A low moral sense or conscience is often evident, as well as a history of crime, legal problems, or impulsive and aggressive behavior.
Antisocial personality disorder (ASPD or APD) is a personality disorder characterized by a long-term pattern of contempt or violation of the rights of others.
Antisocial personality disorder is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM).
Conduct Personality Disorder (DPD), a similar or equivalent concept, is defined in the International Statistical Classification of Diseases and Related Health Problems (ICD), which includes antisocial personality in diagnosis.
Both manuals provide similar criteria for diagnosing the disorder. Both have also stated that their diagnoses have been referred to, or include what is known as psychopathy or sociopathy.
But distinctions have been made between conceptualizations of antisocial personality disorder and psychopathy, and many researchers argue that psychopathy is a disorder that overlaps with, but is distinguishable from, antisocial personality disorder.
Signs and symptoms of antisocial disorder
People with this disorder will normally have no qualms about exploiting others in detrimental ways for their own benefit and will often manipulate and deceive other people, achieving this through wit and a facade of superficial charm or through intimidation and deception. violence.
They can display arrogance, think humbly and negatively of others, and lack remorse for their harmful actions and have a callous attitude towards those they have wronged.
Those with antisocial personality disorder are often impulsive and reckless, without considering or ignoring the consequences of their actions.
They may repeatedly ignore and endanger their own safety and that of others, and endanger themselves and others.
They are often aggressive and hostile and exhibit an unregulated temperament and may lash out violently with provocation or frustration.
These behaviors lead such individuals into frequent conflict with the law, and many people with antisocial personality disorder have a long history of antisocial behavior and criminal offenses dating back before adulthood.
Serious problems with interpersonal relationships are often seen in those with the disorder.
Although antisocial personality disorder is a mental disorder diagnosed in adulthood, it has its precedent in childhood.
The Fifth Edition criteria for antisocial personality disorder requires the individual to have obvious behavior problems by the age of 15 years.
Persistent antisocial behavior as well as lack of consideration for others in childhood and adolescence is known as behavior. disorder and is the precursor to antisocial personality disorder.
About 25-40% of young people with conduct disorder will be diagnosed with antisocial personality disorder in adulthood.
Conduct disorder (CD) is a disorder diagnosed in childhood that parallels the features found in antisocial personality disorder.
It is characterized by a repetitive and persistent pattern of behavior in which the basic rights of others or the most important norms for age are violated.
Children with the disorder often display impulsive and aggressive behavior, can be insensitive and deceptive, and may repeatedly engage in petty crimes such as theft or vandalism or get into fights with other children and adults.
This behavior is typically persistent and can be difficult to deter with threats or punishment.
Attention deficit hyperactivity disorder (ADHD) is common in this population, and children with this disorder may also be involved in substance abuse.
Conduct disorder differs from oppositional defiant disorder (ODD) in that children with oppositional defiant disorder do not commit aggressive or antisocial acts against other people, animals, and property.
Although many children diagnosed with oppositional defiant disorder are later re-diagnosed with conduct disorder.
Two developmental courses have been identified for conduct disorder based on the age at which symptoms become present.
The first is known as the “childhood-onset type” and occurs when conduct disorder symptoms are present before age 10 years.
This course is often linked to a more persistent life course and more generalized behaviors.
And children in this group express higher levels of symptoms of attention deficit hyperactivity disorder, neuropsychological deficits, more academic problems, greater family dysfunction, and greater likelihood of aggression and violence.
The second is known as the “adolescent onset type” and occurs when conduct disorder develops after age 10.
Compared with the childhood-onset type, less impairment in various cognitive and emotional functions are present, and the adolescent-onset variety may subside into adulthood.
In addition to this differentiation, the Diagnostic and Statistical Manual of Mental Disorders provides a specifier for an emotionless and callous interpersonal style, which reflects the characteristics observed in psychopathy and is believed to be a childhood precursor to this disorder.
