Friday 31 January 2014

The Devil Gene: Part I 'Anti-Social Personality Disorder'

Good day everyone,

Welcome to the first chapter of The Devil Gene series. The first chapter is Anti Social Personality Disorder. The second chapter is on Sociopathy. The third chapter will be on Psychopathy. And hopefully, the final chapter will be an integrated collection of all three, elucidating their differences and similarities. I wanted to write a chapter of all three once and for all but the literature is so vast, it's best if I divided each into small sections to make it easier for you (and myself).

Introduction

When someone says, 'He's a Psychopath!' What comes into mind? The normal person would think about serial killers and Batman's Joker. However, this isn't the case, at least not entirely. What about Sociopathy? 'Hold up, wait - I thought they were the same thing?' OR 'Oh yeah I've heard about sociopathy but what's the difference?' Many psychologists argue that Sociopathy and Psychopathy are the same thing but the literature tends to change the terms. At one point, I would have agreed with this but with some new research studies, I'm standing on the side where there's a difference between both and hopefully for my Doctorate thesis, I could thoroughly study it. What about Anti-Social Personality Disorder? What comes to mind?

Anti Social? As in I don't like socializing?
Does this mean I'm an introvert?
Is there such a thing as a personality disorder?

According to the DSM-IV-TR (2000) Anti-Social Personality Disorder is one of the many disorders found in the AXIS II spectrum. In order to understand this spectrum, I have to list the clusters and disorders.

Cluster A (odd disorders)

Cluster B (dramatic, emotional or erratic disorders)

Cluster C (anxious or fearful disorders)

I won't get into all of them but notice how each cluster categorizes them into a set of attributes. For eXample, Cluster A is classified into 'Odd Disorders' which means people with this personality disorder are the ones you go 'Huh? What's up with this dude? Weirdo..'  Let us look at a few from Cluster A before moving to Anti Social which is in Cluster B.

Schizoid - This has nothing to do with Schizophrenia (at least in this blog) - please remember this is a personality disorder NOT a mental or medical disorder. I'm not saying it isn't possible to find someone with Schizophrenia with a Schizoid or Schizotypal personality. It's like cancer - you can be a psychopath or a 'normal' person with a 'normal' personality and you're still at risk in getting cancer. So what about a person with Schizoid personality?

The World Health Organization's ICD-10 lists schizoid personality disorder as Schizoid personality disorder.
It is characterized by at least four of the following criteria:
  1. Emotional coldness, detachment or reduced affect.
  2. Limited capacity to express either positive or negative emotions towards others.
  3. Consistent preference for solitary activities.
  4. Very few, if any, close friends or relationships, and a lack of desire for such.
  5. Indifference to either praise or criticism.
  6. Little interest in having sexual experiences with another person (taking into account age).
  7. Taking pleasure in few, if any, activities.
  8. Indifference to social norms and conventions.
  9. Preoccupation with fantasy and introspection.

As you can see, it takes 4 or more of these traits to be classified as a Schizoid  Personality. Now you may be saying, 'Ouf I know someone like that'. Well, chances are rare. A schizoid is someone like a hermit, living alone in the cold mountains all his life. In the work place, schizoids are usually librarians who sit all day alone in a quiet space. You can have the first four traits listed above 1 to 4 (or 5) and the last 6-9 traits. No matter, you'll be classified as a Schizoid Personality.

If you got that, we can now talk about Anti Social Personality Disorder. As you can see, it's in the Cluster B category with the dramatic, emotional or erratic disorders. I've already briefly spoken about Histrionic Personality Disorder in the past.

They say ASPD makes up 2% generally but I personally believe it's way more than that. At least 5% because it's harder to be detected in people with higher intelligence. I shall write more on this momentarily. 

Here are the 'symptoms' according both to the DSM IV and ICD 10 manual for ASPD

The APA's Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV-TR), defines antisocial personality disorder (in Axis II Cluster B):
A) There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following::
  1. failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
  2. deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
  3. impulsivity or failure to plan ahead;
  4. irritability and aggressiveness, as indicated by repeated physical fights or assaults;
  5. reckless disregard for safety of self or others;
  6. consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;
  7. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another;
B) The individual is at least age 18 years.
C) There is evidence of conduct disorder with onset before age 15 years.
D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.
In the DSM-5, the diagnosis antisocial personality disorder is kept, but it is no longer on another axis as the other mental disorders.

