Antisocial Personality Disorder

Antisocial Personality Disorder

Antisocial personality disorder describes an ingrained pattern of behavior in which individuals consistently disregard and violate the rights of others around them. The more egregious, harmful, or dangerous behavior patterns are referred to as sociopathic or psychopathic. There has been much debate as to the distinction between the two descriptions. Sociopathy is chiefly characterized as something severely wrong with one's conscience; psychopathy is characterized as a complete lack of conscience regarding others.

 

Features

1.      Individuals with antisocial personality disorder fail to conform to social norms with respect to lawful behavior

2.      Persons with this disorder disregard the wishes, rights, or feelings of others. They are frequently deceitful and manipulative in order to gain personal profit or pleasure

3.      They may repeatedly lie, use an alias, con others, or malinger. A pattern of impulsivity may be manifested by a failure to plan ahead

4.      For this diagnosis to be given, the individual must be at least age 18 years and must have had a history of some symptoms of conduct disorder before age 15 years

5.      These individuals also display a reckless disregard for the safety of themselves or others.

Symptoms

1. Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds 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 physical fights or assaults.

5. Reckless disregard for safety of self or others.

6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.

7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.

Treatment

Antisocial personality disorder is one of the most difficult personality disorders to treat. Individuals rarely seek treatment on their own and may initiate therapy only when mandated to do so by a court. 
There is no clearly indicated treatment for antisocial personality disorder. Recently, the antipsychotic medication clozapine has shown promising results in improving symptoms among men with antisocial personality disorder. 

Schizoid Personality Disorder

Schizoid Personality Disorder

Schizoid personality disorder is a pattern of indifference to social relationships, with a limited range of emotional expression and experience. People with schizoid personality disorder rarely feel there is anything wrong with them. The disorder manifests itself by early adulthood through social and emotional detachments that prevent people from having close relationships. Crucially, people with schizoid personality disorder are in touch with reality, unlike those with schizophrenia or schizoaffective disorder.

Features 

The essential features of Schizoid Disorder are:

1.     a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings. This pattern begins by early adulthood and is present in a variety of contexts.

2.     appear to lack a desire for intimacy, seem indifferent to opportunities to develop close relationships, and do not seem to derive much satisfaction from being part of a family or other social group

3.     they prefer spending time by themselves, rather than being with other people. They often appear to be socially isolated or "loners" and almost always choose solitary activities or hobbies that do not include interaction with others

4.     They prefer mechanical or abstract tasks, such as computer or mathematical games. They may have very little interest in having sexual experiences with another person and take pleasure in few, if any, activities

5.     These individuals have no close friends or confidants, except possibly a first-degree relative

6.     often seem indifferent to the approval or criticism of others and do not appear to be bothered by what others may think of them

Symptoms

According to the DSM-5, symptoms of schizoid personality disorder include the following:  

• Does not desire or enjoy close relationships
• Appears aloof and detached
• Avoids social activities that involve significant contact with other people
• Almost always chooses solitary activities
• Little or no interest in sexual experiences with another person
• Lacks close relationships other than with immediate relatives
• Indifferent to praise or criticism
• Shows emotional coldness, detachment, or flattened affect
• Exhibits little observable change in mood
• Takes pleasure in few if any activities

Diagnosis

1.     A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts

2.     Does not occur exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, another psychotic disorder, or autism spectrum disorder and is not attributable to the physiological effects of another medical condition.

Treatment 

Medications are not usually recommended for schizoid personality disorder. However, they are sometimes used for short-term treatment of extreme anxiety states associated with the disorder.
Individual therapy that successfully attains a long-term level of trust may be useful, as it helps people with the disorder to establish authentic relationships, in cases where this is desired. Individual psychotherapy can gradually affect the formation of a true relationship between the patient and therapist.
Long-term psychotherapy should not be pursued because this disorder is difficult to ameliorate. Instead, therapy should focus on simple treatment goals to alleviate current pressing concerns or stressors within the individual's life. Cognitive-restructuring may be proper to address certain types of clear, irrational thoughts that are negatively influencing the patient's behaviors.