Compared to the adolescent-onset subtype, the childhood-onset subtype, especially if there are insensitive and non-emotional traits, tends to have a worse treatment outcome.
Causes and pathophysiology of antisocial disorder
Personality disorders are considered to be caused by a combination and interaction of genetic and environmental influences.
Genetically, they are the intrinsic temperamental tendencies determined by their genetically influenced physiology, and from an environmental point of view, they are the social and cultural experiences of a person in childhood and adolescence that encompass their family dynamics, their influences and their social values.
People with an antisocial or alcoholic parent are considered to be at higher risk. The fixation of fire and cruelty towards animals during childhood are also linked to the development of the antisocial personality.
The condition is more common in men than women, and among people who are in prison.
Research on genetic associations in antisocial personality disorder suggests that antisocial personality disorder has some, or even a strong genetic basis.
The prevalence of antisocial personality disorder is higher in people related to someone affected by the disorder.
Twin studies, which are designed to discern between genetic and environmental effects, have reported important genetic influences on antisocial behavior and conduct disorder.
Of the specific genes that may be involved, a gene that has shown particular interest in its correlation with antisocial behavior is the gene that encodes monoamine oxidase A (MAO-A), an enzyme that breaks down monoamine neurotransmitters, such as serotonin. and norepinephrine.
Several studies examining the relationship of the gene to behavior have suggested that variants of the gene that produce less monoamine oxidase A that is produced, such as the 2R and 3R alleles of the promoter region, have associations with aggressive behavior in males.
The association is also influenced by negative experience in early life, and children with a low-activity variant (MAOA-L) who experience such abuse are more likely to develop antisocial behavior than those with the high-activity variants ( MAOA-H).
Even when controlling for environmental interactions (eg, emotional abuse), a small association persists between MAOA-L and aggressive and antisocial behavior.
The gene encoding the serotonin transporter (SCL6A4), a gene that has been extensively investigated for its associations with other mental disorders, is another gene of interest in antisocial behavior and personality traits.
Genetic association studies have suggested that the short “S” allele is associated with impulsive antisocial behavior and antisocial personality disorder in the prison population.
However, research in psychopathy finds that the long ‘L’ allele is associated with Factor 1 traits of psychopathy, which describes its affective core (eg, lack of empathy, fearlessness) and interpersonal disturbances (eg, grandiosity). , manipulation) of personality.
This suggests two different forms, one associated more with impulsive behavior and emotional dysregulation, and the other with the predatory aggression and affective disturbance of the disorder.
Several other genetic candidates for antisocial personality disorder have been identified through a genome-wide association study published in 2016.
Several of these genetic candidates are shared with attention deficit hyperactivity disorder, with which antisocial personality disorder is comorbid.
Hormones and neurotransmitters
Traumatic events can lead to an alteration of the standard development of the central nervous system, which can generate a release of hormones that can change normal development patterns.
Aggression and impulsivity are among the possible symptoms of antisocial personality disorder. Testosterone is a hormone that plays an important role in aggressiveness in the brain.
For example, criminals who have committed violent crimes tend to have higher levels of testosterone than the average person.
The effect of testosterone is counteracted by cortisol, which facilitates the cognitive control of impulsive tendencies.
One of the neurotransmitters that has been discussed in people with antisocial personality disorder is serotonin, also known as 5-hydroxytryptamine or 5HT receptors.
A meta-analysis of 20 studies found significantly lower levels of 5-hydroxyindoleacetic acid (5-HIAA) (indicating lower levels of serotonin), especially in those younger than 30 years.
While it has been shown that lower serotonin levels may be associated with antisocial personality disorder.
There has also been evidence that decreased serotonin function is highly correlated with impulsivity and aggressiveness in a number of different experimental paradigms.
Impulsivity is not only related to irregularities in 5HT metabolism, but it may also be the most essential psychopathological aspect related to this dysfunction.
