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Antisocial Personality Disorder (ASPD)

It is a personality pattern characterized by disregard for and violation of the rights of others, without feeling guilt or remorse. It is not the same as "being antisocial = shy." Here, "antisocial" means "against society."

1. Key Criteria according to DSM-5

To diagnose it, 3 or more of these criteria must be met by age 15:

1. Disregard for laws:: Theft, fighting, repeated scams.
2. Deceitfulness:: Lying, using aliases, manipulating for personal gain.
3. Impulsivity:: Lack of planning, making decisions without considering the consequences.
4. Irritability and aggression:: Physical fights, assaults.
⁠5. Neglect of safety:: Self or others'. Driving under the influence, neglecting children.
⁠6. Irresponsibility:: Not paying debts, not keeping a job, not caring for family.
7. Lack of remorse:: Justifying the harm: "they deserved it," "it's their problem."

Important requirements:

Must begin before age 15 with a childish "Conduct Disorder":
lying, stealing, running away, animal cruelty.⁠
The person must be 18+ years old for a diagnosis of ASPD.

2. How does it manifest in daily life?

1. Relationships:: They manipulate, lie, abandon. They have difficulty maintaining a partner/job.
2. Work:: Unstable, conflicts with authority, frequent layoffs.
3. Emotions:: Superficial charm at first, but emotional coldness. They are indifferent to the harm they cause others.
4. ⁠Risks:: Higher likelihood of substance abuse, legal problems, accidents.

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3. Difference with others

1. Psychopathy:: The term most commonly used in forensics. All psychopathy includes ASD, but not all ASD is psychopathy. Psychopathy measures emotional coldness with specific tests such as the PCL-R.
2. Sociopathy:: A popular term. Similar to ASD, but it is said to be more influenced by environment. In mainstream psychiatry, ASD is used.

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4. Causes

It is multifactorial:: Genetics + environment.
Risk factors:: Childhood abuse, parents with ASD/substance abuse, a violent environment, neglectful parenting. The brain often shows differences in areas related to impulse control and empathy.

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5. Is there a treatment?

There is no medication that "cures" personality disorder. But it can be addressed:

1. Therapy::: Cognitive-Behavioral Therapy, anger management, impulse control programs. The challenge is that the person often doesn't recognize the problem.
2. Symptom management:: Medication if there is impulsivity, aggression, or comorbidity with addictions/depression.
3. Prognosis:: Many improve after age 40.

Key fact:

Having some traits does not mean you have ADD. We can all lie or be impulsive sometimes. The disorder is a stable, intense pattern that damages the person's life and the lives of others from a young age.

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