Teens and adults alike are often accused of being antisocial. While some teens are naturally outgoing and social, others seemingly prefer to spend time alone. Antisocial personality disorder (like other personality disorders) is characterized by an ongoing pattern of behavior that can lead to other new or worsening mental health or emotional challenges for teens. Someone with an antisocial personality disorder often struggles to adhere to or conform to society’s social and functional expectations. They are often considered those who “can’t play by the rules.” Teens with antisocial personality disorders are those who seem to buck the system consistently. If they do follow expectations for some reason, it is often because a punishment has been set forth based upon their actions.
Teens with antisocial personality disorder can also be highly charming yet deceitful. Many have the unique ability to act in a convincing manner and be the person they need to be in the moment that they need to be that person. They use these skills to convince others that their actions or words are genuine when inevitably they may not be. Unfortunately, a teen with antisocial personality disorder typically has little interest in pleasing anyone other than themselves.
Explaining Antisocial Personality Disorder
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) is often considered the first line of information for diagnostic criteria by members of the mental health community. Current versions of the text consider antisocial personality disorder as a combination of two related yet not identical conditions. The first condition is that of a psychopath. A psychopath is someone whose actions towards others are hurtful and typically reflect manipulation, cunning, and calculated behaviors. A psychopath typically feels little or no emotions, and they mimic empathy for others as they are generally incapable of truly experiencing empathic emotions. They’re usually charming and charismatic; however, their actions and behaviors make them incapable of forming lasting or intimate relationships with others. A psychopath is a severe form of antisocial personality disorder.
The second condition is a sociopath. Different than a psychopath, a sociopath is more capable of forming attachments with others; however, they still have little concern for social roles or acceptable social behaviors. They are often haphazard, easily agitated, and more impulsive than someone who meets the criteria for a psychopath. Overall, the diagnosis of antisocial personality disorder is more common in males and is believed to affect approximately 5% of the nation’s population.
Antisocial Personality Disorder and Teen’s
The Diagnostic and Statistical Manual for Mental Disorders lists specific diagnostic criteria for antisocial personality disorder. Often, the diagnostic criteria are a limiting factor in diagnosing particular personality disorders in teens under the age of eighteen. However, it is possible to see some of the criteria or specific symptoms present beginning around or just before the age of fifteen. One example is the first listed diagnostic criteria. It specifically states that one must have a “pervasive pattern of disregard for and violation of the rights of others, since age fifteen, as indicated by three (or more) of the following.” The list that follows includes seven characteristics such as reckless disregard for the safety of others, lack of remorse, deceitfulness, inability or failure to conform to social norms, and others. However, the second criteria states that the individual must be at least age eighteen for an official diagnosis of antisocial personality disorder. Therefore, although your teen must display specific elements of the diagnostic criteria starting at or before age fifteen, an “official” diagnosis cannot be provided until they reach their eighteenth birthday.
Causes and Risk Factors for Antisocial Personality Disorder
Many personality disorders, including antisocial personality disorder, do not have a specific cause, or at least not one that has been confirmed by research. As is typical for personality or mood disorders, many contributing factors could increase one’s risk for developing an antisocial personality disorder. Some of the most common include genetics, biology, environmental factors, and trauma. Children who grow up in an environment where child abuse, parental abandonment, or with antisocial or alcoholic parents may be at an increased risk for developing antisocial personality disorder or similar behaviors as they grow. Additionally, brain defects or traumatic brain injuries during early developmental years may also contribute. Many adolescents or teens with antisocial personality disorder experience struggles with the legal system, and for this reason, the prison population consists of a high percentage of individuals with varying degrees or levels of severity of antisocial personality disorder. Some research indicates as many as 47% of male (and 21% of female) inmates meet the diagnostic criteria.
