The term antisocial is thrown around in every day language as slang to describe someone who is reclusive, intrusive, or in general just does not play well with others. From a clinical perspective, the term Antisocial Personality Disorder is exactly that, with some clinical presentation that involves an absolute disregard for the legal system, the law, and the personal rights of other people.
Antisocial personality disorder, also known as APD or ASPD, is a clinical diagnosis that falls on the Axis II and Cluster B segment of the DSM IV personality disorders. Clinically it is coded by the DSM IV code of 301.7. The
DSM IV defines this disorder as:
"...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.”
Are Antisocials Sociopaths?
In order to receive an APD diagnosis, the client presenting must be 18 years of age or older, and often presents with a documented history of complications with the law often before the age of 15. APD is often precluded by a diagnosis of Conduct Disorder, and it is this disorder during their childhood years that will lead individuals to problems with the law prior to 15 years of age.
Today the APD personality is often referred to as “sociopathic” , “psychopathic” though many clinicians today do not find these terms to be synonymous with the presentation of APD. Even so however, many clinicians will find that antisocial behaviour is very close to a personality profile that embodies criminal behaviour.
Many of the profiles you will find on television shows such as Criminal Minds will fall into the Antisocial category.
Characteristics of Antisocial Personality Disorder
- Consistent stealing and lying
- A perception of charm, these people are among the most charming you will meet
- No sense of remorse or ability to exhibit empathy; do not care about harming others
- Inconsistency with jobs and academics
- Impulsive, reckless behaviour
- A sustained lack of realistic or long term goal setting; a persistent failure in the development and execution of long term goals
- History of making and keeping friends and relationships, frequent marital disruptions and/or marriages
- Grandiose self esteem or delusions of self perception
- Extreme sense of entitlement
- Continued and consistent sense of agitation and depressive feelings
- History of childhood conduct disorder
- Repeated difficulties with the legal and justice system, but has a tendency to “wiggle out of” extensive criminal records
- Will easily violate the rights and boundaries of others and offers justification for doing so
- Violent and aggressive behaviour over small or petty issues
- Can not tolerate boredom
- Consistent irresponsibility in terms of social obligations, norms, and rules
DSM-IV Criteria for Antisocial Personality Disorder
In order for a clinician to adequately diagnose Antisocial Personality Disorder, the client must present with a minimum of three of the following criteria:
I. Pervasive pattern and disregard for the needs and rights of others since the age of 15. This will be
indicated by 3 or more of the following:
- Lack of conformity to social norms and expectations, and disrespect to the law
- Consistent deceitfulness, repeated lying, and conning others for personal gratification
- Impulsive behaviour
- Aggressive and irritable behaviour as a consistent personality trait
- Recklessness in terms of safety for themselves and others
- Consistent irresponsibility
- Extreme lack of remorse, empathy, and affect
II. 18 years of age.
III. Evidence of Conduct Disorder occurring before the age of 15
IV. Schizophrenia and Bipolar Disorder have been ruled out.
Key Markers of Antisocial Behavior
It is important to understand that a clinical diagnosis of Conduct Disorder before the age of 15 is not a requirement to Antisocial Personality Diagnosis. Rather, the clinician must identify through a comprehensive history at least the presence of conduct disorder behaviour during a client’s formative years.
In other words, if a client has a history of antisocial behaviour or conduct disorder like symptoms, the clinician can still provide an adequate APD diagnosis. These types of symptoms can be identified through childhood presentation that involves animal abuse or torture, bedwetting, and pyromania (fire setting).
The key features of this disorder are often identified by those that are close to them before the client realizes or is willing to acknowledge a problem. Manipulation and deceitfulness are clinically recognized as essential characteristics of this disorder.
It is imperative to the clinician making the diagnosis that history from sources other than the client is taken, as the client is a known manipulator, and well versed in beating the system.
References
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association. pp. 645–650.
"Antisocial Personality Disorder". Mayo Foundation for Medical Education and Research. 2006.
