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Antisocial Personality Disorder They are the Scott Petersons and the Bernie Madoffs of society. They comprise at least 70 percent of the jail population and about three to four percent of the general population, in five times more men than women. Individuals with Antisocial Personality Disorder are deceitful, manipulative and have no remorse after having hurt or mistreated someone. The terms sociopathy and psychopathy are often used instead of Antisocial Personality Disorder and even experts do not agree on the distinctions between them. Psychopathy expert Dr. Robert Hare believes the varying terms are used based on how a person views the factors leading to the antisocial behavior. Sociologists prefer the term sociopath, believing the behavior stems from social conflicts and psychologists use the term psychopath, believing that the behavior is a product of psychological, biological, genetic and environmental factors. Regardless of the term used to describe it, none are synonymous with insanity. People who do not curb their desire to harm others or break the law repeatedly are often assumed to be mentally ill. However, according to the consensus of most experts (Samenow, 2004), they may be more cruel and cunning than psychotic, they know right from wrong, know exactly what they are doing and are not insane. The American Psychiatric Association provides the following diagnostic criteria for Antisocial Personality Disorder: A. There is a pervasive pattern of and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following: 1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest 2. Deceitfulness, as indicated by repeatedly lying, using aliases, or conningothers for personal profit or pleasure 3. Impulsivity or failure to plan ahead 4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults 5. Reckless disregard for safety of self or others 6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations 7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated or stolen from another B. The individual is at least 18 years old. C. There is evidence of conduct disorder with onset before the age of 15. D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode. Antisocial Personality Disorder is not just a medical term for criminality; it infers a pervasive and ongoing disorder that is extremely resistant to treatment. Although alcoholism, vagrancy, social isolation and suicide are not uncommon in individuals with the disorder, there is an astonishing lack of depression or anxiety in situations for which these emotions would be expected. In spite of their run-ins with the law, they usually present a very charming and normal facade. The Mayo Clinic website states, “Although the precise cause of Antisocial Personality Disorder is not known, researchers have identified certain factors that seem to increase the risk of developing the disorder.” These factors include: • • • • • • Being diagnosed with childhood conduct disorder A family history of antisocial personality disorder or other personality disorders or mental illness Being subjected to verbal, physical and/or sexual abuse during childhood Having an unstable or chaotic family life during childhood Erratic, inconsistent or non-existent discipline Being “rescued” each time the person is in trouble and never having to suffer the consequences of his or her own behavior Individuals with APD are not always found in prisons. The same characteristics that lead to criminal behavior – no conscience, no sense of right and wrong except for how to get what they want – can just as easily be masked by charm and found in elected officials, salespeople or Wall Street executives. There is no widely accepted effective treatment for Antisocial Personality Disorder and no research supports the use of medication to treat it. Psychotherapy is nearly always the treatment of choice, though, like with most personality disorders, the affected individual rarely seeks treatment. Unless they are mandated by the courts to treatment, most will never even believe they have a disorder, let alone try to get help. Intensive psychoanalytical approaches seem ineffective and inappropriate for this population. A more successful approach involves reinforcement of appropriate behaviors and an attempt to help the individual make connections between his or her feelings and behaviors, a skill typically lacking in persons with Antisocial Personality Disorder. For more information about this and other personality disorders, visit the following websites: www.mentalhelp.net www.mayoclinic.com www.nlm.nih.gov personalitydisorders.suite101.com