Antisocial Personality Disorder
An antisocial personality disorder is a mental health illness that affects the way people think, feel, or relate with other people. It is characterized by irresponsible, impulsive, and criminal behavior. The DSM-5 stipulates that there are four diagnostic criteria for antisocial personality disorder, of which criteria A has seven subsections.
In the first criteria, an individual shows lack of regard for and violation of other people’s rights from 15 years. It is also indicated by the failure to get in line with social norms, with repeated forms of activity that warrant arrest (Porter, n.d.). There is also deceitfulness and impulsivity. The other sub-feature is aggressiveness, and lack of consideration for the safety of others and themselves. There is also persistent irresponsibility and the lack of remorse. The second criterion depicts that the individual is at least 18 years (Porter, n.d.). The third criterion is that there is evidence of conduct disorder, which starts at 15 years (Porter, n.d.). The fourth criterion states that the “occurrence of antisocial behavior is not exclusively during a manic period or schizophrenia” (Porter, n.d.).
The clinical features of Antisocial Personality disorder include; physical abuse, substance abuse stealing, lying, fighting, and drunk driving. These patients lack empathy, interaction with others are mainly exploitative, and though these patients are arrogant, they can be superficially charming (Porter, n.d.).
There are different categories of psychotherapy treatment for antisocial personality disorder. They include cognitive behavioral therapy, psychoanalytic psychotherapy, and therapeutic community (Gibbon et al., 2009). Despite the use of these types of therapy, inpatient self-help groups are instrumental as the patient is not allowed to leave and peer enhancement and interaction minimizes authority (Gibbon et al., 2009).
In line with pharmacotherapy, drug treatments will be used in patients whose symptoms interfere with functioning and or meets the criteria of another psychiatric disorder (Khalifa et al., 2009). Research shows that antidepressants would be helpful if depression and anxiety are present. Mood stabilizers like Lithium, anticonvulsants, and beta-blockers use for impulse control play a huge role in treating antisocial personality disorder (Khalifa et al., 2009).
In this case, the clinical features that led to the above diagnosis include the fact that the client was very arrogant, aggressive, and destructive (“Antisocial personality disorder – Symptoms and causes,” 2017). The patient reported a history of neglect and abuse during childhood and unstable and chaotic family life. These entities are directly related to the depicted criminal features psychologically, and that is what led to the diagnosis of this illness.
The differential diagnosis of antisocial personality disorder includes; Narcissistic Personality disorder. These patients are exploitative and lack empathy but not deceitful and aggressive as antisocial personality disorder patients (“Antisocial personality disorder – Differential Diagnosis,” 2017). In Borderline Personality disorder, patients are manipulative, impulsive and are more emotional in getting gratification rather than finance. These patients are emotionally unstable and are less aggressive as patient with an antisocial personality disorder (Khalifa et al., 2009).
Antisocial personality disorder – Symptoms and causes. (2017). Retrieved from https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928
Gibbon, S., Duggan, C., Stoffers, J., Huband, N., Völlm, B., Ferriter, M., & Lieb, K. (2009). Psychological interventions for antisocial personality disorder. Cochrane Database Of Systematic Reviews, 6(CD007668). doi: 10.1002/14651858.cd007668
Khalifa, N., Duggan, C., Stoffers, J., Huband, N., Völlm, B., & Lieb, K. (2009). Pharmacological interventions for antisocial personality disorder. Cochrane Database Of Systematic Reviews, 6(CD007667). doi: 10.1002/14651858.cd007667
Porter, D. (n.d). Antisocial Personality Disorder DSM-5 301.7 (F60.2) – Therapedia. Retrieved from https://www.theravive.com/therapedia/antisocial-personality-disorder-dsm–5-301.7-(f60.2)
Discussion: Treatment of Personality Disorders
Personality disorders occur in 10–20% of the population. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.
In this Discussion, you will explore personality disorders in greater detail and discuss treatment options using evidence-based research.
