Ever heard of Antisocial Personality Disorder? No, probably not. You cannot be blamed. In a world dominated by mental disorders such as Attention Deficit Disorder (ADD), Down Syndrome, and Alzheimer's it is not likely for you to hear of the very misunderstood and widely unknown Antisocial Personality Disorder (APD). Most doctors and psychologists today have not the simplest inkling as to what APD is. Rather, their minds are filled with media propaganda and untrue and untried theories as to the origins of APD. Widely misunderstood and filled with unsound theories, makes APD one of the most virtually unknown mental disorders. Although not an incredibly common mental disorder, it is still an extremely destructive disorder, both to the victim and those around the victim. Studies show that most serial killers have this mental disorder. Doctors and psychologists should be informed of this disorder so that the proper treatment can be given to the victims before the disorder escalates to the dangerous levels. The nature of this paper is to inform you of the causes of APD, the symptoms, and the treatments available for it.
What are the causes of Antisocial Personality Disorder? There are many theories circumnavigating the medical arena, but most are based on few facts and little evidence. Some doctors believe that APD is caused by abnormalities in the development of the nervous system, but such abnormalities are more likely to spawn learning disorders then Antisocial Personality Disorder. Other doctors theorize that smoking while pregnant may cause the child in the womb risk developing antisocial behavior, thus suggesting that the smoking would bring down the oxygen levels of the child and cause subtle brain damage while in the womb. Further theories yet depict that any abnormal brain function could lead to the development of Antisocial Personality Disorder. Such abnormal brain functions could include overproduction of the neurotransmitter serotonin, which is linked with impulsive and aggressive behavior. A popular theory, which is often applied to any and all abnormal brain activity, is the act of shaking or physically abusing an infant child. This is because such trauma can result in brain injury in the form of disrupting normal development patterns of the brain. Such trauma could also trigger the release of hormones and other brain chemicals which could alter the pattern of normal development, and thus APD may develop. In the end, however, these are are only theories, lacking concrete facts and evidence to prove their truth or worth.
True discoveries as to the cause of Antisocial Personality Disorder rests in the realm of the environment. A child that grows up in a dysfunctional family setting, especially one filled with abuse and lack of proper parent figures, can cause a child to develop APD as he ages, and I say "he" because APD is prominently found in men and is almost non-existent in women. In the case of foster care and adoption a child is just as likely to develop APD as in a dysfunctional family setting, as being deprived of the emotional bond of parents and family can damage the child's ability to form intimate and trusting relationships, the first step of Antisocial Personality Disorder. This lack of emotional bonding extends to not only other children, but to adult and authority figures as well, which leads to another of the main symptoms of APD: The disregard for authority. Studies show that children developing antisocial behavior choose other such children as playmates, outcast by other social groups they bond with one another. These relationships can encourage and reward aggression and other antisocial behavior. These associations may lead to gang membership in the later years of life. A child who grows up in a disturbed home may enter the adult world emotionally injured. Without forming strong bonds, he is self-absorbed and indifferent to others. Often the causes of APD are forgotten as the symptoms themselves are difficult enough to deal with.
The symptoms for Antisocial Personality Disorder are both numerous in quantity and crippling in nature. Most symptoms for APD do not manifest until the late teens to early twenties, but there are some signs of early antisocial development. The McDonald Triad: bed wetting, cruelty to animals, and pyromania, are the early signs most commonly associated with antisocial behavior in children. Not all children showing those early signs will develop APD, but the chances are very high. These early signs, however, are commonly misunderstood and diagnosed as early signs of either conduct disorder or oppositional defiant disorder. Thus a child developing antisocial behavior can be lost in the medication and therapy sessions of a disorder they do not possess. Things will only get worse for that child as he or she ages, as antisocial behavior spikes between the ages of twenty and thirty. Although there is no method of snipping APD "in the bud", a child early diagnosed with antisocial personality disorder has a higher chance of succeeding later in life. If caught at that early age that child may be able to undergo therapy, medication, and in some cases incarceration, that will help them get over and beyond the effects of their crippling disorder. It is a great pity that most people with antisocial personality disorder never discover they have it until the dangerous and life crippling symptoms manifest.
