Dissocial disorder: symptoms, causes and treatments

We are gregarious beings, and living in society requires establishing a series of basic rules to ensure a healthy coexistence that respects the fundamental rights of each citizen, both legally and ethically. Most of us obey most of these rules, or at least the latter, often almost unconsciously when we have internalized them.

However, there are people who exhibit a pattern of behavior characterized by constant rejection of them and indifference to the basic rights of others.

Probably, after this description, we can think that we will talk about adults with antisocial personality disorder. But the truth is that these patterns are also seen in childhood, in children with dissocial disorders. It is this disorder that we will be discussing throughout this article.

    Definition of dissocial disorder

    Dissocial disorder, now called conduct disorder in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is an alteration of minor subjects (which may begin at different times in child and adolescent development) which all throughout their childhood exhibit a continuous pattern of behavior characterized by the presence of a systematic violation of social norms and the rights of others for at least twelve months.

    More precisely, this behavior pattern is identified with the presence of aggressive behavior against people (which may include the use of weapons) or animals (frequent torture and / or execution of small animals and pets), use of fraud and theft of small items or invasion of home, serious violation of general social norms of coexistence and / or vandalism.

    Children with this disorder suffer significant impairments in various areas such as social and school life. They tend to show low levels of empathy, ignoring the rights and feelings of others. It is also common for them to give a feeling of harshness of character, as well as to have preconceived ideas about society and rejection. They are also characterized, in general, by acting without thinking of the consequences and in an impulsive manner, with risky behaviors and with a low capacity for delay gratification and tolerance for frustration.

    Their actions do not usually go unnoticed by the environment, which can also lead to socialization problems and frequent problems in school and with the law. Despite this, certain behaviors often go unnoticed, being hidden or barely visible (such as animal torture). They may show negligence in their performance, superficial affection, lack of empathy and a low or no level of remorse for the consequences of their actions, although these characteristics do not occur in all cases.

    Relationship to Antisocial Personality Disorder

    Dissocial disorder has been considered throughout history, and in fact has sometimes been confused with antisocial personality disorder. It should be noted that the two are not synonymous, although in some cases there is syndromic continuity and the diagnostic criteria for the two disorders show few differences beyond the age of onset (the antisocial disorder requires that the subject already have a formed personality, taking into account the turning point from the age of 18 when antisocial behavior should “appear before the age of fifteen).

    In fact, although most disorders go away when they reach adulthood and develop more elaborate behaviors and abilities (especially in cases where the manifestation of the disorder has a rather adolescent onset), a considerable percentage of these children will eventually develop antisocial personality disorder. . In this case, we largely end up with subjects who have had an early-onset dissocial disorder, further fixing and limiting their behavioral repertoire and their outlook on life.

      Possible causes associated with this psychological phenomenon

      Since the conception of this disorder, the scientific community has tried to find an explanation for this type of behavioral disorder. It is considered that there is no single cause for this disorder, but there are many factors that influence its genesis.

      From a biological point of view, the possible existence of behavioral inhibition problems derived from a lack of development or infraactivation of the frontal with an excess of activation of the limbic system and the brain reward system has been raised. The existence of a lack of moral development, the capacity for empathy and immaturity, which can be given in part by elements intrinsic to its biology, is also valued. and partly because of poor socialization.

      On a more psychological and social level, it has been observed that many of these children come from households where there are behavioral and marginal problems. The presence of ongoing intra-family conflict may be associated by minors as a natural way of proceeding, serving as a role model, while it can condition the child to learn not to trust others. Social rejection has also been linked to the onset of this disorder, noting that they often have difficulty relating and problem solving.

      The type of parental role model is also related: authoritarian and critical parents with a punitive way of acting or parents who are too permissive, the directions are not clear and do not allow them to learn discipline or the need to comply are more likely to teach their children to act secretly or that their will must always be done. It doesn’t necessarily involve dissocial disorder, but it can make it easier.

      An attempt has also been made to explain this problem as an aspect based on conditioning: throughout the child’s life observed that performing aggressive acts serves them to achieve their goals, Feel the consequences of these appetizing acts first and reinforce the repetition of the same way of proceeding.

      treatment

      Dissocial disorder is a problem for which treatment is not yet fully established today. It is common to use various multimodal programs, which include both child and parent and child contact services, and that they require the collaboration of professionals from different disciplines and with an eclectic approach.

      At the psychological level, a program is usually recommended that includes training in social and communication skills, as well as problem solving. Reinforcement of prosocial behaviors, behavioral contracts, modeling and emotional expression are also helpful. Cognitive-behavioral programs are generally used, Seeking to teach positive ways to relate and generate alternative behaviors to those of the disorder.

      Parental training and psychoeducation are also elements to be taken into account and can help to reassure and teach principles of action and learning with regard to the child.

      In very extreme cases and especially in these subjects, the behavioral alterations are due to the experience of emotional discomfort, in addition to a treatment dedicated to the modification of the elements generating discomfort or the perception of these. may recommend the use of certain medications like SSRIs.

      Bibliographical references:

      • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.
      • Thief, A. (2012). Clinical child psychology. CEDE PIR preparation manual, 0 .. CEDE: Madrid.
      • Pérez, M .; Fernandez, JR,; Fernández, I. (2006). Guide to effective psychological treatments III. Childhood and adolescence. Pyramid: Madrid.

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