Antisocial personality disorder criteria

Psych CentralPersonality Disorders Test

Based upon the Diagnostic & Statistical Mental of Mental Disorders, 5th Edition

Some people are concerned that they may have a personality disorder — a pervasive pattern of thoughts and behaviors that significantly impact the way a person relates to others and the world around them.

Our personality disorders test is meant to examine your agreement with symptoms associated with the 10 recognized personality disorders. Personality disorders are different than your core personality. Your personality is made up of different facets that can be measured by a personality test. Everyone has a personality, but not everyone has a personality disorder.

Typically, general personality tests measure five factors: extraversion, agreeableness, conscientiousness, emotional stability (also referred to as “neuroticism”), and intellect/imagination (also referred to as “openness”). Please remember that these are only personality traits or preferences — they do not predetermine every action you prefer in every situation. This test does not measure these aspects. Rather, it measures dysfunctional behavior that is symptomatic of a more serious concern, such as a personality disorder.

This test consists of just 80 questions and takes about 10 minutes for most people to complete. Answer as many questions as you can to get the most accurate score possible. Your answers are held in strictest confidence and are not shared with anyone. At the end of the test, you will receive a free, comprehensive report about your vulnerability to having symptoms associated with a personality disorder.

First, let’s get started with some basic demographic information about you…

Personality Disorder Test

This test, sponsored by 4degreez.com, is meant to help determine whether or not you have a personality disorder. It is not meant to be used as a diagnostic tool, but rather as a tool to give you insight into a potential disorder that may be having a negative impact on your life. If you believe you may be suffering from a personality disorder or any other disorder, you should ask your family doctor to recommend a therapist in your area to meet with.

In addition to this personality test we have psychology forums to discuss issues with other visitors.

First, what is a personality disorder?

A personality disorder is basically a set of traits that combine to negatively affect your life. They have a wide range of causes and some are easier to treat than others. This test is set up to look for the ten recongized personality disorders which are Paranoid, Schizoid, Schizotypal, Antisocial, Borderline, Histrionic, Narcissistic, Avoidant, Dependent, and Obsessive-Compulsive.

Once again, this test is not meant to be used as a diagnostic tool. Only a trained professional can properly diagnose a personality disorder.

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Sociopath

ASPD is part of a category of personality disorders characterized by persistent negative behaviors.

The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) says that someone with ASPD consistently shows a lack of regard for others’ feelings or violations of people’s rights. People with ASPD may not realize that they have these behaviors. They may live their entire lives without a diagnosis.

To receive a diagnosis of ASPD, someone must be older than 18. Their behaviors must show a pattern of at least three of the following seven traits:

  1. Doesn’t respect social norms or laws. Theyconsistently break laws or overstep social boundaries.
  2. Lies, deceives others, uses false identities or nicknames, and uses others for personal gain.
  3. Doesn’t make any long-term plans. They also often behave without thinking of consequences.
  4. Shows aggressive or aggravated behavior. They consistently get into fights or physically harm others.
  5. Doesn’t consider their own safety or the safety of others.
  6. Doesn’t follow up on personal or professional responsibilities. This can include repeatedly being late to work or not paying bills on time.
  7. Doesn’t feel guilt or remorse for having harmed or mistreated others.

Other possible symptoms of ASPD can include:

  • being “cold” by not showing emotions or investment in the lives of others
  • using humor, intelligence, or charisma to manipulate others
  • having a sense of superiority and strong, unwavering opinions
  • not learning from mistakes
  • not being able to keep positive friendships and relationships
  • attempting to control others by intimidating or threatening them
  • getting into frequent legal trouble or performing criminal acts
  • taking risks at the expense of themselves or others
  • threatening suicide without ever acting on these threats
  • becoming addicted to drugs, alcohol, or other substances

Other ways to diagnose ASPD include:

  • evaluating the person’s feelings, thoughts, behavioral patterns, and personal relationships
  • talking to people close to the person about their behaviors
  • evaluating a person’s medical history for other conditions

ASPD can be diagnosed in someone as young as 15 years old if they show symptoms of a conduct disorder. These symptoms include:

  • breaking rules without regard for the consequences
  • needlessly destroying things that belong to themselves or others
  • stealing
  • lying or constantly deceiving others
  • being aggressive toward others or animals

16 questions doctors use to figure out if you’re a sociopath

One of the best books about sociopathy is “Confessions of a Sociopath; A Life Spent Hiding in Plain Sight,” written by pseudonymous author M.E. Thomas. She describes what it’s like to be a sociopath — someone who lacks the ability to feel or sympathize with others.

