Personality Disorders – Specifically APD

Personality Disorder – an ongoing pattern of inner experience and behaviour that deviates from the expectations of the individual’s culture.

Borderline Personality Disorder involves having a history of intense but unstable relationships in which a person alternates between putting the partner on a pedestal and then devaluing the partner. These people try to avoid real or imagined abandonment by others. They have unrealistic self-images. They are self-desctructive and impulsive, often spending too much money, abusing drugs, and threatening to commit suicide. They are emotionally volatile, going from anger to euphoria to anxiety.

Antisocial Personality Disorder (APD)

People with Antisocial Personality Disorder (APD) are sometimes called sociopaths (in the past):

! Occurs in about 3 % of males

! Occurs in less than 1% of females

! People with APD meet at least 3 of the following criteria (according to the DSM – Diagnostic and Statistical Manual of Mental Disorders):

1. repeatedly break the law

2. are deceitful, using charm, aliases and lies to con others for personal gain or pleasure

3. are impulsive, and unable to plan ahead

4. repeatedly get into physical fights or assaults – aggressive / irritable

5. show reckless disregard for their own safety or that of others

6. are irresponsible, failing to meet obligations to others “repeated failure to sustain steady work or honor financial obligations” -- wikipedia

7. lack remorse for actions that harm others

A common quality of people with APD is that they lack conscience and empathy. If caught in a lie or a crime, they may seem sincerely sorry and promise to make amends, but it is all an act.

Causes:

1. Central Nervous System abnormalities --Antisocial individuals do not respond physiologically to punishments the way other people do this my be why they can behave fearlessly in situations that would scare others to death. Anticipation of danger, punishment, or pain normally causes changes in skin’s conductivity but this doesn’t happen as readily in people with ADP. This suggests they may be unable to feel the anxiety necessary for learning that their actions will have unpleasant consequences. Their inability to feel emotional arousal – empathy, guilt, fear of punishment, and anxiety under stress – suggests an abnormality in the CNS.

2. Genetically influenced problems with impulse control – children of parents with APD, substance-abuse problems, or disorders involving an inability to control impulsive behavior are at greater risk

3. Brain damage resulting from abuse, physical neglect, accidents, or injury

“According to the vulnerability-stress model, most individuals with APD develop the disorder when a biological vulnerability is combines with physical abuse, parental neglect, lack of love and contact comfort, or environmental stresses.”

Source:

Wade, Carole, Caroll Tavris, Deborah Saucier, and Lorin Elias. Psychology (Canadian Edition). Toronto: Pearson Education Canada Inc. P. 583 – 586, 2004

Symptoms

Common characteristics of people with antisocial personality disorder include:

· Persistent lying or stealing

· Recurring difficulties with the law

· Tendency to violate the rights of others (property, physical, sexual, emotional, legal)

· Aggressive, often violent behavior; prone to getting involved in fights

· Inability to keep a job

· A persistent agitated or depressed feeling (dysphoria)

· Inability to tolerate boredom

· Disregard for the safety of self or others

· A childhood diagnosis of conduct disorders

· Lack of remorse for hurting others

· Superficial wit and charm

· Impulsiveness

· A sense of extreme entitlement

· Inability to make or keep friends

· Lack of guilt

· Recklessness, impulsivity [8] [6]

People who have antisocial personality disorder often experience difficulties with authority figures. [9]

[edit] Prevalence

The National Comorbidity Survey, which used DSM-III-R criteria, found that 5.8% of males and 1.2% of females showed evidence of a lifetime risk for the disorder. [10] Prevalence estimates within clinical settings have varied from 3% to 30%, depending on the predominant characteristics of the populations being sampled. {Diagnostic and Statistical Manual of Mental Disorders} Perhaps not surprisingly, the prevalence of the disorder is even higher in selected populations, such as people in prisons (who include many violent offenders) (Hare 1983). Similarly, the prevalence of ASPD is higher among patients in alcohol or other drug (AOD) abuse treatment programs than in the general population (Hare 1983), suggesting a link between ASPD and AOD abuse and dependence. [11]

[edit] Relationship with other mental disorders

Antisocial personality disorder is negatively correlated with all DSM-IV Axis I disorders except substance-abuse disorders. Antisocial personality disorder is most strongly correlated with Psychopathy as measured on the Psychopathy Checklist-Revised (PCL-R).

[edit] Potential warning signs

Though antisocial personality disorder cannot be formally diagnosed before age 18, three warning signs, known as the MacDonald Triad, can be found in some children. These are, a longer-than-usual period of bedwetting, cruelty to animals, and pyromania.

It is not known how many children who exhibit these signs grow up to develop antisocial personality disorder, but these signs are often found in the histories of diagnosed adults. Because it is unknown how many children have these symptoms and who do not develop antisocial personality disorder, the predictive value (ie, the usefulness of these symptoms for predicting future antisocial personality disorder) is unclear.

These three traits are now included in the Diagnostic and Statistical Manual of Mental Disorders IV-TR under conduct disorder.

A child who shows signs of antisocial personality disorder may be diagnosed as having either conduct disorder or oppositional defiant disorder. Not all of these children will grow up to develop antisocial personality disorder.

Mnemonic

A mnemonic that can be used to remember the criteria for antisocial personality disorder is CORRUPT[3][4]:

· C - cannot follow law

· O - obligations ignored

· R - remorselessness

· R - recklessness

· U - underhandedness

· P - planning deficit

· T - temper

Source: Wikipedia, April 10, 2007

http://en.wikipedia.org/wiki/Antisocial_personality_disorder