Anti-social personality disorder is a chronic mental condition that affects the way the patient thinks, perceive situations, and relate with other people around. People ailing from this disorder have no feelings with regards to what is considered right and wrong. They often disregard the rights, feelings, and expectations of the people they interact with. It makes the patients malicious in that they tend to treat other people harshly without caring about the outcome of such unfair treatment. They are in conflicts with others since they try to manipulate and treat people with arrogance. The current paper seeks to describe the condition, present the diagnostic criteria, differential diagnostic information, multicultural and gender concerns, prevalence, demographics, prognosis and effective interventions.
Background Information
People suffering from this disorder often violate the law and frequently find themselves in the harms of the law without their knowledge. They show no signs of remorse in the activities they get involved in, and they do not care about the possible outcome. They engage in criminal behaviors since they are violent. They may find themselves abusing drugs and alcohol; thus, preventing them from undertaking their responsibilities fully, either in the family, work or even in school (American Psychiatric Association, 2013). The anti-social personality disorder has clear visible symptoms, diagnosis criteria, treatment, and medication.
People suffering from this disorder tend to be less concerned about their safety and the safety of the others, and they get involved in very risky endeavors, which may endanger their lives and those of the other people around. Due to the lack of guilt and failure to take personal responsibility, they tend to demonstrate behaviors that are not acceptable in the society (Tyrer, et al., 2015). In the initial stages of the disorder, people may neglect them before the symptoms clearly unveil themselves. Other people may mistakenly think that the actions of these patients are just for seeking attention. However, they should be handled with great care and dealt with a lot of diligence to avoid any encounter with them that can lead to unnecessary accidents.
Diagnostic Criteria
For individuals to be diagnosed with the anti-social personality disorder, they are supposed to meet the symptom criteria as outlined in the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013). The manual was published by the American Psychiatric Association to help the mental health practitioners to diagnose various mental complications and insurance firm for compensating such treatments. The diagnostic criterion outlines many symptoms of anti-social personality disorder. For people to undergo the diagnosis test, they should be at least 18 years old and have portrayed some symptoms of the disorder before the age of 15, such as stealing, vandalizing property, being violent, and cruel to other people or animals (American Psychiatric Association, 2013).
Another key symptom is repeatedly breaking the law, conning and lying to others, and failure to undertake responsibilities. Moreover, other symptoms include having the desire of irritating others and being aggressive in every undertaking as well as engaging in physical fights with other people and assaulting them repeatedly. People with the symptoms of disregarding their safety and those of the others by acting without prior thinking or overacting to very small issues need to undergo the diagnosis test for the anti-social personality disorder to establish its presence in the early stages. Such people tend to be very careless, and they may fail to honor their deadlines or fail to completely do their work (Patrick & Nelson, 2014).
Once a mental specialist believes that someone has a reasonable number of the outlined symptoms of the anti-social personality disorder, he or she perform a series of medical and psychological tests and exams on the patient to try reach at a diagnosis. A physical exam is done to confirm that the symptoms are not arising from another disorder or mental complication, but rather they are caused by this type of disorder. The physical exam ensures that the right information is acquired to provide the right treatment for the patient (Tyrer, et al., 2015). The mental specialist also conducts lab tests on the patients by testing the complete blood count, the thyroid function check, and thorough screening for alcohol and other drugs to establish if there are other possible causes of these symptoms.
The last test conducted in the diagnostic criteria for the anti-social personality disorder is the psychological evaluation of the patient. The test is done by a mental health practitioner who explores and analyzes the thoughts, relationships, feelings, behavior, trends and the family history of the patient. The test involves rigorous psychological tests on the personality of the patients by asking them when the symptoms began =, the severity of the symptoms, the frequency of the effects of the symptoms, and the main scenario associated with these symptoms. However, due to the condition of the patients, they may be unable to provide an accurate account of their symptoms (Venables, Hall & Patrick, 2014). Therefore, family members and friends are required to provide reliable information about the true symptoms and behaviors of the patient to avoid using the wrong information to treat the wrong disorder or worsen the situation.
Differential Diagnostic Information
Differential diagnosis is the process of weighing the probability of one disease verses that of other diseases being responsible for a certain illness in a patient. Diagnosis of mental disorders may be very difficult because of the overlapping symptoms of many mental disorders and high frequency of the symptoms occurrences. It becomes very difficult to associate a symptom with a specific disorder (Venables, Hall & Patrick, 2014). The dimension of the anti-social personality disorder is closely linked to the narcissistic personality disorder because they have very close symptoms. The description of the anti-social personality disorder can be used to explain the concept of other mental disorders because the symptoms are quite similar. The anti-social personality disorder is closely associated with the syndrome of malignant narcissism, narcissistic personality disorders, other severe personality disorders, and the neurotic personality disorders.
