Antisocial personality disorder is a personality structure, a character trait that manifests itself in complete disregard for the rights and feelings of others. All patients are confident in the correctness of their actions, they are not characterized by guilt, shame. The diagnosis is most clearly manifested in adolescence, and then fixed in adulthood. Then, as a rule, this disorder is practically impossible to correct.
Manifestations
People suffering from this ailment behave destructively and aggressively, often this leads to constant contacts with law enforcement agencies. But not in all cases, the pathological structure of the personality is manifested in this way.
Due to the same characteristics, some people with dissocial personality disorder achieve great success in business, where you often need to go ahead when confronted with public opinion face to face. Impulsiveness in actions, the ability to show indifference and a tendency to take risks are appreciated in this field. Dissocial personality disorder is accompanied by "corporate" egocentrism, ambition and megalomania, which is combined with charming behavior, which also increases a person's chances of success.
The diagnosis is made by 1% of women and 3% of men. Antisocial disorder is manifested in the impossibility of creating warm relationships with people. Most often, urban residents, immigrants from low-income families, are exposed to it.
According to some studies, 75% of prisoners suffer from antisocial personality disorder. Nevertheless, many people with this pathology do not associate with the criminal world, satisfied with the commission of acts condemned by society.
Causes
Opinions of experts about the path of occurrence, the causes of antisocial personality disorder differ. Adherents of the first camp note that a genetic role plays a large role. So, in the immediate family of the patient, similar symptoms are more common than on average in other people. Often family members of a person with dissocial personality disorder have signs of hysterical disorders. Therefore, this diagnosis is considered hereditary, during mutations it can be transmitted from generation to generation in the form of these two deviations.
Proponents of a different point of view indicate that antisocial disorder is formed under the influence of the environment. Neglect, excessive custody, lack of love in childhood lead to the development of psychopathy. An additional factor contributing to the formation of a deviation model of behavior is the example of adult family members. If they were prone to criminal activity, alcoholism, drug addiction, lived in poverty as a result of all kinds of events right up to wars, then there is a great chance that the child will suffer from such a diagnosis.
The most common approach to the causes of the development of the disease is an intermediate position. Antisocial personality disorder occurs in the presence of both hereditary and external factors. An important role in the formation of the disease is played by head injuries, mental illnesses. Often among people suffering from this diagnosis, there are people with neurological abnormalities that indicate brain damage in childhood.
Symptoms
Most often, the first symptoms of antisocial personality disorder appear in early childhood in males. Girls show the first signs of an emerging ailment only in the prepubertal period. Impulsive, cruel actions are characteristic of children. Usually such people are extremely stubborn and selfish. A psychopath with an antisocial personality disorder skips classes at school, is engaged in damage to public property, torments peers, is engaged in vagrancy.
A distinctive feature of patients with this diagnosis is an early oppositional attitude towards adults. In communication with others, they are either openly hostile, or not explicitly, but stubbornly neglect the interests and feelings of people.
Children and adolescents suffering from antisocial personality disorder are not prone to torment of conscience, even if they commit cynical acts. They believe that they did the right thing, because they did what they wanted. And in the eyes of the public, they blame others. Often there is early use of drugs, alcohol, illegibility in the choice of sexual partners. Sometimes addicted to drugs.
However, growing up, patients begin to look completely adapted to life in society by people. A person with antisocial personality disorder may not have difficulty interacting with others.
Moreover, it is not uncommon for people with this diagnosis to have a peculiar charm and the ability to attract an interlocutor, in the process of superficial communication they can make a pleasant first impression.
Nevertheless, they are distinguished by an inability to build deep affection, they do not know how to sympathize, their behavior is filled with manipulation. Symptoms of dissocial personality disorder appear later in the course of communication, when the patient easily lies, using the people around him like bowling balls to achieve his goals. In his arsenal of threats of suicide, stories of a difficult fate, an imitation of serious illnesses, in order to provoke others with certain emotions, to achieve the desired.
The main goal of patients is to take pleasure in snatching as much as possible from life, no matter what. Symptoms of dissocial personality disorder are manifested in the fact that patients never reproach themselves, do not feel shame and do not suffer from guilt. No threats of punishment, no one's conviction affects them, they are deprived of the slightest alarm about this. When the public becomes aware of their misconduct, they, using their abilities to manipulate people, easily avoid the consequences. Experience does not teach them anything, since they most often consider any criticism addressed to them unfair. It should be noted that sometimes they accept acceptance of criticism, but only when they see this as a benefit to themselves.