Sociopaths can be sexy and beguiling; they take risks the rest of us don’t and come across as bold and exciting. Socially, they are often leaders, the life-and-soul of the party.

The downside is that they regard others as objects to be used, don’t feel sympathy, empathy or guilt, and are one step away from becoming criminally vindictive types whose only motivation is to take advantage of weaker people.

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Psychologists have changed the definition of sociopathy several times over the decades. It used to be called being a “psychopath.” Sociopath is the newer term. The first researcher to name the concept of psychopathy was Dr. Hervey Cleckley in 1941. Cleckley noted that psychopathy was difficult to diagnose precisely because it presents itself without the obvious symptoms of mental disorder. Psychopaths and sociopaths are often a bit too rational.

Here are Cleckley’s 16 characteristics. Ask yourself if they apply to you.

1. Are you superficially charming and intelligent?

(Answer: For sociopaths, the answer to this question is yes.)

2. Do you have delusions or other signs of irrational thinking?

(A: For sociopaths, the answer is no. They’re super-rational, coldly so.)

3. Are you overly nervous, or do you have other neuroses?​

(A: Sociopaths are rarely nervous or anxious. They aren’t scared of risk.)

4. Are you reliable?​

(A: Sociopaths are unreliable.)

5. Do you tell lies or say insincere things?

Netflix/”Liar Liar”

6. Do you feel remorse or shame?

(A: Sociopaths rarely feel guilt.)

7. Is your behavior anti-social for no good reason?

(A: Sociopaths may have “inadequately motivated antisocial behavior,” according to Cleckley.)

8. Do you have poor judgment, and fail to learn from experience?

(A: Sociopaths think they’re smarter than everyone else, but they take risks the rest of us would not and don’t learn from punishment.)

9. Are you pathologically egocentric, and incapable of love?​

(A: Sociopaths are.)

10. Do you generally lack the ability to react emotionally?

(A: Sociopaths don’t experience emotions the way the rest of us do.)

11. Do you lack insight?

(A: Sociopaths aren’t self-reflective or meditative.)

12. Are you responsive to others socially?

(A: Interestingly, sociopaths often have to fake their reactions and responses to the rest of us in order to get through their days without being “spotted.”)

13. Are you a crazy party fiend?

(A: Sociopaths engage in “fantastic and uninviting behavior with drink and sometimes without,” Cleckley says. Thomas adds that sociopaths often crave (meaningless) sex more than the rest of us, too.)

14. Do you make false suicide threats?

(A: Yep, sociopaths are drama queens.)

15. Is your sex life impersonal, trivial or poorly integrated?

(A: Sociopaths lack the ability to love.)

16. Have you failed to follow a life plan?

(A: Sociopaths have difficulty holding down jobs. It requires long-term obligations to others.)

There’s no surefire way of self-diagnosing yourself as a sociopath, as sociopaths also tend to lie in tests like these.

But if you recognised yourself or others in these questions, you might want to seek professional help.

Many sociopaths do not want to end up in prison, or as psychotic outcasts. They can use their skills to be successful in business, in ways that less single-minded people cannot.

They’re just not your friends, is all.

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Differences Between a Psychopath vs Sociopath

Society has conspired with Hollywood to put two seemingly-sexy psychology terms into our collective consciousness — psychopath and sociopath. Psychopath and sociopath are pop psychology terms for what psychiatry calls antisocial personality disorder. These two terms are not well-defined in the psychology research literature — hence the confusion about them.

Nonetheless, there are some general similarities as well as differences between these two personality types. Both sociopaths and psychopaths have a pervasive pattern of disregard for the safety and rights of others. Deceit and manipulation are central features to both types of personality. Contrary to popular belief, a psychopath or sociopath is not necessarily violent.

The common features of a psychopath and sociopath lie in their shared diagnosis — antisocial personality disorder. The DSM-51 defines antisocial personality as someone have 3 or more of the following traits:

  1. Regularly breaks or flouts the law
  2. Constantly lies and deceives others
  3. Is impulsive and doesn’t plan ahead
  4. Can be prone to fighting and aggressiveness
  5. Has little regard for the safety of others
  6. Irresponsible, can’t meet financial obligations
  7. Doesn’t feel remorse or guilt

In both cases, some signs or symptoms are nearly always present before age 15. By the time a person is an adult, they are well on their way to becoming a psychopath or sociopath.

Traits of a Psychopath

Psychology researchers generally believe that psychopaths tends to be born — it’s likely a genetic predisposition — while sociopaths tend to be made by their environment. (Which is not to say that psychopaths may not also suffer from some sort of childhood trauma.) Psychopathy might be related to physiological brain differences. Research has shown psychopaths have underdeveloped components of the brain commonly thought to be responsible for emotion regulation and impulse control.

