ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. F60
Although a dissocial personality disorder usually manifests itself in childhood, it is not always recognized as such. In adulthood, however, it is difficult to treat.Marian Grosser, PhysicianArticle overviewDissocial personality disorder
- Causes and risk factors
- Examinations and diagnosis
- Disease course and prognosis
Dissocial personality disorder: description
An antisocial personality disorder, also called antisocial personality disorder by professionals, is a serious and potentially dangerous disorder. Some sufferers are so irritable that a small disagreement can already animate them to commit acts of violence.
A dissocial personality disorder is already noticeable in childhood and adolescence. The children torture animals or bully their classmates. Even as adults, they have a heartless effect on their fellow human beings.
They do not fear consequences for their often irresponsible behavior. Even a punishment does not change your belief in being right. On the contrary, they are often guilty of the victims of the attacks themselves. An extremely low to completely missing empathy is characteristic of an antisocial personality disorder. Partnership is therefore a difficult topic. As a rule, the relationships of people with dissocial personality disorder do not last long.
However, people with this disorder are not only responsible for others, but also for themselves. They lack access to their feelings. They experience the world as monotonous and boring. Often, therefore, they tend to endanger themselves, for example, by frenzy in traffic or drug abuse to at least feel a certain kick. A dissocial personality disorder has many overlaps with psychopathy - especially the lack of empathy and is common to both disorders. However, psychopaths are usually good at concealing their anti-social attitudes - at first glance, they seem to be often, charming and well-dressed. In fact, they manipulate their environment and do not feel guilty about harming others.
Dissocial personality disorder: how many are affected?
In the general population, about three percent of men and one percent of women have a dissocial personality disorder. In prisons, this proportion is significantly higher. For example, more than half of maltreatment detainees were diagnosed with a dissocial personality disorder. However, not everyone who has a dissocial personality disorder will be delinquent.
Special form of psychopathy
Psychopathy is an extreme form of dissocial personality disorder. Those affected can act very manipulatively and are unable to empathize with others. They also do not feel guilty when they behave anti-social or against the law.
A psychopathy is often difficult to recognize, even for experts - especially as many sufferers hide the disorder well and pretend empathy to their fellow man. So far, psychopathy can not be adequately treated. In addition, those affected do not find themselves in need of treatment: they do not perceive their social behavior as disturbed.
Read more about this particularly manipulative form of dissocial personality disorder in the article Psychopathy.To the table of contents
Dissocial personality disorder: symptoms
There are certain symptoms that make a subsequent dissocial personality disorder likely. Children who steal, are aggressive, lie and are defiant to parents and teachers are at particular risk.
The dissocial personality disorder is diagnosed according to the International Classification of Mental Disorders (ICD-10) due to the following symptoms:
On the one hand, the general criteria of a personality disorder must be met. But what is a personality disorder? People with a personality disorder show traits and behaviors that differ significantly from social norms. Those affected are unable to adapt their behavior and get into conflict with their social environment.
Personality disorders develop as early as childhood. The full symptoms usually appear in early adulthood. It is important to distinguish whether the antisocial behavior is not the result of another mental disorder or damage to the brain.
In addition, at least three of the following characteristics and behaviors must be used to diagnose a dissocial personality disorder:
People with dissocial personality disorder
- behave heartlessly and are uninvolved with the feelings of others
- behave irresponsibly and disregard social norms, rules and obligations
- can not sustain lasting relationships, though it is easy for them to socialize
- have a low frustration tolerance and behave quickly aggressive and violent
- have no sense of guilt and are unable to learn from negative consequences, such as punishment
- tend to blame others or offer plausible explanations for their antisocial behavior
Dissocial personality disorder: causes and risk factors
The dissocial personality disorder develops from an interaction of biological factors and environmental influences. Since the dissocial personality disorder starts early, the parents as a role model and their educational methods have a significant impact on further development.
Dissocial personality disorder: biological causes
In identical pairs of twins, a dissocial personality disorder occurs more frequently in both siblings than in dizygotic twins. From this it can be deduced that the risk for a dissocial personality disorder is partially inherited.
Also the messenger substances in the brain have a significant influence on the behavior. For example, low levels of the happiness hormone serotonin are often associated with higher aggressiveness. Scientists have also discovered that the brain of people with dissocial personality disorder react differently to images of violence than the normal population. A small area of the outer layer of the brain, the so-called island cortex, is activated by pain perception and compassion with others. If you show people with dissocial personality disorder pictures in which other people are hurt, their island cortex is barely or not at all active.
Dissocial Personality Disorder: Psychosocial Causes
People with a dissocial personality disorder often report traumatic experiences in their childhood. As a result of these experiences, such as physical or mental abuse, people became insensitive to violence over time.
Certain familial features are also associated with later antisocial behavior. Children who have received little attention or whose parents already show antisocial behavior are more likely to develop a dissocial personality disorder. When parents pay little attention to the positive behavior of their children, but excessively punish small offenses, they increase their anti-social behavior. The children learn that they only get attention if they misbehave. If they are good, they are neglected.
Many people with dissocial personality disorder were also taught no moral values in childhood. They have not learned from their parents what is right and what is wrong. As a result, they have not internalized social norms. Already in childhood, they behave anti-social and aggressive towards humans and animals. With puberty, some enter a criminal career. They steal, commit arson and commit other violations of the law.
Children who are unrestrained and risk-taking, indifferent to others, and who have little compassion are more likely to develop a dissocial personality disorder. Even a reduced intelligence is considered a risk factor.To the table of contents
Dissocial personality disorder: examinations and diagnosis
Even though the disorder often develops in childhood and adolescence, the diagnosis "dissocial personality disorder" is usually made only from the age of 16 years. Children and adolescents are undergoing major changes in their development.
To rule out other causes of deviant behavior, the doctor will do some research. Blood and urine are examined to see if the behavior is due to drug use. Possible damage in the brain can exclude computed tomography (CT). With the help of X-rays, images of the brain can be taken in a computed tomography. Computed tomography is painless for the patient, but there is radiation exposure. In pregnancy, doctors do not perform CT to protect the child.
Antisocial personality disorder: test
Therapists or psychiatrists use questionnaires such as the Structured Clinical Interview (SKID) to diagnose dissocial personality disorder. The problem with the diagnosis of personality disorders is that those affected often know what the therapist wants to hear from them and respond accordingly. To still get a realistic picture of the person, therapists often ask the relatives for information.
The following questions could be posed by the therapist or psychiatrist: