Antisocial personality disorder is a personality structure, a character trait that manifests itself in a 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 pronounced in adolescence, and then consolidated in adulthood. Then, as a rule, this disorder is practically not amenable to correction.
Manifestations
People suffering from this disease 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 manifests itself in this way.
Some people with antisocial personality disorder, due to the same characteristics, achieve great success in business, where you often have to go ahead, facing public opinion head on. Impulsiveness in actions, the ability to showindifference and risk-taking are valued in this field. Antisocial personality disorder is accompanied by "corporate" egocentrism, ambition and megalomania, which is combined with charming behavior, which also increases the person's chances of success.
Diagnosed by 1% of women and 3% of men. Antisocial disorder manifests itself in the inability to create warm relationships with people. Most often it affects urban residents, people from low-income families.
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, being satisfied with the commission of acts condemned by society.
Reasons
Specialists' opinions about the origin, causes of antisocial personality disorder differ. Adherents of the first camp point out that genetic predisposition plays a big role. So, in the next of kin of the patient, similar symptoms are more common than on average in other people. Often, family members of a person with antisocial personality disorder show signs of hysterical disorders. Therefore, this diagnosis is considered hereditary, in the course of mutations it can be transmitted from generation to generation in the form of these two deviations.
Proponents of a different point of view point out that antisocial disorder is formed under the influence of the environment. Neglect, overprotection, lack of love in childhood lead to the development of psychopathy. An additional factorcontributing to the formation of a deviational model of behavior is an example of adult family members. If they were prone to criminal activity, alcoholism, drug addiction, lived in poverty due to all sorts of events up to wars, then there is a high 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 and mental illness. Often among those 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 disease only in the prepubertal period. Children are characterized by impulsive, violent actions. Usually such people are extremely stubborn and selfish. A psychopath with antisocial personality disorder skips school, vandalizes public property, tortures peers, and wanders.
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 indirectly, but stubbornly neglect the interests and feelings of people.
Children and adolescents suffering from antisocial personalitydisorders, pangs of conscience are not characteristic, even if they commit cynical acts. They think they did the right thing because they did what they wanted to do. And in the eyes of the public, others are blamed. Often there is an early use of drugs, alcohol, promiscuity in the choice of sexual partners. Sometimes there is also addiction to drugs.
However, growing up, patients begin to look quite adapted to life in society as people. A person with antisocial personality disorder may have no difficulty interacting with others.
Moreover, often people with this diagnosis are characterized by a peculiar charm and the ability to win over an interlocutor, in the process of superficial communication they can make a pleasant first impression.
However, they are distinguished by their inability to build deep affection, they do not know how to sympathize, their behavior is filled with manipulation. Symptoms of antisocial personality disorder appear later in the course of communication, when the patient lies easily, using the people around him as bowling balls to achieve his goals. In his arsenal are suicide threats, stories about a difficult fate, imitation of serious diseases in order to provoke certain emotions in others and achieve what he wants.
The main goal of patients is to enjoy, snatching from life as much as possible, no matter what. Symptoms of antisocial personality disorder are manifested in the fact that patients never reproach themselves, do not feel shame and do not sufferfrom feelings of guilt. No threat of punishment, no condemnation affects them, they are deprived of the slightest anxiety about this. When their misdeeds become known to society, they use their ability to manipulate people to easily avoid consequences. Experience does not teach them anything, since they most often consider any criticism addressed to them to be unfair. It should be noted that sometimes they also accept criticism, but only when they see it as a benefit for themselves.
According to Eric Bern's classification, there is a passive and an 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 do not have both internal and external frames. They easily demonstrate responsibility to people and follow social rules when necessary. But as soon as they see an opportunity, they break all the rules and again behave uncontrollably. It is active sociopaths who are characterized by open criminal actions. While passive - hidden forms of deviant behavior, for example, manipulation and lies.
Current
The disorder progresses throughout a person's life. Often, carriers of this disease can be found in public associations isolated from society. Many examples of antisocial personality disorder are found in the leaders of sects or criminal gangs. After reaching the age of 40, the active manifestations of the disease become less pronounced. Patients often develop affective disorders, alcohol and drug addiction.
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 "antisocial personality disorder" (according to ICD-10 code F60.2), you need to identify the following factors:
- lack of empathy, indifference towards people;
- lack of a sense of responsibility towards others, non-compliance with social norms;
- lack of communication difficulties coupled with an inability to form a lasting attachment;
- aggressive behavior;
- irritability;
- shifting responsibility for your 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 ICD-10 antisocial personality disorder from mania, schizophrenia, and secondary personality changes that are rooted in alcohol and drug addiction. When establishing the degree of neglect of established norms, it is imperative to take into account the peculiarities of the social and cultural conditions characteristic of the patient's place of residence.
Treatment
Treating antisocial personality disorder is difficult. Patients almost never turn to specialists for help in resolving this issue, as they reject their negative emotions.do not bring. Feeling that they are going against society, lacking something important, they can turn to psychotherapists, but there will be practically no chance of successfully fighting 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, 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 at the same time with the doctor, expressing resistance to what is happening.
Self-help groups most often turn out to be effective, in which patients with a diagnosis of "dissocial personality disorder" (in the ICD-10 code F60.2) open up without fear of condemnation and being in a circle of their own kind who are disposed towards them friendly.
