APPENDIX_______

CLINICAL PICTURE OF ANTISOCIAL PERSONALITY DISORDER

Andres Suan Gerong, RGC, CPS, RPsy, RPm,Ph.D.

The DSM-IV provides Diagnostic Criteria for Antisocial

Personality Disorder (ASPD).

A. There is a pervasive pattern of disregard for and

violation of rights of others occurring since age 15, as

indicated by three (or more) of the following:

(1) failure to conform to social norms and respect

lawful behaviors as indicated by repeatedly

performing acts that are grounds for arrest.

(2) Deceitfulness, indicated by repeated lying, use of

aliases, or conning others for personal profit and

pleasure;

(3) Being impulsive and failure to plan ahead

(4) Irritability and aggressiveness, as indicated by

repeated physical fights or assaults;

(5) Reckless disregard for the safety of self and

others;

(6) Consistent irresponsibility (e.g. repeated failure

to sustain consistent work behavior (joblessness)

or honor financial obligations (defaulting on

debts, swindling involving money, fraudulent

deals, estafa, etc.);

(7) Lack of remorse, guilt or shame;

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(8) history of a conduct disorder in childhood

(truancy in school, absenteeism, petty stealing,

running away from home and school, “black

sheep” syndrome, destroying properties, etc.;

(9) Self-centeredness and insensitivity

(10) Callousness, denseness, and numbness of

feelings

(11) Although they show friendly behavior and

sometimes likeable, but could be dangerous and

unreliable, they can feign regrets; it could be a

manipulation, or a maneuver;

(12) Inability to sustain a strictly monogamous

relationship.

B. The individual is at least age 18 years;

C. There is evidence of Conduct Disorder while at age 15.

(this is also called Oppositional Defiant Behavior or in

legal parlance, Juvenile Delinquency.

Note: From American Psychiatric Association (1994,

pp.649-650).

The impulsive nature of antisocial behavior is usually

indicative in pathological drinking, gambling, womanizing, and

other vices. This

is not unusual; a lack of impulse control seems to be an

intrinsic part of antisocial personality disorder. The category is

very broad, involving

behavior patterns that are socially maladaptive. Lay person

uses a shorthand, saying that a person engages in a habitual

pattern of irresponsible behavior.

From the socio cultural perspectives, antisocial behaviors

are caused by:

A. lack of adequate discipline due to parental

separation or estrangement;

B. Disharmony between parents characterized by

constant quarrels and discord;

C. Continuous argument, hated and violent exchange

of bitter words and accompanied by manhandling
and physical assaults;

D. Parental vacillations in effecting discipline, between

unreasonable harshness and extreme laxity, thus
sending confusing messages to the child about what
is right and what is wrong, or what is acceptable
and what is unacceptable. Children with such
parents fail to make connections between their
actions, bad or good, and the consequences.

E. Childhood abuse either physical, verbal or neglect.

F. Inadequate parental role identification.

Is ANTISOCIAL PERSONALITY DISORDER TREATABLE?

Few adults with antisocial behavior seek treatment, and

even fewer are motivated to change (Carson, 2004, Schwartz,

2000). The

behavior is always repeated and apparently no traces of

remorse. If they show regrets it often feigned only to repeat it.

Psychologists have agree that they could not change

antisocial behavior once it is developed. What therapist can do

is to plan a prevention program as early as during the growth

period. For instance, parenting, training, school based

counseling. Milieu treatment is possible by removing the

young individual in a high risk environment. But, this is

prevention only and the antisocial behavior is not yet formed.

Once they are developed, prevention strategies are too

late and secondary and even tertiary prevention programs are

simply useless.

Personality disorders which have remained

overdeveloped tend to be permanent, inflexible and apparently

very resistant to behavior modifications.

There is a dimension of being ego-syntonic. This means that

the person is not bother at all of his personality make-up.

Thus, the repeat of the antisocial pattern is always evident.

They always create great distress on individuals they happen

to relate with, for instance with a spouse, business partner, or

among siblings in the home.

Antisocials appear very normal on overt behavior. As a

matter of fact they are in the professions. Many are

professionals and are leading a executive position but could be

leading at the same time an aberrant lives. Many are

shoplifters, womanizers, swindlers, burglars, corrupt

politicians, police, drug lords, and drug dealers, snatchers,

hookers, fixers, etc., clever businessmen, irresponsible

husbands, and the most extremes are the murderers, serial

killers, thieves, and robbers, terrorists, etc. These are more

problematic than psychotic persons.