Antisocial Personality Disorder: What is it?

Most people use the word antisocial to refer to people who find it difficult, do not like or do not seem to like to relate. Basically it is used as a synonym for withdrawn and selective person.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.

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Personality disorders

Throughout our development, human beings gradually build our identity. During childhood, adolescence and youth we test and acquire values, beliefs, ideologies or even appearances that allow that we finally end up finding who we are, forming a self that we would like to be and configuring a way of seeing, thinking and acting in it world. This continuing 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 life life. personal.

The study of these maladaptive patterns of behavior, which are now considered disorders of the personality due to the high level of maladjustment and discomfort that they cause in themselves or in the environment, has generated different categories according to the patterns of thought, emotion and behavior of those who suffer from it.

They are generally divided into three large groups or clusters, sharing several characteristics in common. 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 avoidance disorder, dependence and obsessive-compulsive personality.

Cluster B groups disorders characterized by the presence of drama, emotionality and / or instability. Among them we find disorders of the borderline personality, the narcissistic, the histrionic or the one that concerns us today, the antisocial personality disorder.

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Antisocial personality disorder

Antisocial personality disorder is a pattern of behavior characterized by inattention and violation of the rights of others in favor of their own, which appears before the age of fifteen. This contempt can manifest itself from various types of behavior, including criminal behavior punishable by law.

At the personality level, it is observed that those with 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.

These people are generally ambitious and independent; These are individuals with little 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 the psychopathsMany of them are outgoing people and have considerable charm and relatability, but only on a superficial level. They tend to possess narcissistic characteristics, considering their well-being above that of the rest, and they often use deception and manipulation to achieve their goals.

These people have an unstable lifestyleBecause they have great future plans to consider and the repercussions of their actions. That is why in general they are irresponsible and find it difficult to take charge of what involves a commitment, which together with the rest of the aforementioned characteristics causes people with antisocial personality disorder to present serious problems of adaptation to society, having difficulties on a personal, work and Social.

All this causes that it is frequent that they suffer depressive problems, tension and addictions to different substances or activities. Although this disorder facilitates criminal behavior, it is necessary to bear in mind that this does not imply that all criminals are antisocial or that all antisocials are criminals.

Possible causes

As with all other personality disorders, establishing the causes of antisocial personality disorder is a complex process that requires having a great variety of variables are taken into account, taking into account that personality is an element that is built continuously 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.

The characteristics of this disorder suggest frontal and prefrontal activation problems, 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 of which people with this type of personality show off.

2. Psychosocial hypotheses

At a more psychosocial level, it is common that those with antisocial personality disorder tend to have lived a childhood in which they had ineffective parenting models, in conflictive environments or excessively permissive.

It is common for them to have parents who are hostile to them, abuse them or mistreat them. So with these types of models they may end up assuming that exercising their will trumps other considerations, which 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 bidding, and that they react vindictively to the termination or threat to do so finish.

Another element to keep in mind is that antisocial personality disorder can be preceded by another type of behavioral disorder in childhood: conduct disorder. Although it does not happen 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 slowing down of cognitive development, which prevents are little able to put themselves in the role of other people and see the world from perspectives other than the hers.

Treatments applied

Treatment of personality disorders in general is complicated, since they are configurations that include behaviors and ways of seeing and acting that have been acquired and reinforced throughout life. In addition, people often consider that it is their way of being, so they usually do not 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, and that is that the treatment is usually imposed or by close people or by judicial means after committing a crime. Thus, the subject in question is not usually cooperative when 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 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 mean in his life.

As far as possible, the therapist must be able to make himself see himself as someone respectable and close who does not intend to impose his authority, avoiding possible resistance from the patient and facilitating the establishment of a good relationship therapy.

The passage through psychotherapy

The application of cognitive therapy is frequent (specifically brief cognitive therapy with dialectical orientation, based on Linehan's dialectical therapy), in which sessions of training in which awareness skills, interpersonal effectiveness, emotional regulation and tolerance to frustration.

Wanted at first raising 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, also community and group therapies seem to be of some help.

Other useful elements include having the patient narrate her life story, as this can help greatly. measure to help you observe events that have happened to you differently and reflect on your lifetime. Work in the capacity of empathy, although complicated for this type of patient, can be increased through exercises such as role reversal.

Psychoeducation to the close environment of the subject is also helpful, in order to help establish limits in behavior and have a greater capacity to cope with the situation.

Pharmacological treatments?

At the 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 well established in the day-to-day life of the person that an approach based on reductionism of acting on certain brain circuits does not reach the full magnitude of this phenomenon. After all, part of the disorder is also in the way in which the person establishes relationships with others, and they reinforce this type of maladaptive behaviors because of their expectations.

However, it can help to administer substances that keep the mood stable, such as some antidepressants (The use of SSRIs is frequent). Of course, this does not solve the problem in its entirety, but it can be a complement.

Despite this, it must be taken into account that this type of disorder is associated with some frequency with the use of psychoactive substances, the appearance of addictions being not rare.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. Fifth edition. DSM-V. Masson, Barcelona.

• Davidson, K.M. & Tyrer, P. (1996). Cognitive therapy for antisocial and borderline personality disorders. Single case study series. British Journal of Clinical Psychology, 35 (3), 413-429.

• Quiroga, E. & Errasti, J. (2001). Effective psychological treatments for personality disorders. Psicothema, Vol. 13, no. 3, pp. 393-406. University of Almería and University of Oviedo.

• Santos, J.L.; García, L.I.; Calderón, M.A.; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Roman, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical psychology. CEDE Preparation Manual PIR, 02. CEDE. Madrid.