Antisocial Personality Disorder

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October 16, 2021 / By thadmin2

Does the term ‘Psychopathy’ sound familiar to you? This term is commonly used in the media to portray someone that is cold and has a lack of empathy. However, psychopathy is not an actual mental health disorder, and the proper terminology is Antisocial Personality Disorder (ASPD). 

ASPD is a personality disorder which typically involves emotional, impulsive or dramatic thoughts (Raypole, 2019). ASPD is a mental disorder in which an individual consistently shows no regard for right and wrong, and disregards the autonomy of others. People with ASPD tend to antagonize, manipulate or treat others harshly or with callous indifference.  In addition, they tend to show no guilt or remorse (Mayo Clinic, 2019). These may manifest into challenges such as, failure to conform to the law, inability to sustain employment, deception, manipulation for personal gain, and incapacity to form stable relationships.

Antisocial Personality Disorder is one of the many personality disorders that face heavy stigmatisation, due to the effects of mass media and its portrayal as a disorder that makes one a criminal. Though it may be true that they often lack empathy and might display  impulsive behaviours that result in them getting in trouble with the law, it is possible that they can learn to avoid actions that harm others with the help of therapy. 

 

Underlying factors of the development of ASPD

Personality is a combination of thoughts, emotions and behaviors that makes everyone unique. It’s the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.

The exact causes of ASPD are not known, however there are many factors that play a part, namely biological and environmental factors. Research has shown that children who have had parents that are diagnosed with ASPD are at higher risk of developing ASPD (Smith, 2020). Children that have been diagnosed with childhood conduct disorder may potentially develop ASPD as well. Traits like aggressiveness or impulsivity can appear to be strongly influenced by genes, but the specific manner it is externalised is strongly influenced by environmental factors (Verona, 2015). 

 Environmental factors such as poor upbringing or abusive parents may also increase the risk of developing ASPD.  Adverse experiences and threats to safety associated with violent communities may, in concert with aberrant dispositional tendencies (ie, impulsiveness and hostile negative affectivity), account substantially for the elevated sensitivity to provocation and threat seen in individuals with ASPD. In most cases, a mixture of different factors can lead to ASPD as well, in particular children with genes that make them vulnerable to ASPD may experience childhood trauma that leads to the onset of ASPD

 

Diagnosis and Symptoms 

ASPD is one of the most stigmatised personality disorders due to the nature of its symptoms, some hallmark symptoms include lying, conning or exploiting others. The tendency to act impulsively for those suffering from ASPD is also common. Due to their lack of empathy, they usually do not care about the safety of others, or assault others without any sign of remorse (Pagan, 2020). These are some common symptoms, other symptoms generally revolve around aggressiveness and a seemingly lack of emotions or any empathy.  

According to the Diagnostic and Statistical Manual Version 5 (DSM-5), these are some of the main criterias and symptoms in diagnosis of ASPD (American Psychiatric Association, 2013): 

  1. A pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three (or more) of the following:
  1. Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
  2. Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
  3. Impulsivity or failure to plan.
  4. Lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person.
  1. The individual is at least age 18 years
  2. Evidence of conduct disorder typically with onset before age 15 years.

While ASPD is not commonly diagnosed in Singapore, offences committed by those with ASPD still occur. In May of 2020, a man was charged with 20 years in prison with 24 strokes of the cane for various sexual assualts and rape. The Institute of Mental Health diagnosed him with ASPD and assessed a high risk of reoffending (Lim, 2020). It is important to note that ASPD requires long term therapy to become manageable, however treatment is not impossible. 

