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Dissocial Personality Disorder

Dissocial personality disorder: description

Antisocial personality disorder, also called antisocial personality disorder by professionals, is a serious and potentially dangerous disorder. Some people are so irritable that even a small difference of opinion can encourage them to commit an act of violence.

A dissocial personality disorder is already noticeable in childhood and adolescence. The children torture animals or bully their classmates. Even as adults, they seem heartless towards their fellow human beings.

They do not fear consequences for their often irresponsible behavior. Even punishment does not change their belief that they are right. On the contrary: in their opinion, the victims of the attacks are often their own fault. An extremely low to complete lack of empathy is characteristic of an antisocial personality disorder. Partnership is therefore a difficult topic. Typically, relationships for people with dissocial personality disorder don't last long.

However, people with this disorder do not only take responsibility for others, but also for themselves. They lack access to their feelings. You experience the world as monotonous and boring. Therefore, they often tend to endanger themselves, for example through frenzy in traffic or drug abuse, in order to get at least a certain kick. Dissocial personality disorder has a lot of overlaps with psychopathy - especially the lack of empathy and is common to both disorders. However, psychopaths are usually good at concealing their anti-social attitudes - at first glance, they appear often, charming and approachable. In fact, however, they manipulate their environment and have no feelings of guilt when they harm others.

Dissocial Personality Disorder: How Many Are Affected?

In the general population, about three percent of men and one percent of women have antisocial personality disorder. This proportion is significantly higher in prisons. For example, more than half of abusers in prison were diagnosed with dissocial personality disorder. However, not everyone with antisocial personality disorder becomes a criminal offender.

Special form of psychopathy

Psychopathy is an extreme form of dissocial personality disorder. Those affected can act very manipulatively and are not able to empathize with others. They also do not feel guilty when they behave unsocially or illegally.

Psychopathy is often difficult to recognize, even for experts - especially since many sufferers hide the disorder well and fake empathy with others. So far, psychopathy cannot be adequately treated either. In addition, those affected do not perceive themselves as in need of treatment: They do not perceive their social behavior as disturbed.

You can read more about this particularly manipulative form of dissocial personality disorder in the article Psychopathy.

Dissocial personality disorder: symptoms

There are certain symptoms that make later dissocial personality disorder likely. Children who steal, are aggressive, lie, and are recalcitrant towards parents and teachers are particularly at risk.

Dissocial personality disorder is diagnosed according to the international classification of mental disorders (ICD-10) based on the following symptoms:

On the one hand, the general criteria of a personality disorder must be met. But what is a personality disorder? People with a personality disorder show personality traits and behaviors that deviate significantly from social norms. Those affected are unable to adapt their behavior and come into conflict with their social environment.

Personality disorders develop in childhood. The full symptoms usually show up in early adulthood. It is important to distinguish whether the antisocial behavior is the result of another mental disorder or damage to the brain.

In addition, at least three of the following traits and behaviors must be true to diagnose antisocial personality disorder:

People with dissocial personality disorder

  • behave heartlessly and indifferent to the feelings of others
  • behave irresponsibly and disregard social norms, rules and obligations
  • cannot maintain lasting relationships, although they find it easy to make them
  • have a low tolerance for frustration and are quick to behave aggressively and violently
  • have no sense of guilt and are unable to learn from negative consequences such as punishment
  • tend to blame others or offer plausible explanations for their antisocial behavior

Dissocial personality disorder: causes and risk factors

The dissocial personality disorder develops from an interplay of biological factors and environmental influences. Since the dissocial personality disorder starts early, the parents as role models and their educational methods have a considerable influence on further development.

Dissocial personality disorder: biological causes

In identical twin pairs, dissocial personality disorder occurs more frequently in both siblings than in dizygotic twins. From this it can be deduced that the risk of dissocial personality disorder is partly inherited.

The messenger substances in the brain also have a significant influence on behavior. For example, low levels of the happiness hormone serotonin are often associated with higher levels of aggressiveness. Scientists have also discovered that the brain of people with antisocial personality disorder reacts differently to images of violence than that of the general population. A small area of ​​the outer layer of the brain called the insular cortex is activated when pain is perceived and empathy with others. If you show people with dissocial personality disorder pictures in which pain is inflicted on other people, their insular cortex is hardly or not at all active.

