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The term Antisocial Personality Disorder or ASPD for short, refers to a chronic mental condition involving a pattern of disregard for the rights of others including the violation of other’s rights. Personality disorders refer to mental health conditions related to the way a person feels, thinks, perceives or relates to others. This cluster also includes disorders such as Histrionic Personality Disorder, Narcissistic Personality Disorder, Borderline Personality Disorder and of course Antisocial Personality Disorder. In both manuals it is mentioned that the antisocial personality disorder was often referred to as sociopathy or psychopathy and it might include psychopathy and sociopathy. The diagnostic criteria for antisocial personality disorder were based on the work of Hervey Cleckley on psychopathy. Psychopathy is described as a personality disorder defined by traits that includes diminished ability for remorse, antisocial behavior and poor behavioral controls.
Most often psychopathy traits are measured using PCL-R (Psychopathy Checklist Revised), developed by Canadian researcher Robert D.
The spectrum of severity of antisocial personality disorder might range from a mild form that includes occasional bad behavior to a more severe version where the people with the disorder commit serious crimes and break the law repeatedly.
Robert Hare insists that his PCL-R is better than ASPD when it comes to predicting future violence and criminality though ASPD diagnosis covers twice or even three times more prisoners than psychopathy diagnosis. Male are more likely to be diagnosed with ASPD than women and people with ASPD are at higher risk of a violent death. The factors that might cause ASPD include imbalance between levels of testosterone, cortisol and serotonin. Other factors might include head injury, limbic neural maldevelopment, home and social environment or even cultural influences.
The ASPD should be diagnosed only by a trained psychiatrist and in order to understand this disorder people should seek the specialist help of a psychiatrist. The treatment for ASPD is really difficult as the patient lacks remorse and the symptoms include deceitfulness.
Psychiatrists and psychologists like to talk at length about personality disorders, diagnosing people as narcissists, psychopaths or sociopaths. Of course, if you sit around the table with no evidence then the dogmatic views of one or two or three dominate and unfortunately thata€™s whata€™s happened with personality disorder. These are the situations when health professionals turn to the labels attached to personality disordersa€“for example narcissist, psychopath and borderline. This was an interesting and for me challenging read- would that a close relation could indeed live happily on a desert island!
It's easy to forget though that at the basis of much of this behaviour is self-hatred so intense it cannot be borne.
Very interesting reading, though I think it fails to address the fact that those with narcissistic "dysfunction" neither want treatment or even see themselves as having a problem! As long as mental health professionals take it upon themselves to decide that certain people are defective rather than ill, as they do in the case of NPD, then very obviously we will find no answers. I find this idea fascinating: that personality disorders need a relationship within which to emerge and that a person on a deserted island cannot have a personality disorder. Antisocial personality disorder is a pretty difficult personality disorder as the behavior of people with this disorder might be irresponsible, manipulative, impulsive, reckless, and indifferent to other’s feelings.
The disorders in cluster B are characterized by problems with emotional regulation and impulse control.

But the two terms are not recognized or used by professionals to label diagnostics of antisocial personality disorder. Anyway there were critics who argued that as long as the criteria are not exactly the same, the antisocial personality disorder and psychopathy cannot be treated the same way. It is a diagnosis of ASPD with psychopathic features and it is described as the lack of fear or anxiety and bold interpersonal style that could mask fraudulence. However, therea€™s now a fundamental argument going on among experts about these labels and their treatment. Such terms make many cliniciansa€™ hearts sink because they think of them as untreatable, and that means doctors and psychologists often give up before they even start.
Described by various professionals as narcissistic personality disordered her life and the lives of others around her have been disrupted and chaotic- precisely because any and all treatment options are vehemently refused, down to slamming doors shut in community outreach visitation. My eldest son has been diagnosed as having Narcissistic Personality Disorder and can be very testing on our patience and understanding and tolerance. I also feel uncomfortable with some points it makes and would like to address these briefly. My son (35 yrs old) has had Schizophremia (SZ)for 16 years and is drug treatment resistant.
In my experience in two long term relationships with a narcissistic parent and a spouse they were both completely unable to admit to being anything less than perfect and so it was always the other person who was (and still is) at fault when conflicts arise. Psychopathy diagnosis appears nowhere in the DSM or ICD though sometimes distinctions between the antisocial personality disorder and psychopathy or sociopathy are stated. A The psychotherapists who do think they have treatments usually employ extended therapy, with mixed evidence of effectiveness. I agree that most frontline GPs have difficulty with personality mental illnesses, and even mental health community health professionals eventually wash their hands of an individual so resistant to any kind of treatment. So it would be a shame to see this categorisation abolished, if just for the education purposes of those left completely blindsided and even traumatised by their interactions with these people. For some years now I have immersed myself in learning about BPD and I limit my observations to it.Initially I found the BPD label confusing but with time and as I learnt more, I have not found a better descriptor for this cruel mental illness.
Some of us are outgoing and social, some are withdrawn and mistrustful, others are aggro and assertive. In addition, people with personality disorders are more likely to have a mental health issue which, once established, can be harder to treat if their personality problems are not dealt with.Therea€™s a fundamental argument going on among experts about the labels given to personality disorders. Some don't like the 'label' because of the stigma associated with it, others find the DSM criteria unwieldy and so on.I am heartened by the brain research that show those with BPD have limited neural pathways between the amydala and the prefrontal cortex. Most attempts to introduce him to psycho social or therapeutic models fall on stoney ground. One of the leaders of the attack on the status quo is Peter Tyrer, professor of community psychiatry at Imperial College London. He and his colleagues seem to have succeeded in removing the individual names of personality disorders in the forthcoming 11th version of the International Classification of Diseases (ICD11), due out next year. At no time in his treatment have the pyschiatrists offered psycho therapy as an additional treatment to his drug regimes which to him have made no differenece to his voices and delusions.
After a period of isolation they seem to lose most of their of their narcissistic traits - at least until the next time you see them when they invariably return. After that, I felt like that was all I was worth, and then grew to like the attention, but its not directly from the BPD. However, sometimes a persona€™s personality gets in the way of their life and the lives of others.A  Someone at the extreme end of uncaring, callous and self-centred may be prone to impulsive violence.

