What is antisocial disorder?

In the field of psychiatry and psychotherapy, sociopathy is defined with the term “antisocial personality disorder "to indicate a disorder that prevents the individual from adapting to the ethical and behavioral standards of his or her socio-cultural community. A sociopath can become a threat, show criminal attitudes, organize dangerous sects, and cause harm to himself and others. A person can show various signs of sociopathy, such as an absence of remorse, contempt for the law, and a habit of lying and manipulating.

It is placed from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) inside of the cluster B personality disorders, which also includes the borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder.

The DSM-5 provides a description of the antisocial personality disorder that has many common characteristics with sociopathy and psychopathy. These latter disorders cannot be diagnosed as an antisocial personality disorder, but some research has found that they are specific disorders belonging to the category of antisocial disorder, with which they have different aspects in common. Here is a shortlist:

- Disdain for laws and social customs.

- Inability to recognize the rights of others.

- Inability to feel sorrow or guilt.

- A tendency to adopt controlling, manipulative, and often violent behaviors and attitudes.

- dishonesty: the subject lies, uses false names, scams others

- impulsiveness or inability to plan

- irritability and aggression

- inability to cope with financial obligations or to sustain work continuously

- lack of remorse

- the individual is at least 18 years old

- presence of a conduct disorder with onset prior to 15 years

- antisocial behavior does not manifest itself exclusively during a manic episode or in the course of schizophrenia.

- Nervousness

- Tendency to anger

- Poor education

- Solitude

- Every crime committed is disorganized and spontaneous without planning.

- The inability to plan often results in a systematic economic non-self-sufficiency.

- Financial irresponsibility is indicated, for example, by the inability to provide support for children and by the systematic accumulation of debts.

The sociopathic occurs predominantly in males, with a ratio of 3: 1 as compared to females. The prevalence is 3% in men and 1% in women in the general population and increases to 3-30% in the clinical setting. In some cases, especially if combined with a narcissistic disorder or borderline personality disorder, it can lead to criminal behavior.

These subjects are impulsive people, unable to organize and plan in the long term. Failing to tolerate frustration, they can also go to the use of violence, raising their hands, killing, but also committing suicide.

Antisocial disorder categories

Generally, those who are affected by the antisocial disorder are divided into four categories:

Common Sociopaths

They are unable to feel ashamed and have a distorted morality. Very often, kleptomania is associated with this type of sociopathy. They are people who move often and have very frequent sexual intercourse.

Alienated Sociopaths

They are characterized by the very low ability to love and, above all, empathize with each other, even if significant. Usually, they experience misanthropy and hatred towards society. They are individuals who do not like to socialize and can, in turn, be distinguished into three other "subtypes":

- the "hostile" sociopaths, irritable, despotic and always in conflict with the law

- the "cheated" sociopaths, who tend to commit crimes because they believe that their attitude is justified by what they have suffered from society

- non-empathic sociopaths, those who know how to feel empathy and affection only for a small group of people (relationships are, however tense and manipulative).

Aggressive sociopaths

They are characterized by a sadistic streak that they show at work and during sexual intercourse. They usually seek positions of power (such as policemen but also teachers or parents) and may find it fun to torture animals.

Dissocial sociopaths

They are characterized by adapting to the rules of a group as long as they involve violation of the law.

Genetics and Sociopathy

Some research seems to suggest that there is a genetic factor in sociopathy, while others point attention to a denied childhood or abuse. One study, in particular, showed that 50% of sociopathic subjects inherited the disorder through their genetic structure. However, it is undeniable that environmental factors and other conditions may be the cause of the disorder affecting the rest of the sociopaths examined by the research. Because of these conflicting results, the origin of sociopathy cannot be identified with certainty to date.

Studies carried out on adopted individuals have shown that those who had adoptive parents with antisocial disorder presented a high risk of developing this disorder. The conduct disorder (before the ten years of life) and the disorder attention deficit hyperactivity disorder (ADHD) increase the risk that the individual develops sociopathy. Instead, studies focused on the family environment of individuals with sociopathy have instead found that individuals with this disorder tend to come from families with abusive or violent parents or close relatives.

A sociopath can have different ways of approaching others:

1. There is almost always a tendency to arrogate the right to occupy certain positions, to "possess" people, exercising systematic control over them. He tends to believe that his own opinions and beliefs are absolute truth, and he despises (even if not always directly) the ideas of others. Generally speaking, they are not shy, insecure, or short words. They have difficulty managing emotional responses such as anger, impatience, or disappointment; they cannot manage direct confrontation and verbally attack others by reacting hastily to these emotions.

2. The attitude can appear overly spontaneous and courageous; it gives the impression of acting outside the reality of social norms and engages in bizarre, risky, or outrageous activities, without evaluating the possible repercussions. Sociopaths can be criminals. Since they have a tendency to despise the law and social rules, they can have a criminal record. 

3. The way in which a human being interacts with other people is an excellent indicator of sociopathy. A disturbed person is very skilled in convincing his audience to do what he wants, either through charm or manipulative and indirect strategies or through more aggressive and controlling means. The result is that the people who gravitate around him find themselves, despite themselves, acting as the sociopath wants.

How to recognize sociopathy

However, there are clues, clearly to be "taken with the springs," which could suggest an antisocial personality disorder and to which anyone can pay attention. Without a doubt, however, the evaluation of a specialist, in case of doubt, can clarify the situation.

1. Try to maintain good eye contact while talking to the other person and try to notice if it is returned. Sociopathic subjects, in fact, often fail to support the direct gaze of others when they interact. They can also take a nervous or irritated attitude. However, even shy people sometimes react this way, so it is very important not to jump to hasty conclusions.

2. Look for symptoms of sociopathic behavior, which include lying, a tendency to aggression, intimidating behavior, excessive use of alcohol or drugs, and tendency to injure people or animals.

3. Find out about the person's past, especially about his or her significant relationships. Sociopaths tend to have had many wrong relationships in their past. Of course, not just because someone has been unsuccessful in emotional relationships, it means that he is a sociopath.

4. Observe how the individual interacts with the people he knows. If he has no close friends or family members, this may be because relationships have deteriorated due to manipulative, aggressive, or offensive behavior. Clearly, even in this case, it is not said that if someone has no friends, he is a sociopath.

5. Sociopaths are often in trouble with the law because of their contempt for the rules of society, although a sociopathic person will tend to lie about it. 

Drugs

The health organization reports that the use of drugs in the treatment of sociopathy is minimally effective. However, in the case of co-presence with further disorders such as paranoia, anxiety, depression, and substance abuse, the drugs are useful in reducing these symptoms and facilitating psychotherapeutic work.

The violent nature of the sociopath often requires low-dose antipsychotic drugs to control the symptoms of aggressive behavior further. In addition to antipsychotics, mood stabilizers, anxiolytics, and antidepressant drugs are also used in the treatment of sociopathy.

Author: Vicki Lezama