The Antisocial personality disorder

Literature refers to these disorders as either sociopaths or psychopaths as two different disorders. According to the Diagnostical and Statistical Manual of Mental Disorders (DSM), there is no distinction between the two, and simply referred to as antisocial personality disorder (APD). The classic psychopath or APD is not necessarily a serial killer and is common even though they represent only about 1% of the population.

What is Antisocial personality disorder?

Antisocial Personality Disorder (APD) is a complex mental health condition characterized by a persistent disregard for the rights of others, social norms, and ethical behaviour. People with APD often struggle with impulsivity, manipulation, and a lack of empathy, leading to challenges in their personal and professional relationships. Understanding APD requires exploring its causes, symptoms, and impacts on individuals and society.

Where does the term Antisocial personality disorder come from?

The term Antisocial personality disorder (APD) has evolved over time, with its roots in early psychiatric classifications. In the late 19th and early 20th centuries, psychologists and psychiatrists began categorising behaviours that deviated significantly from societal norms. The term psychopathy emerged during this period, largely attributed to Emil Kraepelin, a German psychiatrist who laid the groundwork for modern psychiatric classification.

By the mid-20th century, the American Psychiatric Association (APA) refined these ideas further. The Diagnostic and Statistical Manual of Mental Disorders (DSM), first published in 1952, included criteria that would eventually evolve into what we now recognise as ASPD. The DSM-II (1968) referred to sociopathic personality disturbance, but it wasn’t until DSM-III (1980) that ASPD was officially introduced as a distinct diagnosis.

Historically, the condition has been referred to by various names, including moral derangement, moral insanity and sociopathy.  Over time, ASPD has been distinguished from psychopathy, with ASPD being a behaviourally focused diagnosis included in the DSM, while psychopathy includes personality traits such as callousness and egocentricity.

Diagnostic criteria of APD

APD can briefly be defined as a disorder in which a person disregards and violates the rights of other people. From age 15, we can identify the traits in any three or more of the following criteria:

1. failure to obey laws and norms by engaging in behaviour that results in a criminal arrest, or would warrant criminal arrest
2. lying, deception, and manipulation, for profit or self-amusement
3. impulsive behaviour
4. irritability and aggression, manifested as frequently assaulting others, or engaging in fighting
5. blatantly disregards the safety of self and others
6. a pattern of irresponsibility, and
7. lack of remorse for their actions.

A brief explanation of the diagnostic criteria

Antisocial Personality Disorder (APD) is a complex mental health condition characterised by persistent patterns of disregard for the rights of others, social norms, and laws. Individuals with APD often exhibit behaviours that are manipulative, deceitful, and potentially harmful, yet they may lack remorse for their actions. Here is a discussion of some key symptoms:

Core symptoms

1. Disregard for social norms and laws

People with APD often engage in behaviours that violate societal rules, such as theft, aggression, or deceit. This pattern typically begins in adolescence and continues into adulthood.

2. Deception and manipulation

Lying, conning others for personal gain, and using charm to manipulate are common traits. They may take advantage of people without concern for the consequences.

3. Impulsivity and recklessness

Individuals with APD often act without considering the repercussions, leading to dangerous behaviours, such as substance abuse, risky sexual activity, or reckless driving.

4. Irritability and aggressiveness

They may have difficulty controlling their temper, frequently engaging in fights, conflicts, or violent acts.

5. Lack of empathy and remorse

One of the hallmark symptoms is a disregard for others’ feelings and suffering. They may not feel guilt after harming or exploiting people.

6. Failure to maintain responsibilities

These individuals may struggle with long-term commitments, such as jobs, relationships, or financial obligations. They might abandon responsibilities without concern.

Impact on Relationships and Society

APD can severely affect personal relationships, as individuals may struggle with trust, emotional connections, and cooperation. Their behaviour can lead to legal trouble, employment instability, and isolation from loved ones. While some individuals with APD are highly intelligent and capable of maintaining a façade of normality, their actions often reveal a persistent pattern of irresponsibility and harm.

A story of someone with Antisocial personality disorder

Garth* (not his real name) is someone with a cluster-B personality disorder. We will refer to them as the cluster-B’s throughout this article and I will explain it to you later.

You will immediately like Garth when you meet him. He presents himself as a friendly, pleasant person with a kept appearance. A person of principles and values.  Someone who can and will charm you from the first moment you meet him. Garth was chief elder of his church. He led the youth of the church with great principles and firmness of direction. The church’s youth movement was so strong that other congregations in the surrounding regions began to emulate its congregation’s Youth Program.

The congregation got a new minister. The new minister was also a trained psychologist. The new, yet experienced, minister was impressed with Garth’s leadership in the congregation. Garth had huge plans for the congregation, such as building a new, larger church auditorium without costing the congregation any money. Garth could wrap anyone around his little finger.  

One day Garth decided to enter a big city in our country and started buying and selling properties left, right, and centre with money or properties he did not even possess. Garth’s escapades caused him to be the headline of the next day’s national newspaper. That day, Garth’s actions were the primary cause of the near-total collapse of the city’s real estate market. He just managed to manipulate them all that easily.

Garth never took responsibility for his actions and continued with one scheme after another. Or shall I rather call his schemes scams? 

Meanwhile, Garth’s wife started with divorce proceedings for reasons no one ever understood, since Garth was a very pleasant guy, but Garth’s day also had to come.

One evening, two police officers, with a warrant for his arrest, arrived at his house. A warrant is what it is – no questions are being asked: arrest the man – lock him up. But not with Garth.  He called his minister of religion and psychologist. The pastor and psychologist, as well as the policemen, were convinced of his innocence and left his premises without Garth, warrant et al.

After a long period of time, even years after his crimes, Garth finally appeared in court. Garth told the court long and tragic stories of his life, his miseries, his failures, and his childhood.  Even the judge started to take out his handkerchief, wiping tears from his eyes.

Fast forward – Garth’s day in court eventually dawned, and he finally got sentenced.

Garth started a Bible study group in prison.  This group became so high and holy that Correctional Services could no longer cope with them. Garth was therefore transferred to another prison, where he also started a Bible study group with the same result. My knowledge of Garth ends here. I do not know what happened next, but I’m convinced Garth was eventually released again since they could not manage him and his Bible study groups.

Garth was able to turn a whole bunch of experienced businessmen around his little finger. These types of people have destroyed countries, bankrupted powerful institutions, and destroyed beautiful, powerful, and successful women and men who all have fallen head over heels for incredible charm.

• If you are wondering why I am telling you this story, you might want to look at the diagnostic criteria again and see how many of the criteria you can identify in the above story.

*Not their real names