Dissocial personality disorder: essence, causes, symptoms, correction

Dissocial personality disorder (sociopathy) is a disregard for social norms and rules, lack of attachment, aggression and a tendency to commit illegal actions. A sociopath is impulsive and aggressive, devoid of sympathy and affection, and therefore does not experience pangs of conscience when he harms others. However, with treatment from a psychotherapist, it is possible to improve the behavior of a person with a dissocial disorder, which makes life easier not only for those around him, but also for himself.

Dissocial personality disorder is not a disease, but a personality trait. A psychotherapist will help smooth out manifestations of character and make life easier in society.

This condition is also referred to as sociopathy, antisocial personality disorder, antisocial psychopathy.

As in psychotic states, such a person is driven by impulses. However, unlike illegal behavior in psychosis, sociopaths understand that they are violating the norms and rules of society.

The exact cause of the disorder is unknown, but genetic factors (heredity, random genetic mutations) and upbringing play a major role.

Dissociative identity disorder

A person with dissociative disorder often has a “core personality” that can be passive, dependent, and depressed. Their alternate personalities may be of different ages and genders and exhibit different moods and preferences. These alternate personalities are believed to take turns in control of the situation.

The impact of symptoms on a person's quality of life may depend on the number of changes they have, their social status, and other health conditions.

Diagnosis of the disease: split personality

The diagnosis is made based on the following criteria:

1. A person has two or more personal identities or two or more personal states. It is important to note that each of them involves the formation of a separate behavioral model, worldview
2. The minimum number of identities that exercise control over a person is about two or more
3. The patient is unable to retain even important information data in his memory. It is worth noting that forgetting is pathological and differs from the ordinary mechanism when a person cannot remember an ordinary event or birthday
4. Adverse symptoms do not develop as a result of alcohol or drug intoxication.

Experts face an important task: to separate the actual occurrence of the disease and the human game. However, it is worth noting that there are still discussions among experts about how effective the above criteria really are. They lack validity, which is why a specialist can form an incorrect diagnosis. Studies such as MRI, CT, and EEG also help eliminate the possibility of error.

Dissociative identity disorder - causes

Dissociative identity disorder most often develops during childhood, and its symptoms may become more severe over time. But the disorder can develop in people of any age, ethnicity, gender and social background. The most significant risk factor is physical, emotional or sexual abuse in childhood.

Dissociation, or detachment from reality, can be a way to shield a person from painful mental or physical experiences.

Post-traumatic stress disorder (PTSD) and a number of other mental health conditions are associated with dissociative identity disorder. Other dissociative disorders include:

1. dissociative amnesia;
2. depersonalization;
3. acute stress disorder;
4. anxiety, distress and depression.

Modern psychiatry

Now dissociative disorders are understood as a whole group of mental disorders, which includes the following pathological conditions:

1. Psychogenic (dissociative) fugue is the loss of personal identity and the emergence of another. The phenomenon is quite rare. It is characteristic of persons with schizoid disorder.
2. Psychogenic amnesia (some memories are inaccessible to consciousness). The most common form. With clear consciousness, memory suddenly disappears, and the person is aware of it. It recovers on its own after some time.
3. Dissociative identity disorder is the most severe form. It can begin in childhood or adolescence, and appears most often in young people, especially women.

In this case, the manifestation of any form of the disease can suddenly stop. This usually happens if the impetus for a dissociative disorder was a traumatic situation.

According to ICD-10, this disease is divided into the following subtypes:

• fugue;
• convulsions;
• amnesia;
• stupor;
• loss of sensory perception;
• movement disorders;
• convulsions;
• obsession and trance.

To separate such conversion disorders from other mental pathologies, there is a special criterion - the presence of integrity in the patient between the following components:

• your feelings;
• memory of one's own history;
• ability to control one’s motor function;
• awareness of oneself as a person.

Such integrity may be broken partially or completely.

Dissociative Identity Disorder - Symptoms

For both adults and children, the disorder is diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders. The doctor will also ask the person or child's caregiver about the symptoms they are experiencing and refer them to a mental health professional.

