Antisocial personality disorder

It is also sometimes referred to as psychopathy. inadequate control of anger and temper A history of childhood conduct disorder Recurring difficulties with the law Promiscuity Tendency to violate the boundaries and rights of others Aggressive.Antisocial personality disorder (ASPD or APD) is defined by the American Psychiatric Association's Diagnostic and Statistical Manual as ". and violation of. threats.a pervasive pattern of disregard for. Antisocial personality disorder is the most reliably diagnosed condition among the personality disorders. yet treatment efforts are notoriously difficult. and verbal abuse. A similar finding was reported nearly 40 years ago. often violent behavior.." Antisocial personality disorder is sometimes known as sociopathic personality disorder. impatience. the rights of others that begins in childhood or early adolescence and continues into adulthood. Diagnostic refinement is critical before any treatment efforts are undertaken. and one study indicated that almost two-thirds of psychiatrists think that ´psychopathic disorderµ is sometimes a treatable condition. Some researchers believe that antisocial personality disorder and psychopathic personality are different conditions. however. Therapeutic hope has not vanished. prone to getting involved in fights Inability to tolerate boredom Disregard for right and wrong Poor or abusive relationships Irresponsible work behavior Disregard for safety . annoyance.. however. especially the determination of the degree of psychopathy in the patient with antisocial personality disorder. aggression. Signs and symptoms Characteristics of people with antisocial personality disorder may include: y y y y y y y y y y y y y y Persistent lying or stealing Apparent lack of remorse[3] or empathy for others Cruelty to animals[4] Poor behavioral controls ³ expressions of irritability.

needs and demands immediate gratification). tension and poor tolerance for boredom) Lacks emotional attachment to others³even parents Displays preference for stimulation rather than isolation .Client Assessment Database Circulation Heart Rate: Slight increase may be demonstrated when anticipating stress (correlates with electrodermal responses indicating minimal anxiety) Ego Integrity Lacks motivation for change. demeanor is often a pretense intended to deceive or facilitate exploitation of others. and is usually intelligent. low tolerance level results in feelings of frustration when desires are not immediately gratified Mood: Adaptive to individual·s intended goal. engaging. with lack of concern for other people·s feelings Thought Processes: Client is preoccupied with own interests and has grandiose expressions of own importance.. manipulation is style of operating (e.g. poor insight/judgment. mood may range from charming and pleasant to intensely angry Affect: Emotional reactions may be erratic and extreme. and impulsivity or failure to plan ahead Signs of personal distress possibly evident (e.g.. often not seeking therapy voluntarily (unless client can no longer tolerate the mess he or she has made of own life or is facing long-term imprisonment) Absence of feelings of guilt/shame Use of aliases Neurosensory Mental Status: Personality appears charming.

failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest. and limitation of capacity for anxiety) that are useful in predicting client outcome and likelihood of future violent crime activity. reflecting a possible deficit in inhibitory mechanisms. . as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. Drug Screen: Determines substance use DSM: The Diagnostic and Statistical Manual of Mental Disorders fourth edition. a widely used manual for diagnosing mental disorders. use of aliases. as indicated by being indifferent to or rationalizing having hurt. lack of remorse. New evidence points to the fact that children often develop Antisocial Personality Disorder as a cause of their environment. as indicated by repeated physical fights or assaults.7. as indicated by three (or more) of the following: 1. deceitfulness. heightened ability to tune out aversive stimuli. consistent irresponsibility. associated with a lower than normal level of physiological arousal. 2. 5. which may lessen impact of punishment. as indicated by repeatedly lying. 7. egocentricity. or conning others for personal profit or pleasure. 3. or in the case of many who are influenced by environmental factors. around age 15. impulsivity or failure to plan ahead. 9. Psychopathy Checklist: Recently developed rating scale identifies 2 sets of characteristics (impulsiveness and instability. as well as their genetic line. irritability and aggressiveness. DSM IV-TR = 301. 6. having shallow or seemingly nonexistent feelings. or stolen from another. reckless disregard for safety of self or others. 8. 4.Diagnosis EEG: Abnormally higher amounts of slow-wave activity. defines antisocial personality disorder (in Axis II Cluster B) as: A) There is a pervasive pattern of disregard for and violation of the rights of others occurring for as long as either childhood. Aversive Stimuli: Tends to be slower in learning to avoid shock. promiscuity. mistreated. callousness.

avoidant features malevolent antisocial .variant of the pure pattern where individuals feel that life has not given them their due. paranoid features. Any individual antisocial may exhibit none. although contingency management programs.including schizoid. such as substance abuse. Differential diagnosis The following conditions commonly coexist with antisocial personality disorder: y y y y y y y y Anxiety disorders Depressive disorder Substance-related disorders Somatization disorder Pathological risk-seeking Borderline personality disorder Histrionic personality disorder Narcissistic personality disorder When combined with alcoholism. although others have reported contradictory findings.including sadistic. Subtypes Theodore Millon identified five subtypes of antisocial. reputation-defending antisocial . people may show frontal function deficits on neuropsychological tests greater than those associated with each condition. Schema therapy is being investigated as a treatment for antisocial personality disorder. . Treatment To date there have been no controlled studies reported which found an effective treatment for ASPD. as well as medicinal marijuana treatments. or a reward system.including narcissistic features risk-taking antisocial . one or more than one of the following: y y y y y covetous antisocial .including histrionic features nomadic antisocial . Some studies have found that the presence of ASPD does not significantly interfere with treatment for other disorders.The individual does not need to meet a certain age requirement in order to be diagnosed with this disorder. has been shown moderately effective for behavioral change.

Self-control maintained. constructive methods of interacting with others. promote socially acceptable responses. A trusting relationship initiated. Assist client to learn healthy ways to deal with anxiety. 5. 2. 5. Client/family involved in ongoing therapy/support groups. Assertive behaviors used to gain desired responses. 3. Plan in place to meet needs after discharge.Nursing Management 1. 3. Discharge Goals 1. . 6. Promote development of alternate. Anxiety recognized and diminished/managed. 4. 2. Increase sense of self-worth. Develop a trusting relationship. Limit aggressive behavior. 4.

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