antisocial personality disorder

Etiology

• child abuse or harsh punishment in childhood may be risk factor

Clinical manifestations

• disregard for social norms
• disregard for the law
• lack of conscious
• lack of empathy for others
• reckless &/or criminal behaviors
• elderly:
  • frequent remission of antisocial behaviors
  • less aggression & impulsivity

Management

• assess for & treat mood lability, depression, anxiety, substance abuse
• consistent, structured approach with well-defined boundaries to contain unacceptable behaviors
• team approach with a common plan (teamwork)
• behavioral contracts to address recurrent unacceptable behaviors
• resort to higher level of care if management ineffective
• do not personalize aggressive behavior directed towards staff
  • all staff opportunities to vent

More general terms

• cluster B personality disorder