ICD-10

The WHO's International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10), has a diagnosis called dissocial personality disorder
It is characterized by at least 3 of the following:
  1. Callous unconcern for the feelings of others;
  2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations;
  3. Incapacity to maintain enduring relationships, though having no difficulty in establishing them;
  4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence;
  5. Incapacity to experience guilt or to profit from experience, particularly punishment;
  6. Marked readiness to blame others or to offer plausible rationalizations for the behavior that has brought the person into conflict with society.
Looking at the DSM-IV-TR criteria, it says three or more of the following should be met in order to be classified with the disorder. I'm going to take 3 from the 7 listed up there that I find least destructive.

2 - Deception - repeated lying - manipulating others for profit.
3- Impulsivity - failure to plan ahead
5- Reckless regard for safety of others and oneself.

When you read those 3 in one person, does a serial killer come to mind? To me, it doesn't. What I see here is a person in a white suit in a high corporation company. Think about it, the kid of some rich millionaire enjoying the party life:

He'd definitely deceive women to get into her pants.
Impulsive behavior - what does he care? He's got everything he needs. No regard or value whatsoever.
Fast driving, substance abuse, all for into part of the entertainment.

Now let me pick 1, 4 and 7.

1 - Rebellious attacks - can't seem to follow the law. Multiple acts that lead to arrest.
4-Irrability and aggressiveness - easily agitated - gets into physical fights
7-Lack of remorse - doesn't care who is hurt in the process.

What springs to mind? I see those thugs on the streets who hold up liquor stores. They just can't seem to function in society, they make up a large number of prison inmates too.

So as you can see, between those two eXamples. They're very similar and very different too. Imagine putting the rich anti social kid in a room with the thug?  That's what makes it unique - no two classifications are the same. Now imagine you have someone with 7/7 of those classified attributes. The results depends and I personally believe and I'll be sure to do a study on it in future is that it falls into 'Intelligence'. When you have a high degree of emotional and social intelligence, you tend to 'mask' your emotions better. Take two eXamples again - this time fully classified ASPD.

The first one has low emotional and social ASPD. I would deduce that this person may get away with things because as long as they eXhibit these traits, they'll still be able to retain some of their charm and manipulative techniques but not for long. If you can't hide your emotions, you've shown a breaking point. Therefore someone smarter than you will be able detect the game you're playing. If you 'tick' on every detail with an aggressive answer, you'll wind up in jail hence the large amount of inmates are classified ASPD but come from a background of poor education and supervision. These people are violent and dangerous and they're the type to take a blunt object and attack you with it, as long as it gets the job done.

For the second eXample with ASPD but this time with high emotional and social intelligence, you're not eXactly looking at some super villain although it is possible but I can't discuss this without going into psychopathy and sociopathy so I'll do my best to elucidate what I can. I would personally go with the white suit corporate leaders. With that much intelligence, it's quite simple to deceive others. They tend to go into positions which empowers them. What comes to mind is the main character from American Psycho or the Wolf of Wall Street. Please take note that doesn't mean you won't find them in other areas. You'll find most of them in the workforce that deals with people, even psychologists, teachers, politicians, doctors, lawyers etc Why is it that 4% of the priesthood are involved in crimes? Does that mean all Priests are evil? Absolutely not. They just outsmarted you by joining a 'workforce' whereby nobody would suspect this nice man of God who serves with honest people would ever do such a thing. Does this mean all business corporate leaders are evil? Absolutely not. Please take into account that ASPD is seen in 1-5% in the general population

Theodore Millon has listed subtypes within the disorder. Please take a look. 
I once told my professor that the disorders in Cluster B are not as concrete as the others. What I was trying to say is that you can finds bits of each symptom in Cluster B personalities in one another. You'd find borderline, histrionic and narcissistic personality disorder traits in Anti Social (and vice versa) 







The graph above works as a more advanced eXample than what I wrote above so I hope you can understand or at least get an idea of what I'm trying to convey. I could briefly describe each one for you but it would be prudent if you use your imagination. I'm sure we all know someone or seen a piece of art and literature that has a character with such traits.

Interestingly enough, ASPD shares multiple comorbid disorders

Comorbidity

The following conditions commonly coexist with ASPD:
 We've already stated Borderline, Histrionic and Narcissistic Personality disorder above. Ignore Sadistic Personality Disorder for now. The rest of them are not personality disorders but mental disorders that are usually found in this personality disorder, such as substance abuse (Tends to do drugs) and ADHD in which the precise science is fully yet to be known the relationship between ASPD and having ADHD disorder.

For now I won't go into the Neurological and Biological aspect of the disorder. I would love to talk about the brain and what neurotransmitters are involved that causes the person to have such a make up but I will leave that for the coming chapters. Please feel free to message me any questions regarding the disorder and take note my neXt blog post would continue with Sociopathy.