What+is+Antisocial+Personality+Disorder?

Antisocial Personality Disorder (ASPD) is, "a pervasive pattern of disregard for others and the violation of their rights as well as the inability or unwillingness to conform to societal norms" (Mariani, Horey, Bisage, Aharonovich, Raby, Cheng, Nunez & Levin, 2008). As will be discussed in this wiki, this behaviour would most likely cause these individuals severe impairment in healthy daily functioning and negatively affect the lives of those around them on a consistent basis. A subset of ASPD is psychopathy which is an absolute extreme to ASPD. Conduct disorder is commonly a predisposing factor as a youth to becoming diagnosed with ASPD (Psychiatric Association, 2011). It is based on an individual under the age of 18 who continuously violates societal norms by engaging in destructive behavior (Mental Disorders, 2012). This may include drug use and illegal activities, such as stealing, destroying property or acting cruel towards animals (Mental Disorders, 2012). In our opinion, and based on the research we have found, when combined with substance abuse, this disorder has an increased potential to wreck havoc on not only themselves and others, but on society as a whole. This content is all within the wiki and will be further explained.

Thus, this wiki will introduce the realm of ASPD, including contributing factors, assessments, and their relationship with the criminal justice system. It will then describe ASPD's relationship to substance abuse, including alcohol, cannabis, methamphetamine, cocaine, and opiates. This wiki also includes pharmacological treatment outcomes.

flat = = = = =**__Personality Impairments__** = To be diagnosed with a personality disorder, two significant personality impairments must be present in a patient's behaviour (Psychiatric Association, 2011): > > > (Psychiatric Association, 2011)
 * 1) ** __Self Functioning__: **
 * //Identity// - Pleasure seeking, selfish, self centered.
 * //Self Directive// - Self esteem directly related to personal wealth and power with no regard for others personal thoughts and/or feelings.
 * 1) ** __Interpersonal Functioning__: **
 * //Empathy// - Inability to see or feel concern, need or suffering of another.
 * //Intimacy// - Unable to maintain relationships, lies, uses people to his/her own gain with no remorse.

=__**Pathological Personality Traits**__ =  According to the Psychiatric Association (2011), one or more of these traits need to be present for a personality disorder to be diagnosed and these behavioral patterns and personality traits are pathological, unchanging and consistent throughout a person's lifetime. Also, these patterns and traits do not fit in with the developmental or social cultural norms appropriate for an individual's age (Psychiatric Association, 2011).

 **__Antagonism__:** Manipulates in order to gain control over anyone in a relationship usually feigning some personal victimization or offense. They are also deceitful, hard and always angry or easy to anger (Psychiatric Association, 2011).

 **__Disinhibition__:** Risk taking, impulsive behaviour, irresponsibility, personal and/or financial disregard, as well as, no regard for others or their safety (Psychiatric Association, 2011).

For example, the Joker from the movie, "The Dark Knight" displayed all the following characteristics that Dougherty and Moeller (2001) noted were the criteria for Antisocial Personality Disorder in their study:
 * Repeated criminal acts
 * Deceitfulness
 * Impulsiveness
 * Repeated fights or assaults
 * Disregard for the safety of others
 * Irresponsibility
 * Lack of remorse

=__**Levels of Personality Function**__ = **__Self and Interpersonal Functioning Dimensional Definition__** Because no one person is the same as another, a dimensional model with different levels and mental representations of self have been put together in the proposed DSM V, helping to make the best individual diagnosis possible (Psychiatric Association, 2011). These are:


 * <span style="font-family: Arial,Helvetica,sans-serif;">**__Self-Identity:__** Does one see him/her self as a unique being and do they have a clear sense of boundaries between him/her self and others? How stable is their self-esteem and do they have a realistic perspective of themselves and their true competencies? Do they or are they able to emote through a basic range of experiences? (Psychiatric Association, 2011).[[image:homolka-bernardo_ASPD.jpg width="248" height="314" align="right" caption="Paul Bernardo & Karla Homolka - Were they capable of having a relationship based on love and respect and did they show personal respect towards others?"]]


 * <span style="font-family: Arial,Helvetica,sans-serif;">**__Self-Direction:__** Do they follow clear sensible plans for short term and long term goals? How socially competent is he/she? How does he/she generally fit in socially and intimately? Does he/she understand basic right from wrong along with showing personal respect toward others? (Psychiatric Association, 2011).


 * <span style="font-family: Arial,Helvetica,sans-serif;">**__Empathy:__** Is he/she capable of understanding another's situation and the motivations behind them practically and emotionally? Are they able to understand and accept another's point of view? Can he/she recognize the effect of their actions on others? (Psychiatric Association, 2011).


