Antisocial personality disorder, ASPD, is defined by Moss, Yao, and Panzak, 2013 as a mental condition that results in a pattern of irresponsible and antisocial behavior that occurs in childhood and progresses into adulthood (Moss, Yao, & Panzak, 1990). According to Blair, 2001, to be diagnosed with ASPD, you have to have a history of behavioral issues, must be diagnosed with a conduct disorder from childhood to adulthood (Blair, 2001). A conduct disorder is defined as being defiant persistently and constantly disrespectful, all during childhood. And the patient must also have reactive or instrumental aggression. Reactive aggression is an outburst or response that results because of frustration or threats. Instrumental aggression occurs when there is a specific goal that is met by being aggressive (Blair, 2001).
There are many signs and symptoms that go along with ASPD. Moss, Yao, and Panzak, 2013 list irritability, recklessness, impulsivity, and multiple sex partners (Moss, Yao, & Panzak, 1990). Blair, 2001, states that aggression is a common sign (Blair, 2001). Schaeffer et al, 2003, reported that substance abuse was common with ASPD patients (Schaeffer et all, 2003). I will discuss that more later on in the paper.
The causes of ASPD are not widely known. From the sources I looked out, there were a few theories but nothing definitive. Moss, Yao, and Panzak, 1990, believed that ASPD was a combination of nature and nurture. That while in the womb, the fetus could not develop properly and that could lead to the ASPD and that child abuse or neglect while the child is still young could bring out their aggression and irrational behavior they are prone to (Moss, Yao, & Panzak, 1990).
The first thing to point out is that ASPD is more common in men. Alegria et al, cited a source that found that men had a 3:1 ratio of having ASPD than women (Alegria et al, 2013). One interesting note the article pointed out is that during childhood, women were more likely to be victims of child abuse, yet it is the men that are more likely to develop ASPD and statistically they are abused less as children. Studies have not been done to determine whether females with ASPD were abused more than males with ASPD. This could be a point of further research for ASPD patients to help understand the impact that child abuse has on people with this diagnosis. Another key point the article mentioned was that there were similarities between male and female ASPD patients. Neurocognitive deficits and problems within the family were common for both males and females. Males and females with ASPD also have different reckless behavior tendencies, which I found interesting. Men tended to be more aggressive and violent, as well as high rates of being arrested or having traffic offenses. Women, on the other hand were more likely to be sexually promiscuous, impulsive, and run away from home. They observed, however, that there were no differences between males and females and the use of alcohol and drugs. Both groups tend to abuse substances (Alegria et al, 2013).
Alegria et al, 2013 did a study to research the differences between males and females in childhood adverse events and adult adverse events. They compared men and women with ASPD adverse events, lifetime comorbidity, differences in behavior, and differences in social support, disability, and stress levels.
The results showed that when looking at adverse events, women were far more likely to endure and report a negative event happening in their childhood. This includes neglect, as well as, physical, verbal, and sexual abuse. They were also more likely to have an adverse event occur when they were adults. Women with ASPD were more likely to have been raped or attacked. This could also be true in women without ASPD; there is a nationwide epidemic on sexual abuse of women. Media coverage of this is current and ongoing.
Looking at lifetime comorbidity, unlike previous studies that showed no difference between substance abuse in males and females, this study showed that women were less likely to abuse alcohol and drugs than men with ASPD. They also found that women were more likely to have another mood disorder in addition to ASPD. Personality disorders were just as common in men as in women with ASPD.
With respect to differences in behavior, women reported being more likely to run away from home, lie, skip school or work, and threatened someone. Men reported being more likely to destroy others’ property, launder money, engage in illegal behavior, and use weapons against others.
Looking at differences in social support, disability, and stress levels, men reported being less stressed than women, as well as having more social support (Alegria et al, 2013).