Analyze diagnostic criteria for personality disorders
Analyze evidence-based psychotherapy and psychopharmacologic treatments for personality disorders
Analyze clinical features of clients with personality disorders
Align clinical features with DSM-5 criteria
Compare differential diagnostic features of personality disorders
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!
To prepare for this Discussion:
By Day 5 of Week 2, your Instructor will have assigned you a personality disorder, which will be your focus for your initial post for this Discussion.
Review the Learning Resources.
By Day 3
Explain the diagnostic criteria for your assigned personality disorder.
Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned personality disorder.
Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.
Support your rationale with references to the Learning Resources or other academic resources.
By Day 6
Respond to at least two of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. What are their similarities and differences? How might you differentiate the two diagnoses?
Antisocial Personality Disorder
Diagnostic Criteria for Antisocial Personality Disorder
Antisocial Personality Disorder falls under Cluster B of the personality disorders. Cluster can be remembered as the category of rather “Dramatic” like behaviors. The incorrect term that is often associated with Antisocial Personality Disorder are “sociopath” and “psychopath” (American Psychiatric Association, 2013). Clinical features for Antisocial Personality Disorder that align with the DSM-5 include an individual whom (American Psychiatric Association, 2013):
Feels little to no empathy towards other people
Disregards other peoples and their rights
Breaks and/or bends the law, and does not see a problem
Problems with aggression as early in children and continues to adult life
May have an inflated self esteem
Demonstrate Superficial charm
Lack of remorse
18 years or older.
Diagnostic Criteria for Antisocial Personality Disorder includes:
That the individual be at 18 years old age. (Must be 18 years or older, cannot be diagnosed in anyone whom is younger than 18) (American Psychiatric Association, 2013).
Evidence of Conduct Disorder with onset before the age of 15 as demonstrated by at least three of the following characteristics :
B1- often bullies, threatens and/or intimidates others
B2- often initiates physical fights
B3- has used a weapon that can cause serious physical harm to others
B4- Has stolen with confrontation with a victim (stealing a purse, armed robbery, mugging, etc.)
B5- has been physically cruel to people
B6- has been physically cruel to animals
B7- has forced someone into sexual activity
B8- often lies are breaks promises to obtain goods or favors (cons others).
B9- Often stays out late at night, despite parental prohibitions beginning before the age of 13 (American Psychiatric Association, 2013).
Other behaviors such as unlawful acts, deceitfulness, impulsivity, repeated physical fights, disregard for safety, consistent irresponsibility and lack of remorse (American Psychiatric Association, 2013).
Evidence Based Psychotherapy for Antisocial Personality Disorder
Evidence based research has shown the diagnosis is not official unless the individual has shown evidence of significant distress in many areas of their life. Antisocial personality disorder is also 70 % more common in males than in their female counterparts. Research has also show that this disorder tends to decrease in intensity with age. Many people in their 40s to 50 years of age show a significant reduction symptom for this disorder as they continue to age.
Psychopharmacologic Treatment for Antisocial Personality Disorder
The best choice of treatment for Antisocial Personality Disorder is psychotherapy. Medications are also used for this disorder to help stabilize mood swings and other psychiatric concerns that concurrently occur with the Antisocial Personality Disorder. Research has shown that some medications such as phenytoin can help reduce the intensity of impulsive aggressive acts people with the disorder. Further research is required to clarify which medications are effective for Antisocial Personality Disorder (American Psychiatric Association, 2013).
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013.
Holzer, K. J., & Vaughn, M. G. (2017). Antisocial personality disorder in older adults: A critical review. Journal of Geriatric Psychiatry and Neurology, 30(6), 291–302. https://doi-org.ezp.waldenulibrary.org/10.1177/0891988717732155
Rosenström, T., Ystrom, E., Torvik, F. A., Czajkowski, N. O., Gillespie, N. A., Aggen, S. H., … Reichborn-Kjennerud, T. (2017). Genetic and Environmental Structure of DSM-IV Criteria for Antisocial Personality Disorder: A Twin Study. Behavior Genetics, 47(3), 265–277. https://doi-org.ezp.waldenulibrary.org/10.1007/s10519-016-9833-z
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.