The term Antisocial Personality Disorder (ASPD) can often trigger images of crime shows and the terms sociopath or psychopath. While ASPD can be referred to as sociopathic personality disorder and these terms do refer to individuals with this disorder, there is certainly a sensationalist tone to how the disorder can be displayed and discussed. The end result is that for those struggling with this disorder, it can be difficult to understand what having this disorder means and there can be significant social stigma associated with it.
Antisocial Personality affects approximately the same number of people in the United States that Schizophrenia does. It is found to have a much higher lifetime prevalence in males, 4.5%-6.8%, than in females, 0.8%, and males tend to continue their antisocial behaviors more persistently than females.
The American Psychiatric Association characterizes the disorder as “a pervasive disregard for and violation” of other people, their rights, emotions or possessions. For a diagnosis to be made an individual must be 18 years or older, but the characterizing traits must have been present since 15 years of age. There is often a general disregard for rules and social norms with persistent criminal activity. Illegal activity is a defining component of this personality disorder and in the prisoner population 47% of males and 21.9% of females meet criteria for ASPD. People with this disorder can show impulsivity and recklessness. An individual can be very aggressive, regularly getting into fights and physical altercations. The individual may struggle with responsibility – holding down a job or taking care of financial responsibilities. Lastly, those with ASPD do not necessary feel remorse both in regards to their actions and their mistreatment of others.
The cause of ASPD has been a topic of great interest and there has been a significant amount of research trying to answer the question whether causation is due to nature or nurture, genetics or environment. It appears that it is not quite one or the other. Rather, there do seem to be genetic markers for this personality type, but whether the disorder will emerge is highly dependent on the way the child grows up. There may be a genetic vulnerability to callousness or aggression, and it is not the only factor that plays a role in ASPD. Research has shown that children who have the biological factor when raised within cultures of violence and neglect or have sporadic but severe discipline they are more likely to develop the disorder than those who are not. It is often the case that the care of these children is transferred to an organization outside of the family due to both parental issues and unmanageable behaviors. This leads to greater trouble in school, truancy and exposure to substance usage and abuse.
Antisocial Personality shows a particularly high rate of co-occurring disorders with around 90.4% of those with ASPD having at least one other psychiatric disorder. A further complication for those with ASPD is involvement in the criminal justice system and substance abuse. Of those with a second diagnosis about 90% meet criteria for a substance abuse disorder. The impulsivity, recklessness and overall disregard for safety or laws that define this disorder often come together to create a sort of perfect storm. Individuals will seek out dangerous behaviors, which often involve misusing alcohol and marijuana, this further increases other risky behaviors and illegal activity. Individuals with ASPD tend to struggle in school, home and in any structured environment making holding down employment or success academically particularly challenging. Drugs or alcohol can provide an alternative outlet. What healthcare professionals have found is that even when antisocial behaviors are treated, there is still a high prevalence for substance abuse within these population. This means that the individuals do not simply need treatment for ASPD but may need an alcohol rehab center for young adults which focuses on dual-diagnosis as an additional form of treatment.
Antisocial Personality Disorder is often considered a particularly challenging population to treat because these individuals rarely seek treatment on their own. It is usually only under threat or because some secondary disorder has brought the individual into treatment that they will go. However, that does not mean that ASPD does not respond to therapies or interventions. The sooner an individual gets treatment, the higher the likelihood for recovery. This is especially true for substance abuse, the longer and more the substance abuse and ASPD has occurred untreated, the more difficult recovery can be. Due to the nature of these co-occurring disorders, it is essential that both are treated. Furthermore, in teens or adolescents who are misusing substances with markers for ASPD, the more severe the misuse, the higher the likelihood of later ASPD diagnosis. Getting substance abuse treatment for troubled teens is very important for management of this disorder.
If you or someone you know is struggling with substance or alcohol use and Antisocial Personality Disorder, there is treatment available. We provide a full continuum of outpatient treatment, including intensive outpatient addiction treatment for adolescents and young adults in Denver, CO and Boulder, CO. There is support and help for you and your family. This disorder does not have be dealt with alone, let us help you along the way to recovery. Contact Us.