Question about Anti-Social Personality Disorder

RochesterRN-BSN, BSN, RN · Mar 24, 2009

Unfortunately there is not a treatment for ASPD, even if he does have it. The most you could do is if he is unsafe again call 911 and tell them you want him mental hygiene arrested and they will have to bring him in for an eval......

Here is some interesting info I got on an a-mail--I am part of a group on Facebook called stop the mental health stigma and they send out info on different dx each month.......this e-mail was about ASPD

Hope it helps

Diagnostic Features:

Antisocial Personality Disorder is a condition characterized by persistent disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood. Deceit and manipulation are central features of this disorder. For this diagnosis to be given, the individual must be at least 18, and must have had some symptoms of Conduct Disorder (i.e., delinquency) before age 15. This disorder is only diagnosed when these behaviors become persistent and very disabling or distressing.

Complications:

Individuals with this disorder have an increased risk of dying prematurely by violent means (e.g., suicide, accidents, and homicide). Prolonged unemployment, interrupted education, broken marriages, irresponsible parenting, homelessness, and frequent incarceration are common with this disorder.

Comorbidity:

Anxiety Disorders, Depressive Disorders, Substance-Related Disorders, Somatization Disorder, Pathological Gambling (and other impulse control disorders), and other Personality Disorders (especially Borderline, Histrionic, and Narcissistic) frequently co-occur with this disorder.

Associated Laboratory Findings:

No laboratory test has been found to be diagnostic of this disorder.

Prevalence:

The prevalence of Antisocial Personality Disorder in the general population is about 3% in males and 1% in females. It is seen in 3% to 30% of psychiatric outpatients.

Course:

The course of this disorder is chronic. This disorder is usually worse in young adulthood and often improves in middle age.

A common misconception is that antisocial personality disorder refers to people who have poor social skills. The opposite is often the case. Instead, antisocial personality disorder is characterized by a lack of conscience. People with this disorder are prone to criminal behavior, believing that their victims are weak and deserving of being taken advantage of. Antisocials tend to lie and steal. Often, they are careless with money and take action without thinking about consequences. They are often agressive and are much more concerned with their own needs than the needs of others.

Symptoms of Antisocial Personality Disorder:

* Disregard for the feelings of others

* Impulsive and irresponsible decision-making

* Lack of remorse for harm done to others

* Lying, stealing, other criminal behaviors

* Disregard for the safety of self and others

What are the treatments for antisocial personality disorder?

Another very common question asked is, can antisocial personality disorder be cured? While it can be quite resistant to change, research shows there are a number of effective treatments for this disorder. For example, teenagers who receive therapy that helps them change the thinking that leads to their maladaptive behavior (cognitive behavioral therapy) has been found to significantly decrease the incidence of repeat antisocial behaviors.

On the other hand, attempting to treat antisocial personality disorder like other conditions is not often effective. For example, programs that have tried to use a purely reflective (insight-oriented) approach to treating depression or eating disorders in persons with antisocial personality disorder often worsen rather than improve outcomes in those individuals. In those cases, a combination of firm but fair programming that emphasizes teaching the antisocial personality disorder individuals skills that can be used to live independently and productively within the rules and limits of society has been more effective.

While medications do not directly treat the behaviors that characterize antisocial personality disorder, they can be useful in addressing conditions that co-occur with this condition. Specifically, depressed or anxious individuals who also have antisocial personality disorder may benefit from antidepressants, and those who exhibit impulsive anger may improve when given mood stabilizers.

Atheos · Mar 24, 2009

So I guess I have a couple questions on how to deal with this...
1.) Do you think it is even remotely realistic that I could convince him to get treatment? I mean on some level he does acknowledge there is something off with him but he laughs at me whenever I bring up therapy...he doesn't "believe" in it.

As with any mental illness or addiction you really can't force anyone to go seek help. It isn't going to happen. They have to want to go on their own.

2.)Is there even an effective treatment for APD?

Answered above...

3.)Am I right to fear for my daughters safety when she is alone with him? I have never witnessed any kind of abuse towards her, and believe me I've kept a close eye out for any sign of it...he does say he loves her and I believe he does but he has also admitted that when he sees me with her acting cuddly or other fathers acting affectionate and loving towards their kids it makes him angry because it doesn't feel "natural" to him...And I can see it when they interact. He doesn't "get" her, he is sarcastic with her and he teases her relentlessly, and he gets extremely frustrated when she whines or cries or asks for mommy (I should probobly mention that she JUST turned two in January, and he's only been involved in her life for the last 7 months so she doesn't even know him that well)

Personally, I'd NOT leave him alone by herself. I'm not saying he is unsafe because people with ASPD CAN be normal and handle their issues. The question is do you want to take this gamble. He COULD be fine his whole life but he may not be. I personally, having dealt with my own mental illness and that of others wouldn't but then I don't know him.

I would suggest that you see a psychologist on your own and discuss possible courses of action.

As posted above...

Symptoms of Antisocial Personality Disorder:

* Disregard for the feelings of others

* Impulsive and irresponsible decision-making

* Lack of remorse for harm done to others

* Lying, stealing, other criminal behaviors

* Disregard for the safety of self and others

Those features can be dangerous when a young child is involved. Remember, a key element of this illness is 'lack of a conscience.' They may not always behave as someone we consider to be normal would. Even if their intentions are purely good.