Differential diagnostic information for the anti-social personality disorder is very important because it helps to explain the dissimilarities with other differential diagnoses. Some of the differential diagnoses that can be associated with this disorder include alcoholism, anxiety disorders, brief psychotic disorder, depression, dissociative disorders and ganser syndrome (Repo-Tiihonen & Hallikainen, 2015). The diagnosis of the alcohol problem is ascertained through the screening process, such as the alcohol use disorders identification test, which tries to establish the extent to which alcoholism disorder contributes to the illness of the patient compared to the anti-social personality disorders (Repo-Tiihonen & Hallikainen, 2015). The psychotic disorder is characterized by the symptoms of delusions, hallucinations or disorganized speech. However, it differs from the other mental disorders because it is experienced in a short duration. On the other hand, the dissociative disorders are characterized by disruptions of the consciousness, identity, memory or the environmental awareness of the patient. The patients of these conditions do not exhibit clear arrangement of thoughts. The differential diagnosis information of these disorders provides a strong background for analyzing the anti-social personality disorder.
Multicultural and Gender Concerns
Personality disorders are closely associated with the Western clinical entities because they are perceived to have evolved from the process of medicalization of the social behavior, which is being spread around the world. However, the symptoms and behaviors described in the personality disorders are perceived as pan-cultural, meaning they cut across many cultures around the world. The personality behaviors associated with this disorder seem to appear in many countries, for example, the Big Five personality trait that is witnessed in different societies around the world (Paniagua & Yamada, 2013). The western culture advocates for individuals to be independent, autonomous, and strive to attain their personal goals while other cultures encourage interdependent and cooperative behaviors among the people. Therefore, the immigration and globalization process has led to the interaction of these two cultures; thus, leading to the high rates of personality disorders experienced in the modern world.
Gender differences in patients with anti-social personality disorders are very critical because they guide the mental health practitioners on the assessment and treatment processes. It is perceived that more men suffer from this disorder compared to women. Although the differences in prevalence by gender may be quite insignificant. Men with the anti-social personality disorder tend to portray more explosive symptoms as compared to the women who do not portray many abnormalities. Therefore, the assessment of the cultural and gender factors concerning the anti-social personality disorder shows that this disorder has more multicultural concerns as compared to the gender concerns (Paniagua & Yamada, 2013). The influence of the culture of the people is more compared to the gender factors that play a very small role in the development of this disorder. Therefore, the cultural orientation of the patients will determine their likelihood of suffering from this disorder.
Prevalence
The prevalence of the anti-social personality disorder in the global population depends on the methodology used and the countries studied. The condition is most prevalent among the men in the society compared to the women. A study in North America revealed that the prevalence of anti-social personality disorder is around 4.5 percent of the men and 1.3 percent of the women (Repo-Tiihonen & Hallikainen, 2015). Despite the relative differences in the prevalence of the disorder in North America and the European countries, studies have shown the same prevalence rate in men and women. The condition is taken very seriously by the mental health professionals. Despite the fact that the anti-social personality disorder is less prevalence in women, it has been established that women who have this condition experience greater severity of problems characterized by more abnormal symptoms (Repo-Tiihonen & Hallikainen, 2015). It shows that the same attention should be given to both men and women with this condition to avoid the severity of the complication.
The anti-social personality disorder is very prevalence in the prisons because it amounts to 47 percent of the men and 21 percent of the women in the prisons (Pluck et al., 2015). For instance, in the United Kingdom prison population, the prevalence of people with anti-social personality disorders is approximated at 63 percent of male remand prisoners and 31 percent female prisoners (Pluck et al., 2015). It is also worth noting that although the prevalence of men with this disorder is higher compared to that of women, the few women with this disorder have a very high prevalence of substance misuse compared to their male counterparts (Pluck et al., 2015). It shows that as much as fewer women may be exposed to this disorder compared to men, the few with this disorder portray severe symptoms whenever they have this condition. Therefore, this justifies why the mental health professionals pay a lot of attention to this disorder regardless of the gender of the patient.
The national survey on the prevalence of personality disorders in the United States population has revealed that about nine percent of the United States population exhibit symptoms of personality disorders as outlined in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association (Patrick & Nelson, 2014). The main personality disorders prevalent in the United States are the anti-social personality disorder and the borderline personality disorder with their prevalence being 0.6 percent and 1.4 percent respectively (Patrick & Nelson, 2014). The research also revealed that people with these two main personality disorders have higher chances of suffering from other related disorders, such as anxiety disorders, impulse control disorders, and substance abuse disorders. It signifies that the prevalence of the anti-social personality disorder should be checked on to minimize the chances of developing new mental disorders in the long term.