According to Eric Berne's classification, there is a passive and active syndrome. Sociopaths of the first type do not have internal restrictions - conscience, humanity, but at the same time they comply with the norms of external authorities - religion, legislation. Thus, formally meeting the requirements of society, they are protected from open confrontation with the entire society.
Patients of the second type are not characterized by both internal and external frames. They easily demonstrate responsibility to people and follow public rules when necessary. But as soon as they see the opportunity - they violate all the rules and again behave uncontrollably. Active sociopaths are characterized by open criminal actions. While passive - hidden forms of deviation behavior, for example, manipulation and falsehood.
Flow
The disorder progresses throughout a person’s life. Often the carriers of this ailment can be found in public associations isolated from society. Many examples of dissocial personality disorder are found in sect leaders or criminal groups. After reaching the age of 40, the active manifestations of the disease become less pronounced. Often, patients develop the formation of affective disorders, alcohol and drug addiction.
Establishing diagnosis
Diagnosis is carried out taking into account the characteristics of the patient’s biography and the results of a conversation with him. To make a diagnosis of "dissocial personality disorder" (ICD-10 code F60.2), you need to identify the following factors:
- lack of ability to empathy, indifference to people;
- lack of a sense of responsibility to others; non-observance of social norms;
- lack of communication difficulties in conjunction with the inability to create a stable attachment;
- aggressive behavior;
- irritability;
- shifting responsibility for their actions to others.
To make a diagnosis, it is enough to establish the presence of 3 of the listed features.
It is important to differentiate the antisocial personality disorder according to ICD-10 from mania, schizophrenia and secondary personality changes, the roots of which stretch from alcohol and drug addiction. Be sure to set the degree of neglect of established norms to take into account the characteristics of social and cultural conditions characteristic of the patient's place of residence.
Treatment
Treating antisocial personality disorder is a difficult undertaking. Patients almost never turn to specialists for help in resolving this issue, since their rejections of negative emotions do not bring them. Feeling that they are contrary to society, experiencing a lack of something important, they can turn to psychotherapists, but there will be practically no chance of a successful fight against the diagnosis. This is because patients cannot build the empathic relationships that are needed in psychotherapy.
Most often, therapy is initiated by people around them from among employers, employees of educational institutions, and law enforcement agencies. But in such cases, the chances of effective treatment are even less, since the patient has no motivation, he will not act along with the doctor, expressing resistance to what is happening.
Most often, self-help groups are effective, in which patients diagnosed with "dissocial personality disorder" (in ICD-10 code F60.2) open up without fear of condemnation and are in the circle of their own kind, who are friendly towards them.
For such therapy to bear fruit, the leader must be experienced, not amenable to other people's manipulations. It is also important that there are no guided participants who could succumb to the influence of the patient.
In some cases, the manifestations of the diagnosis of "antisocial personality disorder" (ICD-10 code F60.2) are accompanied by depression and increased anxiety. Then apply drug therapy.
If the patient is aggressive, he is prescribed lithium. In these cases, the prognosis is unfavorable: most often, the disorder cannot be corrected.
The difference between dissocial disorder and psychopathy
Psychopathy is not an officially recognized psychiatric disorder, the manifestations of which correspond to severe forms of dissocial disorder. A psychopath is diagnosed with someone who does not have a sense of shame for their own behavior, demonstrating an open disregard for social rules. Only 15% of all patients suffering from antisocial disorder had symptoms of psychopathy.
The psychopath is a more suspicious, paranoid personality compared to other patients. This type of thinking leads to the fact that all the actions of the surrounding patients are interpreted as aggressive towards them. With a criminal record, they will see injustice in their charge. They will be sincerely convinced that this is arbitrariness by the court.
Methods of struggle
This condition is highly resistant to therapy, however, a number of researchers have found effective methods to combat it. So, in relation to adolescents, treatment methods are applied that lead to a change in their thinking, leading to the commission of actions condemned by society. After undergoing this therapy, patients showed much less manifestations of antisocial behavior.
And yet, most often, attempts to make adjustments to this state are not crowned with success. Some methods of treatment only exacerbated the situation. This happened with the programs of the internally-oriented approach used in the treatment of depression, when they tried to work with patients with antisocial disorder.
The most positive effect was demonstrated by rigorous programs that teach patients new skills that are applicable in life, regardless of the limitations of society.