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Psychopaths, in general, have a hard time forming real emotional attachments with others. Instead, they form artificial, shallow relationships designed to be manipulated in a way that most benefits the psychopath. People are seen as pawns to be used to forward the psychopath’s goals. Psychopaths rarely feel guilt regarding any of their behaviors, no matter how much they hurt others.

But psychopaths can often be seen by others as being charming and trustworthy, holding steady, normal jobs. Some even have families and seemingly-loving relationships with a partner. While they tend to be well-educated, they may also have learned a great deal on their own.

When a psychopath engages in criminal behavior, they tend to do so in a way that minimizes risk to themselves. They will carefully plan criminal activity to ensure they don’t get caught, having contingency plans in place for every possibility.

Psychopath Pop Culture Examples: Dexter, Anton Chigurh in No Country for Old Men, Henry in Henry: Portrait of a Serial Killer, Patrick Bateman in American Psycho

Traits of a Sociopath

Researchers tend to believe that sociopathy is the result of environmental factors, such as a child or teen’s upbringing in a very negative household that resulted in physical abuse, emotional abuse, or childhood trauma.

Sociopaths, in general, tend to be more impulsive and erratic in their behavior than their psychopath counterparts. While also having difficulties in forming attachments to others, some sociopaths may be able to form an attachment to a like-minded group or person. Unlike psychopaths, most sociopaths don’t hold down long-term jobs or present much of a normal family life to the outside world.

When a sociopath engages in criminal behavior, they may do so in an impulsive and largely unplanned manner, with little regard for the risks or consequences of their actions. They may become agitated and angered easily, sometimes resulting in violent outbursts. These kinds of behaviors increase a sociopath’s chances of being apprehended.

Sociopath Pop Culture Examples: The Joker in The Dark Knight, JD in Heathers, Alex Delarge in A Clockwork Orange

Who is More Dangerous?

Both psychopaths and sociopaths present risks to society, because they will often try and live a normal life while coping with their disorder. But psychopathy is likely the more dangerous disorder, because they experience a lot less guilt connected to their actions.

A psychopath also has a greater ability to dissociate from their actions. Without emotional involvement, any pain that others suffer is meaningless to a psychopath. Many famous serial killers have been psychopaths.

Not all people we’d call a psychopath or sociopath are violent. Violence is not a necessary ingredient (nor is it for a diagnosis of antisocial personality disorder) — but it is often present.

Clues to a Psychopath or Sociopath in Childhood

Clues to psychopathy and sociopathy are usually available in childhood. Most people who can later be diagnosed with sociopathy or psychopathy have had a pattern of behavior where they violate the basic rights or safety of others. They often break the rules (or even laws) and societal norms as a child, too.

Psychologists call these kinds of childhood behaviors a conduct disorder. Conduct disorders involve four categories of problem behavior:

  • Aggression to people and animals
  • Destruction of property
  • Deceitfulness or theft
  • Serious violations of rules or laws

If you recognize these symptoms (and the specific symptoms of conduct disorder) in a child or young teen, they’re at greater risk for antisocial personality disorder.

Summary

Psychopathy and sociopathy are different cultural labels applied to the diagnosis of antisocial personality disorder. Up to 3 percent of the population may qualify for a diagnosis of antisocial personality disorder. This disorder is more common among males and mostly seen in people with an alcohol or substance abuse problem, or in forensic settings such as prisons. Psychopaths tend to be more manipulative, can be seen by others as more charming, lead a semblance of a normal life, and minimize risk in criminal activities. Sociopaths tend to be more erratic, rage-prone, and unable to lead as much of a normal life. When sociopaths engage in criminal activity, they tend to do so in a reckless manner without regard to consequences.

Differences Between a Psychopath vs Sociopath

Footnotes:

  1. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the reference manual that defines the symptoms of mental disorders.

Diagnostic criteria for 301.7 Antisocial Personality Disorder

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) deceitfulness, as indicated by repeated 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.

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Copyright 2000 American Psychiatric Association

How Antisocial Personality Disorder Is Diagnosed

Diagnosis Based on DSM-5 Criteria

The criteria for antisocial personality disorder in the DSM-5, the most recent edition, is more complex and nuanced. It also removes the requirement for evidence of conduct disorder before age 15. The DSM-5 defines a person with antisocial personality disorder as someone at least 18 years old who meets five other criteria:

1. Poor Individual and Interpersonal Functioning

The person must have problems with how they function as an individual and with how they interact with other people.

