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 happens if antisocial personality disorder is not treated?
Some societal costs of antisocial personality disorder, like the suffering endured by victims of the crimes committed by people with this disorder, are clear. However, when people with ASPD are the charismatic leaders of religious cults, the devastation they can create is often not known unless and until a catastrophe results. The mass suicide that occurred at the command of
the Reverend Jim Jones in Guyana in 1978 is just one such example.
Individuals who suffer from antisocial personality disorder have a higher risk of abusing alcohol and other drugs and repeatedly committing crimes. Imprisonment is a potential consequence. People with antisocial personality disorder are also vulnerable to mood problems, such as major depression, anxiety, and bipolar disorder; having other personality disorders, especially borderline (BPD) and narcissistic personality disorders; self-mutilation and other forms of self-harm, as well as dying from homicide, suicide, or accident.
Antisocial personality disorder tends to make virtually any other condition more problematic and difficult to treat. Having antisocial personality disorder makes individuals who also have a substance abuse problem more difficult to help abstain from alcohol or other drug use. People who have both antisocial personality disorder and schizophrenia are less likely to comply with treatment programs and are more likely to remain in an institution like prison or a hospital. These risks become magnified if antisocial personality disorder is not treated. Statistics indicate that many people with antisocial personality disorder experience a remission of symptoms by the time they reach 50 years of age.
Antisocial Personality Disorder At A Glance
A personality disorder (PD) is a persistent pattern of thoughts, feelings and behaviors that is significantly different from what is considered normal within the person's own culture.
Personality disorders are grouped into clusters A, B, and C based on the dominating symptoms.
Antisocial personality disorder is specifically a pervasive pattern of disregarding and violating the rights of others and may include symptoms such as breaking laws, frequent lying, starting fights, lack of guilt and taking personal responsibility, and the presence of irritability and impulsivity.
Psychopathy is considered to be a more severe form of antisocial personality disorder. Specifically, in order to be considered a psychopath, an individual must experience a lack of remorse or guilt about their actions in addition to demonstrating antisocial behaviors.
Psychopaths tend to be highly suspicious or paranoid, even in comparison to individuals with antisocial personality disorder, which tends to lead the psychopathic person to interpret all aggressive behaviors toward them as being arbitrary and unfair.
Antisocial personality disorder is likely the result of a combination of biologic/genetic and environmental factors.
Some theories about the biological risk factors for antisocial personality disorder include dysfunction of certain genes, hormones, or parts of the brain.
Diagnoses often associated with antisocial personality disorder include substance abuse, attention deficit hyperactivity disorder (ADHD), and reading disorders.
Theories regarding the life experiences that put people at risk for antisocial personality disorder include a history of childhood physical, sexual, or emotional abuse; neglect, deprivation, or abandonment; associating with peers who engage in antisocial behavior; or having a parent who is either antisocial or alcoholic.
Since there is no specific definitive test that can accurately assess the presence of antisocial personality disorder, practitioners conduct a mental-health interview that looks for the presence of antisocial symptoms. If the cultural context of the symptoms is not considered, antisocial personality disorder is often falsely diagnosed as being present.
Research indicates ethnic minorities tend to be falsely diagnosed as having antisocial personality disorder, inappropriately resulting in less treatment and more punishment for those individuals.
Although antisocial personality disorder can be quite resistant to treatment, the most effective interventions tend to be a combination of firm but fair programming that emphasizes teaching the antisocial personality disorder individuals skills that can be used to live independently and productively within the rules and limits of society.
While medications do not directly treat the behaviors that characterize antisocial personality disorder, they can be useful in addressing conditions like depression, anxiety, and mood swings that co-occur with this condition.
If untreated, people with antisocial personality disorder are at risk for developing or worsening a myriad of other mental disorders. Antisocial personality disorder individuals are also at risk for self-mutilation or dying from homicide or suicide.
Many people with antisocial personality disorder experience a remission of symptoms by the time they reach 50 years of age.
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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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