Do you know people who are witty, charming, extremely fun to spend time with, and have good intentions, yet contrastingly can lie flawlessly and exploit to some extent? Or specific individuals who are uncaring, refrain from abiding by social norms, and display no remorse for their wrongful actions? Can you think of a friend who acts hastily, destructively, and dangerously without remorse when their activities cause harm to you or others? These are symptoms of Antisocial Personality Disorder.
So here’s the thing: we have known these individuals for a very long time; ignore certain actions by saying, “they are like this only. Don’t worry about it, or don’t take them seriously”. However, are there times when you question these acts? Suggest them to take help? Do you know people who are witty, charming, extremely fun to spend time with, and have good intentions, yet contrastingly can lie flawlessly and exploit to some extent? Or specific individuals who are uncaring, refrain from abiding by social norms, and display no remorse for their wrongful actions? Can you think of a friend who acts hastily, destructively, and dangerously without remorse when their activities cause harm to you or others? These are symptoms of Antisocial Personality Disorder.
Conduct disorder is a severe emotional, and behavioural condition seen in children and teenagers below 18. Symptoms of conduct disorder are aggression, deception, destruction, and constant violation of rules. It is normal for individuals below 18 to have behaviour problems to some extent. The differentiator factor- conductor disorder symptoms are long-lasting, negatively impact the person or family's daily routine, violate others' rights and go against accepted norms of behaviour. Poor academic performance, social isolation, drug use, and greater engagement in criminal acts in adolescence are all substantially correlated with a diagnosis of conduct disorder. This association persists into adulthood, further associated with worse educational and career-related objectives, involvement in the criminal justice system, and a high prevalence of mental health issues. Ninety per cent of individuals with an antisocial personality disorder will experience another mental health issue at some point in their lives (National Institute for Health and Care Excellence (NICE); 2017 Apr 2017).
Diagnosed as conduct disorder in childhood, the diagnosis converts to ‘Antisocial Personality Disorder’ (ASPD) at age 18 if antisocial behaviours have persisted. Adding to the symptoms of conduct disorder, ASPD advocated for manipulation, lack of concern or regret, irresponsibility, lacking guilt and unable to sustain long-term relationships of any kind.
The prime reasons for ASPD are genetic components, environmental factors, and childhood trauma. Patients of ASPD may have closely related family members with personality or mood disorders strengthening their condition. A study by Tuvblad & Beaver (2013) explains that genes responsible for ASPD affect other systems like Dopamine (regulating mood, reward, and motivation), Serotonin (sleep, impulsiveness, managing emotions, and behaviours), and Epinephrine (fight or flight responses). Additionally, during pregnancy, if the mother suffers anxiety or stress, consumes harmful substances or misused drugs, or faces complications during delivery can result in the baby having ASPD. In a happy and warm environment, these conditions are treated better. However, if the child experiences abandonment, negative interactions with family, or an abusive environment (physical/ verbal) can stimulate ASPD traits later in life (National Institute for Health and Care Excellence (NICE); 2017 Apr, 2017).
Personality disorders, like ASPD, are perceived negatively- more like criminal behaviour than a genuine illness. The vast majority of research on ASPD focuses on dangerous criminal "psychopaths" who are serving time for grave offenses. However, a sizable portion of the population leads peaceful, law-abiding lifestyles. Yes, they have been diagnosed with ASPD; however, when they have been vocal about their condition, they are almost perceived as cold-hearted criminals.
One example is Andy, who was diagnosed with ASPD at age 33. His father had schizophrenia, died due to excessive drug consumption, and his mother neglected him. After being adopted when he was 2, he received love and affection yet suffered sexual abuse by a distant figure. The sexual abuse triggered Conduct behaviour followed by ASPD. He knew something was wrong with him. Therefore he consulted several top psychologists- a certificate of sanity was given to him. He continued to underperform in tests and career opportunities. Only once he was convicted of theft. However, he chose to hide this from his family and friends.
At last, he was diagnosed with ASPD- there was an ease he felt. Andy could finally understand his actions and reasoning. He then started receiving the proper treatment and therapy. An interesting finding, in this case, is that ASPD patients can feel love, empathy (his wife and daughter), and other emotions but only towards certain people who are close to them yet void towards other humans around them. More research on this would be interesting. Andy also mentions that approximately ten years ago, no one around him would be able to even point out his behavior, and was considered completely normal but for himself, he knew.
In conclusion, there are many Andys around the world, and more research needs to be done. Diagnosis and solely publishing the understanding of any disorder limits perceptions and treatment one should receive. Having a lovable environment and family in these conditions is imperative for better results. Lastly, shows like Dahmer or the movie Spilt, display only the highest level of these conditions. They instill fear among viewers and limit identification, therefore not receiving treatment at the right time. Therefore, more research and awareness of these conditions should be done.
References
Camille Noe Pagán. (2014, March 25). Antisocial Personality Disorder. WebMD; WebMD. https://www.webmd.com/mental-health/antisocial-personality-disorder-overview
Junewicz, A., & Billick, S. B. (2021). Preempting the Development of Antisocial Behavior and Psychopathic Traits. Journal of the American Academy of Psychiatry and the Law Online. https://doi.org/10.29158/JAAPL.200060-20
National Institute for Health and Care Excellence (NICE); 2017 Apr. (2017). Antisocial behaviour and conduct disorders in children and young people: recognition and management. In PubMed. National Institute for Health and Care Excellence (UK). https://pubmed.ncbi.nlm.nih.gov/32073810/
Smitha Bhandari, 2022. (2003, February 10). Mental Health and Conduct Disorder. WebMD; WebMD. https://www.webmd.com/mental-health/mental-health-conduct-disorder
Tuvblad, C., & Beaver, K. M. (2013). Genetic and environmental influences on antisocial behavior. Journal of Criminal Justice, 41(5), 273–276. https://doi.org/10.1016/j.jcrimjus.2013.07.007
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