There are numerous disorders that plague the world today. There is so much that individuals are expected to interact with and understand that it can be staggering and overwhelming. The sad truth is that there are people who suffer; they must struggle on a daily basis with a problem that they have no true understanding of. Beyond that, people in the medical world are expected to understand these problems on a different level, exactly what is causing the problems that their patients are dealing with. Yet how can one really and truly understand what a person is going through when they are suffering from a mental or emotional disorder? Understanding the basics is key before addressing the study that is about to take place. People with Antisocial Personality Disorder have a lot to manage on their plate; this study aims to show the results that are received when an individual with a personality disorder (PD) is forced into scenarios that require social interaction. The goal is to work towards preventative measures. Measuring from three scenarios: a simple board game, a work environment, and a group dinner will provide the necessary answers that are required.
Antisocial Personality Disorder Facts
Antisocial personality disorder affects 12 million people throughout the world. There are a variety of symptoms that present themselves around and after the age of 15. When these symptoms continue to manifest and are demonstrated, the disorder is thusly diagnosed. However, even within the initial affected people, the disorder itself is broken down into smaller subgroups (A, B and C), which are all defined by the strongest symptoms that are present. (Treatment and Tests) On the basic level, the World describes people suffering from antisocial personality disorder as “bad kids.” These individuals are constantly in trouble. They have an extreme disregard for the rules, including laws, they can be manipulative and deceitful and most notably these is a sense of impulsivity. Being “impulsive” does not simply imply that they do things in the moment that they feel like they want to do. The focus for impulsivity is that things are done with zero regard for the feelings of others. An individual will do whatever they want, regardless of the possible consequences of those actions. As a side note, antisocial personality disorders can many times be associated to the term “psychopath” but it is important to remember that this is only considered when extreme cases of the disorder are presented. A key component that differentiates these too is the intense sense of paranoia that accompanies the other symptoms.
Methodology
The study itself is looking to focus on the fact that many people are wrongfully diagnosed with antisocial personality disorder. The biggest problem that stems from this, the fact that there was a misdiagnosis in the beginning, which ultimately leads to people being “punished” as opposed to receiving appropriate treatment. So what if there was a way to watch the diagnosed patients and really understand the symptoms that are present? By watching patients, we can take the time to assess the problem and address them directly to give the patients the help that they require. I believe that being able to establish controlled scenarios we will 1) be able to more accurately diagnose individuals with Antisocial Personality Disorder, 2) can give more specific treatment recommendations, 3) begin establishing a more grounded methodology of providing treatment for patients.
The majority of the research study is going to be conducted using a more qualitative study. With the three presented scenarios (a simple board game, a work environment, and a group dinner) the results aren’t going to be numerical, but rather more theoretical and will provide doctors with a direct insight into specific situations. From a personal experience, stress levels and levels of interactions range and vary depending on the situation. So with the established scenarios we will be able to further the study on individuals with Antisocial Personality Disorder.
Scenario Breakdown
The first scenario, playing a board game, is perhaps the most basic stage of the test. One of the key symptoms is the blatant disregard for others. Typically, individuals with personality disorders are deemed to have no conscious, which is reflected in their actions. So by placing them in a situation where rules are required to be followed, will force and mold them into abiding by the rules and understanding that there will be consequences when the rules are not followed. I believe that this will help relegate people with the mildest forms of the disorder and may in fact work as a means of regulation. Mind you this is merely a regulatory procedure, not a cure. (Bressert, 2016)
The second scenario, a work environment situation, will be used as a means of helping individuals adapt in these situations in the real world, but will also work as a means of understanding for those who have suffered problems already with this area of life. Suffering from antisocial personality disorder, individuals struggle with being “socially irresponsible” and with this comes a “failure to sustain consistent employment.” (Natural History). This in and of itself stems from their natural proclivity towards going against the norm and standards of societal expectations. In the workplace, it is expected that interpersonal relationships will be developed and established, this scenario will work to help the individuals prior to entering into the workplace. With supervision in the study, we can help determine what sort of issues trigger problems and how the patients are coping with stress from the work environment.
The final scenario is a typical group dinner situation. Moments like these are the most typical situations that any individual will come across in their lives, and yet it is also the most likely instance for symptoms to rear their ugly heads and for the disorder to be established and acknowledged. Watching and monitoring the patient, again the heavy focus will be placed upon watching the stress levels of the situation. Much has already been learned from other studies and family scenarios suffer from a double whammy when those with antisocial personality disorders are affected at home. Their outbursts, regardless of the form of expression that they choose to reveal themselves, causes the family to pull away from the individual, further isolating the patient to deal with his or hers disorder alone. (Black, 2015)
Pushing For Preventative Treatment
In each of these scenarios, the focus is placed on monitoring the individual to watch their levels of stress and to study their brain activity in each of these moments. The situations that they will find themselves in are each unique, and as such, the brain will handle them differently. So as opposed to simply diagnosing a patient, we are going to be able to know and see specific moments and patterns within the brain scans and activity, and using those we can work on preventative treatments and avoid exacerbating the problems. This in turn will keep patients away from the long-term treatments that are involved with treating individuals with antisocial personality disorder.
