psychiatry Rep. 2002;4:25-29.

FROM THE INTERNET
Dilley JW. Antisocial personality disorder. MedlinePlus. Medical Encyclopedia. Update Date: 12/9/2004. 2pp.
www.nlm.nih.gov/medlineplus/ency/article000921.htm

Antisocial Personality Disorder. Provided by Psychology Today. Last Editorial Review: 9/24/2004.
Definition of Antisocial Personality Disorder. 2pp.
Antisocial Personality Disorder Symptoms)
Causes of Antisocial Personality Disorder), 2pp.
Antisocial Personality Disorder Treatment, 5pp.
www.medicinenet.com

The information in NORD’s Rare Disease Database is for educational purposes only. It should never be used for diagnostic or treatment purposes. If you have questions regarding a medical condition, always seek the advice of your physician or other qualified health professional. NORD’s reports provide a brief overview of rare diseases. For more specific information, we encourage you to contact your personal physician or the agencies listed as “Resources” on this report.

Report last updated: 2008/04/20 00:00:00 GMT+0

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