Antisocial personality disorder
- A pervasive pattern of disregard for and violation of the rights of others
- Three (or more) of the following criteria, occurring since age 15 years:
- Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.
- Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure.
- Impulsivity or failure to plan ahead.
- Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
- Reckless disregard for safety of self or others.
- Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
- Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
- The individual is at least age 18 years
- There is evidence of conduct disorder with onset before age 15 years
- The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder
- Substance use disorders
- Schizophrenia and bipolar disorder
- Other personality disorders and personality traits
- Criminal behavior not associated with a personality disorder
- A clinical diagnosis; however if entertaining other organic causes may initiate workup below
- Point-of-care glucose
- Chem 7
- ECG (for toxicology evaluation)
- ASA level
- Tylenol level
- Urine toxicology screen/Blood toxicology screen
- Urine pregnancy/beta-hCG (if female of childbearing age)
- Set clear boundaries and expectations
- Referral for outpatient psychiatric treatment, although difficult to treat with psychotherapy. Antipsychotics, antidepressants and mood stabilizers can be used to control symptoms such as aggression and impulsivity
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.