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It is of importance to understand that millions of Americans often live with various types of mental illness, as well as mental health problems. The diagnosis of antisocial personality disorder and psychopathy can be said to have intrigued societies for centuries. There is a need to assess psychopathy and antisocial behavior in adult forensic population in order for treatment to start early (Maj, 2005). The serious mental illness, that occurs in antisocial behavior and psychopathy, incurs a lot of money. This paper is going to look at the case of psychopathy and anti-social disorder and why it should be assessed, and the turnaround it can bring to a case involving persons that have the disorder.
Early detection and intervention often reduce the toll of serious mental illness. In fact, it is of the essence to understand the different aspects of anti-social behavior and psychopathy in order to ensure that the signs are diagnosed in the population and the persons that suffer from the disorders are taken into account and treatment starts early (Horwitz¸ 2002). Therefore, it can be argued that the early detection, the assessment and the links with treatment and support can often prevent mental health problems for worsening, and they can be mitigated early in a responsible way. There will also be a reduction in crime in the society, given that the crime in the society at times has been associated with anti-social behavior and psychopathy amongst the persons.
Psychopathy and antisocial disorder are mental conditions and cannot be described as the fault of the person with the disorder. Therefore, it can be argued that there are times when the persons with the disorder might engage in crime and during the adjudicative process; there is a need to understand the different fundamentals of the disorder in order for the court to fully understand condition of the person (Morey, 2007). In fact, there are times where the person might be ruled for insanity and the court might argue that indeed the person at the time of the crime was not of sound mind and consequently, the person might be ruled that he was insane and cannot, therefore, be prosecuted. For example, a person, that had antisocial behavior and committed crime at time and was diagnosed with the antisocial behavior, might be treated as being insane and might not be prosecuted because of the crime.
There is a need to understand that an evaluation and assessment of for psychopathy and antisocial disorder is important, and it might be able to influence a case outcome. It is important to understand to assess the psychopathy and anti-social personality disorder schematics in order to ensure that the case outcome comes out in a just manner. If the persons, which committed a crime, are diagnosed to have a psychotic disorder, it can be argued then that the person was not of sound mind and consequently it might be said that he or she is insane (Morey, 2007). The availability of effective treatments as well as a better understanding of the basis of the disease is important as it often helps lessen the barriers that prevent early detection and brings an accurate diagnosis and the decision in order to seek medical treatment.
In conclusion, there is a need to understand that mental health of the persons is extremely important, and the courts should understand these disorders. Cases can turn around if a person is diagnosed with the disorder as it might mean that he was not of sound mind when he was committing a crime and consequently might be acquitted based on the disorders.
References
Morey, B., & Mueser, K. T. (2007). The family intervention guide to mental illness: Recognizing symptoms & getting treatment. Oakland, Calif: New Harbinger Publications
Horwitz, A. V. (2002). Creating mental illness. Chicago (Ill.: University of Chicago press.
Maj, M. (2005). Early detection and management of mental disorders. Chichester, West Sussex: J. Wiley.
The conventional research on the epidemiology indicates that there is a relationship between the use of alcohol and aggressive behavior. However, some of the research conducted seeking to discredit the claim states that some of the people have different behavior while under the influence of alcohol (Sutker & Albert et al 448). In this case, people that have antisocial personality disorder display increased aggression while under the influence of alcohol. This means that people suffering from the disorder are more likely to have the aggressive behavior compared to the people that do not have it. The research conducted on the people suffering from this disorder indicates that people with the disorder display high alcohol dependency among other signs. The disease poses a particular risk to the people that have it but attempt to find a working cure for the condition is futile. This paper will look at the disorder the way it manifests in most of the patient and the checklist of signs and symptoms that one should be on the lookout for when dealing with the disorder.
Antisocial personality disorder is probably the most easily behavioral complication to be diagnosed. The diagnoses that most of the practitioners make are also reliable. This could be partly because the disorder manifests itself in different ways. The practitioners look for when making the diagnosis for patients suffering from it many symptoms. However, despite the advancements made in research on the issue, there is no defined and known cure for the disorder. In fact, most of the people are of the opinion that the disorder is incurable (Compton et al. 22). However, some sections in the psychology fraternity still believe that the disorder is indeed curable. The arrival at the exact diagnosis is the key to the development of effective treatment approaches. The most important part of the diagnosis is making the determination of the extent at which the psychopathy of the patient has reached. This process is known as the diagnostic refinement.