To be diagnosed with dissociative identity disorder, a person must:

1. Display two or more personality changes that interfere with behavior, awareness, memory, perception, cognition, or feelings;
2. He may have gaps in his memory of personal information and daily events, as well as past traumatic events;
3. Has symptoms that cause significant distress in the work and social environment;
4. A person may have amnesia or erratic behavior that is not caused by alcohol or drug use.

Some of the tests used for diagnosis include the Rorschach technique.

Are all sociopaths the same?

Eric Berne identified two types of sociopaths.

He called the first type latent. He writes that such a person most of the time can behave without standing out too much from the general mass of law-abiding citizens. It is with the identification of this type that the biggest problems arise. Because such a person accepts the authority of religion or a temporary strong personality who is perceived as ideal. One gets the deceptive impression that a person is trying very hard to “fit in” with the environment. And most often, only the closest people understand that everything is not so simple. Concepts and postulates are “read” and reinterpreted in their own way. As a trivial example, we can cite the phrase from the Bible “... let the wife fear her husband,” which can be interpreted as an opportunity to do whatever you want with your wife. Often latent sociopaths refuse to treat their loved ones, hiding behind religious beliefs. While they simply don’t want to part with money or, what’s even sadder, expecting an inheritance in the event of their death.

Please note that such people are rarely diagnosed as sociopaths. Most often, relatives of such a person come to the appointment with complaints about “excesses,” sectarianism, and problems with mutual understanding. However, if the picture described seems too familiar to you, be sure to talk with a psychologist to identify other obvious signs of dissocial disorder or refute such a diagnosis.

An active sociopath, according to Berne, is devoid of internal and external stoppers. He exhibits persistent characteristic behavior and is able to restrain himself only for a short time in the event of a scam or deception. It is these individuals who are prone to characteristic types of deviant behavior, which can be divided into:

1. criminal deviation, which is expressed:

• acts of sexual violence;
• robberies;
• murders for hooligan reasons;
• fraud;
• extortion;
• evasion of assigned duties prescribed by law (most often financial; but there may be claims in case of neglect of children, which entailed serious consequences);
• demonstrative acts of disobedience.

1. Non-criminal, formally not punishable actions:

• verbal aggression;
• inappropriate driver behavior;
• evasion of official duties or other assigned duties, excluding criminal offenses;
• revenge and petty dirty tricks;
• using the merits and achievements of colleagues, passing them off as one’s own work

In principle, this list can be continued indefinitely, since social condemnation depends on the norms of the society itself and can vary in terms of what is permissible or not. For example, in recent times, copyright registration or patenting determines the “owner” of the invention. And this is not always a real inventor.

Dissociative Identity Disorder - Treatment

Photo: Shutterstock
Dissociative identity disorder is usually treated with psychotherapy and focuses on:

• teaching a person about his condition;
• increasing awareness and tolerance of emotions;
• working on impulse control;
• preventing further dissociation;
• managing current relationships, stressors and daily functioning.

The goal of treatment is to help all the personalities live and work together harmoniously and to help the person identify what causes the personalities to switch so that he can feel prepared.

Living with dissociative identity disorder can be frustrating and scary. Many people are not diagnosed until they are adults, meaning they may experience years of frightening symptoms.

A person's alternate personalities may not always cooperate with each other. When another personality takes control, the person may "wake up" in an unfamiliar place and have no memory of how they got there. However, personalities can also work together and help a person cope with everyday situations.

Some people with dissociative identity disorder may also suffer from social prejudice. Many people are only familiar with what they have read in fiction or seen in films.

Diagnosis of dissociative identity disorder often takes a long time and may be accompanied by other mental illnesses. The social stigma of this disorder can lead to anxiety, guilt, shame and depression.

They are at increased risk of self-harm and suicide. Correct diagnosis and timely treatment are important and can save a person's life. Treatment for dissociative identity disorder can improve quality of life and reduce other mental health problems.

