Antisocial Personality Disorder: Causes, Symptoms And Treatment
Most people use the word antisocial to refer to people who have a hard time, don’t like it, or don’t seem to like socializing. It is basically used as a synonym for a withdrawn and selective person.
However, in psychology the term antisocial is used to designate something completely different, a type of disorder known as antisocial personality disorder that tends to be linked to behaviors contrary to social norms and even to the laws, ignoring the rights of others in favor of their own.
Throughout our development, human beings gradually build our identity. During childhood, adolescence and youth we try and acquire values, beliefs, ideologies or even appearances that allow us to finally find who we are, forming a self that we would like to be and configuring a way of seeing, thinking and acting in the world. This continued and relatively stable pattern of way of being is what we call personality.
However, in many cases the personality that is configured throughout the life cycle is extremely maladaptive, being a very inflexible and continuous element that causes suffering to the person and makes it difficult for them to integrate into social, work and personal life.
The study of these maladaptive patterns of behavior, which are considered personality disorders due to the high level of maladjustment and discomfort they cause in themselves or in the environment, has generated different categories according to the patterns of thought, emotion and behavior that those who suffer from it have.
They are generally divided into three large groups or clusters, sharing several common characteristics. Within cluster A behavioral patterns considered eccentric are found and the disorders that would be part of it would be paranoid, schizoid and schizotypal disorder.
Cluster C includes personality disorders that include fearful and anxious behaviors as in the case of avoidant, dependency and obsessive-compulsive personality disorder.
Cluster B groups disorders characterized by the presence of drama, emotionality and/or instability. Among them we find borderline personality disorders, narcissistic, histrionic or the one we are dealing with today, antisocial personality disorder.
Antisocial personality disorder
Antisocial personality disorder is a pattern of behavior characterized by inattention and violation of the rights of others in favor of one’s own which appears before fifteen years of age. This contempt can manifest itself through various types of behavior, including criminal behavior punishable by law.
At the personality level, it is observed that those who present this disorder usually have a low level of kindness and responsibility which together makes it easier for them to get into disputes with other individuals and with the system.
Typically, these people are ambitious and independent; These are individuals with low tolerance for frustration, little sensitivity to the feelings of others and a very high level of impulsivity. They act without thinking about the consequences of their actions both for themselves and for others.
As with psychopaths, many of them are extraverted people and have considerable charm and ease of relationship, but only on a superficial level. They tend to have narcissistic characteristics, considering their well-being above that of others, and they frequently use deception and manipulation to achieve their goals.
These people have an unstable lifestyle Because they have great plans for the future and consider the repercussions of their actions. That is why they are generally irresponsible and have a hard time taking charge of things that involve a commitment, which, together with the rest of the aforementioned characteristics, causes people with antisocial personality disorder to have serious problems adapting to society, having difficulties on a personal, work and social level.
All of this makes it common for them to suffer from depressive and tension problems and addictions to different substances or activities. Although this disorder makes it easier to carry out criminal behavior, it is necessary to keep in mind that this It does not imply that all criminals are antisocial nor that all antisocial people are criminals.
Possible causes
As with the rest of personality disorders, establishing the causes of antisocial personality disorder is a complex process that requires taking into account a wide variety of variables, given that personality is an element that is continuously built over time. throughout development.
Although its specific causes are not known, A wide variety of more or less accepted hypotheses have been established.
1. Biological hypotheses
Studies carried out with twins and adopted individuals show the presence of a certain genetic component, transmitting some personality characteristics that can cause the disorder to end up being generated.
The characteristics of this disorder suggest problems with frontal and prefrontal activation, the areas that regulate the inhibition of impulses and govern processes such as planning and forecasting results.
In people with antisocial personality disorder, it has also been detected that there is less activation than usual in the amygdala. Taking into account that this area of ​​the limbic system governs aversive responses such as fear, an element that leads to a negative evaluation of a situation and therefore allows an impulse to be inhibited, This could lead to difficulty stopping the behavior which people with this type of personality display.
At a more psychosocial level, it is common that those who suffer from antisocial personality disorder tend to have lived a childhood in which they had ineffective parental models, in conflictive or excessively permissive environments.
It is common for them to have parents who are hostile to them, abuse them, or mistreat them. Thus, with these types of models They may end up assuming that exercising their will takes precedence over other considerations. something they will replicate in adulthood.
Cases have also been found at the opposite extreme: with absent or excessively permissive parents, children end up learning that they can always do their will, and that they react vindictively to the cessation or threat of it ending.
Another element to take into account is that antisocial personality disorder can be preceded by another type of behavioral disorder in childhood: conduct disorder. Although it does not occur in all cases, having had a conduct disorder in childhood multiplies the risk that as an adult the individual will end up developing antisocial disorder.
Some authors consider that the underlying problem is a slowdown in cognitive development, which prevents them from being able to put themselves in the role of other people and see the world from perspectives different from their own.
Applied treatments
Treatment of personality disorders in general is complicated since these are configurations that include behaviors and ways of seeing and acting that have been acquired and reinforced throughout life. In addition, people usually consider it to be their way of being, so they do not usually want to change it unless they perceive that it causes them excessive discomfort.
In the case of antisocial personality disorder, the treatments usually have one more complication, which is that The treatment is usually imposed either by close beings or by judicial means after committing a crime. Thus, the subject in question is usually not cooperative, seeing it as an external imposition, generally not accepting the need for treatment.
In therapy, the management of these cases requires that the patient be asked not only what is intended to be achieved and how to do it, but especially to make him aware of the need for change and the advantages and disadvantages that this would entail in his life.
To the extent possible, the therapist must be able to make himself/herself seen as someone respectable and close who does not seek to impose his/her authority, avoiding possible resistance on the part of the patient and facilitating the establishment of a good therapeutic relationship.
The journey through psychotherapy
The application of cognitive therapy is frequent (specifically brief cognitive therapy with a dialectical orientation, based on Linehan’s dialectical therapy), in which training sessions are used in which awareness skills, interpersonal effectiveness, emotional regulation and frustration tolerance are addressed.
Searched at first raise interest in the long-term consequences of treatment and make them understand how their own behavior affects others and then try to increase interest in the well-being of others. Community and group therapies also seem to be of some help.
Other useful elements include having the patient narrate his life story, as this can greatly help him to observe the events that have happened to him in a different way and to reflect on his life. Working on the capacity for empathy, although complicated for this type of patient, can be increased through exercises such as role reversal.
Psychoeducation of the subject’s immediate environment is also helpful, in order to help establish limits on behavior and have a greater ability to cope with the situation.
Pharmacological treatments?
At a pharmacological level, there is no specific treatment for antisocial personality disorder. This is due, among other things, to the fact that the behavioral patterns associated with this condition are so established in the person’s daily life that an approach based on reductionism of acting on certain brain circuits does not cover the entire magnitude of this condition. freak. After all, part of the disorder is also in the way in which the person establishes relationships with others, and these reinforce this type of non-adaptive behavior due to their expectations.
However, it can help to administer substances that keep the mood stable, such as some antidepressants (the use of SSRIs is common). Of course, this does not solve the problem entirely, but can be a complement.
Despite this, we must try to take into account that this type of disorder is frequently associated with the consumption of psychoactive substances, and the appearance of addictions is not rare.
