As its name implies, antisocial personality disorder is characterized by behaviour that is antisocial in nature. Socially irresponsible behaviour, failure to conform to the law, manipulation of others and lack of remorse are trademarks of this difficult condition.
Antisocial personality disorder affects roughly one percent of the population, but it occurs two to four times more often in men than women and is extremely prevalent within correctional settings – affecting 80 percent of that population. It is most commonly observed in people between the ages of 24 and 44.
People with antisocial personality disorder are also likely to experience addictive disorders, have a shortened life expectancy, and are more prone to traumatic injuries, accidents, suicide attempts and hepatitis C. They use a disproportionate amount of medical and mental health services.
Unfortunately, antisocial personality disorder is not easy to treat. People with this condition seldom seek help for their antisocial pattern of behaviour and tend to dislike the authority of a mental health professional.
Although not diagnosed in children, the pattern of behaviour often begins before the age of eight. In childhood it is referred to as conduct disorder. A quarter of girls and 40 percent of boys with conduct disorder will have antisocial personality disorder as adults and the variety and severity of childhood behaviour problems are the best predictors of adult antisocial behaviour. If a child makes it to age 15 without exhibiting conduct disorder, he or she will not likely have antisocial personality disorder as an adult.
For parents of children with these maladaptive behaviours, it is a difficult diagnosis to accept and deal with. Typically, parents are advised to maintain close supervision and enforce strict consequences that are firm but fair for inappropriate behaviours. It is not a good idea to shield children from the consequences of their behaviour with police or school authorities.
Many such young people become involved in drugs and related criminal activity and end up leaving home at a young age. They are not above taking advantage of their parents, family and friends if given the opportunity. Firm limits are required if those close to them are to avoid becoming victims of their behaviour.
Marriage is said to be a moderating influence on those with antisocial personality disorder. Over half of those with antisocial personality disorder who are married improve while few who are unmarried do. Job stability is another predictor of improvement. These factors may, however, simply reflect a less severe personality disorder to begin with.
Although the antisocial and criminal behaviour tends to lessen with age this does not mean that older people with this personality disorder are necessarily happy and well adjusted. They may continue to have many behavioural, psychiatric and social problems that continue to be difficult to treat.
Unfortunately there is no easy solution to this problem and a realistic and long-term view of the likely outcome is important. There is always hope, but the improvement tends to be slow and gradual when it occurs.