Perhaps one of the most stigmatized disorders in society, Antisocial personality disorder is often closely tied to sociopathy and psychopathy. Due to the popularity of true crime, when most people hear the phrase “antisocial personality disorder”, their mind conjures up infamous killers such as Ted Bundy or Jeffrey Dahmer. However, despite the media’s current obsession with serial killers, the majority of people with Antisocial personality disorder are not remorseless killers waiting to go on a rampage. Rather, like many disorders, Antisocial personality disorder, or ASPD, exists on a spectrum. While yes, violent killers like Ted Bundy were diagnosed with the disorder, this is an extreme case and most people with ASPD simply have the ability to turn off their emotions and empathy towards other human beings. Many people with ASPD have described it as having the ability to turn off their empathy like flipping off a light switch, but that doesn’t mean people who can do this are inherently dangerous. Like any behavior, it depends on the person exhibiting the behavior. If a person isn’t naturally violent, then turning off their empathy and emotions isn’t going to suddenly make them turn violent. Likewise, if someone is inherently violent, then they’ll be violent even if they don’t have Antisocial personality disorder. The disorder simply means they are less likely to feel remorse if they do something illegal.
While there is some argument amongst researchers about whether or not they are symptoms or other disorders that overlap with ASPD, psychopathy and sociopathy are closely tied with the disorder. When many view the two as synonymous, there’s actually a key difference between the two. A psychopath is someone who is born without empathy, whereas a sociopath develops a lack of empathy due to outside influence. This difference between nature and nurture can also lead to more distinct differences between people who suffer from ASPD. Those who have the ability to flip their empathy on and off would fall under the label of sociopaths rather than psychopaths and while both may have similar symptoms, how these symptoms present themselves can be remarkably different. Antisocial personalty disorder is the one personality disorder that has an age criterion in the DSM-V. In order to be diagnosed with Antisocial personality disorder, the patient must be at least eighteen years old and have shown three or more of the following symptoms before the age fifteen.
1. Failure to conform to social norms specifically those involving lawful behaviors, usually indicated by repeating behaviors that can lead to arrest.
2. Deceitfulness such as conning others for profit or pleasure, lying, or using aliases.
3. Impulsivity and or a failure to plan ahead.
4. Aggressiveness and irritability as demonstrated by repeated assaults or physical fights.
5. Reckless disregard for safety whether for themself or others.
6. Consistent irresponsibility shown through a failure to sustain consistent work behaviors or honoring financial obligations.
7. Lack of remorse.
Due to the overlap of psychopathy and sociopathy in this disorder, ASPD can have both genetic and social causes. Studies have shown that people who have relatives with the disorder have a higher prevalence of ASPD. Some studies have actually shown that the variants gene that encodes Monamine oxidase A (MAO-A), an enzyme that breaks now neurotransmitters such as serotonin, may result in less of the enzyme being created and may make the person more likely to develop ASPD. Other gene studies are ongoing to locate the biological cause of ASPD, but many researchers believe it is related to serotonin. On the other hand though, many studies have also shown an environmental factor when it comes to developing ASPD. A lack of parental stimulation and affection in early development stages can lead to an underdevelopment in the area of the child’s brain that deals with emotion and empathy. While there has been a rise in cases of ASPD in the United States, some psychologists believe this is due to the cultural norms. As the first symptom of ASPD listed in the DSM-V is a failure to conform to social norms, these behaviors may be more noticeable in certain societies.
Unfortunately, while studies have been done into the cause of ASPD, the effectiveness of certain treatments is still largely unknown. At the time of writing there are no medications approved for treatment of ASPD, however many therapists do suggest residential programs with controlled structure and supervision to help with treatment. Most of the treatment, however, comes with treating other disorders comorbid with ASPD. As a society, the stigma against ASPD has led to a lack of resources to those with the disorder and this needs to be corrected. Hopefully, education is the first step towards understanding and if you or someone you loves suffers from ASPD, please know the stigma is not a reflection on who you are as a person.
