Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
What is the difference between antisocial personality disorder and psychopathy?
In contrast, psychopathy, although not a mental health disorder formally recognized by the American Psychiatric Association, is considered to be a more severe form of antisocial personality disorder. Specifically, in order to be considered a psychopath, also called a sociopath, an individual must experience a lack of remorse of guilt about their actions in addition to demonstrating antisocial behaviors. While 50%-80% of incarcerated individuals have been found to have antisocial personality disorder, only 15% have been shown to have the more severe antisocial personality disorder type of psychopathy.
Psychopaths tend to be highly suspicious or paranoid, even in comparison to individuals with antisocial personality disorder. The implications of this suspicious stance can be dire, in that paranoid thoughts (ideations) tend to lead the psychopathic person to interpret all aggressive behaviors toward them, even those that are justified, as being arbitrary and unfair. A televised case study of a psychopath provided a vivid illustration of the resulting psychopathic anger. Specifically, the criminal featured in the story apparently abducted a girl and sexually abused her over the course of a number of days in an attempt to prove to investigating authorities that his stepdaughter's allegations that he sexually abused her were false.
What causes antisocial personality disorder?
One of the most frequently asked questions about antisocial personality disorder by both professionals and laypeople is whether or not it is genetic. Many wonder if it is hereditary, just as much as hair, eye, or skin color; if this were the case, children of antisocial people would be highly expected to become antisocial themselves, whether or not they live with the antisocial parent. Fortunately, human beings are just not that simple. Like all personality disorders, and also most mental disorders, antisocial personality disorder tends to be the result of a combination of biologic/genetic and environmental factors.
Although there are no clear biological causes for this disorder, research on the possible biologic risk factors for developing antisocial personality disorder indicates that, in those with antisocial personality disorder, the part of the brain that is primarily responsible for learning from one's mistakes and for responding to sad and fearful facial expressions (the amygdala) tends to be smaller and respond less robustly to the happy, sad, or fearful facial expressions of others. That lack of response may have something to do with the lack of empathy that antisocial individuals tend to have with the feelings, rights, and suffering of others. While some individuals may be more vulnerable to developing antisocial personality disorder as a result of their particular genetic background, that is thought to be a factor only when the person is also exposed to life events such as abuse or neglect that tend to put the person at risk for development of the disorder. Similarly, while there are some theories about the role of premenstrual syndrome (PMS) and other hormonal fluctuations in the development of antisocial personality disorder, the disorder can, so far, not be explained as the direct result of such abnormalities.
Other conditions that are thought to be risk factors for antisocial personality
disorder include substance abuse, attention deficit hyperactivity disorder
(ADHD), and a reading disorder or conduct disorder, which is diagnosed in
children. People who experience a temporary or permanent brain dysfunction, also
called organic brain damage, are at risk for developing violent or otherwise
criminal behaviors. Theories regarding the life experiences that put people at risk for antisocial personality disorder provide important clues for its prevention. Examples of such life experiences include a history of childhood physical, sexual, or emotional abuse; neglect; deprivation or abandonment; associating with peers who engage in antisocial behavior; or a parent who is either antisocial or alcoholic.
Anxiety is a feeling of apprehension and fear characterized by physical symptoms. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
Schizophrenia is a disabling brain disorder that may cause hallucinations and delusions and affect a person's ability to communicate and pay attention. Symptoms of psychosis appear in men in their late teens and early 20s and in women in their mid-20s to early 30s. With treatment involving the use of antipsychotic medications and psychosocial treatment, schizophrenia patients can lead rewarding and meaningful lives.
Suicide is the process of intentionally ending one's own life. Approximately 1 million people worldwide commit suicide each year, and 10 million to 20 million attempt suicide annually.
Bipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood stabilizer medications, antidepressants, and psychotherapy.
Borderline personality disorder is a serious mental illness characterized by pervasive instability in moods, interpersonal relationships, self-image, and behavior. This instability often disrupts family and work life, long-term planning, and the individual's sense of self-identity. Originally thought to be at the "borderline" of psychosis, people with borderline personality disorder (BPD) suffer from a disorder of emotion regulation.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
Obsessive compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder characterized by the symptoms hyperactivity, impulsivity, and inattention. Treatment for ADHD may involve behavioral therapy and psychostimulant or antidepressant medication.
Child abuse falls into four categories: neglect, physical abuse, sexual abuse, and emotional abuse. There are certain risk factors that predispose a child to being abused and an adult to abusing a child. Risk factors for children are age, children with learning disabilities, adopted and foster children, children with congenital abnormalities, and a past history of abuse. Parental risk factors include young or single parents, those who suffered abuse themselves, adults with substance-abuse problems or psychiatric disease, and those who didn't graduate from high school.
Narcissistic personality disorder (NPD) is a dramatic personality disorder that is characterized by a distorted self-image, preoccupation with success and power, and an abnormal love of self, which mask insecurity and a fragile self-esteem. Other symptoms include constantly seeking attention and admiration, setting unrealistic goals, exaggerating talents, self-centeredness, arrogant behavior, and an inability to recognize others' feelings. Though there is no known treatment for NPD, psychotherapy may be of some help.
Mental illness is any disease or condition affecting the brain that influence the way a person thinks, feels, behaves, and/or relates to others. Mental illness is caused by heredity, biology, psychological trauma and environmental stressors.
Compulsive gambling is a disorder that affects millions in the U.S. Symptoms and signs include a preoccupation with gambling, lying to family or loved ones to hide gambling, committing crimes to finance gambling, and risking importance relationships and employment due to gambling. Treatment may incorporate participation in Gamblers' Anonymous, psychotherapy, and medications like carbamazepine, topiramate, lithium, naltrexone, antidepressants, clomipramine, and fluvoxamine.
Brief psychotic disorder is a short-term mental illness that features psychotic symptoms. There are three forms of brief psychotic disorder. The first occurs shortly after a major stress, the second has no apparent trauma that triggers the illness, and the third is associated with postpartum onset. Symptoms include hallucinations, delusions, unusual behavior, disorientation, changes in eating and sleeping, and speech that doesn't make sense. Treatment typically involves medication and psychotherapy.
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