Antisocial personality disorder

Not to be confused with Anti-social behaviour, Avoidant personality disorder, Schizoid personality disorder, or Dissociative identity disorder.

Antisocial personality disorder
Classification and external resources
ICD-10	F60.2
ICD-9	301.7
MeSH	D000987

Personality disorders
Cluster A (odd)
Paranoid · Schizoid Schizotypal
Cluster B (dramatic)
Antisocial · Borderline Histrionic · Narcissistic
Cluster C (anxious)
Avoidant · Dependent Obsessive-compulsive
Not specified
Depressive Passive–aggressive Sadistic · Self-defeating
v · American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition (DSM-IV-TR), as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."[1] The World Health Organization's International Statistical Classification of Diseases and Related Health Problems', tenth edition (ICD-10), defines a conceptually similar disorder to antisocial personality disorder called (F60.2) Dissocial personality disorder.[2] The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders incorporated various concepts of psychopathy/sociopathy/antisocial personality in early versions but, starting with the DSM-III in 1980, used instead a diagnosis of antisocial personality disorder. This was based on some of the criteria put forward by Cleckley but operationalized in behavioral terms and more specifically related to conduct and criminality. The World Health Organization's ICD incorporates a similar diagnosis of Dissocial Personality Disorder. Both the DSM and the ICD state that psychopathy (or sociopathy) are synonyms of their diagnosis. Psychopathy and sociopathy are terms related to ASPD. ASPD replaced psychopathy as a diagnosis in the DSM but the terms are not identical. Psychopathy is now (like sociopathy) usually seen as a subset of ASPD.[3][4] Many people with this disorder are not violent unless significantly and specifically provoked.[citation needed] Diagnosis DSM-IV The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV-TR), defines antisocial personality disorder (in Axis II Cluster B) as:[1] A) There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following: failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest; deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure; impulsiveness or failure to plan ahead; irritability and aggressiveness, as indicated by repeated physical fights or assaults; reckless disregard for safety of self or others; consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations; lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another; B) The individual is at least age 18 years. C) There is evidence of conduct disorder with onset before age 15 years. D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode. New evidence points to the possibility that children often develop antisocial personality disorder as a result of environmental as well as genetic influence. The individual must be at least 18 years of age to be diagnosed with this disorder (Criterion B), but those commonly diagnosed with ASPD as adults were diagnosed with conduct disorder as children. The prevalence of this disorder is 3% in males and 1% from females, as stated in the DSM IV-TR. ICD-10 The World Health Organization's International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10), defines a conceptually similar disorder to antisocial personality disorder called (F60.2) Dissocial personality disorder.[2] It is characterized by at least 3 of the following: Callous unconcern for the feelings of others and lack of the capacity for empathy. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations. Incapacity to maintain enduring relationships. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence. Incapacity to experience guilt and to profit from experience, particularly punishment. Markedly prone to blame others or to offer plausible rationalizations for the behavior bringing the subject into conflict. Persistent irritability. The criteria specifically rule out conduct disorders.[5] Dissocial personality disorder criteria differ from those for antisocial and sociopathic personality disorders.[6] It is a requirement of ICD-10 that a diagnosis of any specific personality disorder also satisfies a set of general personality disorder criteria. Further diagnostic considerations Millon's subtypes Theodore Millon identified five subtypes of antisocial behavior.