Consequently, the Diagnostic and Statistical Manual of Mental Disorders classifies “impulsivity or lack of advance planning” and “irritability and aggressiveness” as two of the seven sub-criteria in category A of the diagnostic criteria for antisocial personality disorder.
Some studies have found an association between monoamine oxidase A and antisocial behavior, including conduct disorder and symptoms of adult antisocial personality disorder, in abused children.
Antisocial behavior may be related to a head injury. Antisocial behavior is associated with a decrease in gray matter in the right lentiform nucleus, left insula, and frontopolar cortex.
Increased volumes have been observed in the right fusiform gyrus, the inferior parietal cortex, the right cingulate gyrus, and the posterior central cortex.
People who display antisocial behavior show decreased activity in the prefrontal cortex. The association is more evident in functional neuroimaging compared to structural neuroimaging.
The prefrontal cortex is involved in many executive functions, including inhibitions of behavior, planning ahead, determining the consequences of action, and differentiating between right and wrong.
Cavum septi pellucidi (CSP), also known as the fifth ventricle, is a marker of limbic neuronal maldevelopment, and its presence has been loosely associated with certain mental disorders, such as schizophrenia and post-traumatic stress disorder.
One study found that those with Cavum septi pellucidi had significantly higher levels of antisocial personality, psychopathy, arrests, and convictions compared to controls.
Some studies suggest that the social and domestic environment has contributed to the development of antisocial behavior. The parents of these children have been shown to display antisocial behavior, which could be adopted by their children.
The sociocultural perspective of clinical psychology considers that disorders are influenced by cultural aspects; Since cultural norms differ significantly, mental disorders such as antisocial personality disorder are viewed differently.
Robert D. Hare has suggested that the reported increase in antisocial personality disorder in the United States may be related to changes in cultural mores, the latter serving to validate the behavioral tendencies of many people with antisocial personality disorder.
While the increase in reported antisocial personality disorder may be in part simply a by-product of the increasing use (and abuse) of diagnostic techniques.
Given Eric Berne’s division between individuals with active and latent antisocial personality disorder, the latter are kept in check through attachment to an external source of control such as law, traditional standards, or religion:
It has been plausibly suggested that the erosion of collective standards may in fact serve to liberate the individual with latent antisocial personality disorder from their previous prosocial behavior.
There is also an ongoing debate about the extent to which the legal system should be involved in the identification and admission of patients with preliminary symptoms of antisocial personality disorder.
Diagnosis of antisocial disorder
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR)
The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM IV-TR) defines antisocial personality disorder as:
A) An ever-present pattern of contempt and violation of the rights of others, occurring from the age of 15, as indicated by three or more of the following:
- Lack of conformity with social norms regarding legal conduct as indicated by repeatedly performing acts that are grounds for arrest.
- Deception, as indicated by repeated lies, use of aliases, or deceiving others for personal gain or pleasure.
- Impulsiveness or failure to plan ahead.
- Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
- Reckless disregard for the safety of oneself or others.
- Consistent irresponsibility, as indicated by repeated failure to maintain consistent work behavior or honor financial obligations.
- Lack of remorse, as indicated by being indifferent or rationalizing having hurt, abused or robbed another.
B) The individual is at least 18 years old.
C) There is evidence of a conduct disorder with onset before 15 years of age.
D) The appearance of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
The essential characteristics of a personality disorder are deficiencies in the functioning of the personality (self and interpersonal) and the presence of pathological personality traits.
To diagnose antisocial personality disorder, the following criteria must be met:
A) Significant deficiencies in the functioning of the personality are manifested by:
- Deficiencies in autonomous functioning (one or the other):
Identity : egocentricity; self-esteem derived from personal gain, power, or pleasure.
Self-direction : goal setting based on personal gratification; absence of prosocial internal standards associated with non-compliance with legal or culturally normative ethical behavior.
- Deficiencies in interpersonal functioning (one or the other):
Empathy : lack of concern for the feelings, needs, or suffering of others; lack of remorse after hurting or abusing another.
