Monday, April 30, 2012

The Serial Killers & The Outcasts: Antisocial Personality Disorder

(photo: myotaku.com)
By: Bradley W. Reynolds

            Being “antisocial” is not just a popular remark, but rather an allusion to a complex and very powerful personality disorder that alters one’s mindset to that of utter indifference. Antisocial Personality Disorder (APD) is defined in the DSM-IV-TR as one of several illnesses within the “B Cluster” of personality malfunctions. Cluster B is characterized by dramatic or error-prone personality schemas, which often drive individuals to act without regard for others while demonstrating little emotional stability.
            APD behavior centers on a significant absence of concern for others; it can explain an individual’s lack of remorse or care given in fragile situations. Biologically, genetic research shows that APD is upwards of five-times more common amongst 1st degree male relatives; in terms of all demographics, white males show the highest prevalence of the disorder. ADD is often comorbid or a key precursor to APD development, as well as alcoholism and substance abuse. Chemically, our reliable “chemical supervisor” serotonin, acting as a neuromodulator (active gauge of other chemicals’ levels), is in low amounts with APD patients. Because serotonin is inadequately supplied to these individuals, they tend to lack impulse control and demonstrate severe aggressive tendencies; serotonin in normal amounts would be able to activate/allot the production of neurotransmitters to suppress inner impulses from becoming processed actions.

Although created by the imaginative minds at DC Comics, The Joker was suffering from APD. (photo:  psychablog.blogspot.com
The Serial Killer
            One of the biggest interests of non-psychology majors concerning subjects within our field is the topic of serial killers and their mental capacity. Antisocial patients can develop harmful traits through the lack of concern for others and the desire to engage in sudden impulsive ideals. One prime example is Jeffrey Dahmer, who was diagnosed with APD during criminal analysis in court. Perhaps the disorder led to his development of such a deranged mentality…
            This is probably not indicative of the true reasons for his actions though. Although APD patients show signs of very absurd thinking that often seeks to dethrone authority figures and corrupt common rules, as a standalone disorder, it would not indicate someone as certain to develop into a harmful human being. To support this, the diagnosis itself is actually difficult to assert; the patient must be older than 18 to actually qualify, and MUST  have had one conduct disorder before the age of 15. Therefore APD must be a recurring theme or pattern in one’s life to be a realistic option.
Jeffrey Dahmer is a real-life example of APD gone horribly wrong. (photo:  thesmokinggun.com)
            More often than not, I believe that the combination of APD with another neurological disorder or a substance problem will actually trigger someone to behave in such a seriously threatening manner. Meaning APD is the basis, but not the only underlying causation, of serial killer-like activity. More probabilistically, alcoholism or drug abuse can lead someone to become psychotic enough to behave so abnormally.

The Outcast
            Being isolated or unconcerned with the existence of others is a common outcome from APD. The “outcast” is the more realistic manifestation of the disorder in my opinion, where the patient lacks social development and refuses to conform to societal norms. Therefore, left to their own devices, they continue to exploit all relationships and have no desire to establish connections to others. This function of APD is similar to the actions of a “spoiled brat” personality of sorts, in which they act only for themselves and fail to seek mainstreaming into society.
Not to exhaust the Batman references, but Bruce Wayne is a perfect example of the Schizoid Personality Type that can seem similar to the social isolation of some Antisocial patients (photo: fanpop.com)
            APD patients may have struggled to develop true attachments in childhood, and as such, only wish to control others for their own self-improvement rather than for trust and love. As interpersonal relationships have floundered in the past, they become infatuated with asserting their dominance over others and as a result, have few friends. This social deprivation by their own hands makes them rather off-kilter and mentally inconsistent. As a result, APD’ers sometimes act like Schizoid Personality Disorder patients, in that they are detached from society and remain that way for many years.

Treatment Outlook: Don’t Hold Your Breath
            As I covered in my Abnormal Psychology class (where most of the basic definitional information I offer up in these disorder analyses comes from), APD patients do not seek treatment (social indifference), and the few that do are relatively unaffected by therapy. Obviously SSRI’s may increase Serotonin modulation within the nervous system, but the drug of choice tends to center on limiting violent outbursts. Tranquilizers are actually one of the few positive impactful options on APD, limiting those that often feel the impulse to harm others.
Common tranquilizers Valium and Librium and their respective doses (photo: drugsinfo.netne.net)

            There is a common belief that APD fades with age; those patients that cross the 40-year old age plateau are often less likely to act impulsive and often assimilate back into society. That being said, treatment is futile in most cases; this disorder is very difficult to handle.

So What? The Verdict
            Antisocial Personality Disorder is a personality dysfunction that cripples one’s sense of socialization and ethical logic, and instead supplants it with a drive to defy authority and discard others. With mental stability at a crossroads, and chemical imbalance a clear possibility, controlling the symptoms (and moreover the actions) as a result of this disorder is very problematic.
(photo: cerebromente.org.br)
            APD feels empowering to the patient; they seek to deprive their superiors of basic control, while taking advantage of relationships and exhibiting brutal displays of force and regulation. APD individuals do not emit sympathetic responses, nor do they reciprocate respect. In a basic sense, they are the “trouble-makers.”
            With treatment results that are sickeningly unimpressive, APD is an under-the-radar psychological disorder that desperately needs to be defended against.

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