Psychotherapy is something that is often used to help treat the situation. This is referred to as “talk therapy” to allow the patients discuss the emotional stresses that they are dealing with. (Prevention and management) With the proposed study, psychotherapy will be proved even more appropriate and helpful, as there will be a more solid understanding of the patient specifically both from a personal standpoint and from a medical one. Medically, there are no specific drugs that can treat the personality disorder. However, there are a handful of drugs that can help suppress the emotional outbursts that include antidepressants. (Staff, 1998) It is highly recommended that family members receive their own form of treatment so that they can handle the patient properly. All of these aspects of treatment will benefit from and be enhanced by the studies that are being proposed.
Participant Evaluation
The participant selection process will consist of both patients who volunteer and those who have been found to be greatly troubled (patients who have been suffering from the disorder and have already been causing problems to those around them.) Each group will be broken down into their respective groups and then each of the scans from the three scenarios will be looked at analyzed. Group 1, comprised of people who have begun to show signs, but have yet to undergo any other testing from other medical procedures, will have their scans looked at and compared to those in Group B. Group B, patients who have already had serious problems and have had previous scans performed, will have their new scans taken and compared to their previous scans. The goal is to find specific changes and patterns within each scenario that can then be focused upon and tested and enhanced. These findings will in turn be used to help the patient. Further, more specific breakdowns will then take place to focus on age groups and to locate and address the differences in scans from 15 years and up. See Appendix A for reference.
Implications and Ethical Considerations
Of course, there are inevitable limitations of the process. The first being that the results are always going to be slightly skewed. The biggest limitation that we are going to encounter is that these symptoms are not diagnosed until the patient is at least 15 years of age. By this point in time, the brain has already gone through the changes that lead to this disorder being prevalent, so there is no real ground work for comparisons to be made to. The knowledge that is available is always going to be slightly off. The second biggest hindrance is that while brain scans can be taken and comparisons can be made between differing patients who are struggling in different scenarios, all that there is to study are simply pictures that don’t truly explain what is taking place within the brain. There is no direct explanation as to what is occurring or why these feelings are more prominent in some than they are in others.
Pushing beyond the simple limitations are the ethical considerations that need to be addressed. First and foremost, these patients are struggling with something that naturally makes them avoid social interactions, thusly finding individuals that are going to willingly volunteer for the procedure may be an issue. Guidelines and standards will need to be constructed and addressed for family members who wish to have a member of their family committed into the program. Similarly working to ensure that I am being culturally competent will be there. An established set of rules and regulations will be in place to ensure that nobody is going to be offended inadvertently while trying to obtain information from these studies. It is important to note that nobody will be punished in anyway as a result of these studies, which will fully eliminate any potential for racial, or cultural, ignorance.
The study searches to help create a better sense of understanding, while also establishing a means for preventative measures to be taken to help those suffering from Antisocial Personality Disorder.
Appendix A
Questionnaire:
Any Medications Being Taken
Any Psychotherapy Attended
Previous Issues
Law Violations
Breaking And Entering
Destruction of Property
Feelings of Irritability
Problems Within The Work Place
Family Issues
Feelings/Moments of Impulsivity
Physical Altercations
Violence Inflicted
Violence Received
Sexual Abuse
Verbal Abuse
Scenario One:
Prior to the study, did you have problems following the rules at school/work/at home?
After the study, did you feel any differently about your ability to function in the given situation when rules are in place?
Brain Scan Comparisons:
Noticeable differences between previous scans (if applicable)
Scenario Two:
Prior to the study, did you experience any moments of problems within the work environment?
After the study, do you feel that you have learned anything about working in the situation more effectively?
Brain Scan Comparisons:
Noticeable differences between previous scans (if applicable)
Scenario Three;
Prior to the study, did you encounter any personal problems within your family?
After the study, do you feel that you are better able to function within your family while avoiding problems?
Bran Scan Comparison:
Noticeable differences between previous scans (if applicable)
References
ANTISOCIAL PERSONALITY DISORDER. (n.d.). Retrieved February 20, 2016, from http://www.mentalhealth.com/home/dx/antisocialpersonality.html
Antisocial Personality Disorder Treatment and Tests. (2016, February 16). Retrieved February 20, 2016, from http://www.medicinenet.com/antisocial_personality_disorder/article.htm
Antisocial personality disorder: Prevention and management. (2009, January). Retrieved February 20, 2016, from
https://www.nice.org.uk/guidance/cg77
Black, D. W. (2015, July). The Natural History of Antisocial Personality Disorder. Retrieved February 20, 2016, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500180/
Bressert, S. (2016, February 18). Antisocial Personality Disorder Symptoms. Retrieved February 20, 2016, from
http://psychcentral.com/disorders/antisocial-personality-disorder-symptoms/
Personality Disorder Symptoms, Causes and Effects. (n.d.). Retrieved February 22, 2016, from http://www.psychguides.com/guides/personality-disorder- symptoms-causes-and-effects/
Staff, M. C. (1998). Antisocial personality disorder. Retrieved February 22, 2016, from http://www.mayoclinic.org/diseases-conditions/antisocial- personality-disorder/basics/treatment/con-20027920
