According to DSM III
Anti-social behavior …“as a condition not attributable to a mental disorder”
-Difficulty in diagnosis because of the ambiguity
-Whether it is a constitutional defect or a deviation of normal phenomenon or a sociological phenomenon
According to DSM III; the essential behavior must begin before the age of 15
Essential Features
i. Chronic & recurrent varied anti social behavior from childhood through adult life
A. Childhood Behavior (until age 15, three or more necessary)
1. Truancy, 2. Expulsion from school 3. Delinquency, 4. Running away,
5. Persistent lying, 6. Usually easy/ aggressive sexual behavior,
7. Usually easy drinking to excess, 8. Thefts 9. Vandalism
10. Low Academic achievement, 11. Chronic violation of rules at home or school
B. Poor occupation Performance (After the age 18)
1. Frequent job changing (3 or more)
2. Significant unemployment (6 months or more)
C. Adult performance (After the 15, at least 2)
1. Three or more arrests
2. Two or more divorce/separations
3. Physical fights
4. Drinking to intoxication weekly or often
5. Defaulting on debts/other financial responsibility
6. Travelling from place to place without pre-arranged jobs
ii. Behavior occurred in periods related to drugs/alcohol abuse
iii. Absence of other major psychiatric and neurological disorder
Association Features
1. Normal mental states (although anxiety, dysphoria and instability) to tolerate boredom may be present
2. Family history of alcoholism and antisocial behavior
3. Instability to sustain lasting close relationship
Other features, Clinical Profile
1. Superficial charm and good intelligence
2. Absence of delusions & other signs of vocational thinking
3. Absence of nervousness & psychoneurotic manifestations
4. Unreliability
5. Untruthfulness and insincerity
6. Lack of remorse and shame
7. Inadequately motivated antisocial behavior
8. Poor judgment and failure to learn from past experience
9. Pathological egocentricity & incapacity for love
10. General poverty in major affective reactions
11. Specific loss of insight
12. Unresponsiveness in general interpersonal relations
13. Fantastic & uninviting behavior with drink and sometimes without
14. Suicide rarely carried out
15. Sex life impersonal, trivial and poorly integrated
16. Failure to follow up
Causes
1. Constitutional deviations
· Psychological and Genetics
Parnell (1952)
Delinquent groups seem to posses more muscle mass and a mesomorphic body built
Cantwell (1978)
- Significant are between hyperactive and antisocial behavior
- High incidents of antisocial behavior in parents of Hyperkinetic children
- May be some type of CNS dysfunction plays a role in the development of anti-social behavior
- But some neurologically normal persons manifest high degree of violence and anti-social behavior
- EEG abnormality is 50 percent
- Strong association between alcohol use, violence and crime
- Possible relationship between minimal brain damage and Anti-social behavior
Psychophysiology
2. Defect in conditioning: defective learning and training particularly in social situations.
- Difficulty in learning the rules
- May be because of hyperactivity, it is impossible for the anti-social persons to respond to avoidance learning
DSM II Dyssocial Behavior
1. Unsocialized
2. Repeated conflict with society
3. Disloyal individuals, groups, social values
4. Selfish, callous, irresponsible, impulsive and unable to feel guilty
5. Unable to learn from experience and punishment
6. Low frustration tolerance
Koch 1891: First used the term ‘psychopathic’ ‘psychopathic inferior’ ‘constitutional inferior’
Epidemiology
- Diagnosis differs from country to country & diagnostician to diagnostician
- Antisocial behavior included various objectionable behavior, eg., aggressive behavior, criminality, general violations of social standards.
- Cleckley (1976): 20% psychopaths in prison population
- Guzel (1976): 78% psychopaths in Jail population are males compared to the female population of 65%
1. Genetics
Data from genetics & twin studies and adoption
Mednick (1978): 60% concordance in monozygotic twins & 30% in dizygotic twins.
- Highest rate of ASB had biologically criminal father and adoptive criminal father
- Non-criminal sons of criminal fathers, the sons had the fastest electrode rival recovery time while the criminal sons had the slowest recovery time (physiological vulnerability)
2. Environment
- Urban: 20% boys & 13.2% girls
- Rural: 13.8% boys & 7.1% girls
- Sons of unskilled workers and the similar neighborhood commit more numerous and more serious crimes as compared with middle class or skilled working class parents.
- Parents psychopathology is a great contributor, 72% of the parents of delinquent
3. Psychological factors
- Two major themes are discussed, first of all the quality of parenting, secondly, the development of conscience.
- Maternal deprivation in the first five years of life (Bowlby 1946) because meaningful interpersonal relationship with others are not formed. ‘affectionalist character’.
- Some parent enjoy their anti-social behavior
- Modeling & experiences.
Personality Disorders
General Diagnostic Criteria
1. Deviated behavior from expectation of the individual’s culture. The manifestation is in the following areas.
a. Cognition (way of perceiving, interpreting self, others and event)
b. Affectivity (range, intensity, liability and appropriateness of emotional response)
c. Interpersonal functioning
d. Impulse control
2. The enduring pattern is inflexible & pervasive across a broad range of personal and social situations
3. The enduring pattern leads to clinically significant distress or impairment in social, occupational or other area of functioning
4. The pattern is stable, deviation longer the onset in adolescence or early childhood
5. May be a consequence of another mental disorder
6. Not due to drug or general medical condition
Cluster A
301.6: Paranoid personality Disorder
301. 20: Schizoid
301. 22: Schizotypal
Cluster B
301.7: Antisocial personality Disorder
301.50: Histrionic personality
301.81: Narcissistic
Cluster C
301. 82: Avoidant personality
301.6: Dependent personality
301.4: O.C.P Disorder
301.9: Personality Disorder not otherwise specified
Anti-social Personality Disorder
301.7
A. pervasive pattern of disregard /violation of the rights of others (age 15 years on ward)
At least 3/or more of the following
1. Failure to conform to social norms (unlawful behavior and arrest)
2. Deceitfulness (repeated lying, counting others for personal profit or pleasure)
3. Impulsivity or failure to plan ahead
4. Irritability and aggressiveness as indicated by physical fights or assaults
5. Reckless desire 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 (trust, mistreated or stolen)
B. Age at least 18
C. Evidence of conduct Disorder at the onset 15 years
D. the occurrence of anti-social behavior is not due to schizoid or MDP
As per the ASEBA School Age Form and Profiles; Achenbach system of empirically based assessment for the age group of 6-18.
Ø Argues a lot
Ø Cruelty, bullying or meanness to others
Ø Demands a lot of attention
Ø Destroys his/her own things
Ø Destroys things belonging to his/her family or other
Ø Disobedient at home
Ø Disobedient at school
Gets into many fights
Ø Physically attacks the people
Ø Screams a lot
Ø Stubborn, sullen or irritable
Ø Sudden changes in mood or feeling
Ø Sulk a lot
Ø Suspicious
Ø Teases a lot
Ø Temper tantrums or hot tempered
Ø Threatens people
Ø Unusually loud
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