To show poor functioning as an individual, they may be egocentric and base their self-esteem on personal gain, power, or pleasure. Or they set goals based on how good it will make them feel without regarding its impact on others. They do not have an internal motivation to follow social rules, laws, or cultural ethics.

A person meets the criteria for poor interpersonal functioning by showing a lack of empathy or lack of intimacy with others. They demonstrate a lack of empathy by showing no concern for others’ feelings, needs, or suffering, and they lack remorse after hurting someone else.

Or their intimacy deficit makes them incapable of developing intimate relationships with others. Instead, they manipulate, exploit, or control others for personal gain by lying, intimidating others, and forcing others to do what they want.

2. Antagonism and Disinhibition

To meet the second criteria, a person must have two specific personality traits: antagonism and disinhibition.

They demonstrate antagonism by being manipulative, deceitful, callous, and hostile toward others. Their manipulativeness may involve using their charm or wit to seduce or control others to meet some goal for themselves.

Deceitfulness shows up in frequent lying to others or exaggeration about themselves. They may make things up when telling a supposedly true story, for example.

Callousness refers to showing no concern about others’ feelings or problems and not feeling guilt or remorse if their actions harm someone else. They may be aggressive or even sadistic, taking pleasure in other people’s pain.

Hostility refers to being frequently angry or irritable and seeking revenge for even minor insults or accidental harm from others.

A person with antisocial personality disorder demonstrates disinhibition through irresponsibility, impulsivity, and risk-taking. They may break promises or fail to meet financial, employment, personal, or social obligations, and they do not feel remorse for these actions.

They act spontaneously without thinking or caring about the possible consequences of their actions or without a plan to deal with those consequences.

They engage in dangerous activities that may harm themselves or others but without concern about the possible consequences. They may do so out of boredom, to prove that they are capable of doing something especially risky, or because they are in denial about their limitations.

In addition to the two criteria above, a person must meet all three of the following criteria to receive a diagnosis of antisocial personality disorder:

3. Consistent Behavior Across Time and Situations

Their problems with personal and interpersonal functioning described above have occurred throughout their life in all situations. Their problems do not go away for certain periods or in certain situations.

4. No Other Psychological, Social, or Cultural Explanation

Their personality problems and difficulties in interpersonal relationships are not otherwise explained by their stage of psychological development or by their social or cultural environment. If it would be normal for them to display these problems or characteristics based on their mental development or the social or cultural situation they live in, they would not meet this requirement.

5. Behavior Not Caused by Substance Abuse or Medical Disorder

Their problems are not a result of physical effects from drugs, alcohol, or another substance, and they are not a result of another medical condition, such as head trauma or another mental disorder.

Psychopathy and Antisocial Personality Disorder: A Case of Diagnostic Confusion

A Secret Service agent recently asked if I was familiar with a 1992 FBI report that almost half of the killers of law enforcement officers met the criteria for antisocial personality. I replied that I had not seen the report but that the finding did not seem surprising or noteworthy to me. My comment was based on the assumption that the report had used antisocial personality as a synonym for antisocial personality disorder (ASPD), a category listed in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and applicable to the majority of criminals.

However, the agent explained that the description of the killers in question indicated to him that they matched the profile of the psychopath defined by the Psychopathy Checklist-Revised (Hare 1991). When I later saw a copy of the FBI report, I realized that he was correct in his assessment and that the report’s findings were indeed noteworthy and chilling, particularly for law enforcement officers.

The killers’ characteristics referred to as antisocial personality in the FBI report were as follows: sense of entitlement, unremorseful, apathetic to others, unconscionable, blameful of others, manipulative and conning, affectively cold, disparate understanding of behavior and socially acceptable behavior, disregardful of social obligations, nonconforming to social norms, irresponsible. These killers were not simply persistently antisocial individuals who met DSM-IV criteria for ASPD; they were psychopaths- remorseless predators who use charm, intimidation and, if necessary, impulsive and cold-blooded violence to attain their ends.

The distinction between psychopathy and ASPD is of considerable significance to the mental health and criminal justice systems. Unfortunately, it is a distinction that is often blurred, not only in the minds of many clinicians but in the latest edition of DSM-IV.

Source of the Problem

Traditionally, affective and interpersonal traits such as egocentricity, deceit, shallow affect, manipulativeness, selfishness, and lack of empathy, guilt or remorse, have played a central role in the conceptualization and diagnosis of psychopathy (Cleckley; Hare 1993; in press); Widiger and Corbitt). In 1980 this tradition was broken with the publication of DSM-III. Psychopathy-renamed antisocial personality disorder- was now defined by persistent violations of social norms, including lying, stealing, truancy, inconsistent work behavior and traffic arrests.

