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Marianne Alfaro 

week 3- Discussion -Antisocial Personality Disorders

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Week 3 Discussion- Antisocial Personality Disorder

 

Antisocial Personality Disorder

            Antisocial Personality Disorder(ASPD) is characterized by a pattern of socially irresponsible, exploitative, and guiltless behavior. ASPD is linked with severe and complex comorbidity with other psychiatric conditions, especially drug use and increase death rates through careless conduct and at least half of cases have anxiety disorders and a quarter have depressive disorders (Gabbard, 2014).According to American Psychiatric Association (2013), diagnostic criteria for ASPD is a pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years and continues into adulthood, and must meet criteria from a list of symptoms. The essential feature of ASPD fall  into one of four classifications: aggression to people and animals, destruction of property, deceitfulness of theft, or serious violation of rules(American Psychiatric Association, 2013).

Treatment Options

            According to Gabbard(2014), pharmacological interventions should not be the primary treatment of ASPD but should be used only for the treatment of comorbid mental disorders, specifically depression and anxiety. Cognitive-behavioral techniques have shown to have some success in patients with personality disorders, which are likely to include many diagnosed with ASPD(Matusiewicz,2010). Gabbard (2014), states that CBT techniques include relapse prevention programs, combining cognitive skills with social skills and problem solving, such as Reasoning and Rehabilitation and Enhanced Thinking Skills, and anger and violence management programs. Additionally, group-based cognitive-behavioral approaches may be the most effective (Gabbard, 2014).Psychotropic medications generally are viewed as an adjunctive treatment in the management of personality disorders. They can be helpful for some symptoms in some patients.

Clinical Features of ASPD

            In order to correctly diagnose , practitioners must focus on enduring pattern rather than isolated incidents. To identify an enduring pattern of antisocial behaviors, clinicians may opt to speak with client family members, friends, and probation and parole officers when applicable (Evans, 2011).Some of these clinical features include manipulation, irritability, impulsivity, grandiose self-appraisal, glib superficial charm, affective instability and unstable interpersonal relationships (Evans, 2011).Knowledge of the core characteristics of these disorders allows physicians to recognize, diagnose, and treat affected patients. These clinical features align perfectly with the DSM-5 criteria in which patients will be deceitful, impulsiveness, irritable, aggressive and have lack of remorse(Sleep,2020).

Differential Diagnostic features of ASPD

            ASPD can be compared to Narcissistic personality disorder due to the exploitive and uncompassionate characteristics of ASPD but it lacks the aggression or deceitfulness of ASPD criteria(Sleep, 2020).Borderline personality disorder is another personality disorder with connection to ASPD due to the manipulative characteristics(Sleep, 2020).Accordingly, substance use disorder can also be muddled with ASPD due to the impulsivity and irresponsibility because of the substance influence and must be ruled out before diagnosing ASPD(Sleep, 2020). There is a lack of consensus on effective treatment for clients with ASPD. Favorable practices such as CBT may provide a systematized clinical approach needed in treating this disorder.

 

Reference

 

American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders(5ht ed.).Washington, DC: Author

Evans, M. (2011). Pinned against the ropes: Understanding anti-social personality- disordered patients through use of the countertransference. Psychoanalytic Psychotherapy, 25, 143–156. doi:10.1080/02668734.2011.576493 

Gabbard, G.O.(2014).Gabbard’s treatment of psychiatric disorders(5th ed.). Washington, DC: American Psychiatric Publications

 

Matusiewicz, A. K., Hopwood, C. J., Banducci, A. N., & Lejuez, C. W. (2010). The effectiveness of cognitive behavioral therapy for personality disorders. The Psychiatric clinics of North America, 33(3), 657–685. https://doi.org/10.1016/j.psc.2010.04.007

 

Sleep, C. E., Weiss, B., Lynam, D. R., & Miller, J. D. (2020). The DSM–5 section III personality disorder criterion a in relation to both pathological and general personality traits. Personality Disorders: Theory, Research, and Treatment, 11(3), 202–212.  https://doi.org/10.1037/per0000383

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