Dissocial Personality Disorder: Psychosocial Causes

People with dissocial personality disorder often report traumatic experiences in their childhood. Because of these experiences, such as physical or psychological abuse, people became insensitive to violence over time.

Certain family characteristics are also related to later antisocial behavior. Children who have received little attention or whose parents already display antisocial behavior are more likely to develop antisocial personality disorder. If parents pay little attention to their children's positive behavior, but excessively punish small violations, they reinforce antisocial behavior. The children learn that they will only get attention if they misbehave. If they are good, however, they are neglected.

Many people with dissocial personality disorder were also not taught moral values ​​in childhood. They did not learn from their parents what is right and what is wrong. As a result, they have not internalized social norms either. Even in childhood, they behave unsocially and aggressively towards people and animals. With puberty, some embark on a criminal career. They steal, commit arson, and commit other violations of the law.

Children who are uninhibited, risk-taking, indifferent to others, and lack compassion are more likely to develop antisocial personality disorder. Reduced intelligence is also considered a risk factor.

Dissocial Personality Disorder: Investigations and Diagnosis

Even if the disorder often develops in childhood and adolescence, the diagnosis of “dissocial personality disorder” is usually only made from the age of 16. Because children and young people are still going through major changes in their development.

To rule out other causes of the deviant behavior, the doctor will perform some tests. Blood and urine are tested to determine if the behavior was due to drug use. Computed tomography (CT) can rule out possible damage to the brain. With the help of X-rays, images of the brain can be taken during computed tomography. Computed tomography is painless for the patient, but there is radiation exposure. Doctors do not perform CT on pregnant women to protect the child.

Antisocial personality disorder: test

Therapists or psychiatrists use questionnaires such as the Structured Clinical Interview (SKID) to diagnose dissocial personality disorder. The problem with diagnosing personality disorders is that those affected often know what the therapist wants to hear from them and respond accordingly. In order to get a realistic picture of the person, therapists often ask relatives for information.

The therapist or psychiatrist might ask the following questions:

  • Do you have the impression that you are easily irritable and quickly become aggressive?
  • Do you feel bad when you hurt other people?
  • Do you feel guilty when you violate social norms or laws?
  • Do you find it difficult to have long-term relationships?

Dissocial personality disorder: treatment

Antisocial personality disorder is difficult to treat. Despite psychotherapeutic measures and medication, the therapy remains unsuccessful in many cases. If the patient does not see for himself that his attitude towards his fellow human beings and his behavior are problematic, then no therapy is possible. So far, there are no drugs that have been shown to be particularly effective in antisocial personality disorder. Still, doctors prescribe antidepressants and mood stabilizers, which in some cases help improve symptoms.

As part of cognitive behavioral therapy, the therapist tries to get the person with antisocial personality disorder to empathize with other people. However, if the person concerned does not have the basic requirements, this change of perspective will not succeed. In these cases, work can be done to ensure that people learn to better control their behavior. This also means that in the course of the therapy they acquire strategies with which they can get a better grip on impulsive and aggressive reactions.

Experts believe that the best chance of success exists when antisocial behavior is discovered and treated in childhood. It is much more difficult to influence the dissocial personality disorder in its full form in adulthood. The first progress in treating dissocial personality disorder shows a method in which the therapist teaches the patient that he can better realize his potential by changing his behavior.

Dissocial personality disorder: disease course and prognosis

Successful therapy presupposes a certain level of suffering on the part of the patient. However, people with dissocial personality often feel very comfortable in their own skin. They don't believe that sticking to norms, showing compassion, and being less impulsive will make their lives easier.

However, the lives of people with dissocial personality disorder often go badly: Many of them end up repeatedly in prison. Only in middle age does the tendency towards anti-social behavior towards crime decrease. In addition, people with dissocial personality disorder are more likely to be victims of acts of violence. In addition, people commit with dissocial personality disorder more frequent suicide.

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