Friday, February 22, 2019

Into the DSM - Antisocial Personality Disorder

When is bad behavior just bad behavior, and when does it cross the line into being clinically significant? Let's take a look at the DSM criteria for antisocial personality disorder. They are:

A. Pervasive pattern of disregard for and violation of the rights of others, occurring since age 15, including three or more of these:
  1. Failure to conform to social norms.
  2. Deceitfulness.
  3. Impulsivity, failure to plan ahead.
  4. Irritability and aggressiveness.
  5. Reckless disregard for the safety of others.
  6. Consistent irresponsibility (work, money).
  7. Lack of remorse.
B. At least 18 years older.
C. Conduct disorder onset before age 15.
D. Does not occur exclusively during schizophrenia or bipolar disorder.

So, for the LCSW exam, imagine a question about a high school bully who lies, fights, cuts class, and shrugs off his impact on others. Antisocial? Not yet--not, at least, until he turns 18.

How about a high school bully-turned-Fortune 500-CEO who does the grown-up version of that and delights in humiliating underlings? Now you might be onto something. Take a look at the other choices. Maybe conduct disorder (but the adult CEO has outgrown that). Maybe other cluster B personality disorders BPD (not it), NPD (conceivable). Antisocial personality disorder is probably the best of those answers for the non-vignette sketched out above.

For more about the disorder, try the Mayo Clinic antisocial pages here: