As the term antisocial indicates that this personality disorder constitutes the behaviors that are deviant or against the norms set by society. It is a form of mental disorder, i.e. the inability to think clearly and behave in a controlled fashion, in which the intellectual faculties are not impaired, but the moral principles of the mind are deviant, and the individual is incapable of acting with decency and politeness in the matters of his or her life. The prevalence rate of antisocial personality disorder is between 0.2%-3.3% in the general population but in correctional or forensic settings this rate is increased up to 70%.
The terms of antisocial personality disorder (ASPS) have been interchangeably used as ASPD and psychopathy does have a similarity in some of the facets yet they differ in the other. Due to this most psychopaths meet the essential criteria for the diagnosis of antisocial personality disorder but most individuals with ASPD are not psychopaths.
An antisocial personality disorder is characterized as the pervasive pattern of disregard and violation of the rights of others which have been occurred since 15 years of age. The following are the four domains or realm of antisocial personality disorder constituting a total of seven symptoms out of which three needed to be present for diagnosis.
The following factors play an important role in the development of antisocial personality disorder.
The main part of the treatment of antisocial personality disorder is psychological interventions. However, the drugs are sometimes necessary to management aggression and impulsivity. The need for medicine also becomes necessary when psychological interventions are not working. For this purpose, a low dose of antipsychotic drugs or mood stabilizers is prescribed. Benzodiazepines are avoided as maximum as possible.
A multifaceted approach integrating the concepts of various psychological therapies is adopted for the effective treatment of ASPD. Since it is a personality disorder that has a pervasive pattern so the duration of treatment is a little longer that is 12-24 months of weekly individual sessions. Following is the brief summary of the main targets of psychological interventions for ASPD:
The resistance of patients with ASPD to change and seek treatment is been a major challenge as it hinders the course of improvement.
Difficulty forming a strong therapeutic relationship is another challenge since the patients with ASPD are indifferent and are not empathetic so the chance of therapist burnout is very likely.
Mr. X, 28 years old male, referred to a psychiatrist, after getting into a fight with one of his friends over ten rupees bet. He was brutally beaten by the policemen. E.A. was previously being jailed twice before for cheating cases and for assaulting one friend. When being interrogated of his action he confessed that he has beaten the other inmate who refused to pay money. He wanted to show his power and there was no guilt for his action. Family history showed his neglected childhood, father left home when he was 6 years of age and his mother had an extramarital affair with a man in her neighborhood. He didn’t have a good educational background as he failed twice and then left school. He had also indulged in smoking and drinking alcohol at an early age. After a detailed evaluation, he is diagnosed with suffering from an antisocial personality disorder. He entered in a comprehensive psychological intervention program.