Professor Tyrer claims the names are artificial and fail to acknowledge the range of personality traits found in each person.a€?Theya€™ve been derived first of all from a German psychiatrist Kurt Schneider, who was a very good writer and impressed everyone with his writing about abnormal personalities.
He has also been diagnosed with paranoia but no professional has treated him long enough or intensively enough to begin to win his trust. So there is something of a paradox - they are only narcissistic when they are with certain people. And I am afraid of intimacy, although emotional, but I separate sex and love, which would more likely be the BPD reaction to the trauma. A person who is needy and has a weak sense of selfa€“even though they think the world revolves around thema€“can have unstable emotions and swing from love to paranoia in the blink of an eye. This can make them hard to live with, leading to trouble with relationships, not to mention jobs. To actually label someone as borderline or narcissistic, first of all it's artificial because we all have some of those features anyway. Secondly it's actually wrong because very few people have just one slab of personality characteristics which don't overlap with others.
We haven't done a service to patients by becoming obsessed by these labels.a€™Professor Tyrer prefers to use the word dysfunction rather than disorder, because personality is on a continuous spectrum and we all have a little bit of everything.
The evidence is that therea€™s enormous variation in personality traits in people and theya€™re not easily categorised into one label or other. When you do try to fit someone into a particular slot, you find that they fit the criteria for several others as well.
A a€?Very few people,a€™ says Professor Tyrer, a€?have one slab of personality characteristics which dona€™t overlap with others.a€™Professor Tyrera€™s opponents claim that you do find people who match the label very closely, for instance those with borderline personality disorder. These people, who have often been abused as children, are needy, immature, emotionally fragile and find relationships hard to maintain. The severity is judged by the a€?extent of difficulties in interpersonal social functioning, awareness of self and understanding of others, the consequences of difficulties in interpersonal functioning and the risk to self and others as a consequence of their personality disturbancea€™. This allows for a more holistic approach to a persona€™s issues, rather than boxing them inside a narrow set of traits.
In Australia, it is left to individual psychiatrists to decide, and the same psychiatrist might draw their diagnoses from both the US and European classifications.a€?With the average person with a mental health problem,a€™ says Professor Tyrer, a€?what we fail to do is assess their personalities.
So many of the people that we see with, say symptoms of depression, also have personality dysfunction and, according to New Zealand research, they have more than twice the chance of a poor outcome compared to people who dona€™t have a personality disorder.a€™More research is needed in this area, but the evidence suggests that if the personality dysfunction is recognised and dealt with the mental health issue is more tractable to treatment.
The trouble is that there arena€™t many proven ways of accurately detecting such dysfunction.a€?The first thing to do is find out whether their mental health issue is a recurrent problem,a€™ says Professor Tyrer. One of the important things wea€™re taught as psychiatrists is to get a a€?feela€? for the person. If you find someone has had an unstable work record, theya€™ve moved around the country a lot, theya€™ve had all sorts of different relationships and none of them have lasted very long, this is a strong indication of personality pathology. He has helped to pioneer a form of treatment called nidotherapy, where the environment is adapted to suit the person. For example, someone whoa€™s a risk taker and a loner might be happiest as a cattle farmer mustering on a motorbike. This treatment comes back to the notion thata€™s therea€™s no such thing as a personality disorder when youa€™re alone on a desert island.

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