Dissocial personality disorder

Dissocial personality disorder is one of several psychopathic personality disorders, each of which has different operational definitions and terminologies depending on the system of classification of mental disorders used. Psychopathy is a general construct that differs from the specific diagnoses of antisocial, psychopathic, dissocial, and sociopathic personality disorders, the various diagnostic classifications for psychopathy.Dissocial personality disorder is the diagnostic category established for psychopathy in the ICD-10 diagnostic criteria developed by the World Health Organization (WHO). It is conceptually similar to the DSM-IV-TR diagnostic criteria for Antisocial personality disorder.cite web
author
url=http://www.who.int/classifications/apps/icd/icd10online/?gf60.htm+F₆₀₂
title=F₆₀.2 Dissocial personality disorder
publisher=World Health Organization
accessdate=2008-01-12]

ICD-10 Criteria for Dissocial Personality Disorder

Specifically, the dissocial personality disorder is described by the World Health Organization by the following criteria:

# Callous unconcern for the feelings of others and lack of the capacity for empathy.
# Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
# Incapacity to maintain enduring relationships.
# Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
# Incapacity to experience guilt and to profit from experience, particularly punishment.
# Marked proneness to blame others or to offer plausible rationalizations for the behavior bringing the subject into conflict.
# Persistent irritability.

The criteria specifically rule out Conduct disorders. Dissocial personality disorder criteria differ from those for antisocial and sociopathic personality disorders. [cite book
first=
last=
date=2003
authorlink=
coauthors= David P. Farrington, Jeremy Coid
title= Early Prevention of Adult Antisocial Behavior
url=http://books.google.com/books?id=KtXU8R8oZYwC&pg=PA82&lpg=PA82&dq=dissocial+personality+disorder&source=web&ots=lVx_gb_9mM&sig=U_bMqyc-KlzHKEvzXBdeZxplN2E
work=
publisher=Cambridge University Press
pages = p. 82
date=
accessdate=2008-01-12 ]

Confusion in terminology

Although conceptually the antisocial, dissocial, and sociopathic personality disorders are synonymous with psychopathy, operationally the diagnostic criteria for these disorders are definitely distinct. They are not equivalent disorders. The largest difference is the emphasis on delinquent and criminal behaviors found in the DSM-IV-TR's version, the antisocial personality disorder. The dissocial personality disorder pays more attention to the affective, interpersonal and behavioral components not present in DSM-IV-R's criteria.cite web
author=Irving B. Weiner & Donald K. Freedheim
date-2003
url=http://books.google.com/books?id=jk8-b9AwmJgC&pg=PA88&ots=CvEoW7H7Am&dq=dissocial+personality+disorder&ei=2SiJR6eQF4Gk6AK4sqGVBg&sig=WoV7N2uYLmMeEIpCDx2llaEccG4#PPA88,M1
title=Handbook of Psychology
publisher=John Wiley and Sons
pages= p. 88
accessdate=2008-01-12]

The criteria for antisocial personality disorder are largely based on observable behaviors while the ICD criteria for dissocial personality disorder focus more on the affective and interpersonal deficits. However, the ICD criteria do not represent the broad personality and behavioral factors of psychopathy.cite web
author=Ogloff, James R.P.
date=2006
url=http://www.ingentaconnect.com/content/bsc/anp/2006/00000040/F0020006/art00003
title=Psychopathy/antisocial personality disorder conundrum
publisher=Blackwell Publishing
accessdate=2008-01-12]

The blurring of distinctions between these diagnostic categories and psychopathy have caused diagnosis confusion. For the mental health and criminal justice system, the distinction between psychopathy and antisocial personality disorder is of considerable importance. [cite web
author=Robert D. Hare, Ph.D.
date=1996
month=February 1
url=http://www.psychiatrictimes.com/Personality-Disorders/Antisocial-Personality-Disorder/showArticle.jhtml;jsessionid=IO5VAHNKHAYISQSNDLPSKH0CJUNN2JVN?checkSite=psychiatricTimes&articleID=192300193
title=Psychopathy and Antisocial Disorder: A Case of Diagnostic Confusion
publisher=Psychiatric Times
accessdate=2008-01-12] Further, the term "psychopathic" is no longer used in the United Kingdom as it is seen as having pejorative connotations. [cite web
author=
url=http://www.benefitsnow.co.uk/handbook/personalitydisorders.asp
title=The Disability Handbook on Personality Disorders
publisher=
accessdate=2008-01-13]

