The DSM IV describes Antisocial Personality Disorder as "a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." Deceit, manipulation and a general lack of remorse are essential features of the disorder. People having antisocial personality disorder are sometimes referred to as "sociopaths" and "psychopaths". The disorder is much more commonly diagnosed in men than in women.
Three or more of the following are required:
- Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
- Deceitfulness, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
- Impulsivity 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.
The antisocial behavior must not occur exclusively during an episode of schizophrenia or a manic episode.
Characteristics of people with antisocial personality disorder may include:
- Persistent lying or stealing
- Superficial charm
- Apparent lack of remorse or empathy; inability to care about hurting others
- Inability to keep jobs or stay in school
- Impulsivity and/or recklessness
- Lack of realistic, long-term goals -- an inability or persistent failure to develop and execute long-term plans and goals
- Inability to make or keep friends, or maintain relationships such as marriage
- Poor behavioral controls -- expressions of irritability, annoyance, impatience, threats, aggression, and verbal abuse; inadequate control of anger and temper
- Narcissism, elevated self-appraisal or a sense of extreme entitlement
- A persistent agitated or depressed feeling (dysphoria)
- A history of childhood conduct disorders
- Recurring difficulties with the law
- Tendency to violate the boundaries and "rights" of others
- Substance abuse
- Aggressive, often violent behavior; prone to getting involved in fights
- Inability to tolerate boredom
- Disregard for the safety of self or others
- People with a diagnosis of antisocial personality disorder often experience difficulties with authority figures.
Causes
Like the other personality disorders, the causes for Antisocial Personality Disorder are not known. It is important to separate true antisocial behavior from the same patterns of behavior which might be adopted as a matter of survival rather than an indicator of the individual's true nature. Examples which are frequently cited are people struggling with drug addiction or homeless individuals. Both might adopt antisocial behavior as a matter of survival while living on the streets or pursuing their drug of choice. However, when removed from these circumstances, the antisocial behavior dissipates. An individual with true Antisocial Personality Disorder demonstrates antisocial symptoms throughout their lives, regardless of circumstances.
Some of the causes which have been cited by researchers are; an alcoholic father, maternal deprivation in the first five years of life and mothers who did not discipline their children and showed little affection toward them. Some studies indicate a genetic component in the development of the disorder.
Due to their lack of regard for the rights of others, you will find a disproportionate number of individuals with APD in jail or prison. A fellow clinician and mentor once told me that the largest number of people with APD would be found in prison, or as the CEO's of major companies.