Intimacy : inability for mutually intimate relationships, as exploitation is a primary means of relating to others, including through deception and coercion; use of domination or intimidation to control others.
B) Pathological personality traits in the following domains:
- Antagonism, characterized by:
Manipulation : frequent use of subterfuge to influence or control others; use of seduction, charm, extravagance or ingratiation to achieve one’s own ends.
Deception : dishonesty and fraud; misrepresentation of oneself; beautification or fabrication when events are related.
Insensitivity : lack of concern for the feelings or problems of others; lack of guilt or remorse for the negative or damaging effects of one’s actions on others; aggression; sadism.
Hostility : persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; bad, disgusting or vindictive behavior.
- Disinhibition, characterized by:
Irresponsibility : ignoring and not respecting financial and other obligations or commitments; lack of respect and failure to follow through on agreements and promises.
Impulsivity : acting spontaneously in response to immediate stimuli; acting momentarily without a plan or consideration of the results; Difficulty establishing and following plans.
Risk-taking : participation in dangerous, risky and potentially self-harming activities, unnecessarily and without taking into account the consequences.
The propensity for boredom and the thoughtless initiation of activities to counteract boredom; lack of concern for one’s own limitations and denial of the reality of personal danger.
C) The deficiencies in the functioning of the personality and the expression of the individual’s personality trait are relatively stable over time and consistent in all situations.
D) The deficiencies in the functioning of the personality and the expression of the personality trait of the individual are not better understood as normative for the stage of development of the individual or the sociocultural environment.
E) Alterations in the functioning of the personality and the expression of the individual’s personality trait are not solely due to the direct physiological effects of a substance (for example, a drug of abuse, medication) or a general medical condition (for example , severe head injury).
F) The individual is at least 18 years old.
Antisocial personality disorder falls under the dramatic / erratic group of personality disorders, “Group B”.
International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10)
The International Statistical Classification of Diseases and Health Problems, Tenth Edition (ICD-10) of the World Health Organization, has a diagnosis called Conduct Personality Disorder (F60.2):
It is characterized by at least 3 of the following:
- Warm unconcern for the feelings of others.
- Rude and persistent attitude of irresponsibility and indifference towards social norms, rules and obligations.
- Inability to maintain lasting relationships, although without difficulty in establishing them
- Very low tolerance for frustration and a low threshold for the performance of aggression, including violence.
- Inability to experience guilt or to profit from the experience, particularly punishment.
- Marked availability to blame others or offer plausible rationalizations for behavior that has brought the person into conflict with society.
The International Statistical Classification of Diseases and Related Health Problems states that this diagnosis includes “amoral, antisocial, asocial, psychopathic, and sociopathic personality.”
Although the disorder is not synonymous with conduct disorder, the presence of conduct disorder during childhood or adolescence can further support the diagnosis of Conduct Personality Disorder.
There may also be persistent irritability as an associated feature.
It is a requirement of the International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10) that a diagnosis of any specific personality disorder also satisfies a set of criteria for general personality disorder.
Psychopathy is commonly defined as a personality disorder characterized in part by antisocial behavior, a diminished capacity for empathy and remorse, and poor behavioral controls.
Psychopathic traits are assessed using various measurement tools, including the Psychopathy-Revised Checklist (PCL-R) by Canadian researcher Robert D. Hare.
“Psychopathy” is not the official title of any diagnosis in the Diagnostic and Statistical Manual of Mental Disorders or the International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10).
Nor is it an official title used by other major psychiatric organizations.
The Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases and Related Health Problems, Tenth Edition (ICD-10), however, states that their antisocial diagnoses are sometimes referred to (or include what is called) such as psychopathy or sociopathy.
The work of American psychiatrist Hervey Cleckley on psychopathy formed the basis of the diagnostic criteria for antisocial personality disorder, and the Diagnostic and Statistical Manual of Mental Disorders indicates that antisocial personality disorder is often referred to as psychopathy.