Medicines can only help in alleviating the conditions that accompany the disorder. So, in the presence of symptoms of depression accompanying antisocial disorder, antidepressants are taken. Aggressive patients are prescribed mood stabilizers that stop the manifestations of anger and impulsivity.
What will happen if not treated?
Patients suffering from this ailment leave their negative mark in society in the form of mental suffering of the victims against whom they committed crimes. But sometimes a person with antisocial disorder can occupy a high post, be the leader of public groups. Then the consequences of its destructive effects are not so obvious until the moment when mass suicides occur. This has happened more than once in history. For example, this happened in Guyana in 1978 among the followers of Jim Jones.
People with symptoms of the disorder are prone to alcohol, drugs, and crime. Most often, they sooner or later end up in prison. They are prone to depression, anxiety, bipolar disorder, and many other psychiatric diagnoses. They are self-mutilating in relation to themselves and others, often they die as a result of murder or suicide, often get into accidents.
The behavior of a person with dissocial disorder can contribute to a change in the situation around him to negative. Often, such people end their lives in psychiatric hospitals.
The risk of a life like this increases if the disorder is not treated. Nevertheless, by the age of 50, in many patients, the disease goes into remission.
Types of Disorder
There are several varieties of dissocial personality disorder (F 60.2 - ICD-10 code). So, for the first type are characteristic: lack of emotions and aggression, cold prudence, the presence of organic disorders. People with the first type of diagnosis will go to power without the pain of conscience from any of their actions.
In the second type, people are in constant search of dangerous behavior for themselves and the people around them. They are characterized by attacks of aggression and impulsivity, the consequences do not excite them. At the same time, there is a lack of organic changes, patients show emotions. It is difficult to treat them because they show aggression against doctors, and they themselves never come for help.
A prime example of dissocial disorder is Alex, a character in the Clockwork Orange movie.
It's important to know
Not always antisocial behavior is a sign of mental illness. It must be remembered that some people like to live with risk, without worries and not burdened with responsibility.
Patients do not feel the desire to be treated, because they do not believe that something is wrong with them. The disorder also manifests itself differently depending on the gender of the person. Thus, male representatives are characterized by manifestations of recklessness and aggression, including on the roads, they can abuse animals, engage in fights, use weapons, and engage in arson. Female representatives are prone to gambling and are less aggressive in physical form, preferring manipulation.
Child disobedience
There is oppositional disorder in children. It manifests itself in disobedience to adults, but at the same time, a sense of responsibility for their own actions remains. It can be cured until it develops into a dissocial disorder. Children often break all sorts of rules, challenging everyone around them.
At the initial stage of disobedience, psychotherapists successfully use drugs. It is necessary to participate in the process of correcting the behavior of parents.
The more symptoms of a behavioral disorder manifested in childhood, the more likely it is that a person will encounter antisocial disorder in adulthood.
Betrayal
Most often, the roots of the disease lie in the psychological trauma received in childhood. Future patients grow up in fake relationships. This happens when parents cheat on a child by pretending to love each other and him. Their behavior demonstrates love, but in fact, the child feels cheated. In such conditions, he adopts the seen model of behavior.
, , , .
, , .
, - . « , , ».
In this picture of the world, friends become means of achieving the goal, matrimony is evaluated in terms of the benefits it brings. All surrounding people are functional. From the side it may seem that the patient lives a meaningful life. However, he is only moving away from the existential meaning, striving for needs.
Antisocial disorder is similar to paraexistential. They differ in that, in the presence of the second, the patient's behavior is more acceptable to society.
In any case, patients with both ailments only use the people around them.
Conclusion
All people sometimes behave in an unacceptable way for society. Everyone at least once parked in the wrong place, violated the rules of the road, walked out of turn, behaved indifferently, selfishly and cynically. But the real dissocial disorder manifests itself in a slightly different way. The patient is capable of causing serious injuries to someone and not to experience any torment in this regard.
Most often, people adapt to society and life in accordance with its laws. But patients are not capable of doing this. They are in opposition to the whole society, do not relate themselves to it.
And this ailment is expressed not only in asociality. Patients suffer deeply, it is not easy for them to endure isolation, and they begin to take actions to control this. By committing criminal acts, they help themselves.
They are able to act against themselves, easily irritated by the most minor influences. Having a person suffering from such a disorder nearby is a serious test for family members. It is difficult to interact with him on an ongoing basis, since he does not have internal structures in order to realize what exactly others have in mind. None of the family members are able to handle this. Having found such manifestations in someone close, you need to contact specialists.