PERSONALITY DISORDERS (CLUSTER B)

ANTISOCIAL PERSONALITY DISORDER

Symptoms of Antisocial Personality DisorderAccording to the DSM-5, there are four diagnostic

criterion, of which Criterion A has seven sub-features.

A. Disregard for and violation of others rights since age 15, as indicated by one of the seven sub features:

1. Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest

2. Lying, deception, and manipulation, for profit tor self-amusement,3. Impulsive behavior4. Irritability and aggression, manifested as frequently assaults

others, or engages in fighting5 Blatantly disregards safety of self and others,6 A pattern of irresponsibility and7. Lack of remorse for actions (American Psychiatric Association, 2013)

The Other Diagnostic Criterion Include:

B. The person is at least age 18,C. Conduct disorder was present by history

before age 15D. and the antisocial behavior does not occur

in the context of schizophrenia or bipolar disorder

(American Psychiatric Association, 2013)

The Initial Onset and PrevalenceOnsetThe DSM-5 notes that Antisocial Personality Disorder

cannot be diagnosed before age 18, so while an adolescent may display antisocial features, prior to age 18, if diagnostic criteria are met, the appropriate diagnosis would be Conduct Disorder (American Psychiatric Association, 2013).

PrevalenceAccording to the DSM-5, the annual prevalence of

Antisocial Personality Disorder is .02% to 3.3.% when the criteria from prior DSM editions are applied

(American Psychiatric Association, 2013).

Brain Abnormalities/Genetic FactorsThe DSM-5 indicates that risk factors for Antisocial Personality Disorder are having a first degree biological relative with APD, and being a male, (American Psychiatric Association, 2013).

It was noted that physiological and anatomical deficits observed in the frontal /parietal areas, as well as the cerebellum, may account for the chronic low arousal, high impulsivity, lack of conscience, callousness, and decision-making problems commonly seen in individuals with APD (Tang, Jiang, Liao, Wang, & Luo, 2013). There is also evidence that environmental factors, such as internalizing messages from antisocial peers or parents are at work in Antisocial Personality Disorder. One possible developmental pathway if there are not appropriate treatment interventions is ODD, or RAD (Reactive Attachment Disorder) , and CD leading to Antisocial personality disorder.

(American Psychiatric Association, 2013).

(Tang, Jiang, Liao, Wang, & Luo, 2013).

Treatment of Antisocial Personality DisorderThe DSM-5 does not specify treatment options for APD (American

Psychiatric Association, 2013).Incarceration/ long-term Hospitalization

The DSM-5 does not specify treatment options for APD (American Psychiatric Association, 2013).

Incarceration may not a deterrent to the antisocial individual, as those with APD

have difficulty learning from mistakes, are rigid in decision making, make poor

decisions, and are unresponsive to punishment . The DSM- 5 as well as other

sources note that individuals with APD typically cease behavioral expression of

their antisocial belief system in their 40's (American Psychiatric Association,

2013) although this is inconclusive. Other sources argue that antisocials become

too emotional battered by resisting society, and accumulate physical injuries from

a lifestyle of neglect of medical and dental care, untended injuries, and drug and

alcohol abuse that they are no longer physically capable of acting out aggression

or to engage in ongoing criminal activity. They still retain an antisocial belief

system in their day to day dealings with others, and may hide their behavior

better through practice effects- learning to be more subtle and not draw attention

to themselves and risk arrest or other containment. A specific form of CBT

(Cognitive Behavioral Therapy) called CSC (Cognitive Self Change) based on

Samenow and Yochelson's seminal work with offenders seems to be the only

methods which has even marginal success at modifying the behavior of violent

offenders, both antisocial and otherwise 301.7 (F60.2).

(Barbour, 2013; Powell, & Sadler, n.d. ).