Diagnostics

Antisocial disorder is diagnosed when at least 3 of the following are present:

• callousness and indifference to other people, inability to show empathy;
• regular and persistent irresponsibility, disregard for social norms and rules, responsibilities;
• inability to maintain long-term and close relationships, but at the same time good ability to make acquaintances and establish contacts;
• instability to frustration, low threshold of aggression and violence;
• inability to realize one’s guilt and learn from one’s mistakes, inability to draw conclusions from punishments;
• blaming other people, justifying one’s behavior (inventing good intentions), leading to conflicts;
• constant irritability.

Literature

1. Boysen GA, VanBergen A. Simulation of multiple personalities: a review of research comparing diagnosed and simulated dissociative identity disorder //Clinical psychology review. – 2014. – T. 34. – No. 1. – pp. 14-28.
2. Brand BL et al. A longitudinal naturalistic study of patients with dissociative disorders treated by community clinicians //Psychological Trauma: Theory, Research, Practice, and Policy. – 2013. – T. 5. – No. 4. – P. 301.
3. Tibon Czopp S. et al. The amnestic syndrome: Applying the Rorschach Inkblot method for differential diagnosis //Neurocase. – 2014. – T. 20. – No. 6. – pp. 652-665.
4. Dorahy MJ et al. Dissociative identity disorder: an empirical overview //Australian & New Zealand Journal of Psychiatry. – 2014. – T. 48. – No. 5. – pp. 402-417.
5. Dorahy MJ et al. Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups //Journal of affective disorders. – 2015. – T. 172. – P. 195-203.
6. Itzkowitz S. et al. Exploring dissociation and dissociative identity disorder: A roundtable discussion //Psychoanalytic Perspectives. – 2015. – T. 12. – No. 1. – pp. 39-79.
7. Krüger C., Fletcher L. Predicting a dissociative disorder from type of childhood maltreatment and abuser–abused relational tie // Journal of Trauma & Dissociation. – 2021. – T. 18. – No. 3. – pp. 356-372.

general information

Dissocial personality disorder (DID or DID) is also popularly called sociopathy or psychopathy. Doctors do not use such terms in their practice, at least not in medical research.

DID is included in the International Statistical Classification of Diseases and Related Health Problems, abbreviated ICD 10.

Most common among men. Perhaps this is due to the fact that representatives of the stronger half of humanity are more aggressive and impulsive. According to statistics, it is detected in 3% of men and only 1% of women.

That the behavior of sociopaths is antisocial is supported by evidence from prison services. It turns out that about 75% of the world's prisoners are people with DID.

But it is worth considering that not all dissocials are criminals. Most of them commit acts for which it is difficult, and sometimes impossible, to prove guilt. Or they are unacceptable in society, but are in no way punishable by law.

Most often it affects those who belong to disadvantaged sections of the population. Especially if they grew up in large families. And also city residents.

Classification

To make a diagnosis of a personal disorder according to one of the ICD-10, the pathology must satisfy three or more of the following criteria:

• the disorder is accompanied by deterioration in professional productivity;
• mental conditions lead to personal distress;
• abnormal behavior is pervasive;
• the chronic nature of stress is not limited to episodes;
• noticeable disharmony in behavior and personal positions.

The disease is also classified according to DSM-IV and DSM-5, which group the entire disorder into 3 clusters:

1. Cluster A (eccentric or unusual disorders). They are divided into schizotypal (301.22), schizoid (301.20), paranoid (301.0).
2. Cluster B (fluctuating, emotional or theatrical disorders). They are divided into antisocial (301.7), narcissistic (301.81), hysterical (201.50), borderline (301.83), unspecified (60.9), disinhibited (60.5).
3. Cluster C (panic and anxiety disorders). They are dependent (301.6), obsessive-compulsive (301.4), avoidant (301.82).

In Russia, before the adoption of the ICD classification, there was its own orientation of personality psychopathies according to P. B. Gannushkin. The system of a famous Russian psychiatrist, developed by a doctor at the beginning of the 20th century, was used. The classification includes several types of pathologies:

• unstable (weak-willed);
• affective;
• hysterical;
• excitable;
• paranoid;
• schizoid;
• psychasthenic;
• asthenic.

