Antisocial Personality Disorder: Causes, Symptoms, and Treatment

Most people use the word antisocial to denote people who find it hard not to like or who seem to like to relate. It is mainly used as a synonym for withdrawn and selective person.

However, in psychology the term antisocial is used to refer to something completely different, a type of disorder known as antisocial personality disorder that tends to be linked to behaviors that are against social norms and even to the laws, ignoring the rights of others in favor of his own.

    Personality disorders

    Throughout our development, we humans slowly build our identity. During childhood, adolescence and youth, we have tried and acquired values, beliefs, ideologies or even appearances that allow us to finally find who we are, to form a self that we would like to be and to put in place a way of seeing, thinking and acting. world. This continuous and relatively stable pattern of the way of being is what we call the personality.

    However, in many cases the personality that is formed throughout the life cycle is extremely maladaptive, being a very rigid and continuous element that causes suffering to the person and makes it difficult to integrate into social, professional and life. personal.

    The study of these maladaptive behaviors, which come to be considered as personality disorders due to the high level of maladjustment and discomfort they cause in themselves or in the environment, generated different categories according to the thought, emotion and behavior patterns of those who suffer from it.

    They are generally divided into three large groups or clusters, sharing several characteristics in common. Within cluster A behavioral models are considered eccentric and the disorders that would be part of it would be paranoid, schizoid and schizotypal disorders.

    Cluster C groups together the personality disorders they include fearful and anxious behaviors as in the case of avoidance, addiction and obsessive-compulsive personality disorder.

    Cluster B groups disorders characterized by the presence of drama, emotion and / or instability. Among them are borderline personality disorders, the narcissist, the histrionic or what concerns us today, the antisocial personality disorder.

      Antisocial personality disorder

      Antisocial personality disorder is a pattern of behavior characterized by inattention and violation of the rights of others in favor of their own, Which appears before the age of fifteen. This contempt can manifest itself in behavior of all kinds, including criminal behavior punishable by law.

      At the personality level, it is observed that those who present this disorder generally have one. low level of kindness and responsibilityThis, together, makes it easier for them to come into conflict with other people and with the system.

      In general, these people are ambitious and independent; they are individuals with little tolerance for frustration, little sensitivity to the feelings of others, and a very high level of impulsivity. They act without thinking about the consequences of their actions both for themselves and for others.

      As with psychopaths, many of them are outgoing people and have considerable charm and ease of relationship, but only on a superficial level. They tend to possess narcissistic characteristics, considering their well-being to be superior to that of others, and they often use deception and manipulation to achieve their goals.

      These people have an unstable lifestyleBecause they have the grain to plan for the future and consider the repercussions of their actions. This is why they are generally irresponsible and find it difficult to take charge of what constitutes a commitment, which, along with the other characteristics mentioned above, causes people with antisocial personality disorder to have serious problems with ‘adaptation to society with personal, professional and social difficulties. level.

      All this makes it common for them to suffer from depressive, stressful and addictive problems to different substances or activities. Although this disorder facilitates the conduct of criminal behavior, it should be noted that this it does not imply that all criminals are anti-social nor that all anti-social people are criminals.

      Possible causes

      As with other personality disorders, establishing the causes of antisocial personality disorder is a complex process that requires taking into account a wide variety of variables, as personality is a building block. continuously throughout development.

      Although the specific causes are not known, a wide variety of more or less accepted hypotheses have been established.

      1. Biological hypotheses

      Studies in twins and adopted individuals show the presence of a certain genetic component, transmit certain personality traits that can lead to the onset of the disorder.

      Features of this disorder suggest problems with frontal and prefrontal activation, the areas that regulate impulse inhibition and govern processes such as planning and predicting outcomes.

      In people with antisocial personality disorder, it has also been found that there is less activation than usual in the amygdala. Considering that this area of ​​the limbic system governs aversive responses such as fear, an element which leads to the negative evaluation of a situation and therefore makes it possible to inhibit an impulse, this could cause difficulty in curbing the behavior that people with this personality type show.

