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What is Antisocial Personality Disorder?
Antisocial personality disorder is a common mental illness among criminals such as con men or even serial killers. Personality disorders develop over a lifetime, and someone needs to be at least 18 years old to be diagnosed with one1. Antisocial personality disorder is different from other personality disorders in that there are previous disorders which may precede it such as conduct disorder and operational defiant disorder. The symptoms of antisocial personality disorder are many and include repeatedly performing unlawful behaviors for which one may be arrested, deceitfulness for personal gain, impulsivity, irritability and aggressiveness, lack of caring about the safety of self or others, consistent irresponsibility, and lack of remorse. Before a diagnosis can be made for antisocial personality disorder, a person has to exhibit three of these symptoms, be at least 18 years old, and have a past history of violence or criminal activity.
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Treatment for Antisocial Personality Disorder
Personality disorders tend to be difficult to diagnose, and people rarely seek treatment for them making therapy difficult. Antisocial personality disorder treatment becomes increasingly difficult because those who suffer from it usually are mandated to receive treatment, rather than seeking treatment voluntarily. This presents motivational problems for long term change for those mandated to be treated in a correctional center, but the problems can be overcome. This can be accomplished by focusing on goals, improving relationships, and learning new coping skills. However, this is the realistic limit for those mandated to seek treatment in a correctional facility2.
In outpatient treatment, it is a different situation which focuses on the emotional state of the client. Psychotherapy is the best approach for doing this. While motivation is less of an issue, other issues will be prominent. A therapist will begin to build trust which may be unsettling for the client due to past trust issues and poor relationships. Through honesty and time, this trust can be built into a working therapeutic relationship. Once this trust obstacle has been removed, therapy will move towards a focus on the emotions of the client. This is because they have not been able to recognize many emotions and, generally, don't relate behavior to emotion.
Therapy then focuses on emotions and the recognition of them. After trust has been established, patients begin to learn to recognize emotions, and the experience of intense emotions is a sign of progress. These emotions, except for anger or frustration, will then be reinforced until these emotions can be felt regularly. Also, taking responsible for their actions is a helpful treatment tool which can lead to positive outcomes and a reduction of symptoms for anti-social personality disorder.
Something that will not be done in anti-social personality disorder therapy by the therapist is acting like an authority figure to the client, who is likely to rebel against such treatment. A neutral stance is more likely to be used by the therapist during treatment. Also, there is no specific medication for anti-social personality disorder available. Medications may be used to treat the secondary symptoms of depression, anxiety, mood swings, and psychosis3, but they are not a primary treatment for this personality disorder.
In conclusion, anti-social personality disorder is a difficult mental illness to diagnose and an even harder mental illness to treat, but it is not hopeless. Psychotherapy based around emotions should be used for treatment, and medications should only be used indirectly, if at all.