[7][8] Any antisocial individual may exhibit none, one or more than one of the following: covetous antisocial - variant of the pure pattern where individuals feel that life has not given them their due. reputation-defending antisocial - including narcissistic features risk-taking antisocial - including histrionic features nomadic antisocial - including schizoid, avoidant features malevolent antisocial - including sadistic, paranoid features. Differential diagnosis The following conditions commonly coexist with antisocial personality disorder:[9] Anxiety disorders Depressive disorder Substance-related disorders Somatization disorder Borderline personality disorder Histrionic personality disorder Narcissistic personality disorder When combined with alcoholism, people may show frontal function deficits on neuropsychological tests greater than those associated with each condition.[10] Epidemiology Antisocial personality disorder is seen in 3% to 30% of psychiatric outpatients.[1][9] The prevalence of the disorder is even higher in selected populations, such as people in prisons (who include many violent offenders).[11] A 2002 literature review of studies on mental disorders in prisoners stated that 47% of male prisoners and 21% of female prisoners had anti-social personality disorder.[12] 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.[13] Treatment To date there have been no controlled studies reported which found an effective treatment for ASPD, although contingency management programs, or a reward system, has been shown moderately effective for behavioral change.[14] Some studies have found that the presence of ASPD does not significantly interfere with treatment for other disorders, such as substance abuse,[15] although others have reported contradictory findings.[16] Schema Therapy is being investigated as a treatment for antisocial personality disorder.[17] Cognitive behavioral strategies are being studied as a means to combat personality disorders, and they appear to help at least some antisocial persons. Medications targeting comorbid psychiatric disorders may help to reduce antisocial behaviors. [18] Psychopathy and sociopathy Psychopathy and sociopathy are terms related to ASPD. ASPD replaced psychopathy as a diagnosis in the DSM but the terms are not identical. Psychopathy is now (like sociopathy) usually seen as a subset of ASPD. Psychopathy Main article: Psychopathy Psychopathy (/saɪˈkɒpəθi/[19][20]) was, until 1980, the term used for a personality disorder characterized by an abnormal lack of empathy combined with strongly amoral conduct but masked by an ability to appear outwardly normal. The publication of DSM-III changed the name of this mental disorder to Antisocial Personality Disorder and also broadened the diagnostic criteria considerably by shifting from clinical inferences to behavioral diagnostic criteria.[21] The ICD-10 diagnostic criteria of the World Health Organization also lacks psychopathy as a personality disorder, its 1992 manual including Dissocial (Antisocial) Personality Disorder, which encompasses amoral, antisocial, asocial, psychopathic, and sociopathic personalities.[22] Psychopathy is normally seen as a subset of the antisocial personality disorder, but Blair believes that the antisocial personality disorder and psychopathy may be separate conditions altogether.[23] Some researchers are critical of the changed diagnostic criteria. Antisocial personality disorder is diagnosed via behavior and social deviant behaviors, whereas a diagnosis of psychopathy also includes affective and interpersonal personality factors. The Hare Psychopathy Checklist is better able to predict future criminality, violence, and recidivism than the diagnosis of ASPD using the DSM-III-R. Robert D. Hare writes that there are also differences between psychopaths and others on "processing and use of linguistic and emotional information" while such differences are small between those diagnosed with ASPD and not.[3][24] However, the Hare Psychopathy Checklist requires the use of a rather long interview and availability of considerable additional information[24] as well as depending in part on judgements of character rather than observed behavior. Hare writes that the field trials for the DSM-IV found personality traits judgements to be as reliable as those diagnostic criteria relying only on behavior but that the personality traits criteria were dropped in part because it was feared that the average clinician would not use them correctly. Hare criticizes the instead used DSM-IV criteria for being poorly empirically tested. In addition, the introductory text description describes the personality characteristics typical of psychopathy, which Hare argues make the manual confusing and actually containing two different sets of criteria. He also argues that confusion regarding how to diagnose ASPD, confusion regarding the difference between ASPD and psychopathy, as well as the differing future prognoses regarding recidivism and treatability, may have serious consequences in settings such as court cases where psychopathy is often seen as aggravating the crime.