      2. Psychosocial assumptions

      On a more psychosocial level, it’s common for people with antisocial personality disorder to tend to have had a childhood in which they had ineffective parenting models, in conflicting or overly permissive environments.

      It is common for them to have parents who are hostile to them, who mistreat them or who mistreat them. So with these types of models they may end up assuming that the exercise of their will is above other considerations, Something they will reproduce as adults.

      Cases have also been found at the opposite extreme: with absent or overly permissive parents, children end up learning that they can still do their will and react with revenge to the cessation or threat it takes. end.

      Another thing to keep in mind is that antisocial personality disorder can are preceded by another type of behavioral disorder in childhood: dissocial disorder. Although this does not happen in all cases, having a dissocial disorder in childhood increases the risk that in adulthood, the individual will eventually develop the antisocial disorder.

      Some authors consider the underlying problem to be a slowdown in cognitive development, which prevents them from being unable to put themselves in the role of others and see the world from a different perspective than their own.

      treatments applied

      Treatment of personality disorders in general is complicatedBecause they are configurations that include behaviors and ways of seeing and acting acquired and reinforced throughout life. Additionally, people often see it as their way of being, so they usually don’t want to change it unless they perceive it to be causing them undue discomfort.

      In the case of antisocial personality disorder, treatments usually have an additional complication, namely the treatment usually comes imposed or by close beings or by the court after committing a crime. Thus, the subject in question generally does not show cooperation in viewing it as an external imposition, generally not accepting the need for treatment.

      In therapy, the management of these cases requires that we ask the patient not only what to achieve and how to do it, but above all to make him aware of the need for change and the advantages and disadvantages. that this would imply. him in his life.

      As far as possible, the therapist should be able to be seen as someone respectable and close who does not intend to impose his authority, avoiding possible resistance on the part of the patient and facilitating the establishment of a good therapeutic relationship.

      The passage through psychotherapy

      The application of cognitive therapy is common (Specifically, a Brief Dialectically Oriented Cognitive Therapy, based on Linehan’s Dialectical Therapy), in which training sessions are used that address skills of awareness, interpersonal effectiveness, emotional regulation, and frustration tolerance. .

      He is wanted at first generate interest in the long-term consequences of treatment and clearly explain how it affects one’s own behavior in others, then try to increase interest in the well-being of others. Community and group therapy also seem to be of some help.

      Other useful elements help to get the patient to tell their life story, as this can greatly help them to observe events that have happened to them differently and to reflect on their life. Work on the capacity for empathy, although complicated for this type of patient, it can be increased by exercises such as role reversal.

      Psychoeducation in the subject’s immediate environment is also useful, in order to help establish behavioral limits and to have a greater capacity to cope with the situation.

      Pharmacological treatments?

      Pharmacologically, there is no specific treatment for antisocial personality disorder.. This is due, among other things, to the fact that the behavioral patterns associated with this condition are so established in the daily life of the person that an approach based on reductionism to act on certain brain circuits can reach the full extent of this phenomenon. . after all, part of the disorder is also how the person relates to others, and these reinforce this type of maladaptive behavior due to their expectations.

      However, it can help deliver mood-sustaining substances, such as some antidepressants (SSRIs are commonly used). Of course, this does not solve the entire problem, but can be a supplement.

      However, it should be borne in mind that this type of disorder is often associated with the consumption of psychoactive substances and that the occurrence of addictions is not uncommon.

      Bibliographical references:

      • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.

      • Davidson, KM and Tyrer, P. (1996). Cognitive therapy for antisocial and borderline personality disorders. Series of unique case studies. British Journal of Clinical Psychology, 35 (3), 413-429.

      • Quiroga, E. and Errasti, J. (2001). Effective psychological treatments for personality disorders. Psicothema, vol. 13, n ° 3, p. 393-406. University of Almeria and University of Oviedo.

      • Sants, JL; Garcia, LI; Calderon, MA; Sanz, LJ; of rivers, P .; Left, S .; Román, P .; Hernangómez, L .; Navas, E .; Lladre, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. CEDE PIR preparation manual, 02. CEDE. Madrid.

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