First the child will develop a callous unconcern for the feelings of others, becoming indifferent and outcast among children his or her own age. He will become capable of injuring others, both physically and emotionally, without knowing it or feeling guilty for it. Next, he will develop a gross disregard for social norms, rules, and obligations. Appointments, obligations, rules, codes of conduct, and the very law of the country all but forgotten and ignored. The incapacity to maintain relationships with others is one of the main symptoms of APD, and causes the antisocial individual to become incapable of maintaining any form of long-term relationship, although he will have little trouble starting relationships. A low tolerance to frustration causes the individual to become easily moved to anger, aggression, and violence, making him a threat to society at large. Perhaps one of the most crippling symptoms of APD is the incapacity to experience guilt that most antisocial people develop. This problem can escalate to the point that individual cannot even benefit from experience, never learning from their mistakes and becoming immune to punishment. Those suffering from APD are also likely to blame others for their faults or, failing that, to offer plausible rationalizations to cover themselves, and these rationalizations are usually wild, far fetched, and unbelievable. Many other smaller symptoms exist with in the realm of APD, but those listed above are the most common and most dangerous symptoms associated with Antisocial Personality Disorder. Treatments exist to aid in overcoming the problems and issues of Antisocial Personality Disorder.
Many methods of dealing with Antosocial Personality Disorder exist, but not one true cure exists. Most antisocials go their whole lives without treatment, as they have the inability to see that they have a problem. Some antisocials will go in for treatment for other mental problem, such as alcohol or drug abuse, but even then they do not believe the diagnosis and deny their symptoms. The only way to get most antisocials to accept treatment is for the courts to force them to, usually on pain of imprisonment if they do not undergo treatment. Medications do exist that can help people with Antisocial Personality Disorder, such as carbamazepine, valproate, propranolol, buspirone, and trazodone, but all these medications do is suppress aggression, anger, and threatening behavior. They do not "fix" the problem, they only reduce the problems and calm the antisocial down, but at the risk of drug addiction. The most efficient medication for APD is lithium carbonate, which reduces anger, threatending behavior, and aggression, as well as reducing behaviors such as bullying, fighting, and emotional outbursts in antisocial and aggressive children. An anticonvulsant, phenytoin, has been shown to reduce impulsive aggression in a prison setting, but that does little to help anyone outside of the prison system. Antipsychotic medications have also been tested in a prison setting and have proven to reduce aggression, but with potential irreversible side effects. also, injections of medroxyprogesterone acetate, a synthetic hormone that reduces testosterone levels, has been used to treat and suppress antisocials with sexually aggressive behavior issues.
Medications are seldom the answer to anything. Although they can reduce and suppress, they do nothing to actually deal with the issues of APD and help the victims move on with their lives. Psychotherapy, on the other hand, has taken incredible steps towards aiding antisocials by helping them understand the nature and the consequences of their mental disorder, so that they may better control their behavior. Cognitive therapy, a form of psychotherapy first developed to help patients with depression, is now applied to APD. Therapists deal first with their patients by setting down guidelines, such as the level of the patients involvement, regular attendance, and active participation and the completion of any work issued for them while they are outside the office. A antisocial who cannot conform to those rules does not want to get better, and is likely just using the treatment plan as a means of staying out of jail, because an antisocial unwilling to get better won't get over his disorder, because of the mental nature of the disorder. In addition to psycho- and cognitive therapy, there exists addiction and family counseling courses that can prove greatly beneficial to someone suffering from Antisocial Personality Disorder. The base symptoms, such as substance abuse, make it difficult for a patient to get over APD, but once a lesser problem is fixed, such as substance abuse, it becomes easier to treat the antisocial behaviors. Likewise with marital problems, a patient can go in for marital and family counseling and mend the fracture between him and his family, and that healing can reduce stress and emotional trauma, a big step towards getting over, or rather around, APD. If they cannot be treated then prison always exists as a means of preventing an antisocial from hurting more people in their destructive spiral into oblivion.
Antisocial Personality Disorder, the great tragedy of the medical world; unknown, unclear, rejected, forgotten, and misunderstood. Methods swirl around through the minds of the intelligent, but can they even discover the true cause of antisocial behavior, or will they be stuck with simple theories such as "It's hereditary" or "It's the environment", but no real answer ever given? What hope can a victim of Antisocial Personality Disorder have when most doctors and psychologists will not recognize their symptoms and simply pin another handy mental or behavior disorder on them? What future do they have when no true cure exists and all the medical world gives them is suppressant drugs that destroy their bodies and therapy programs they would never take due to their problems? Studies into antisocial behavior need just as much support and funding as those for cancer, because although cancer is fatal, antisocial personality disorder not only destroys the victim, but also destroys the lives of those around them. Which is worse, the single bullet or the hand grenade?
"The forgotten man of psychiatry who probably causes more unhappiness and more perplexity to the public than all mental disordered patients combined." - Harvey Cleckley