However, critics argue that antisocial personality disorder is not synonymous with psychopathy since the diagnostic criteria are not the same, since the criteria relating to personality traits are emphasized relatively less in the former.
These differences exist in part because such traits were believed to be difficult to measure reliably and it was “easier to agree on the behaviors that typify a disorder than on the reasons why they occur.”
Although the diagnosis of antisocial personality disorder encompasses two to three times as many inmates as the diagnosis of psychopathy, Robert Hare believes that the revised Psychopathy Checklist is better able to predict future crime, violence, and recidivism than a diagnosis of psychopathy disorder. antisocial personality.
It suggests that there are differences between the Revised Psychopathy-Diagnosed Psychopaths and Non-Psychopaths Checklist on ‘Processing and Use of Linguistic and Emotional Information’.
While such differences are potentially smaller between people diagnosed with antisocial personality disorder and those without.
Additionally, Hare argued confusion about how to diagnose antisocial personality disorder, confusion about the difference between antisocial personality disorder and psychopathy.
As well as different future prognoses on recidivism and treatability, it can have serious consequences in settings such as court cases where psychopathy is often seen as compounding crime.
Nonetheless, psychopathy has been proposed as a specifier in an alternative model for antisocial personality disorder.
In the Diagnostic and Statistical Manual of Mental Disorders, under “Alternative Model of the Diagnostic and Statistical Manual of Mental Disorders for personality disorders.”
Antisocial personality disorder with psychopathic characteristics is described as characterized by “a lack of anxiety or fear and a bold interpersonal style that can mask maladaptive behaviors (such as fraud).”
Low levels of withdrawal and high levels of attention seeking combined with low anxiety are associated with “social potency” and “immunity to stress” in psychopathy.
Under the specifier, affective and interpersonal characteristics are comparatively emphasized over behavioral components.
Theodore Millon suggested 5 subtypes of antisocial personality disorder. However, these constructs are not recognized in the Diagnostic and Statistical Manual of Mental Disorders and the International Statistical Classification of Diseases and Related Health Problems.
Nomadic antisocial (including schizoid and avoidant characteristics).
Drifters; roamers, tramps; adventurers, itinerant vagabonds, vagabonds, vagabonds; they typically adapt easily to difficult, cunning, and impulsive situations. The mood is focused on ruin and invincibility.
Malevolent antisocial (including sadistic and paranoid characteristics).
Belligerent, scathing, spiteful, vicious, sadistic, evil, brutal, resentful; anticipates betrayal and punishment; wants revenge; gruesome, insensitive, fearless; innocent; many dangerous criminals, including serial killers Ted Bundy, Harvey Glatman, and mass murderer Anders Behring Breivik fit these criteria.
Greedy antisocial (including negative characteristics).
Raptor, grudgingly, yearning discontent; one angle was seen as assertively hostile to dominate; he was envious, seeking more profit, and greedily greedy; pleasures more in taking than in having.
Antisocial risk-taking (including histrionic characteristics).
Fearless, enterprising, fearless, daring, daring, daring; reckless, reckless, careless; undeterred by the danger; chases dangerous companies.
Antisocial defending reputation (including narcissistic characteristics).
It needs to be considered as infallible, unbreakable, indomitable, formidable and inviolable; uncompromising when the state is questioned; exaggerated to slights.
On the other hand, Theodore Millon distinguishes ten subtypes (partially overlapping with the previous ones):
Greedy, risky, malevolent, tyrannical, evil, phony, explosive and abrasive, but he specifically highlights that “the number 10 is not special … Taxonomies can be presented at levels that are coarser or finer.”
Antisocial personality disorder usually coexists with the following conditions:
- Anxiety disorders
- Depressive disorder
- Impulse control disorders.
- Substance-related disorders.
- Somatization disorder.
- Hyperactive disorder and attention deficit.
- Bipolar disorder.
- Borderline personality disorder.