 * <span style="font-family: Arial,Helvetica,sans-serif;">**__Intimacy:__** How close are their relationships with others and how long do their relationships generally last? Are they capable of having a mature relationship based on reciprocal caring, mutual love and respect? (Psychiatric Association, 2011).

= = = = =<span style="color: #933939; display: block; font-family: Arial,Helvetica,sans-serif; font-size: 90%; text-align: left;">**__Antisocial Personality Disorder, Substance Abuse & Substance Produced Psychotic Disorders__** = <span style="font-family: Arial,Helvetica,sans-serif;">Characteristics of antisocial personality disorder often bring the sufferer into conflict with behavior society deems morally and legally acceptable. In consequence, a pattern of frequent jail terms, alcoholism and drug abuse often apply. People with antisocial personality disorder may use substance abuse issues as a way to manipulate any social accountability and/or legal system consequence in their favour. There are two types of substance related disorders (Mental Disorders, 2012)<span style="font-family: Arial,Helvetica,sans-serif;">:
 * ===<span style="font-family: Arial,Helvetica,sans-serif;">__**Substance Use Disorder:**__ ===
 * <span style="font-family: Arial,Helvetica,sans-serif;">Dependance and abuse represent the two main characteristics of substance use disorder. Abuse is the continued use of a substance (legal and/or illegal) even though it's use repeatedly causes problems in his/her personal and professional relationships. However the person is not yet physically dependent on the substance/substances. Dependence is when the user craves and consistently requires more and more of the drug due to the body rapidly adapting to the presence of the substance. They constantly require higher and higher doses to achieve homeostasis (tolerance). Without appropriate and continuing doses of the substance a horrific withdrawal syndrome set's in along with desperation to somehow acquire more of the drug in search of relief (Mental Disorders, 2012).


 * ===<span style="font-family: Arial,Helvetica,sans-serif;">__**Substance Induced Disorder:**__ ===
 * <span style="font-family: Arial,Helvetica,sans-serif;">Intoxication, withdrawal, along with different mental states such as dementia, psychosis, anxiety and mood disorder's characterize the trait's of substance induced disorder. Intoxication is how the substance directly affects the user after exposure. General representation's of intoxication are impaired judgement, appetite and sleep pattern changes and emotional instability (Mental Disorders, 2012).

<span style="font-family: Arial,Helvetica,sans-serif;">People diagnosed with antisocial personality disorder show more drug and alcohol use along with lower than normal life functioning skills along with a high incidence of previous adolescent substance abuse which represents a predictable behavioural factor progressing up from conduct disorder (Mental Disorders, 2012).

=<span style="color: #933939; font-family: Arial,Helvetica,sans-serif; font-size: 90%;">__**Antisocial Personality Disorder-Substance Induced-Alcohol**__ =

<span style="font-family: Arial,Helvetica,sans-serif;">__**Alcohol:**__ <span style="font-family: Arial,Helvetica,sans-serif;">According to the DSM-IV-TR, a diagnosis of a substance induced personality disorder can only be given when the psychotic symptoms displayed during intoxication and withdrawal are considered above and beyond expectation and psychotic symptoms become severe (Mental Disorders, 2012). Long term, chronic alcohol consumption can cause antisocial personality disorder along with other personality behavioural disorders such as mood, bipolar, major depression and anxiety (Mental Disorders, 2012).

<span style="font-family: Arial,Helvetica,sans-serif;">__**Intoxication:**__
<span style="font-family: Arial,Helvetica,sans-serif;">Psychotic symptoms and the speed of onset are varied depending on the amount of alcohol ingested over an amount of time. Alcohol induced ASPD symptoms can appear after days or weeks of intensive, consistent alcohol intoxication. Necessary and essential diagnostic criteria for substance induced ASPD listed in the DSM-IV-TR are (Mental Disorders, 2012):


 * 1) <span style="font-family: Arial,Helvetica,sans-serif;">**The presence of prominent hallucinations or delusions**
 * <span style="font-family: Arial,Helvetica,sans-serif;">Hallucinations and/or delusions develop during, or within one month of, intoxication or withdrawal from a medication or substance known to cause psychosis.
 * 1) <span style="font-family: Arial,Helvetica,sans-serif;">**Psychotic symptoms not part of another psychotic disorder that is not substance induced**
 * <span style="font-family: Arial,Helvetica,sans-serif;">Eg. the psychotic symptoms began prior to use of substance or medication.
 * 1) <span style="font-family: Arial,Helvetica,sans-serif;">T**he psychotic symptoms don't only occur in delirium**

<span style="font-family: Arial,Helvetica,sans-serif;">If the above criteria is met and alcohol is the main variable substance of intoxication, it can be considered the reason for substance induced ASPD (Mental Disorders, 2012).



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