Although diagnosing antisocial personality disorder cannot begin until at least age 15, there are certain indicators in younger children and teens that may indicate the early stages of the disease. For example, setting fires, participating in or individually committing animal cruelty may be early warning signs. Additionally, children and younger adolescents who have been diagnosed with a conduct disorder are more likely to develop antisocial personality disorder in the future. Some research indicates as many as 40% of boys and 25% of girls who meet the diagnostic criteria for conduct disorder will develop an antisocial personality disorder. However, the same research indicates that children who do not develop conduct disorders and progress through age fifteen without exhibiting antisocial behaviors will not develop personality disorders. In general, boys will exhibit symptoms earlier than girls. A small percentage of adults who go on to develop an antisocial personality disorder never met early criteria for antisocial personality disorder nor received treatment for conduct disorders or antisocial behaviors at each treatment center like Beachside.
Treatments for Antisocial Personality Disorder
Treating antisocial personality disorder, whether in teens or adults, is highly challenging. Someone who meets the diagnostic criteria for antisocial personality disorder is highly unlikely to seek treatment on their own or even at the advice of their parents. In most cases, these individuals do not see anything as being “wrong,” and therefore, there is no need to seek help. In many cases, they will only seek out or attend treatment at a treatment center like Beachside because they have received a court order to do so.
Regardless of age, the primary treatment model for antisocial personality disorder is psychotherapy. Psychotherapy treatments focus on one’s thoughts and behavioral patterns. The most frequently used form of psychotherapy used in treatment for personality disorders, including antisocial personality disorder, is cognitive-behavioral therapy or CBT. As part of CBT sessions, a highly trained therapist will work with your teen to encourage them to examine their thoughts and actions. This helps them understand what events and situations may be at the root of their behavioral challenges. Once they have developed a better understanding of what contributes to unhealthy, negative, and often harmful behaviors, they can work towards learning and developing healthier and safer thoughts and ways to act upon those thoughts.
Depending on your teen’s treatment needs and goals and their specific treatment program, group and family therapy sessions may also be beneficial. Family therapy can help other family members understand the individual struggles your teen faces as they progress through overcoming antisocial personality disorder. During and after treatment, families play a critical role in ongoing healing and recovery. Therefore, it is vital to understand the signs and symptoms associated with an antisocial personality disorder. It is also essential to understand the triggers that could contribute to relapse.
At this time, the Food and Drug Administration has not approved any medications to address the symptoms of antisocial personality disorder. However, in specific circumstances, medications may be used to stabilize mood swings or address some of the more severe symptoms related to the illness. This may include impulsivity, violent aggression, and dangerous mood swings. Additionally, if your teen’s antisocial personality disorder co-occurs with another mental health condition (such as anxiety, post-traumatic stress disorder, or depression), medications designed to reduce the intensity and severity of symptoms related to those conditions may also help address symptoms related to antisocial personality disorder.
Although antisocial personality disorders are a lifelong condition, encouraging your teen to seek treatment can reduce the severity of symptoms and provide them with tools to cope with their condition in the future. In some cases, as your teen ages, symptoms may subside. However, relapse remains a lifelong risk, and new or worsening mental health conditions could occur should they account for triggers that they are not equipped to manage adequately or safely.
For treatment programs to be successful, it is crucial for your teen’s program to be focused on their unique needs and goals. At Beachside, we will work with your teen and your family to develop a treatment program based on evidence-based therapies designed to treat their physical, psychological, and holistic needs. We understand treatments that address the mind, body, and spirit are the most beneficial. The path to recovery from antisocial personality disorder is not often straightforward. However, with commitment and a strong support structure behind your teen, they can begin a journey towards healthier, more productive relationships with family and peers. If you are concerned that your teen may be struggling with antisocial personality disorder, don’t wait. Even if they have not yet reached age eighteen, there is much the team at Beachside can do to help them learn to manage their symptoms early, providing better opportunities for healthy, productive development and reduced symptoms. Contact us at Beachside today if you would like to learn more about how our team can help your teen and family begin their journey towards recovery.
American Psychiatric Association. Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013