About Antisocial Personality Disorder
The following are common dysfunctional
dynamics in family background of antisocial individuals:
exposure to domestic violence
excessive or absent disciplinary practices
parental substance abuse
neglect or abandonment by one or both parents
physical and/or sexual abuse
These are biological and neurological factors that contribute to aggression in
antisocial personalities:
abnormalities in the frontal lobe
serotonin dysfunction
hyperactivity
low anticipatory anxiety
The following statements illustrate the cognitive
perspective of the antisocial personality:
I am always right.
I won’t let anyone push me around.
I deserve to get whatever I want, by whatever means necessary.
When I manipulate other people, it’s their fault for being weak enough to let
me.
It’s a harsh world out there and I need to use force to get by.
Several Axis I conditions are often
associated with antisocial personality disorder:
substance-related disorder
depression
conduct disorder before age 15
These behaviors are associated with poor impulse control in antisocial
individuals:
substance abuse
explosive physical aggression
driving while intoxicated
crimes against property (i.e., arson)
shoplifting and robbery
reckless disregard for the rights of others
These behaviors are associated with a
strong need for power and absolute autonomy in antisocial individuals:
constant challenging of authority figures
chronic lying, including malingering
denying or rationalizing criminal acts; lack of remorse
excusing oneself from moral obligations
failure to develop close trusting relationships
rape and sexual sadism
Treatment for antisocial personality disorder:
Cognitive therapy is more useful than psychodynamic
therapy for antisocial personality disorder.
The therapist should not attempt to make the client feel remorse or shame, but
instead help the client develop a better cognitive understanding of how moral
thought and behavior can be effective tools to achieve personal goals.
The therapist can avoid getting into power struggles with the antisocial client
by directly acknowledging the client’s ability to manipulate and deceive the
therapist.
Ideal qualities in a therapist treating
someone with antisocial personality disorder
self-assurance, flexibility, a relaxed but direct
interpersonal style, a clear sense of personal boundaries, and a strong sense of
humor.
An average of 50 sessions are needed for the antisocial client to make progress
in therapy.