Antisocial Personality Disorder (ASPD) is a personality disorder characterized by a history of continuous and chronic behaviour where there is disregard for and violation of the rights of others. Individuals repeatedly engage in unlawful activities (e.g. - drug use, assault, or theft), endanger the well-being of others, and frequently lie. They tend to be aggressive and impulsive and may find it difficult to maintain employment for long. Contrary to the name, having antisocial personality does not mean the individual does not have friends; on the contrary, they may have a superficial charm and be very deceptive.
The conceptualization of antisocial personality disorder dates back to the 1800s, and has its origins in society and the attitudes towards crime and civil liberties. The framework for the current approach to antisocial personality had its origins in 1939, when psychiatrist Dr. David Henderson began describing various types of antisocial behaviour beyond just criminal activity.[7]
A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15
years, as indicated by 3
(or more) of the following:
The individual is at least age 18
years.
There is evidence of conduct disorder with onset before age 15
years.
The occurrence of antisocial behaviour is not exclusively during the course of schizophrenia or bipolar disorder.
18
years or older to be diagnosed with the antisocial personality. They typically have a history of conduct disorder in adolescence. Conduct disorder becomes antisocial personality disorder once an individual turns 18
.
CORRUPT
can be used to remember the criteria for antisocial personality disorder.[10]
C
- Cannot conform to the lawO
- Obligations ignoredR
- Reckless disregard for safetyR
- RemorselessU
- Underhanded (deceitful)P
- Planning insufficient (impulsive)T
- Temper (irritable, aggressive)Adoption studies suggest that both genetic and environmental factors contribute to the development of ASPD.[11] Adopted children raised by adoptive parents have a greater risk of developing ASPD, if their biological parents have ASPD. However, a healthy adoptive family environment can reduce the risk of the individual developing ASPD.[12] Some neuroimaging studies have suggested that structural and functional changes to the limbic and paralimbic systems may be related to the core features of psychopathy and antisocial personality disorder.[13] Psychological defenses used in ASPD include primitive defenses such as omnipotent control, projective identification, dissociation, rationalizing, and acting out.
18
. Additionally, ASPD can only be diagnosed if the individual at least has some symptoms of conduct disorder before age 15
years. For individuals older than 18
years, a diagnosis of conduct disorder is given only if the criteria for antisocial personality disorder are not met.
Evidence is limited in this area, but individual psychodynamic therapy is not recommended.
There is little evidence for the use of medications. Some limited evidence exists to support the role of lithium or phenytoin in preventing impulsive aggression in those with antisocial personality.[15]
Guideline | Location | Year | Website | |
---|---|---|---|---|
World Federation of Societies of Biological Psychiatry (WFSBP) | International | 2009 | - | Link |
Guideline | Location | Year | Website | |
---|---|---|---|---|
National Institute for Health and Care Excellence (NICE) | UK | 2009 | - | Link |