Among the reasons given for this dramatic shift away from the use of clinical inferences were that personality traits are difficult to measure reliably, and that it is easier to agree on the behaviors that typify a disorder than on the reasons why they occur. The result was a diagnostic category with good reliability but dubious validity, a category that lacked congruence with other, well-established conceptions of psychopathy. This “construct drift” was not intentional but rather the unforeseen result of reliance on a fixed set of behavioral indicators that simply did not provide adequate coverage of the construct they were designed to measure.

The problems with DSM-III and its 1987 revision (DSM-III-R) were widely discussed in the clinical and research literature (Widiger and Corbitt). Much of the debate concerned the absence of personality traits in the diagnosis of ASPD, an omission that allowed antisocial individuals with completely different personalities, attitudes and motivations to share the same diagnosis. At the same time, there was mounting evidence that the criteria for ASPD defined a disorder that was more artifactual than “real” (Livesley and Schroeder).

Psychopathy Checklist

Coincident with the publication of DSM-III in 1980, I presented some preliminary findings on efforts to provide researchers with an operational definition of psychopathy in offender populations (Hare 1980). During the next decade those early efforts evolved into the Hare Psychopathy Checklist-Revised (PCL-R) (Hare 1991), a 20-item construct rating scale that uses a semi-structured interview, case-history information and specific diagnostic criteria for each item to provide a reliable and valid estimate of the degree to which an offender or forensic psychiatric patient matches the traditional (prototypical) conception of the psychopath (Fulero; Stone). Each item is scored on a 3-point scale (0, 1, 2) according to the extent to which it applies to the individual. The total score can range from 0 to 40, with between 15 percent and 20 percent of offenders receiving a score of at least 30, the cutoff for a research diagnosis of psychopathy. To put this into context, the mean scores for offenders in general and for noncriminals typically are around 22 and 5, respectively.

A 12-item version of the PCL-R was developed for use in the MacArthur Foundation study on the prediction of violence in the mentally disordered (Hart and others 1994). Published in 1995 as the Hare Psychopathy Checklist: Screening Version (PCL:SV) by Hart and colleagues, it is highly correlated with the PCL-R and is used both to screen for psychopathy in forensic populations and as a stand-alone instrument for the assessment of psychopathy in noncriminal populations. The PCL:SV formed the basis for the psychopathic personality disorder items used in the DSM-IV field trial for ASPD.

The items fall into two clusters: One cluster, referred to as Factor 1, reflects core interpersonal and affective characteristics; the other cluster, Factor 2, consists of items that reflect a socially deviant and nomadic lifestyle. The similarity between these factors and the behaviors and characteristics described above in the FBI report are obvious.

Most psychopaths (with the exception of those who somehow manage to plow their way through life without coming into formal or prolonged contact with the criminal justice system) meet the criteria for ASPD, but most individuals with ASPD are not psychopaths. Further, ASPD is very common in criminal populations, and those with the disorder are heterogeneous with respect to personality, attitudes and motivations for engaging in criminal behavior.

As a result, a diagnosis of ASPD has limited utility for making differential predictions of institutional adjustment, response to treatment, and behavior following release from prison. In contrast, a high PCL-R score depends as much on inferred personality traits as on antisocial behaviors, andwhen used alone or in conjunction with other variableshas considerable predictive validity with respect to treatment outcome, institutional adjustment, recidivism and violence (Hare 1991; Harris and others; Hart and Hare, in press).

For example, several studies have found that psychopathic offenders or forensic psychiatric patients (as defined by the PCL-R) are as much as three or four times more likely to violently reoffend following release from custody than are nonpsychopathic offenders or patients. ASPD, on the other hand, has relatively little predictive power, at least with forensic populations (Hart and Hare, in press).

It might be argued that a diagnosis of ASPD is useful in civil psychiatric settings, particularly as a general risk factor for substance abuse (Leal and others). Even here, however, psychopathy may be more important than ASPD in understanding substance abuse (Alterman and colleagues; Cacciola and others).

Read this before you take the test:

This sociopath test is an interactive checklist of symptoms typical for people with antisocial personality disorder.

It is important to mention that psychologists did not agree on one single definition of a sociopath.

While most of the time, the words “sociopath” and “psychopath” are used interchangeably, some insist there is a difference between the two.

What makes you the way you are? Take THIS TEST to discover your personality type.

In their view, a sociopath is someone whose impulsiveness and aggressiveness are the result of childhood trauma, environment, or even head injury.

According to this explanation, a sociopath will be very impulsive and spontaneous, unable to keep a job, or have a stable family life.