4.)I'm sure there is a genetic component to this and I'm wondering if there is anything I should be keeping my eye out for when it comes to my daughter.

If he is the biological father, again I would say talk to a psychologist. Mental illness, though not always the same one, tend to run through families.

I really suggest you talk to a psychologist, and maybe if possible a child psychologist.

MattiesMama · Mar 24, 2009

Thank you for the quick response!

I found it interesting that it says it does peak in young adulthood and it gets better in middle age...he is 33 right now. I know that his behavior now is a lot better than it was in his 20's so maybe he is settling down some.

Do people with ASPD mature later? Are their any physical characteristics? He has what I would consider an unusually protruding forehead (I was thinking it could be a sign of a frontal lobe problem)

(My mother always yells at me for trying to diagnose everyone I know, so maybe I'm overanalyzing him...lol)

Atheos · Mar 24, 2009

Most of the criminal and or dangerous behavior tend to rear their heads in younger years.

I have a question.

Has he been officially diagnosed as this? By more than 1 psychologist.

I was misdiagnosed as being ADHD and ASPD as a child and while it SEEMED like I was a sociopath, later in life it turned out I DID have a conscience so to speak but I still exhibit some of the behaviors.

inthesky · Mar 25, 2009

I'm really concerned about the physical and emotional abuse. Your emotional and physical safety (i do believe that emotional health can be endangered) is at risk. It is also well-known that once an abuser displays violence, it most commonly just gets worse. His well-being is irrelevant if you are not safe. Instead of researching ASP, research the cycle of abuse and how abusers keep victims in their lives by manipulating fear and guilt. You were right to get that protective order and not trust him alone with your daughter.

My advice would be to get this guy out of you and your daughter's life and leave him to his own mental health issues. If he one day finds himself sad and alone and wants to work on it, then good for him, but not your concern. As for him being the father of your child, she will suffer much more with him in her life.

*hugs* I'm sorry you are going through this

Whispera, MSN, RN · Mar 25, 2009

Your daughter's dad physically abused you. Your daughter's dad verbally and emotionally abuses your daughter. He WILL eventually physically abuse her. Even if he didn't, he's putting scars on her spirit. I don't know what you can do to keep him from visiting alone with her, but it seems something should be done. The police report of him abusing you should carry some weight, I would think.

Jolie, BSN · Mar 25, 2009

Please seek professional psychiatric and legal guidance.

Your and your daughter's safety are too important to rely on information and advice from an anonymous bulletin board.

Best to you!

Whispera, MSN, RN · Mar 25, 2009

I agree with Jolie. Contact someone locally for some help!

Thunderwolf, MSN, RN · Mar 25, 2009

the topic of aspd is always an interesting one. previously known as sociopathic pd, a predator mentality with a lack of genuine empathy and remorse tends to be its hallmark. projective tests tend to indicate an ego structure lacking sophistication...one reason why they eventually get caught or called upon it. like almost all pd's, it tends to mellow with age (histrionic pd is the exception). also to keep in mind, there are degrees of pathology, like for any illness....from one extreme to a lesser extreme. in general, like wolves, folks with aspd often have a keen sense for prey. if they are not actively searching for potential victims, they can often spot them readily in order to take advantage of them later. like a fisherman, they often bait their hooks with charming, if not charismatic, portrayals of character to lure others close to them. some aspd folks with even less ego sophistication may lack the skills to have or to sustain this "charming" facade. and if present, it is nothing more than that....a facade...for they tend as a group to lack emotional depth that is genuine. take away their facade, the shallowness of their personalities becomes most evident. in a aspd mind, the victims "deserve" what they get; therefore, no remorse. if remorse "appears" to be present, it tends to be either for show or for manipulation or for both. in many ways, they often look down upon their victims..and may even despise them. self entitlement and narcissicism are often present. the use of twisted rationalization and the use of black and white, all or nothing thinking are not uncommon. self delusions of innocence of their wrong doing may also be witnessed.

folks in the news of late that may fit the above:

1. chris brown (rhiannon-victim)

2. bernard madoff (ponzi scheme)

an excellent book on this subject topic, inside the criminal mind by dr stanton samenow.

click here to read an excellent link that summarizes nicely some of the book's premises.

excellent feedback on the thread.

Thunderwolf, MSN, RN · Mar 25, 2009

please seek professional psychiatric and legal guidance.

your and your daughter's safety are too important to rely on information and advice from an anonymous bulletin board.

best to you!

totally agree.

peace to you.

MattiesMama · Mar 25, 2009

Thanks again for all the responses...it really puts everything in perspective.

Unfortunately, my daughter did witness this event and she won't stop talking about it :zzzzz Last night in the bath, she said "daddy push you mommy?" and I answered "yes, and that was not nice of him. We don't put our hands on people like that" and she said "no, daddy is brave". I didn't understand at first but then I remembered that he used to watch kung-fu movies with her and he would tell her that the fighters were "brave"...any advice on how to deal with this topic with her? I have spent so much time talking up her dad because I wanted them to have a good relationship, how do I explain to her that what he did was wrong and why she can't see him anymore?

Oh to the person who asked if he has been diagnosed...no, and he's never sought treatment that I know of. I'm just going off of his history, his actions, and his thoughts (that he has shared with me at least....he has told me that he could kill someone and feel nothing after...and the scary thing is I believe him )

Well in any case, thanks for the advice and I am going to see what is out there as far as help, I think that my daughter and I need to get some before I worry about his treatment!