Demographics
Mental health professionals have raised concerns about the rapidly raising rates of serious mental disorders in the current population. The disorders are becoming even common among the children whereby schools are facing serious disciplinary issues, violent crimes among students, and anti-social behavior among many children (Sperry, 2013). About 30 to 70 percent of the childhood psychiatric admissions in mental health care facilities portray ant-social behaviors; thus, increasing the likelihood of them suffering from anti-social personality disorders (Pluck et al., 2015). However, a very small proportion of antisocial children grows up to become adults with antisocial personality disorders (Sperry, 2013). Therefore, the greater proportion of these children suffers from social, academic or occupational failures that result from their anti-social behaviors. The above analysis shows that the anti-social personality disorder is not serious among children as compared to adults because the behaviors portrayed by children may not necessarily be symptoms of the anti-social personality disorders established by mental disorders specialists.
About 70 percent of the mental health problems among many people start during their childhood or adolescence stage (Bateman, Gunderson & Mulder, 2015). Most of the symptoms of mental illness start to come out during this stage then intensify as the patient grows older. The young people between the age of 15 and 24 years are more prone to experience the anti-social personality disorder and substance abuse disorders (Bateman, Gunderson & Mulder, 2015). On the other hand, adult men have higher chances of developing these disorders while women have more severe experiences whenever they suffer from the anti-social personality disorders. Patients with such disorders are twice likely to abuse substances, such as alcohol and other drugs as compared to those without the condition. They experience abnormal feelings, which are out of their knowledge and control; hence, they find drugs suitable (Bateman, Gunderson & Mulder, 2015). Anti-social personality disorders are also very common among the low-income earners as compared to the high-income earners. Poor people are exposed to harsh social and economic environments, which disrupt their mental orientation making them ruthless, heartless, and careless.
Prognosis
An early and intensive intervention of this disorder guarantees reduced effect in the long term, especially for the children exhibiting anti-social behaviors. Once the condition is diagnosed in the early stages of development, critical analysis by experienced mental health professionals can help to reduce the severity of the anti-social disorder or eliminate it completely. On the other hand, for the patients who grow old with the disorder, it is very hard for them to deal with the condition (Bateman, Gunderson & Mulder, 2015). Instead, it becomes difficult to treat and with prolonged negligence, it becomes chronic and lead to serious implications. Although there are medications available for the anti-social personality disorder, noncompliance with the medical advice or excessive abuse of drugs acts as a barrier to the treatment process. The most recommended treatment program for the anti-social personality disorder is the long term structured treatment, which allows the patients to modify their behavior.
The anti-social personality disorder makes the prognosis of the other mental illness conditions more problematic because they are ignited by the presence of this anti-social behavior (Sperry, 2013). Presence of anti-social personality disorder in a patient makes the treatment of other mental problems, such as substance abuse and emotional substance dependence critical. Therefore, patients suffering from this disorder should remain in prison or hospitals so that they can be closely monitored by mental health professionals because the condition magnifies if the disorder is not treated with immediate effect. Treatment of anti-social personality disorder should be initiated in the early stages of the disorder once it is identified (Sperry, 2013). It ensures that the patient is in stable condition to respond to the medication and be in a position to adjust his or her behavior in time.
The anti-social personality disorder is very difficult to treat but once it is identified early enough, progress can be made and reduce the implications of the disorder. People who develop the disorder up to critical stages may not be in a position to know whether they need any medication; thus, they need to be treated and be given y close follow-up in the long term. Patients with anti-social personality disorder may also require treatment for other mental illness, such as depression, anxiety, and substance abuse, which are closely associated with this disorder. No matter the specialty and the experience of the mental health professionals treating the patients with such disorder, the ability to recover depends purely on the patient’s situation and the severity of the symptoms exhibited (Sperry, 2013). Therefore, it is prudent to seek medication before the situation worsens or the symptoms intensify in order to have high chances of recovering from this condition.
Effective Interventions
The most effective intervention for the anti-social personality disorder is prevention or medication in case the patient portrays its symptoms. On the side of the prevention interventions, patients can be supported and nurtured in well-structured environment to provide a good atmosphere for them to change their behaviors. For instance, children with learning difficulties that may be associated with the disorder should be provided with the appropriate academic assistance (Cloninger & Svrakic, 2016). It can be achieved by taking them to special schools where they will not be subjected to frustration by other children; hence, lowering their self-esteem, which may lead to anti-social behavior in the long term.
There is no specific medication approved for treating the anti-social personality disorder but there are several drugs that can be used to reduce aggression and other common problems associated with the disorder. One of the best drugs for this condition is lithium carbonate, which reduces anger, threatening behaviors, and increases composure among the patients who have the behavior of bullying, fighting, and threatening other people (Cloninger & Svrakic, 2016). Therefore, the most available medication for the disorder is the drugs that are meant to treat certain conditions and lower specific symptoms associated with the disorder. The drugs recommended for these patients should be administered under close supervision to prevent any misuse or overdose by the patients.
Conclusion
References
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