Sher and Trull, 1994 looked at the relationship between ASPD and alcoholism (Sher & Trull, 1994). Alcoholism and ASPD are comorbid with each other as well as anxiety and schizophrenia. Both of these disorders have a slow onset. There are specific behaviors that are present in adolescence that lead to the diagnosis of the disorder in adulthood. There are several personality traits that the researchers came across that link alcoholism and ASPD. These traits are neuroticism, impulsivity and extraversion. People with alcoholism and ASPD are both less likely to be emotional or show stress under normal circumstances. They have lower anxiety levels in general. The cause for this as well as irritability is still unknown. Researchers have hypothesized that there is temporal lobe dysfunction, frontal lobe dysfunction, and just over all brain dysfunction that causes psychopathic tendencies and behaviors. Sher and Trull go on to say that the personality traits linking the two disorders together are not definitive and that some patients will show some signs and not show others, however, as a general rule of thumb, alcoholism and ASPD are comorbid and closely related (Sher & Trull, 1994).
Substance abuse is another commonality with ASPD. It has been shown to have a high correlation. Moss, Yao, and Panzak, 1990, did a study with 15 subjects that were diagnosed with ASPD. They all had substance abuse problems, and thirteen out of the fifteen reported having multiple substance abuse problems. They were asked to answer a bunch of questionnaires and small tests of math and reading skills. The results showed that ASPD patients are predisposed to substance abuse or they coexist with substance abuse. ASPD patients have a greater motivation to use or misuse substances. They are more impulsive. Another interesting result is that they have poor test taking skills. This can be associated with either not being motivated or having cognitive inability (Moss, Yao, and Panzak, 1990).
Diagnosis of this disorder seems to be directly related to childhood behavior. Schaeffer et al, 2003, cites that aggression during childhood seems to be the most significant sign of ASPD. The researches suggest that intervention for these children with aggression is instrumental for preventing dangerous tendencies from occurring. They suggest that teachers should understand the risk factors and warning signs of children with aggression and ASPD symptoms. If teachers are able to do this then they will be more likely to develop intervention techniques to treat these students and keep the other students safe (Schaeffer et al, 2003).
Petras et al, 2009, did a study on first and second graders that have signs of antisocial personality disorder as well as violent and criminal behaviors (Petras et al, 2009). They looked at childhood aggression as well and more specifically the Good Behavior Game, which was implemented in 1985 to try and target aggressive and disruptive behavior. The purpose of this study was to determine the effect of the Good Behavior Game on decreasing the aggressive behavior by some kids. They ended up finding three cases of ASPD like behaviors in the schools. With the Good Behavior Game in place, a significant decrease in violent behavior was reported. With this study’s findings, more intervention mechanisms should be implemented in schools around the country. If aggression and violence are corrected at a younger age, then there is a reduction of ASPD diagnoses decreases as these children enter adulthood (Petras et al, 2009).
Raine et al, 2000, did a study on the gray matter of the brain. Studies have shown that damage to the prefrontal cortex can cause psychopathic tendencies. So, Raine et all, 2000, did a study to see if people with ASPD, while not having any brain trauma, also have problems with their prefrontal cortex. The subjects completed questionnaires about alcohol usage, estimated intelligence tests, history of head injuries, and physical exams. The researchers used MRI scans of the brain as well. The results of the study showed that ASPD subjects had a significant reduction in prefrontal gray matter. White matter did not differ between groups. ASPD patients also had lower heart rates and reduced SAMS response to stress. They concluded that ASPD may be caused in part but the reduction of gray matter in the prefrontal cortex leading to the personality defects these patients have.
In conclusion, antisocial personality disorder is a complex mental disorder. There are many signs associated with this disorder that include but are not limited to aggression, violence, irritability, and recklessness. The causes of this disorder are not widely known, however, many researchers believe there is a nature and nurture component that can also be made worse by child abuse. Several studies have been done to look at preventative methods; most studies show that implementing preventative measures in elementary schools is an effective strategy. In the future, more research needs to be done to determine the exact cause of this disorder so that proper treatment can be given to each specific case.