A psychopath, however, may have excellent social skills, a brilliant career, and a seemingly ideal family life while he carefully plots another crime or murder.

Our visual representation of critical commonalities and differences between psychopaths and sociopaths will help you understand the difference.

We will leave arguing about definitions for psychologists.

The checklist below is the list of most common symptoms associated with sociopaths or people with antisocial personality disorder.

Even a few “yes” answers are a reason for concern, and it’s not a condition for all signs to be present.

This test is not a substitution for professional advice and is provided for educational purposes only.

Have you noticed the following signs and symptoms?

1. Anger and aggression
Yes
No

2. Inability to feel other’s pain, complete lack of empathy
Yes
No

3. Unusual socially unacceptable behavior
Yes
No

4. Disrespect to other people’s property
Yes
No

5. Lies and deceives for entertainment
Yes
No

6. Lies and deceives for personal profit
Yes
No

7. Aggressiveness and irritability
Yes
No

8. Lack of emotions in general
Yes
No

9. Impulsiveness, unhealthy frightening spontaneity
Yes
No

10. Has no real friends, although may belong to a closed anti-social group
Yes
No

11. Superficial charm
Yes
No

12. Manipulative behavior
Yes
No

13. Inflated ego
Yes
No

14. Lack of remorse, guilt or shame
Yes
No

15. Doesn’t learn from negative experiences (punishment in particular)
Yes
No

Your results will be displayed below.

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Antisocial Personality Disorder Test

How does this antisocial personality disorder test work?

This is a quick personality test that helps you figure out if you have experienced antisocial personality disorder symptoms, and at what level you have confronted with it so far. The assessment is organized in 4 sections, within sections 1 and 3 there are 16 survey type questions while in sections 2 and 4 you will be presented with some statements from which you need to choose those you feel apply best to your situation.

The antisocial personality disorder test calculates a percentage of antisocial signs meaning how many antisocial symptoms were chosen and then a status description by adding the symptoms significance.

You should note that the above test is NOT to be considered a substitute for any professional medical/mental health service.

Example message

Presence of antisocial personality disorder symptoms: 31.25% – Mild antisocial personality disorder

Based on your answers you seem to be undergoing mild levels of antisocial personality disorder. There are few important antisocial personality disorder related symptoms that bother you. The best advice would be to take a look at it and if you consider necessary you may search for a professional assessment of your mental especially if what you are experiencing now seems to be getting worse in time. Please note that only a licensed professional has the authority to officially diagnose an individual with antisocial personality disorder symptoms.

The antisocial personality disorder

This can be defined as a pattern of inappropriate social behavior or actions of an individual, that are governed by thoughts, feelings and beliefs that prove disregard for other people’s rights and feelings. An individual suffering from this mental disorder is often called a sociopath.

Causes are said to be strongly related to genetic inheritance and social environmental factors and although some individuals display signs of the condition from childhood, for instance through violent behavior towards animals or other children, lack of empathy and frequent lying, most are diagnosed in their 20s or 30s.

There is an interesting difference to make as the typical signs of this disorder overlap to an extent with those of other mental illnesses such as schizophrenia or mania. However, in those cases, behavior exhibited remains in the boundaries of the episode whilst in antisocial disorder it is the basis of the every day actions of the individual.

Antisocial disorder symptoms

Few of the most common signs of antisocial personality are:

  • Inflated self esteem image
  • Lack of empathy towards other people
  • Disregard for social rules, laws and ethical behavior
  • Lack of shame or guilt
  • No restraint in lying or trying to exploit others
  • Unable to accept blame
  • Dishonesty, permanent resorting to manipulation
  • Ability to stay calm in critical situations
  • Tolerance to high risk or dangerous behaviors
  • Impulsiveness and aggression
  • Violent and abusive behavior
  • Irresponsible and risk taking behavior
  • Inability to learn from mistakes or understand consequences

Diagnosis

For this condition, diagnosis is based on a psychological assessment of the adult and follows certain criteria of repeated offensive behavior such as breaking the law, aggressiveness, deceit or irresponsibility coupled with lack of remorse or empathy. Men are said to be more affected than women and the condition is often coupled with substance abuse.

In some cases, the diagnosis might include a physical exam, a blood count test and other examination to eliminate the possibility that the symptoms are related to something else.

02 Apr, 2015

Synonym: antisocial personality disorder

This article refers to the International Classification of Diseases 10th edition (ICD-10) which is the official classification system for mental health professionals working in NHS clinical practice. The literature occasionally refers to the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification system which – whilst used in clinical practice in the USA – is primarily used for research purposes elsewhere.

