Managing Antisocial Personality Traits
Antisocial Personality Disorder (APD) is highly correlated with criminal behavior and significantly overlaps with substance abuse (Abram 1989, Hodgins 1993). Approximately 90% of persons diagnosed with antisocial personality disorder are further diagnosed as substance abusers (Forrest 1991).
Antisocial behaviors are the things that people do or the actions that people take that undermine, oppose, defy, or work against established moral values, rules and laws. Antisocial behaviors violate our common view of justice and fair play within a community or society. People who use antisocial behaviors refuse to play by the rules or follow the leadership of established authority. This is because they have little respect for laws or the authority figures that make them. As a result people who habitually use antisocial behaviors tend to be loners operating outside the mainstream of society or in isolated subcultures.
Antisocial behaviors are common among criminal offenders. In the general population about 4% of males and 1% of females would be diagnosed as having an antisocial personality disorder. However, some groups of people are at higher risk than others. About 15% of alcoholic males and 5% of alcoholic females have antisocial personality traits. This is more than four times the incidence in the general population. Furthermore, the incidence of antisocial personality is about 32% in male narcotics addicts and 50% – 80% among prison inmates (Forrest 1993).
Antisocial personality (ASPT) is a cluster of personality traits that revolve around criminality. Antisocial behaviors are any actions that oppose legitimate social order that promotes the common good. The three core antisocial behaviors focus upon challenging authority, breaking rules, and violating the rights of others (victimization). These three core behaviors are masked by the three disguising behaviors of superficial charm, duplicity, and deceptiveness. When caught by the consequences of these behaviors, people with antisocial traits show three evasive behaviors– they feel no guilt and justify their behavior, they deny personal responsibility, and they blame the victim or enforcers who are holding them accountable. Anti-socials have difficulty learning from past experience because of three perpetuating behaviors, which include a lack of self-awareness, the unwillingness to accept feedback from others, and an unwillingness to change their self-concept and behavior. Antisocial traits are common among criminals and socially conforming psychopaths who are manipulative and interpersonally destructive but do not engage in overt criminal behavior.
Antisocial personality disorder is outlined in the DMS-IV with personality disorders included under Axis II classification. The essential feature of ASPD is “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood” (DSM IV p. 645).
The key antisocial indicators include; challenging authority; breaking rules; victimizing others; avoiding accountability by blaming the victim or the enforcer; building up self by putting others down; and extreme shifts in self-concept from grandiosity to no self-esteem. A simple model to use in identifying these characteristics is the GORSKI-CENAPS - CRAVER Model:
C = Evades Consequences
R = Breaks Rules
A = Challenges Authority
V =Victimizes Others
E = Lacks Empathy
R = Shifts Responsibility
Most people with serious antisocial traits enjoy acting out their primary symptoms. Acting out the symptoms makes them feel good and enhances their self-esteem. Their distress is caused by the adverse consequences created when they act out. Most of the adverse consequences are related to the attempts of other people to: (1) make them stop acting out, (2) protect themselves from the acting out, or (3) get away from or isolate themselves from the person who is acting out.
The person with ASPD typically seeks treatment when they are forced to by consequences. Their goals in treatment are typically related to getting other people to leave them alone. They tend to blame the victim for complaining and blame the enforcer for making them stop.
If the victim and the enforcer would just leave them alone everything would be fine. As a result, the first step in treatment is intervention. A victim must be willing to confront the person with ASPD about the specific antisocial behaviors. Someone in authority must assume the role of enforcer and be willing to impose consequence if the person with ASPD does not make a commitment to a structured treatment program.
Intervention involves recognizing antisocial behavior, assessing the client with ASPD, assessing the victims and empowering them to take self-protective action, and aligning with legitimate authority that will enforce the expectations of change.
Managing antisocial personality traits requires using cognitive restructuring strategies to engage antisocial clients in a collaborative process of self-assessment and self-change. This is important because people with antisocial traits are highly manipulative. The antisocial behaviors that cause the greatest need of treatment often become their biggest obstacles to recognizing problems, asking for help, and making changes in their personalities and lifestyles that are essential for maintaining a lifestyle of sobriety and responsibility.
Cognitive and behavioral therapy models can assist clients with antisocial personality traits to understand and recognize their antisocial personality traits and develop self-help strategies that promote recovery and lower relapse rates.
For information on Managing Antisocial Personality Traits please contact The CENAPS office at 352-596-8000 or visit www.cenaps.com.
Video’s for Antisocial Personality Disorder and publications for Chemically Dependent Criminal Offenders are available through Herald House Independence Press at www.relapse.orgor 1-800-767-8181.