[3] The DSM-V working party is recommending a revision of Antisocial Personality Disorder to include "Antisocial/Psychopathic Type", with the diagnostic criteria having a greater emphasis on character than on behavior.[25] Sociopathy Hare writes that the difference between sociopathy and psychopathy may "reflect the user's views on the origins and determinates of the disorder." The term sociopathy may be preferred by sociologists that see the causes as due to social factors. The term psychopathy may be preferred by psychologists who see the causes as due to a combination of psychological, genetic, and environmental factors.[26] David T. Lykken proposed psychopathy and sociopathy are two distinct kinds of antisocial personality disorder. He believed psychopaths are born with temperamental differences such as impulsivity, cortical underarousal, and fearlessness that lead them to risk-seeking behavior and an inability to internalize social norms. On the other hand, he claimed that sociopaths have relatively normal temperaments; their personality disorder being more an effect of negative sociological factors like parental neglect, delinquent peers, poverty, and extremely low or extremely high intelligence. Both personality disorders are the result of an interaction between genetic predispositions[citation needed] and environmental factors[citation needed], but psychopathy leans towards the hereditary whereas sociopathy tends towards the environmental.[27] See also DSM-IV codes (personality disorders) The Mask of Sanity Malignant narcissism Conduct disorder Substance abuse Anti-Social Behaviour Order Oppositional defiant disorder Asperger syndrome References ^ a b c Antisocial personality disorder - Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000) - pages 645–650 ^ a b Dissocial personality disorder - International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) ^ a b c Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion By Robert D. Hare, Ph.D. Psychiatric Times. Vol. 13 No. 2 February 1, 1996 http://www.psychiatrictimes.com/dsm-iv/content/article/10168/54831 ^ http://www.mentalhealth.com/icd/p22-pe04.html ^ 602 "F60.2 Dissocial personality disorder". World Health Organization. http://www.who.int/classifications/apps/icd/icd10online/?gf60.htm+F602. Retrieved 2008-01-12.  ^ Early Prevention of Adult Antisocial Behavior. Cambridge University Press. 2003-06-16. p. 82. ISBN 9780521651943. http://books.google.com/?id=KtXU8R8oZYwC&pg=PA82&lpg=PA82&dq=dissocial+personality+disorder. Retrieved 2008-01-12.  ^ Millon, Theodore, Personality Disorders in Modern Life, 2004 ^ Millon, Theodore - Personality Subtypes ^ a b Internet Mental Health - antisocial personality disorder ^ Oscar-Berman M; Valmas M, Sawyer K, Kirkley S, Gansler D, Merritt D, Couture A (April 2009). "Frontal brain dysfunction in alcoholism with and without antisocial personality disorder". Neuropsychiatric Disease and Treatment 2009 (5): 309–326. PMC 2699656. PMID 19557141. http://www.dovepress.com/getfile.php?fileID=4829.  ^ Hare 1983 ^ Fazel, S.; Danesh, J. (2002). "Serious mental disorder in 23 000 prisoners: A systematic review of 62 surveys". The Lancet 359 (9306): 545. doi:10.1016/S0140-6736(02)07740-1.  edit ^ Moeller, F. Gerard; Dougherty, Donald M. (2006). "Antisocial Personality Disorder, Alcohol, and Aggression". Alcohol Research & Health. National Institute on Alcohol Abuse and Alcoholism. http://pubs.niaaa.nih.gov/publications/arh25-1/5-11.pdf. Retrieved 2007-02-20.  ^ J. E. Fisher & W. T. O'Donohue (eds). (2006). Practitioner's Guide to Evidence-Based Psychotherapy, p63 ^ S. Darke, R. Finlay-Jones, S. Kaye, & T. Blatt. Anti-social personality disorder and response to methadone maintenance treatment. Drug and Alcohol Review, vol. 15, 271-276 (1996) ^ A. I. Alterman, M. J. Rutherford, J. S. Cacciola, J. R. McKay, & C. R. Boardman. Prediction of 7 months methadone maintenance treatment response by four measures of antisociality. Drug & Alcohol Dependence, vol. 49, 217-223 (1998) ^ iafmhs.org (PDF) ^ FINK, PCLINICAL PSYCHIATRY NEWS, V. 34 (9), 08/2006, p. 18-18 ^ American Heritage Dictionary ^ Merriam-Webster's Online Dictionary ^ http://www.psychiatrictimes.com/dsm-iv/content/article/10168/54831 ^ http://www.mentalhealth.com/icd/p22-pe04.html ^ Blair, J; Mitchel D; Blair K (2005). Psychopathy: Emotion and the Brain. Blackwell Publishing. pp. 16. ISBN 0631233369. ^ a b Hare, R.D., Hart, S.D., Harpur, T.J. Psychopathy and the DSM—IV Criteria for Antisocial Personality Disorder (pdf file) ^ Proposed revision. DSM5. http://www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=16# . ^ Hare, Robert D. Without Conscience: The Disturbing World of Psychopaths Among Us, (New York: Pocket Books, 1993) pg 23. ^ Lykken, David T. The Antisocial Personalities. Hillsdale N.J: L. Erlbaum, 1995. Print.