People that display the antisocial personality disorder have a history of growing up in fractured families (Sutker & Albert et al 439). They may also come from a harsh parenting background. Since the parental care of most of people with the disorder is unstable, they may fall under the care of agencies. The most likely turn of events after the children go under the social services is that they form truant habits. They may indulge in substance abuse and form alliances with delinquents. The hardship that the patients of antisocial personality disorder face in their childhood and teenage years leads to difficult adulthood. Most of the people with the disorder end up dead out of their recklessness. This is a tendency of the people being incarcerated.
Criminal activity plays a central role in the definition of antisocial personality disorder. However, the criminal tendencies are because of the difficulties that the patients face in their formative years. The difficulties that they face are on the following spheres; socioeconomic and family issues. Therefore, there is more to the antisocial personality disorder than criminal tendencies. If the assumption that the criminal tendencies of a person are the qualifying criteria for a patient of antisocial personality disorder, all the incarcerated people would fit the definition. This assumption would also pose a certain condition whereby the people without any criminal history would be rarely diagnosed with the condition. The representations made from the criteria would be fallacies. In the real sense, the criminals with the disorder are slightly higher than the law-abiding people suffering from the same (Sutker & Albert et al 442).
The diagnosis of people with the disorder does not take place until the person attain the majority age, however, the tendencies of the disorder may come out early in the development of the child. There is a requirement for the history of the disorder before the attainment of the age of 15. The course followed by people with the disorder is variable. Some patients recover over time. Others may continue with the personal and social difficulties. The disorder is usually associated with depression, substance abuse and heightened anxiety. The caregivers or families of patients suffering from the disorder play a pivotal role in the prevention of aggravation and care of patients suffering from the disorder (Sutker & Albert et al 445).
In the earlier days, the traditional approach used in referring to the antisocial disorder was by linking it to the term psychopathy or the psychopathic personality. This approach was distinguished since it attended to both the indicators of the antisocial behavior and the personality traits. In the second aspect, it referred to the callous way that a person suffering from the disorder treated other people (Dolan & Park 422). This means the total disregard of the feeling that other people may be having. The approach led to the development of 20 characteristics that are bound to feature in the people that suffer from the disorder. The checklist is a one-dimensional scale used in observing the patient suffering from the disorder.
After coming up with a correct diagnosis of the antisocial personality disorder or after the antisocial traits in a person are, not in accordance with the threshold for making the diagnosis the degree of severity of the disorder depends on PCL-R screening. The research findings available indicate that the people that of all the people that have the antisocial personality disorder only one in three has severe psychopathy.
People suffering from antisocial personality disorder may display the following symptoms. They tend to have a superficial charm. The charm does not come from their convictions, and it is made to suit the occasion. The other aspect that the patients display is the exaggerated feeling that they have a lot of self-worth. This means that they have a tendency of feeling that they are more important in society than their peers are. They are also indicative of the high need of stimulation from a given source. This aspect means that if they are left on their own they are most likely bound to develop some boredom. The antisocial personality disorder patients are also pathological liars.
They lie in order for them to maintain their perceived sense of importance in the society (De Brito & Hodgin 132). The people also tend to display intense manipulative tendencies. The sense of self-worth makes the antisocial personality disorder patients tot develop immunity to guilt. They know that they are right in their minds. This means that they do not have anything to feel guilty of despite the reality indicating that they ought to have the feeling. They have shallow affect. This means that their relationships are not well rooted.
They tend to sustain short relationships with people. This sign make most of the patient have unstable lives with many short-lived interactions. They may adopt a parasitic lifestyle where they rely on other people without contributing adequately or at all. The patient may also indicate erratic behavior. In some of the cases, the patients may be displaying opposite behavior to another time. The patient is also promiscuous (Hill 11). The patient may start indicating early behavioral problems. The children that have the disorder are generally problematic. The erratic behavior makes the patients suffering from the disorder to lack long-term plans that are tangible or realistic.
The patients also display an uncanny tendency of being impulsive. They act on the feelings and not well thought plans. These people are the ones that have the highest levels of irresponsibility (Loeber & Burke et al 30). The signs of the irresponsible nature may start displaying themselves as early as when they are toddlers. The grandiose feeling of self-worth makes the patient has a tendency of not taking responsibility for their actions and they chose to shift the blame to other people. The people suffering from the antisocial personality disorder have the likelihood of committing crimes owing to their unstable nature.