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 led participants who could be influenced by the patient.
In some cases, manifestations of the diagnosis of "antisocial personality disorder" (ICD-10 code F60.2) are accompanied by depression and increased anxiety. Then drug therapy is used.
If the patient is aggressive, he is prescribed lithium. In these cases, the prognosis is unfavorable: most often the disorder is not subject to correction.
The difference between antisocial disorder and psychopathy
Psychopathy is not an officially recognized psychiatric disorder, the manifestations of which correspond to severe forms of antisocial disorder. The diagnosis of a psychopath is made to those who do 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 were found to have 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 others are interpreted by patients as aggressive towards them. Having a criminal record, they will see the injustice in their accusation. They will be sincerely sure that this is arbitrariness on the part of the court.
Methods of struggle
This condition is highly resistant to therapy, however, a number of researchers have found effective methods to combat it. Thus, treatment methods are applied to adolescents that lead to a change in their thinking, leading to the commission of acts 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 treatments only made matters worse. This is what happened with the inward-oriented approach programs used in the treatment of depression when they were tried to work with patients with antisocial disorder.
The toughestprograms that teach patients new skills that apply to life regardless of the constraints of society.
Drugs can only help to alleviate the conditions that accompany the disorder. So, in the presence of symptoms of depression that accompanies antisocial disorder, antidepressants are taken. Aggressive patients are prescribed mood stabilizers to stop anger and impulsiveness.
What happens if left untreated?
Patients suffering from this disease leave their negative mark on society in the form of mental suffering of the victims against whom they committed crimes. But sometimes a person with an antisocial disorder can hold a high position, be the leader of social groups. Then the consequences of its destructive impact are not so obvious until the moment when mass suicides occur. It has happened so many times in history. For example, this happened in Guyana in 1978 among the followers of Jim Jones.
People suffering from the symptoms of the disorder are prone to alcohol, drugs and crime. Most often, sooner or later they end up in places of deprivation of liberty. They are prone to depression, anxiety, bipolar disorder, and many other psychiatric diagnoses. They tend to self-mutilate themselves and others, often die as a result of murder or suicide, often get into accidents.
The behavior of a person with antisocial disorder can contribute to a change in the environment around him to a negative one. Often such people end their lives inpsychiatric hospitals.
The risk of living this way 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 antisocial personality disorder (F 60.2 - ICD-10 code). So, the first type is characterized by: the absence of emotions and aggression, cold prudence, the presence of organic disorders. People with the first type of diagnosis will go to power without pangs of conscience from any of their actions.
In the second type, people are constantly looking for dangerous behavior for themselves and those around them. They are characterized by bouts of aggression and impulsiveness, they do not care about the consequences. At the same time, there is a lack of organic changes, patients show emotions. It is difficult to treat them because they show aggression towards doctors, and they never come for help.
A striking example of antisocial disorder is Alex, a character from the film A Clockwork Orange.
Important to know
Antisocial behavior is not always a sign of mental illness. It must be remembered that some people like to live with risk, without worries and without the burden of responsibility.
Patients do not feel the desire to be treated, because they do not believe that something wrong is happening to them. Also, the disorder manifests itself differently depending on the gender of the person. So, male representatives are characterized by manifestations of recklessness and aggression, includingon the roads, they can cruelly treat animals, fight, use weapons, and engage in arson. Females tend to gamble and show less physical aggression in favor of 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 one's own actions remains. It can be cured until it develops into an antisocial disorder. Children often break all kinds of rules, throwing numerous challenges to everyone around.
At the initial stage, disobedience is successfully treated by psychotherapists using drugs. Participation in the process of correcting the behavior of parents is necessary.
The more symptoms of a behavioral disorder manifested in childhood, the greater the chance that a person will experience 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 deceive a child by pretending to love each other and him. Their behavior demonstrates love, but in fact the child feels deceived. In such conditions, he adopts the seen behavior pattern.
Growing up, he no longer has anything that would be valuable to him, any behavior patterns are normal for him.
All this leads to the fact that people do notmay be in a long-term relationship, as they absolutely do not appreciate anything and anyone around.
Often among such individuals there is a para-existential disorder, because of which they do not feel themselves and look for themselves in their goals. They tend to think "I'll be nothing if I'm not successful in my career, if I'm not successful."
In such a picture of the world, friends become means to an end, marriage is evaluated in terms of the benefits it brings. All surrounding people are functional. From the outside, it may seem that the patient is living a meaningful life. However, he only moves away from the existential meaning, striving for needs.
Anti-social disorder is similar to para-existential. 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 take advantage of 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, skipped the line, behaved indifferently, selfishly and cynically. But real antisocial disorder manifests itself in a slightly different way. The patient is able to cause serious injury to someone and not experience any anguish about this.
Most often people adapt to society and life in accordance with its laws. But patients are unable to do this. They are in opposition to the whole of society, notidentify with him.
And this disease is expressed not only in asociality. Patients suffer deeply, it is difficult for them to endure isolation, and they begin to take actions to cope with it. By committing criminal acts, they help themselves.
They are able to act against themselves, easily irritated by the most insignificant 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 a permanent basis, since he does not have the internal structures to realize exactly what others have in mind. None of the family members are able to cope with this. Having found similar manifestations in someone close, you need to contact specialists.
