Antisocial Personality And Other Personality Disorders

o Characterized by a marked pattern of disregard for violation of the rights of others o Psychopath or sociopath are terms often used o Self-centered, feel entitles, exploit and seek power over others o Lack empathy, impulsive behavior o Temperamentally aggressive o Lack remorse, some violate laws and end up in jail o Rarely seek mental health care unless admitted through the court system o More likely seen in medical-surgical settings

♣ Must be at least 18 years old and must have exhibited one or more childhood behavioral characteristics of conduct disorder before the age of 15. ♣ Antisocial behaviors tend to diminish later in life, particularly after the age of 40

o ASPD strongly associated with alcohol/drug abuse o Failure to make or sustain stable attachments in early childhood o Child abuse and domestic violence increases risk

o Serotonin deficiency and low dopamine levels are related to impulsive aggression

o Adolescent and adult men with XYY sex chromosome abnormally exhibit more antisocial behavior than others o Occurs more frequently in men

o Can be verbally and psychically abusive if their expectations are not met- Protect other patients and staff! o Group interventions more effective than individual modalities ♣Under fire from other group members. ♣Keeps them in line o Anger management is a priority intervention o Families need help in recognizing the patient's responsibility for his or her actions. o Goal of therapy: develop an untiring sense of attachment and empathy or other people and situations and to live within the norms of society.

o Characterized by a pattern of social and interpersonal deficits o Traits are similar to the symptoms of schizophrenia but are less severe o Magical beliefs o Perceptual aberrations o Paranoia o Odd or eccentric. o Schizotypy- traits similar to those of schizo but less severe o Referential thinking ♣That wreck happened because of me. o Perceived as strikingly odd or strange in appearance and behavior o Void of any close friends o Greater rates among men o Reduction in temporal volume is common o Their odd, eccentric thoughts and behaviors alienate them from others o Unkempt manner of dress o Do not usually seek treatment o Meds not generally used.

o Characterized by avoiding social situations in which there is interpersonal contact with others o Appear timid and shy o Extremely sensitive to negative comments o Behavior becomes problematic when they restrict their social activities and work opportunities because of their extreme fear or rejection. ♣Take job on side lines, don't want authority, shy, eager to please o Chronic low self-esteem o Social skills training may help reduce symptoms

o Do NOT demonstrate obsession and compulsions but rather a pervasive pattern of preoccupation with orderliness, perfectionism, and control o Attempt to maintain control by careful attention to rules, trivial details, lists, and procedures o Uncomfortable with unstructured leisure time- uncomfortable with empty, like vacations o Formalized leisure activities (season tickets to sports, etc.) o Highly structures, organized life o Have a need to control others o Have difficulty completing tasks because they are so involved with details o Mood is tense and joyless o Tightly control the expression of emotions o Usually have a higher education and income ♣CEO, accountant

♣ Parental over-control and overprotection ♣ Sets distinct limits of child's behavior ♣ Teach a deep sense of responsibilities to others ♣ Encouraged to resist natural inclinations toward play and impulse gratification, and parents try to impose guilt on the child to control behavior

♣ Psychotherapy ♣ Short-term antidepressant and anxiolytic

o Grandiose, arrogant o Begins in childhood o Believe they are superior and unique o Overvalue personal worth o Handle criticism poorly o Cannot show empathy o Occurs more often in men o Often found in professionals ♣ Law, medicine, science o Children of parents with this disorder have a higher than usual risk of developing the disorder o May be caused by overindulgence by parents o Commonly occurs in only children and among first-born boys o Do not seek mental health are unless there are coexisting medical or mental disorders

o Longstanding suspiciousness and mistrust of persons in general o Hostile o Assign responsibility to others o Avoid relationships in which they are not in control o Hold grudges o Typical emotional responses are anger and hostility o Outwardly argumentative and abrasive o Internally feel powerless, fearful, and vulnerable o Disturbed thought process o 2nd highest PD

o Expressively impassive and interpersonally unengaged o Unable to experience the joyful aspects of life o Introverted and reclusive o Lifelong loners o Interests are directed at objects, things, and abstractions o Not engaged o Engage primarily in solitary activities o Academic pursuits such as mathematics or engineering o Etiology processes are speculative- para-sympathetic division of the autonomic nervous system if functionally dominant. o May become attached to animals-incapable of forming human social relationships o As children- stamp collection, computer games, electronic equipment, etc. o Communication with others is confused and lacks focus

o Attention-seeking o Emotional o Excitable o Draw attention to themselves o "Life of the party" o quick to form new friendships, then quick to become demanding o Strong dependency need o Appearance is provocative and speech is dramatic o Attempt to control relationships by their seductiveness o Needs for constant attention, quickly alienates their friends o Becomes depressed when they are NOT the center of attention o Ultimate treatment goal is to correct the tendency to expect others to fulfill all of their needs

o Cling to others o Decision making is difficult or nil o Self-esteem is determined by others o Withdraw from adult responsibilities by acting helpless o Need excessive advice and reassurance o Described as "gullible" by friends o Timidly void social tension o Associated with suicide and alcoholism in men o Persons with chronic physical illnesses in childhood may be prone to developing this o The nurse can support them in making their own decisions by resisting the urge to tell them what to do o Likely to have spent years seeking therapy o Overbearing parents (don't let you make decisions), childhood illness