ANTISOCIAL PERSONALITY DISORDER

By: Noor Azifah Bt Ibrahim 070100431

Personality Disorder
Definition: personality is the term used to describe; - a person characteristic behavior in response to his or her inner and outer experiences; - it is predictable and stable. A personality disorder is diagnosed when: - behaviour differs from the range of variation found in most people - becomes so severe and maladaptive that it produces personal distress or significant impairment of adaptive functioning.

Classification..

Personality disorder

Cluster A (the odd and eccentric cluster) 1. paranoid 2schizoid 3schizotypal

Cluster B (the dramatic, emotional and erratic cluster) 1. histrionic 2. narcissistic

3. antisocial
4. borderline

Cluster C (the anxious or fearful) 1. avoidant 2dependant 3obsessive-compulsive

Cluster B (the dramatic, emotional and erratic cluster) these disorder involve the use of dissociation denial splitting acting out and also associated with mood disorder which more common to be happened.

Cluster B (3) antisocial

Definition: antisocial personality disorder is characterized by inability to conform to the social norms that govern peoples behaviour. It is usually associated but not strictly synonymous with criminality Patients are impulsive, egocentric, irresponsible, impatient and unable to tolerate frustration, reject authority or discipline and lack of adequate conscience development.

Epidemiology..
prevalence is 3% in men (may be as high as 7%) 1% in women in general population In prison population, it may be as high as 75%. 5x more common among first degree relatives of men than among controls. more common in lower socioeconomic groups. Predisposing conditions include attentiondeficit/hyperactivity disorder (ADHD) and conduct disorder.

Etiology..
1. genetic factors 2. brain damage or dysfunction is a feature of this disorder, which can be secondary to such condition - perinatal brain injury head trauma encephalitis 3. abnormal brain development adults with antisocial personality have non-specific abnormalities in the electroencephalogram (EEG) of a kind found normally in adolescent, not adults 4. History of parenteral abandonment or abuse are very common

5. Repeated harsh punishment by parents 6. childhood experience (separation from parents during childhood)

DSM-IV Diagnostic criteria for Antisocial Personality Disorder

There is pervasive pattern of disregard for and violation of the rights of others occuring since age 15 years as indicated by three (or more) of the following : 1. Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are ground for arrest

2.Deceitfulness, as indicated by repeated lying, use of aliases or conning others for personal profit or pleasure 3.Impulsivity or failure to plan ahead 4.Irritability and aggressiveness, as indicated by repeated failure to sustain consistent work behavior or honor financial obligation. 5.Reckless disregard for safety of self 6.Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligation. 7.Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated or stolen from anaother

Differential diagnosis..

Adult antisocial behavior- the patient does not meet all the criteria in table above. Substance use disorders the patient may exhibit antisocial behaviour as a consequence of substance abuse and dependence. ADHD- cognitive difficulties and impulse dyscontrol are present

Mental retardation- the patient may demonstrate antisocial behavior as a consequence of impaired intellect and judgement. psychoses- the patient may engage in antisocial behaviour as a consequence of psychotic delusions. Borderline personality disorder the patient attemps suicidal and exhibits self-loathing and intense, ambilvalents attachments. personality change secondary to general medical condition the patient has had different premorbid personality or shows features of an organic disorder.

Management
Treatment

pharmacotherapy

psychotherapy

Other treatment: Self-Help Hospitalization

Pharmacotherapy..
is used to deal with symptoms such as anxiety, anger, and depression, but drugs must be used judiciously due to the risk of substance abuse. If the patient exhibits evidence of ADHD, psychostimulants such as methylphenidate (Ritalin) may be useful

carbamazepine or valproate attemps to alter catecholamine metabolism with drugs and to control impulsive behaviour with antiepileptic drugs especially in cases of abnormal wave forms on EEG. B-Adrenergics have been used to reduce aggression.

Psychotherapy..
Because many people who suffer from this disorder will be mandated to therapy, sometimes in a forensic or jail setting, motivation on the patient's part may be difficult to find. In a confined setting, it may be nearly impossible and therapy should then focus on alternative life issues, such as goals for when they are released from custody, improvement in social or family relationships, learning new coping skills, etc.

Threats are never an appropriate motivating factor in any sort of treatment Self-help methods -Groups can be especially helpful for people with this disorder, if they are tailored specifically for antisocial personality disorder. Individuals with this disorder typically feel more at ease in discussing their feelings and behaviors in front of their peers in this type of supportive modality

A careful and thorough assessment will ensure that the person that the person has antisocial personality disorder. This can often be confused with simple criminal activity (all criminals do not have this disorder), adult antisocial behavior, and other activities which do not justify the personality disorder diagnosis. As with a thorough assessment of any suspected personality disorder, formal psychological testing should be considered invaluable

Prognosis..
The prognosis of antisocial disorder varies. The condition often significantly improves after early or middle adulthood Complication include death by violence, substance abuse, suicide, physical injury, financial difficulties and depressive disorder.

Thank you.