Dissocial personality disorder is one of ten personality disorders defined in the ICD-10 classification system. It is called antisocial personality disorder in the DSM-IV and DSM-5 classification systems and is still sometimes referred to as such by professionals in the UK. For more information, see separate Personality Disorders and Psychopathy article.

People with dissocial personality disorder exhibit traits of impulsivity, high negative emotionality, low conscientiousness and associated behaviours, including irresponsible and exploitative behaviour, recklessness and deceitfulness.

People with dissocial personality disorder have often grown up with parental conflict and harsh inconsistent parenting. Their childhoods have typically featured parental inadequacies and often transfer of care to outside agencies. Associated with this is a high incidence of truancy, delinquency and substance misuse. This in turn results in increased rates of unemployment, problems with housing and difficulties with relationships. Many people with dissocial personality disorder have a criminal conviction and are imprisoned or die prematurely as a result of reckless behaviour.

Criminal behaviour is central to the definition of dissocial personality disorder but there is much more to the disorder than just criminal behaviour. It is often preceded by other long-standing difficulties (socio-economic, educational, family, relationship). Psychopathy is considered to be a considerably severe form of dissocial personality disorder.

The National Institute for Health and Care Excellence (NICE) guidance exemplifies a progression from recognition and definition towards more effective management. The challenge posed by this guidance to the mental health services, substance misuse services, social care and criminal justice system is considerable.

Epidemiology

  • The prevalence of dissocial personality disorder in the general population varies depending on the method used and geographical location. Two European studies reported a prevalence of 1-1.3% in men and 0-0.2% in women.
  • The prevalence of dissocial personality disorder among prisoners is less than 50%.
  • However, only 47% of people with dissocial personality disorder have significant arrest records.

Presentation

Features include:

  • Unstable interpersonal relationships.
  • Disregard for the consequences of their behaviour.
  • A failure to learn from experience.
  • Egocentricity.
  • A disregard for the feelings of others.
  • A wide range of interpersonal and social disturbance.
  • Comorbid depression and anxiety.
  • Comorbid alcohol and drug misuse.

It is important to note that dissocial personality disorder is not formally diagnosed before the age of 18 but there may be a history of conduct disorders before this age.

Conduct disorders may be manifested as antisocial, aggressive or defiant behaviour, which is persistent and repetitive. This includes aggressive behaviour (to people or animals), destruction of property, deceitfulness, theft and serious rule-breaking.

Diagnostic criteria

The DSM-IV criteria were criticised for focusing on the antisocial aspect of the disorder at the expense of the underlying personality structure. It is believed that this resulted in over-diagnosis in some settings such as prisons and under-diagnosis in the community. The insistence that conduct disorder in childhood had to be a prerequisite also presented problems. DSM-5 has addressed some of these criticisms as has the ICD-10 system on which this article is based.

The ICD-10 criteria

The general criteria of personality disorder (F60) must be met.

At least three of the following must be present:

  • Callous unconcern for the feelings of others.
  • Gross and persistent attitude of irresponsibility and disregard for social norms, rules and obligations.
  • Incapacity to maintain enduring relationships, although having no difficulty to establish them.
  • Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
  • Incapacity to experience guilt, or to profit from adverse experience, particularly punishment.
  • Marked proneness to blame others, or to offer plausible rationalisations for the behaviour bringing the subject into conflict with society.

Persistent irritability and the presence of conduct disorder during childhood and adolescence are not required for the diagnosis.

Differential diagnosis

Diagnosis can be very difficult because of overlapping features and the high frequency of comorbid conditions and problems. Premorbid and developmental history from third parties can be helpful when making a diagnosis:

  • Alcoholism.
  • Mental disorders secondary to medical conditions (head injuries, seizure disorders).
  • Anxiety disorders.
  • Other personality disorders.
  • General learning disability.
  • Brief psychotic disorder.
  • Post-traumatic stress disorder.
  • Depression.
  • Schizoaffective disorder.
  • Schizophrenia.
  • Ganser’s syndrome.

Investigations

  • Toxicology screen because substance abuse is common (as with many personality disorders). Intoxication can lead patients to present with some features of personality disorders.
  • Screening for HIV and other sexually transmitted infections may be appropriate because of the poor impulse control and disregard of risk associated with dissocial personality disorder.
  • Psychological testing may support or direct the clinical diagnosis. Those cited by NICE are:
    • Diagnostic Interview for DSM-IV Personality Disorders (DIPD-IV)
    • Structured Clinical Interview for DSM-IV Personality Disorders (SCID-II)
    • Structured Interview for DSM-IV Personality (SIDP-IV)
    • International Personality Disorder Examination (IPDE)
    • Personality Assessment Schedule (PAS)
    • Standardised Assessment of Personality (SAP).