- Histrionic personality disorder.
- Narcissistic personality disorder.
- Sadistic personality disorder.
When combined with alcoholism, people may show deficits of frontal functions on neuropsychological tests greater than those associated with each condition.
Rates of antisocial personality disorder tend to be around 40-50% in men addicted to alcohol and opiates.
Treatment of antisocial disorder
Antisocial personality disorder is considered one of the most difficult personality disorders to treat.
Presenting an effective treatment for antisocial personality disorder is further complicated by the inability to observe comparative studies between psychopathy and antisocial personality disorder due to:
- Different diagnostic criteria.
- Differences in the definition and measurement of results.
And a focus on treating incarcerated patients rather than those in the community.
Due to their little or no capacity for remorse, people with antisocial personality disorder often lack sufficient motivation and do not see the costs associated with antisocial acts.
They can feign remorse instead of truly committing to change: they can be seductively charming and dishonest, and they can manipulate staff and other patients during treatment.
Studies have shown that outpatient therapy is probably not successful, but the degree to which people with antisocial personality disorder do not fully respond to treatment may have been overstated.
Most of the treatment that is done is for those in the criminal justice system who receive the treatment regimens as part of their incarceration.
People with antisocial personality disorder can remain in treatment only when required by an outside source, such as the conditions of probation.
Residential programs that provide a carefully controlled environment of structure and supervision along with peer confrontation have been recommended.
There has been some research on the treatment of antisocial personality disorder that indicated positive results for therapeutic interventions.
Psychotherapy also known as talk therapy is found to help treat patients with antisocial personality disorder.
Schema therapy is also being investigated as a treatment for antisocial personality disorder. A review by Charles M. Borduin presents the great influence of multisystem therapy (MST) that could improve this imperative problem.
However, this treatment requires the full cooperation and participation of all family members.
Some studies have found that the presence of antisocial personality disorder does not significantly interfere with the treatment of other disorders, such as substance abuse, although others have reported conflicting findings.
Therapists who work with people with antisocial personality disorder may have considerable negative feelings toward patients with a long history of aggressive, exploitative, and abusive behaviors.
Rather than trying to develop a sense of awareness in these individuals, which is extremely difficult considering the nature of the disorder, therapeutic techniques focus on rational and utilitarian arguments against the repetition of past mistakes.
These approaches would focus on the tangible and material value of prosocial behavior and refrain from antisocial behavior. However, the impulsive and aggressive nature of people with this disorder can limit the effectiveness of even this form of therapy.
The use of medications to treat antisocial personality disorder has yet to be fully explored, and the Food and Drug Administration (FDA) has not approved any medications to specifically treat antisocial personality disorder.
A Cochrane review of studies in 2010 that explored the use of pharmaceuticals in people with antisocial personality disorder, of which 8 studies met the selection criteria for the review.
It concluded that the current body of evidence was inconclusive for recommendations on the use of pharmaceuticals in the treatment of various antisocial personality disorder problems.
However, psychiatric medications such as antipsychotics, antidepressants, and mood stabilizers can be used to control symptoms such as aggression and impulsivity.
As well as to treat disorders that may coincide with the antisocial personality disorder for which the medications are indicated.
Antisocial disorder prognosis
According to Professor Emily Simonoff of the Institute of Psychiatry, Psychology and Neuroscience:
“Childhood hyperactivity and conduct disorder showed an equally strong prediction of antisocial personality disorder (SAD) and criminality in middle and adult life.”
“Lower IQ and reading problems were more prominent in their relationships with antisocial behavior of childhood and adolescence.”
Epidemiology of antisocial disorder
Antisocial personality disorder is seen in 3% to 30% of psychiatric outpatients. The prevalence of the disorder is even higher in selected populations, such as prisons, where violent offenders predominate.
A 2002 literature review of studies on mental disorders in prisoners indicated that 47% of male prisoners and 21% of female prisoners had antisocial personality disorder.