In the case of the antisocial personality disorder, there are not empirical findings on the treatment of the disorder of psychopathy. The said treatment that people claim to have is not demonstrated to be effective at all. However, the findings do not indicate that the hypothesis that the condition is beyond the control of the medical fraternity.
However, studies in juvenile delinquency have found out that there is a positive effect in the treatment of the delinquents (Loeber & Burke et al 27). The most valuable treatment applied to the delinquents place their basis on the skills and behavior. Treatment for the delinquent targets the high offenders in the society. Research on the effectiveness of the treatment on adults indicates that when the program is well designed and implemented, there is a high chance that it will reduce the probability of recidivism. The programs that target the patient with high risk of offending are the most effective ones. The focus on the need and the responsively also plays a crucial role in determining the effectiveness of the programs (Ogloff 525).
A deep look into the patients suffering from the condition indicates that patients have a high level of resistance to hospitalization. However, the prognosis for the disorder may be improved if there is a condition that can be treated such as an anxiety and a depression. Patients suffering from the antisocial personality disorder also indicate a low response to alcohol rehabilitation and other rehabilitation programs compared to the patients that do not have the condition (Ogloff 525). The development of a helping alliance between the patient with the antisocial personality disorder and a psychotherapist is crucial in the development of a like able outcome.
The impulsive tendencies in the male patients emanate from the low blood glucose, high concentration of testosterone and low reactivity in stress moments. Criminals that have the antisocial personality disorder suffer from the most severe form of the disorder. These individuals are generally un treatable in the legal and clinical sense. However, in some cases, few patients may be referred for treatment. Studies also show that the psychopathic criminals have a high tendency of forming violent recurrences than the prisoners that are untreated this phenomenon is known as the negative treatment effect. Further inquests into the bizarre indication of behavior do not explain why treatment of psychopathy and the antisocial personality disorder leads to the negative treatment effect.
Often, psychopathic criminals do not have anxiety or worry as the non-psychopathic criminals. Psychopaths are craftier when it comes to avoiding the forms of punishment met to them than the normal criminals. However, there is a weak relationship between the self-reports of fear and psychopathy. Anxiety is a crucial element in any correlation health treatment that uses interpersonal approaches (Sutker & Albert et al 445). The reason behind this factor is that it indicates the capacity for the object; it may also be an indicator of other affects in the patient. As the degree of psychopathy increases in patients with antisocial personality disorders, the level of anxiety reduces significantly. The level of the psychopathy also chances the personal discomfort leading to the ultimate motivation of the patient to change.
Attachment is the capacity of people to form bonds with others. The emotional bonds formed by the patient that have severe psychopathic criminals are fewer than the ones formed by mildly psychopathic patients. This finding is in agreement with the contemporary clinical literature that describes the psychopaths as people with a chronical detachment. The level of detachment that the patient varies with the degree of antisocial personality disorder. The ability of the patient to form a relationship with the therapist is an indicator of attachment. This is a marker in the treatment of patients with the disorder (Ogloff 525).
In cases where there is no emotional attachment, the treatment procedures that rely on the presence of emotional relationship between the patients will end up flopping. Such treatment fails since the patient does not have any empathy for the therapist. Absence of empathy towards any person is a major motivation in psychopaths for aggression towards him or her. If a patient relates based on power and not the affect, then the level of psychopathy is high.
Narcissism
Psychopaths are aggressive narcissists. In the clinical setting, the more the disturbance in patients with antisocial personality disorders, the higher the chances that the aggressive devaluation will feature as a tool used by the patient. They use the aggression to increase the feelings of grandiosity. They may also indicate the aggression in order to mend the emotional wounds. To some of the patients, the behavior that they indicate is utterly defensive. On the other hand, in other patients, there is no core sense of injured self. The actions of narcissism may range from subtle abuse to rate or even murder of the defenseless (Lorenz & Newman 513). The behavioral denigration is also crucial in the differentiation between the narcissistic patients from the psychopathic patient. Even though the patient with the narcissistic personality disorder has a high tendency of being self-absorbed and grandiosity, the level of attachment and anxiety makes them better candidates for treatment than the psychopaths (Black 25).
On top of the increased behavior of the psychopaths to devalue other people, the degree of psychopathy determines the extent at which the patient will tend to be manipulative. The feeling that the people around him or her are under his control makes the patient have heightened tendencies of grandiose behavior since there is a feeling of power that comes with the control. The feeling also makes the patient ward off any fear that he has of being under the control of other forces that are beyond him. Whenever the feeling of grandiosity is under a challenge, most of the mild psychopaths end up falling into periods of anxiety and depression (Loeber & Burke et al 27).