Associated diseases

  • Anxiety.
  • Alcohol misuse.
  • Drug misuse.
  • Depression.
  • Attention deficit hyperactivity disorder (ADHD) in childhood.

Management

Dissocial personality disorder poses a big challenge to the different agencies which frequently and, almost inevitably, have to manage individuals with this disorder. Management by any single agency is not usually possible or recommended. Management in general practice alone is not recommended and referral to psychiatric services is essential.

Practice tips

  • Such patients can create very difficult and frightening problems for staff in primary healthcare.
  • It is important to identify patients who have dissocial personality disorders and enlist help with appropriate referral.
  • It is also important to identify patients at risk of violent behaviour. Assessing risk of violence is not routine in primary care but, if such assessment is required, consider:
    • Current or previous violence, including severity, circumstances, precipitants and victims.
    • The presence of comorbid mental disorders and/or substance misuse.
    • Current life stressors, relationships and life events.
    • Additional information from written records or families and carers (subject to the person’s consent and right to confidentiality) because the person with dissocial personality disorder might not always be reliable.
  • Once identified, a tailored management plan can be used to avoid crises and violent episodes. This will involve staff training and collaboration with other agencies. Use of ‘panic buttons’, chaperones and other measures should be considered.

The treatment of people with dissocial personality disorder must involve a wide range of services including particularly:

  • Mental health services.
  • Substance misuse services.
  • Social care.
  • The criminal justice system and associated forensic mental health services.

Drug treatment

No drug has UK marketing authorisation specifically for the treatment of dissocial personality disorder. However, antidepressants and antipsychotics are often used to treat some of the associated problems and symptoms in a crisis situation. NICE recommends that medication should be used for no longer than a week.A Cochrane review studied bromocriptine, nortriptyline and phenytoin but could come to no firm conclusion. However, the authors recommended further research on these drugs.

Psychological treatments

Psychotherapy is at the core of care for personality disorders generally. In theory, psychotherapy aims to help patients cope with the disorder by, for example:

  • Improving perceptions of social and environmental stressors.
  • Improving responses to social and environmental stressors.

Different types of psychotherapy have been used to try to achieve such aims. Cognitive behavioural therapy (CBT) and group psychotherapy are perhaps the most widely used and available forms of psychotherapy. These should target reduction in offending and antisocial behaviour.

Other considerations

  • Good communication is essential between all concerned but especially between healthcare professionals and people with dissocial personality disorder.
  • NICE recommends that services should consider establishing dissocial personality disorder networks, where possible linked to other personality disorder networks. They may be organised at the level of primary care trusts, local authorities, strategic health authorities or government offices. These networks should be multi-agency.
  • Treatment and care should take into account people’s needs and preferences. People with dissocial personality disorder should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. If the person is aged under 16, healthcare professionals should follow the guidelines in ‘Seeking consent: working with children’.
  • If the person agrees, carers (who may include family and friends) should have the opportunity to be involved in decisions about treatment and care. Families and carers should also be given the information and support they need.

Complications

  • Suicide
  • Substance abuse
  • Accidental injury
  • Depression
  • Homicide

Prognosis

The disorder used to be thought of as lifelong. However, a growing body of research suggests that positive changes can be seen over time. Many patients no longer meet the diagnostic criteria for the condition after a decade. It is acknowledged that the condition is difficult to diagnose and that misdiagnosis may be partly to blame for this ‘improvement’ but it is also considered that many patients do respond to therapeutic interventions. Core characteristics such as lack of empathy do not lessen but evidence suggests that patients develop more control over their impulsivity and cultivate a sense of responsibility.

Prevention

The incidence of dissocial personality disorder is reduced during times of war and in many Asian cultures. This suggests that social cohesion and an emphasis on communities rather than individuals are significant preventative factors. Families or carers are thus important in prevention and treatment of dissocial personality disorder. NICE suggests that services should establish robust methods to identify children at risk of developing conduct problems and that vulnerable parents could be identified antenatally. For example, identifying:

  • Parents with other mental health problems, or with significant drug or alcohol problems.
  • Mothers aged younger than 18, particularly those with a history of maltreatment in childhood.
  • Parents with a history of residential care.
  • Parents with significant previous or current contact with the criminal justice system.

The interventions employed after identification of at-risk parents are many and varied according to the problems identified and the age. Examples include:

  • Parenting courses
  • Anger management
  • Cognitive problem solving
  • Family therapy
  • Multi-systemic therapy
  • Multidimensional treatment
  • Foster care

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