Behind Antisocial Personality Disorder

Antisocial Personality Disorder is characterized by aggression, impulsivity, and lack of empathy that can lead to criminal behavior.¹ Terms such as psychopathic and sociopathic are not used in formal diagnosing and is not in the DSM-IV-TR. Psychopathy was originally used to describe psychopathic inferiority. These terms are now referred to as antisocial personality disorder in the DSM-IV-TR. Although, psychopathy is commonly known as an extreme version of antisocial personality disorder. Antisocial personality disorder and psychopathy are sometimes used interchangeably. In order to diagnose someone with antisocial personality disorder, they need to be over the age of 18. If someone is showing characteristics of antisocial personality disorder like impulsivity and disregard for others under the age of 18, a diagnosis of conduct disorder would be needed.²

Like every other mental illness, antisocial personality disorder has treatment options. Currently, the treatment options include medication and therapy.

Treatment for antisocial personality disorder (and psychopathy)

• Cognitive behavioral therapy: CBT seeks to break down existing thought connections in which a trigger causes a harmful action by the creation of new connections with more positive outcomes.
• Antipsychotics: Since individuals with psychopathy can be violent and aggressive in their thoughts and actions, antipsychotic drugs may help to reduce the urge to harm others.
• Mood stabilizers: Mood stabilizers can reduce the agitation that can lead those with psychopathic tendencies to act violently.

Although antisocial personality disorder is nothing that can be changed, harm reduction and symptom management can improve quality of life.³

Culprits Behind Antisocial Personality Disorder

Antisocial personality disorder, like many other mental illnesses, has been thought to stem from genetic and environmental factors. Two genes in particular are overexpressed, RPL10P9 and ZNF132. RPL10P9 and ZNF132 are found to be expressed in the cerebellum.⁴ The cerebellum can play a role in the regulating social dominance and aggression.⁵

Environmental factors largely rely on being in an adverse environment. A study involving adopted children showed that an adverse adoptive home environment in addition to genetic factors can result in psychopathology. In a twin study on peer group norms, it was found that when aggression was favorable the genetic disposition was more likely to be expressed.⁶

Stigma

Those with antisocial personality disorder are thought of as monsters. They are often cast out from society. We see people with antisocial personality disorder in prison or death row. While these people are cast out, they are not given a chance to change. And once they are labeled as “psychopath,” they do not get a chance to live outside of that label. All of this is detrimental for the person’s quality of life. The life expectancy for someone with antisocial disorder is roughly 13 years earlier than those without antisocial personality disorder.⁷ Giving those a chance to receive treatment could possibly change this outcome.

Treatment around antisocial personality disorder is limited and the stigma around it may contribute to this problem. Current treatment has high rates of dropout. People with antisocial personality disorder tend to not take treatment seriously and lack understanding of their own condition.³ New treatments need to be explored to remedy this. Additionally, the threat antisocial personality disorder imposes on the general public due to the high rates of criminal activity in this disorder prove that treatment is important and it’s important to catch this early.

People with antisocial personality disorder must not be cast aside and be forgotten about. People with this disorder are still human and therefore must be treated with dignity and respect. They need a fighting chance to better themselves.

1. Tiihonen, J., Koskuvi, M., Lähteenvuo Markku, Virtanen, P. L. J., Ojansuu, I., Vaurio, O., Gao, Y., Hyötyläinen Ida, Puttonen, K. A., Repo-Tiihonen, E., Paunio, T., Rautiainen, M.-R., Tyni, S., Koistinaho, J., & Lehtonen Šárka. (2019). Neurobiological roots of psychopathy. Molecular Psychiatry, 25(12), 3432–3441. https://doi.org/10.1038/s41380-019-0488-z
2. Meyer, G. R., & Weaver, C. M. (2013). Case studies in abnormal behavior. Pearson Education, Inc.
3. Leeson, Cathy. (2022, October 13). What is a psychopath? Signs, causes, and treatment. Therapist.com. https://therapist.com/disorders/psychopathy/
4. Gene Cards: The Human Gene Database. (2023, March 21). RPL10P9 Gene – Ribosomal protein L10 pseudogene 9. https://www.genecards.org/cgi-bin/carddisp.pl?gene=RPL10P9#expression
5. Chen, C. H., Schott, A. L., & Schnaude, D. (2019). Cerebellar modulation of the reward circuitry and social behavior. Science, 363(6424). https://doi.org/10.1126/science.aav0581
6. Tuvblad, C., & Beaver, K. M. (2013). Genetic and environmental influences on antisocial behavior. Journal of criminal justice, 41(5), 273–276. https://doi.org/10.1016/j.jcrimjus.2013.07.007
7. Krasnova, A., Eaton, W. W., & Samuels, J. F. (2019). Antisocial personality and risks of cause-specific mortality: results from the Epidemiologic Catchment Area study with 27 years of follow-up. Social psychiatry and psychiatric epidemiology, 54(5), 617–625. https://doi.org/10.1007/s00127-018-1628-5