Psychological defenses
Patients suffering from the antisocial personality disorders that have severe psychopathy use the following defenses: projection, denial, omnipotence, projective identification and devaluations. The projective identification is where the patient accords the clinician or any person taking care of him with negative traits (Hill 13). After branding the clinician, the patient attempts to exert control over the clinician with overt or covert intimidation. The aspects that the patients have are seen in the clinician, and it becomes a threat that must be diminished.
The higher levels of defenses such as idealization and isolation are virtually absent in patients suffering from antisocial personality disorder. The people that have the characteristic express their internal experiences with thoughtful considerations and not by impulse.
Objects relationship
The representations of self-made by the severely psychopathic patients are usually aggressive. The patients see themselves as being larger than life itself. They are legends in their minds. The representation of other people is not as grandiose as the one that they use for themselves (Dolan & Park 423). The other people are not meaningful. They do not deserve any respect or empathy. They are objects that he has to dominate for his own gain. The patients that have antisocial personality disorder with mild psychopathic relationship may view themselves as unappreciated. The grandiosity that they have is defensive. They are also susceptible to being harmed.
Affects
The patients display these emotions. The emotions displayed by patients with antisocial disorder lack the subtlety and modulation that is common in the normal people (De Brito & Hodgin 136). The people with the disorder appear to be living in a world that is pre-socialized. The feelings that the patients experience are in relation to themselves and no other members of the society. They lack the ability to have some emotions such as the reciprocal pleasure or mutual eroticism.
The dysfunction of the affections in patients with psychopathic tendencies comes out in the inability of patients to understand the emotional connotations in the words (Compton et al. 52). In cases where the patient with antisocial personality disorder also has severe psychopathy, they will also have limited ability to acknowledge the emotions of the clinicians. They do not develop empathy towards him or her, and they may never end up divulging any true aspect of their life.
In conclusion, antisocial personality disorder is the most easily diagnosed psychological disorder. Patients that have it display some set of behavior that is coded as the identifier for the disorder in the hospitals (Black 45). Some of the symptoms that the patients display include, grandiose, aggressiveness, exaggerated feeling of self-worth, lack of remorse, inability to take responsibility for their actions, manipulative tendencies, a high knack for being pathological liars, lack of remorse for the action that they did despite the nature of the actions, shallow affects and lack of empathy to other people.
The affect that the patients display are directed towards themselves. Most of patients suffering from the antisocial personality disorder are unable to form a relationship with other people. Criminals indicate a higher rate of the disorder than other people do. This is not to mean that the criminals are the only ones with the disorder just that they have a high prevalence. There is no identifiable method of treating the disorder.
References
Black, Donald W. "Antisocial Personality Disorder." Corsini Encyclopedia of Psychology (2007).
Cale, Ellison M., and Scott O. Lilienfeld. "Sex differences in psychopathy and antisocial personality disorder: A review and integration." Clinical psychology review 22.8 (2002): 1179-1207.
Compton, Wilson M., et al. "Prevalence, correlates, and comorbidity of DSM-IV antisocial personality syndromes and alcohol and specific drug use disorders in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions." Journal of Clinical Psychiatry (2005).
De Brito, Stephane A and Sheilagh Hodgins. "Antisocial personality disorder." Personality, personality disorder and violence, 42. (2009): 133--153. Print.
Dolan, Mairead, and Isabelle Park. "The neuropsychology of antisocial personality disorder." Psychological Medicine 32.3 (2002): 417-427.
Hill, Jonathan. "Early identification of individuals at risk for antisocial personality disorder." The British Journal of Psychiatry 182.44 (2003): s11-s14.
Loeber, Rolf, Jeffrey D. Burke, and Benjamin B. Lahey. "What are adolescent antecedents to antisocial personality disorder?." Criminal Behaviour and Mental Health 12.1 (2002): 24-36.
Lorenz, Amanda R., and Joseph P. Newman. "Utilization of emotion cues in male and female offenders with antisocial personality disorder: Results from a lexical decision task." Journal of Abnormal Psychology 111.3 (2002): 513.
Ogloff, James RP. "Psychopathy/antisocial personality disorder conundrum."Australian and New Zealand Journal of Psychiatry 40.6-7 (2006): 519-528.
Sutker, Patricia B., and Albert N. Allain Jr. "Antisocial personality disorder."Comprehensive handbook of psychopathology. Springer US, 2002. 445-490.
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