[page needed] External links Interview with Dr. Martha Stout, author of The Sociopath Next Door on the Living Hero podcast, November 2010. "Into the Abyss." Article on street crime referencing the roots and consequences of sociopathic behavior DSM IV-TR Criteria for Antisocial personality disorder Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion Recent Studies Implicate Slow Monoamine Oxidase Enzyme/High Circulating T3 in Antisocial Behavior/Aggression/Violence 2007 Sociopathic - Research into personality disorders A collaborative to better understand personality disorders such as sociopathy, borderline, paranoid. The Unreal World of Narcissists and Sociopaths, with host Jari Chevalier for Living Hero. Numerous experts, including Nina W. Brown, Linda Martinez-Lewi, Gabor Mate, Martha Stout, Philip Zimbardo Wikimedia Foundation. 2010. Игры ⚽ Поможем сделать НИР USS Kitty Hawk Cordeliers Look at other dictionaries: antisocial personality disorder — n a personality disorder that is characterized by antisocial behavior exhibiting pervasive disregard for and violation of the rights, feelings, and safety of others starting in childhood or the early teenage years and continuing into adulthood,… …   Medical dictionary antisocial personality disorder — noun a personality disorder characterized by amorality and lack of affect; capable of violent acts without guilt feelings ( psychopathic personality was once widely used but was superseded by sociopathic personality to indicate the social aspects …   Useful english dictionary antisocial personality disorder — noun Date: 1979 a personality disorder that is characterized by antisocial behavior exhibiting pervasive disregard for and violation of the rights, feelings, and safety of others starting in childhood or the early teenage years and continuing… …   New Collegiate Dictionary antisocial personality disorder — noun A personality disorder marked by antisocial behavior, a pervasive pattern of disregard for and violation of the rights of others that begins in childhood or early adolescence and continues into adulthood …   Wiktionary antisocial personality disorder — a personality disorder characterized by callous unconcern for others, irresponsibility, violence, disregard for social rules, and an incapacity for maintaining enduring relationships. It was formerly known as dyssocial personality, psychopathy,… …   Medical dictionary antisocial personality disorder — a personality disorder characterized by callous unconcern for others, irresponsibility, violence, disregard for social rules, and an incapacity for maintaining enduring relationships. It is also known as dyssocial personality, psychopathy, and… …   The new mediacal dictionary Personality disorder — Classification and external resources ICD 10 F60 ICD 9 301.9 …   Wikipedia antisocial personality — n a personality exhibiting traits typical of the antisocial personality disorder and often considered as predisposed toward criminality called also psychopathic personality …   Medical dictionary personality disorder — n a psychopathological condition or group of conditions in which an individual s entire life pattern is considered deviant or nonadaptive although the individual shows neither neurotic symptoms nor psychotic disorganization * * * a deeply… …   Medical dictionary personality disorder — Psychiatry. any of a group of mental disorders characterized by deeply ingrained maladaptive patterns of behavior and personality style, which are usually recognizable as early as adolescence and are often lifelong in duration. [1935 40] * * *… …   Universalium 18+ © Academic, 2000-2024 Contact us: Technical Support, Advertising Dictionaries export, created on PHP, Joomla, Drupal, WordPress, MODx. Mark and share Search through all dictionaries Translate… Search Internet Share the article and excerpts Direct link … Do a right-click on the link above and select “Copy Link”