Antisocial Personality Disorder Treatment of Complicating Factors.
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Now, let's talk about alienated personalities. We're discussing a ataxia beginning in the Diagnostic and Statistical Manual beneath the array B of personality disorders. This array includes dramatic, emotional, and aberrant personalities.
Alienated personality ataxia is in the same array as narcissistic, borderline, and aureate personality disorders. It's characterized by several abeyant symptoms, such as consistently agreeable behavior that could advance arrest, lying, and impulsivity."
Irritability or aggression disregarding individual safety being irresponsibl and showing a lack of remorse in order to qualify for this diagnosis an individual has to be at least 18 years old
The symptoms of conduct disorder would have had to been present before the age of 15 also the symptoms can't exclusively appear during the course of schizophrenia or bipolar disorder.
So oftentimes we talk about the treatment of antisocial personality we hear this term complicating factors there's this idea that treating antisocial personalities were is difficult for a variety of reasons and evidence supports that this is true
That this is a difficult disorder to effectively treat now there are a number of reasons why this is the case and I'm going to go through a number of those reasons
here the first one we'll look at is the tendency of cluster B personality soresto have less severe symptoms as individuals grow older now we look at personality sores in general we know that cluster a and cluster C personality disorders tend to stay the same as individuals age or sometimes they get slightly more symptomatic cluster B personality sorters are the personality sores that tend to improve a little bit over time not in every case but sometimes and we can see this improvement in terms of symptom severity duration and frequency decreasing .
We can see sometimes a remission with antisocial personality sorter specifically we tend to see improvement in a number of cases
When somebody reaches their 40s another element is that the co morbidity associated with antisocial personality disorder is challenging oftentimes individuals
Who have this disorder have co morbid substance use disorders and oftentimes co morbid person is orders
Particularly the ones we see in cluster B so narcissistic borderline and histrionic so what this does is it confuses what's actually being treated and what's actually responding to the treatment in terms of symptom characteristics
so if an individual has antisocial person is order and substance use disorder and they're treated and the substance use disorder improves sometimes that presentation is recorded as an improvement overall even though the antisocial personalities wear characteristics may not have improved at all and of course the same thing applies to personality sorters
Another complicating factor is how improvement itself is measured now we know that with antisocial personality disorder a number of individuals with this disorder who received treatment or court-ordered to do so depending on the research you look at about 50 to 70 percent of male prisoners meet the full criteria for antisocial personality disorder so in the criminal justice system the interest may not be to try to improve all of the symptoms
we see with antisocial personality but specifically symptoms related to criminality so common treatment goals in prison settings for example would be reducing the likelihood that somebody would reoffending aggression decreasing substance use and again substance use is not a part of the symptom criteria of antisocial personality
rather just is often co morbid and we also see efforts to decrease impulsivity so in instances when those treatments are effective if they're only focused on reoffending aggression and substance use and impulsivity are.
They really capturing the construct of antisocial personality disorder if there is improvement across those domains does that translate to the full criteria of the disorder so how we measure improvement with antisocial personality disorder and what we focus on during treatment can actually be a complicating factor in successfully treating the symptoms of antisocial personalities orde
r another complicating factor is oftentimes with antisocial personality a lack of motivation and we know that for a number of mental disorders lack of motivation can be problematic in terms of receiving effective treatment and seeing a lot of improvement the last complicating factor .
I'll cover here is the relationship between mental health clinicians and clients who have antisocial personality disorder some of the characteristics we see associated with antisocial personality disorder can create bias on the side of the mental health treatment community including lack of empathy arrogance being opinionated being cynical and being callous these behavioral factors and a lack of experience and lack of training on the part of some mental health clinicians can result in the mental health clinicians being biased fearful or discouraged .
About how effective treatment will be this complicating factor as well as all the other complicating factors in terms of how we treat antisocial personality disorder are unfortunate
Because we know that antisocial personality disorder does seem to respond in some instances to treatment particularly if that treatment has a longer duration and if the mental health clinicians have experience treating that disorder yes antisocial personality sewer is challenging to treat
but it's not impossible to treat and we see some improvement of course as people age as I mentioned but the treatment can also be effective we need better research that's focused on the specific characteristics of antisocial personality sorter not just the co morbidity and not just the related characteristics like criminality
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