Cure for Antisocial Personality Disorder

Break Free From Passive Aggression

Break Free From Passive Aggression

This guide is meant to be of use for anyone who is keen on developing a better understanding of PAB, to help/support concerned people to discover various methods for helping others, also, to serve passive aggressive people as a tool for self-help.

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Empirical Studies

Christopher Perry published an analysis of 15 studies of the effectiveness of psychotherapy for patients with personality disorders. The studies reviewed were the most rigorous of their kind in that the investigators used systematic methods to diagnose the disorders, along with validated outcome measures. 4 of the studies focused on borderline personality disorder there was one on borderline and schizotypal disorders, one each on avoidant and antisocial personality disorders and 8 examining mixed types of personality disorders. 6 studies evaluated psychodynamic psychotherapy three evaluated cognitive-behavioral psychotherapy, and three compared the psychodynamic and cognitive-behavioral treatments. Treatment duration varied, with a median of 28 to 40 sessions. The frequency of sessions ranged from daily in an inpatient study to once or twice weekly for outpatient therapy.

Empathyrelated responding and antisocial behaviour and social competence

Theorists and researchers have argued that empathy sympathy contributes not only to prosocial behaviour, but also to individual differences in antisocial behaviour and social competence. For example, people who tend to experience empathy when they perceive cues of others' negative emotion would be expected to inhibit behaviours that have hurtful effects for others. This argument is consistent with the recognition that deficits in empathy and remorse are common in individuals with antisocial personality disorders. Moreover, because empathy and sympathy

Scenarios For Discussion

You are a supervisor who has had a very challenging supervisee. The supervisee has, for example, made demeaning and passive-aggressive comments to patients and often jokes about them in a cruel and disrespectful way. You have attempted to provide feedback throughout supervision, documenting these attempts and their (lack of) effect. The supervisee schedules an additional session with you and says, I've been looking at my evaluation forms, and I think you've been very unfair with me. I've talked to some other people, and they agree with me. It is important that you change some of these ratings so that they reflect a fair and unbiased evaluation. If you don't, it will continue to hurt my career. My attorney believes that I have a legal right to a fair evaluation that does not defame me.

Multiaxial Diagnostic System

The DSM-IV diagnoses are made on a multiaxial system in which each axis refers to a different domain of information. This system aids in making a comprehensive assessment, organizing complex clinical information, and communicating between professionals. Axis I disorders comprise the clinical syndromes of mental disorders. Conditions listed on Axis II are the personality disorders and developmental disorders, including mental retardation, which may underlie the more florid Axis I syndrome. Axis III notes general medical conditions. Axes IV and V record psychosocial stressors and adaptive functioning. It is generally unnecessary for the emergency physician to make a complete multiaxial diagnosis, but knowledge of this system may facilitate an understanding of medical records and psychiatric consultants' notes. For instance, a patient with previous medical records containing DSM-IV diagnoses of Axis I alcohol intoxication Axis II antisocial personality disorder and Axis III scalp...

The Alcoholabusing Patient

Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations and is characterized by impaired control over drinking, preoccupation with the drug ethanol, use of ethanol despite adverse consequences, and distortions in thinking, most notably denial. Each of these symptoms may be continuous or periodic. 2 Male gender, age of 25 to 34 years, poor education, preexistent psychiatric disorder, and homelessness are common associated factors. However, alcoholism is a disorder that crosses all socioeconomic boundaries and involves all age groups. Among the homeless, estimated at 250,000 on any given night and 3 million people per year in the United States, 20 to 45 percent are alcoholics. 1 Secondary psychiatric diagnoses, including antisocial personality, mania, and schizophrenia, are more common in alcoholics than in the general population. Suicide attempts and problems with drugs other than ethanol are also...

Age and Gender as Risk Factors

Age and level of social development are highly significantly correlated. Men fall ill with schizophrenia 3 to 4 years earlier and, in our population of origin, married 2.5 years later than women. Their level of social development at illness onset, in the social role of marriage in particular, was therefore considerably lower than that of women. In addition, young men with schizophrenia showed a significant excess of socially adverse behaviour at first admission, e.g. self-neglect, lack of interest in finding a job, deficits in hygiene, aggressive behaviour and an elevated lifetime prevalence of alcohol and drug abuse until first admission. Female patients in contrast showed a significant excess of ''social conformity'', which presumably reflects a different type of adaptive behaviour. The socially adverse behaviour of young males has been confirmed in many population studies by elevated rates of conduct disorders, aggressiveness, antisocial personality, and alcohol and drug abuse...

TABLE 2802 Behavioral Characteristics that Suqqest Various Clusters of Personality Disorders

The personality disorder that constitutes a disproportionate share of emergency visits is antisocial personality disorder. The patient shows a continuous pattern of maladaptive behavior displaying disregard for the rights of others in a variety of ways criminal behavior, fighting, lying, abuse and neglect of dependents and spouses, financial irresponsibility, recklessness, and inability to sustain enduring attachments to others.

Differences in Personality

Females express more fear, are more susceptible to anxiety, are more lacking in task confidence, seek more help and reassurance, maintain greater proximity to friends, score higher on social desirability, and at the younger ages at which compliance has been studied, are more compliant with adults (Block, 1976, p. 307). There is much evidence showing that women have stronger guilt feelings, and are more intropunitive than men (Wright, 1971). It has been stated that women experience higher rates of childhood abuse, especially sexual abuse, which is a predictor of later depression, and may have depressions related to hormonal changes and to sex-role conditioning that encourages patterns of negative thinking and passivity (McGrath, Keita, Strickland, & Russo, 1990). In the United States, it has been estimated that between 2.3 and 3.2 of men, and between 4.5 and 9.3 of women, meet the diagnostic criteria for major depressive disorder at any given moment (Depression Guideline Panel, 1993)....

Comorbidity

The comorbidity between somatoform illness and personality disorders is also much higher than that in patients with other psychiatric diagnoses. About 60 of patients with somatoform illness meet criteria for at least one personality disorder of these, a significant proportion are likely to meet criteria for two or more such diagnoses. Contrary to historical belief, there is no particular association between medically unexplained symptoms and histrionic (i.e., hysterical) personality disorder. Indeed, evidence suggests that the most common personality disturbances in these patients are of the avoidant, dependent, paranoid, and obsessive-compulsive types. Similarly, there is little evidence in support of the traditional view that antisocial personality disorder is a common concomitant of unexplained medical symptoms.

Epidemiology

The risk of homicide is also associated with the use of alcohol or illicit substances by the perpetrator and or the victim immediately prior to the killing (Pernanen). Chronic alcohol use has been found to increase by up to tenfold an individual's risk of being a homicide victim (Rivara, Mueller, Somes, et al.). It is believed that the use of alcohol and illicit substances may adversely affect an individual's ability to process and interpret information correctly, thereby increasing the likelihood of miscommunication, which may lead to violence. Additionally, because alcohol use may impair an individual's judgment, intoxicated persons may be more likely to place themselves in situations that entail a high risk of violence. Chronic alcohol use may also indicate that an individual has an antisocial personality disorder, which is associated with increased rates of violence and victimization (Rivara, Mueller, Somes, et al.).