 

What you can do to help someone with ASPD

It will definitely be mentally, emotionally, and physically draining to manage someone with ASPD. However, your help can be crucial in order for them to start picking up proper habits that can help alleviate their symptoms. Here are some tips that you may consider using, when supporting an individual who is diagnosed with ASPD: 

  1. Recognise the symptoms: Educating yourself about the symptoms of ASPD helps build empathy, and allows you to better help the individual by targeting his disorder, and not the person. They may do things that are impulsive and irresponsible which  not only puts themselves at risk, but you as well. It is imperative to not dismiss them as a person, and recognise that the disorder causes them to lack certain key emotions and promote reckless behaviours. However, action should be taken when they display these symptoms. Let them know that they can change for the better and encourage them to reflect, so as to aid them in building empathy. 
  2. Set limits and rules: Letting them know whether their actions are right or wrong  can help them to develop morality. Listing down behaviors that they display and helping  them understand the consequences of their actions can also prove useful. Thereafter, you can set certain limits and rules, and reinforce them when they display positive behaviour. Reinforcements can come in the form of verbal affirmation, or showing signs of physical approval. As ASPD is only diagnosed in people above the age of 18, they may be resistant to change. Reinforcing them slowly and showing them what is right and wrong requires a lot of time, hence be patient and the results will slowly appear. 
  3. Take care of yourself: Social support from others can help lighten your stress and burden associated with managing someone with ASPD. There will be tough times,  recognise that you can rely on other friends and loved ones for the emotional support that you require. You can also get support from people with similar experiences. Support groups are immensely helpful as you can interact with people who understand  what you are going through. Apart from that, you can gain practical tips and create friendships along the way. You don’t have to shoulder the burden alone – support and guidance from others goes a long way in helping you manage your own emotional state.
  4. Seek treatment: Psychological treatment is crucial in helping those with ASPD better manage their symptoms. People with ASPD don’t usually seek treatment by themselves, they  require a lot of persuasion and encouragement. Even if they do go for treatment, they might dispel the idea that it can benefit them, as they might view that their actions are not wrong. Giving them the push in the right direction gives them the opportunity to start their recovery journey. 

 

Treatment offered Thrive Psychological Clinic 

ASPD is a lifelong disorder that can be debilitating if left untreated. Various forms of treatment such as Cognitive Behaviour Therapy (CBT) and Counselling have been proven to be successful in curbing the symptoms of ASPD. CBT aims to change patterns of negative thinking and behavior by teaching clients strategies and exercise to help them acquire more socially acceptable behavior. During CBT, social skills are also thought to help manage their symptoms so that they can integrate back into society easier. Meanwhile, counselling sessions focus on educating the individual on how their negative thoughts and behaviors can affect others. Counselling sessions allow for the client with ASPD to have a venue to express his concerns and help curb any negative feelings he or she may have as well. 

While there is no one-size-fits-all cookie cutter strategy to treat ASPD,  here at Thrive Psychology Clinic, we ensure that each client obtains a specially curated form of therapy that is catered to their specific needs and would best benefit them. We are committed to providing effective and efficient support for every adolescent, child or adult in their mental health. If you believe that any of your friends or loved ones may be struggling with mental health issues, feel free to contact us via email: info@thrivepsychology.com.sg or call: 6962 9753 and we will be happy to assist you. 

 

References: 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.)
  • Lim, A. (2020, June). What you need to know about antisocial personality disorderAsiaOne.https://www.asiaone.com/lifestyle/what-you-need-know-about-antisocial-personality-disorder
  • Mayo Clinic. (2019, December). Antisocial personality disorder – Symptoms and causeshttps://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928
  • Pagán, C. (2014, March). Antisocial personality disorder. WebMD. https://www.webmd.com/mental-health/antisocial-personality-disorder-overview
  • Raypole, C. (2019, May). Understanding antisocial personality: The stigma tied to ASPDGoodTherapy.org Therapy Blog. https://www.goodtherapy.org/blog/understanding-antisocial-personality-the-stigma-tiEd-to-aspd-0510197
  • Smith, K. (2020, November). Antisocial personality disorder (Sociopathy): Causes and symptoms. Psycom.net – Mental Health Treatment Resource Since 1996. https://www.psycom.net/antisocial-personality-disorder
  • Verona, E. (2015, May). Psychobiological aspects of antisocial personality disorder,  psychopathy, and violence. Psychiatric Times. https://www.psychiatrictimes.com/view/psychobiological-aspects-antisocial-personality-disorder-psychopathy-and-violence