Saturday, March 27, 2010

Antisocial Personality Disorder

This destructive personality disorder tends to emerge from childhood patterns of a disregard for the feelings and rights of others and for family, institutional, or social conventions,rules and laws. Childhood diagnoses for such behavior patterns are Oppositional Defiant Disorder and Conduct Disorder. These disorders are listed under Axis I in the DSM-IV. I have presented them here with Axis II disorders because I think it is important that you see the tendency of these childhood problems to evolve into similar but more fully developed adult behavior patterns. It does not always happen, but all too frequently these behavior patterns tend to develop through one or two other child and adolescent diagnoses into its fully mature manifestation known as Antisocial Personality Disorder. The developmental steps toward the fully mature personality disorder are as follows:

In Oppositional Defiant Disorder, children challenge adult rules and demands, argue with adults, have often have bad temper problems, lie and blame others for their troubles. These problems normally start before puberty at around eight years of age.

Conduct Disorder is a more severe pattern of problem behaviors in which the rights of others are frequently violated. These children often lie, cheat, damage property, and run away from school and/or home. They may often aggress against others and may even hurt animals for entertainment. Other illegal activities such a robbery, extortion, rape, and murder may also occur in extreme cases. Conduct disorder can start sometime before 10 years or in later adolescence.

When an individual reaches the age of 18 years and still shows the enough of the previously mentioned behavior patterns they will be diagnosed as antisocial personality disorder. Individuals showing these behavior patterns are also sometimes called "sociopaths" or "psychopaths"; the names may change--but the behaviors the same.

As adults, these people show a strong disregard for the rights of others and the rule of law. They appear to have failed to develop the ability to empathize with others and they do not suffer conscious pangs of consciousness if they hurt or kill others. They are impulsive, seek thrills, take risks, are unreliable, spend money foolishly, can be irritable and aggressive, and have trouble maintaining close relationships with anyone. The motto for this category of diagnosis may be "if I want it---I'll take it, if it feels good---I'll do it: lying, cheating, manipulating, and stealing is good fun."

A Representative Example

Not surprisingly, these individuals have problems with drug and alcohol addiction and are often sentenced to prison for criminal behavior. Charles Manson is often cited as someone who shows many of the features of antisocial personality disorder, as well as other psychological problems.

A thirty year old man sought help from a therapist because he claimed to be having problems with his wife and wished to leave her for his girlfriend, of over one year. He attended only several sessions and attempted to persuade the therapist that leaving his wife and four children for his girlfriend was the right thing for him to do.

He contended that his wife was unstable. When the therapist discussed his responsibilities to his wife and children, and his moral obligation to work on his problem (actually only his reported “problem”) he did not return. Predictably he did not pay the bill for his sessions.

It was apparent that he was seeking a psychologist to support him in an impending court battle with his wife. At the start of the first session, this individual, with unmistakable pride and pleasure, reeled off a report of the drugs he had taken (nearly all that we might think of), the fights, the high speed chases with the police, fires that he set, a car he blew up, a "knee capping" ("shoot the guy in the knee cap --it won't kill them but it will hurt like hell--and others won't mess with you anymore"), and a stint in prison. He seemed excited to tell the therapist what he called the "Sicilian Motto": "The sweetest form of forgiveness is revenge!" Yes, these and similar behavior patterns extended back into this man's childhood; and yes, the diagnosis was antisocial personality disorder.

As you may already surmised, his wife’s psychological problems were largely a result of living with him. She would eventually divorce him, but he would remain a very damaging factor in his children’s lives. If he would remain connected to him, which is doubtful, he would be a very bad model for them to imitate. If he deserted them, they would suffer feelings of abandonment for the rest of their lives. It is common for such divorcing personality disordered individuals to remain unreliably connected to their ex spouses and children to frustrate and torture their ex and to propagandize their children against her or him. They will frequently spend significant sums of money and time to hire lawyers to drain their meager funds with legal fees and make them miserable.

The above is a strong example of how behavioral contagion can damage others who are associated with someone who suffers from a serious personality disorder. Unfortunately, research strongly indicates that anti-social personality disorder has a significant heritability factor and so behavior patterns similar to those of the problem parent are more likely to show-up in the children as they mature.

Suspected Causes


Antisocial personality disorder is perhaps the best researched of all the personality disorders. There is strong evidence that tendencies to show antisocial personality disorder can be inherited. Many studies have demonstrated elevated correlations in antisocial behavior of within families.

While some of the similarities could be due to imitation factors, children adopted and raised by adoptive parents still show stronger correlations for antisocial behavior with their biological parents than with their adoptive parents.

There is evidence that individuals with antisocial tendencies have slower central nervous systems, lower levels of autonomic nervous system arousal and slower skin conductance than normal individuals. They crave excitement and are not much affected by punishing consequences for their inappropriate behavior. One of the earmarks such individuals is their failure to learn from their painful experiences.


Antisocial personality disordered individuals are very likely to have lived in families that experienced poverty, disorganization, discord, family violence, divorce, abuse and abandonment. Presumably as a result of this, antisocial individuals do not trust others and they lack the moral development and interpersonal empathy so important to normal social relationships.

It is also thought that antisocial parents may teach their children to behave in similar ways through their modeling these behavior patterns and children learning to imitate them. Furthermore, it is very possible that when children tantrum, argue, and become aggressive to parental instructions that parents may "give-in" and terminate their demands, thereby teaching the children to behave in these oppositional and coercive ways to authority figures.

It should also be noted that Children diagnosed with Attention-Deficit Hyperactivity Disorder seem to at an increased risk of eventually being diagnosed with antisocial personality disorder.

It is likely that any, or all, of these factors could contribute to the development of antisocial personality disorder in any specific case.

If these behavior pattern emerge in your family, seek help early from an experienced psychologist. Protect yourselves from association with others who show antisocial tendencies and vote for representatives who will work to reduce the growth of these behavioral tendencies
within our population.

Dr. Tom, 3/27/10

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