Research findings

Much research into psychopathy, as operationalized by the Hare Psychopathy Checklist Revised (PCL-R), has been conducted. The checklist assesses both interpersonal and affective components as well as lifestyle and antisocial deficits. However, the research results cannot be easily extrapolated to the clinical diagnoses of dissocial personality disorder or antisocial personality disorder. A sample research finding is that between 50% and 80% of prisoners in England and Wales meet the diagnostic criteria of dissocial personality disorder, but only 15% would be predicted to be psychopathic as measured by the PCL-R. Therefore, the findings drawn from psychopathy research have not yet been shown to be relevant as an aid to the diagnosis and treatment of dissocial or antisocial personality disorders.

Attempts to correlate dissocial personality disorder have had methodological problems. Although a high percentage of prisoners in England and Wales were shown in one survey to fulfill the criteria for a dissocial personality, since the diagnosis of dissocial personality includes a disregard for social rules and norms, it is not surprising that the same individuals commit crimes. [cite web
author=
date=2003
url=http://apt.rcpsych.org/cgi/content/full/9/5/349?ck=nck
title=Dangerous Severe Personality Disorder
publisher=Advances in Psychiatric Treatment
accessdate=2008-01-12]

Research has been done attempting to assess the co-morbidity of dissocial personality disorder with other conditions. However, the few studies that have been done use too many different methodologies to enable forming solid conclusions, although it seems that there is a low prevalence of antisocial personality disorder/dissocial personality disorder in psychiatric hospitals. [cite book
first= Paul
last= Moran
authorlink=
coauthors=
title= Antisocial Personality Disorder: An Epidemiological Perspective|url= |work=
publisher=Amer Psychiatric Publishing
date= 1999
pages = p. 25
accessdate=2008-01-12 ]

Treatment

In practice, mental health professionals rarely treat dissocial personality disorders as they are considered untreatable and no interventions have proven to be effective. In England and Wales the diagnosis is grounds for detention in secure psychiatric hospitals under the Mental Health Act if individuals with that diagnosis have committed serious crimes, but since such individuals are disruptive for other patients and not responsive to treatment this alternative to prison is not often used. [cite book
author =Paul Harrison & John Geddes
url =http://books.google.com/books?id=xjaQa-OseQ0C&pg=PA165&lpg=PA165&dq=dissocial+personality+disorder&source=web&ots=Hx0rs036wg&sig=LwrheM2r9jmuQka5Gb-0eDY60Lg
doi =
title =Lecture Notes: Psychiatry
publisher =Blackwell Publishing
date =
location =
pages = p. 163–165
id =
isbn = ]

ee also

*Antisocial personality disorder
*Psychopathy
*"The Mask of Sanity"

Footnotes

External links

* [http://books.google.com/books?id=EKxtAWmL_8oC&pg=PA83&lpg=PA83&dq=dissocial+personality+disorder&source=web&ots=oFGVN7Ku1T&sig=1M-Ah8Mcx8isIfjTR4J8eejmA58#PPP9,M1 Multiaxial Presentation of the ICD-10 for Use in Adult Psychiatry]
* [http://apt.rcpsych.org/cgi/content/full/9/5/349?ck=nck Dangerous severe personality disorder]
* [http://sciencelinks.jp/j-east/article/200019/000020001900A0581448.php A Case of Psychiatric Evidence of Dissocial Personality Disorder]
* [http://www.mentalhealth.com/icd/p22-pe04.html Antisocial Personality Disorder - European Description]
* [http://books.google.com/books?id=KtXU8R8oZYwC&pg=PA82&lpg=PA82&dq=dissocial+personality+disorder&source=web&ots=lVx_gb_9mM&sig=U_bMqyc-KlzHKEvzXBdeZxplN2E Definitions of Antisocial Personality Disorder, Psychopathic Personality disorder, and Dissoricla Personality Disorder]