Similarly, the prevalence of antisocial personality disorder is higher among patients in alcohol or other drug abuse treatment programs than in the general population.
Suggesting a link between antisocial personality disorder and alcohol or other drug abuse or dependence.
History of antisocial disorder
The first version of the Diagnostic and Statistical Manual of Mental Disorders in 1952 listed sociopathic personality disturbance. The individuals who would be placed in this category were said to be:
“… mainly in terms of society and in accordance with the prevailing environment, and not only in terms of personal discomfort and relationships with other individuals.”
There were four subtypes, called “reactions”;
The antisocial reaction was said to include people who were “always in trouble” and did not learn from it, maintaining “no loyalties”, often insensitive and without responsibility, with the ability to “rationalize” their behavior.
The category was described as more specific and limited than the existing concepts of ‘constitutional psychopathic state’ or ‘psychopathic personality’ which had a very broad meaning.
The narrower definition was in line with the criteria proposed by Hervey M. Cleckley since 1941, while the term sociopathic had been proposed by George Partridge in 1928 when studying the early environmental influence on psychopaths.
George Partridge discovered the correlation between antisocial psychopathic disorder and parental rejection experienced in early childhood.
The second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) in 1968 rearranged the categories and ‘antisocial personality’ was now listed as one of the ten personality disorders, but is still described similarly, to apply to individuals who:
“Basically unsocialized,” in repeated conflicts with society, incapable of meaningful loyalty, selfish, irresponsible, incapable of feeling guilt or learning from previous experiences, and tending to blame others and rationalize.
The manual preface contains “special instructions” including “Antisocial personality should always be specified as mild, moderate, or severe.”
The second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) warned that a history of legal or social crimes was not by itself sufficient to justify the diagnosis.
And that a “group delinquent reaction” of childhood or adolescence or “social maladjustment without overt psychiatric disorder” must first be ruled out.
Dissocial personality type was relegated in the second edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-II) to “dissocial behavior.”
For individuals who are predators and follow more or less criminal activities, such as scammers, rogue gamblers, prostitutes, and street drug dealers.
The Diagnostic and Statistical Manual of Mental Disorder, first edition classified this condition as sociopathic personality disorder, dyssocial type.
It would later resurface as the name of a diagnosis in the Manual for the International Classification of Diseases and Related Health Problems produced by the World Health Organization.
It later spelled Conduct Personality Disorder and was considered roughly equivalent to the diagnosis of Antisocial Personality Disorder.
The Third Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1980 included the full term antisocial and personality disorder, as with other disorders.
There is now a comprehensive list of symptoms focused on observable behaviors to improve consistency in diagnosis between different psychiatrists (‘inter-rater reliability’).
The list of symptoms of antisocial personality disorder was based on the Research Diagnostic Criteria developed from the so-called Feighner Criteria of 1972.
And in turn widely attributed to the influential research by sociologist Lee Robins published in 1966 as “Troubled Children Grow Up.” (Deviant Children Grown Up) ».
However, Lee Robins has previously clarified that while the new criteria for prior child behavior problems come from his work.
She and co-investigating psychiatrist Patricia O’Neal obtained the diagnostic criteria they used from Lee’s husband, psychiatrist Eli Robins, one of the authors of the Feighner criteria who had used them as part of the diagnostic interviews.
The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) maintained the trend for behavioral antisocial symptoms, while noting “This pattern has also been called psychopathy, sociopathy, or dissocial personality disorder.”
And some of the underlying personality traits from the older diagnoses were re-included in the Associated Characteristics Text Summary.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has the same diagnosis of antisocial personality disorder.
The Diagnostic and Statistical Manual of Mental Disorders, Diagnostic and Statistical Manual, Fifth Edition (DSM-5) Pocket Guide to Diagnostic Examination suggests that a person with antisocial personality disorder may exhibit “psychopathic features” if they exhibit “lack of anxiety or fear. and a bold and effective interpersonal style.