Prevention

Preventive recommendations are as follows:

• protect yourself from stress, nervous experiences, psycho-emotional overload;
• normalize your daily routine, ensure proper rest;
• If you have psychological problems, you should seek help from a specialist.

It is very important to start treatment in a timely manner, as soon as the first alarming symptoms appear. People who are at risk should be systematically examined by specialists to prevent the development of serious complications

https://youtube.com/watch?v=W6aUaqrZ-Ns

Causes

It usually appears during puberty, that is, adolescence. At least, it is during these years of life that it is possible to diagnose the presence of sociopathy. Since in childhood, an antisocial style of behavior is most often an inability to realize the cause-and-effect relationship between one’s actions and consequences. For this reason, parents bear responsibility for the child's crimes.

At the moment, there is no exact data on what provokes the development of psychopathy, but there are theories from experts that are the most likely:

• Heredity. It is not uncommon for such a disease to occur in several generations in the same family. Especially on the paternal side.
• Educational mistakes. If parents did not take an active part in raising children, or they themselves were an example of antisocial behavior. Which the child could adopt without knowing a different, healthier model of perceiving the surrounding reality and interacting with it.
• Traumatic brain injuries.
• Severe stress. The effect of stress on the human body is sometimes so serious that the psyche loses its stability and undergoes changes. Unfortunately, destructive.

Types

Psychologist Eric Berne has identified several types of people with dissocial disorder.

• Passive. Such individuals are passive in protesting against social norms. That’s why some of them are still carried out, trying to avoid punishment. Without experiencing pangs of conscience, they can commit actions whose guilt is difficult to prove. But you are afraid to go directly against the system. Passive-aggressive, manipulative and provoke others into conflict. After which they look flawless, presenting their victim as a tyrant.
• Active. It is these people who have absolutely no restrictions in the internal structure of their personality. They lead a criminal lifestyle, so their behavior is not only deviant, but also delinquent. After therapy, they can demonstrate decency and adherence to moral standards, but this is only for others. The internal picture of the world does not change at all, so whenever possible they return to their previous actions.

What not to do

Sometimes it happens that a person with a dissocial disorder turns out to be a close relative, with whom it is quite difficult to completely stop communicating. What then should be done, how to protect yourself and the rest of the family from its effects?

• Give up the illusion that he will understand how wrong he is behaving and will correct himself. Even if he has gone through a long stage of therapy, you should not relax. Credit of trust is not at all an option for such a case. Be careful and careful. This means that you should not trust him with your life, finances, and so on.
• Stop blaming and proving him wrong. Maintain your mental balance, because, trying to reach his consciousness, you will simply encounter powerlessness. Which is better to admit right away. More valuable to yourself. No arguments can evoke pity, sympathy or repentance in him. And after the inevitable conflict in such cases, you will find yourself the injured party. Because in addition to defeat, you will appear in his and not only his eyes as a tyrant, hysterical, and so on.
• Showing emotions in the hope of appealing to his sensuality and conscience will also turn out to be a waste of time and effort. Besides, showing your weak, vulnerable places will only please the sociopath. Realizing that he caused pain, suffering and other unpleasant experiences, he will feel satisfaction rather than guilt.
• Threats are also meaningless. They can provoke an attack of aggression, during which you will suffer due to his inability to control himself. In such a game, the dissocial clearly has superiority.
• Give up trying to appeal to his rationality by trying to organize conversations about good and evil, morality and morality. He doesn’t understand such judgments, not because he’s stupid, but because it doesn’t matter.

What to do in case of threats

If you are threatened and you understand that violence is inevitable, be sure to contact law enforcement. There is no point in risking your own life, especially if threats have previously been translated into reality. He has access to weapons, or even just periodically shares delusional obsessions about harming others.

If you feel the influence of a dissocial person, enlist the support of loved ones and go for a consultation with a psychologist. In therapy, you can discover your own boundaries and ways to protect them. Develop a style of behavior that will help maintain integrity and ensure safety.