Do I Have Anti-Social Personality Disorder?

So do I have anti-social personality disorder? According to the IPDE (international personality disorder examination) I do. I did this while in hospital and it came back that I have a definite diagnosis of ASPD. There are 3 results for each PD within the IPDE; negative, probable and definite diagnosis. I got the definite diagnosis but I find this hard to believe. It just doesn’t fit. I had a hard time accepting this in hospital. Immediately after my results from the psychiatrist I ended up in restraint and then in general hospital after ingesting hair removal cream. I didn’t take it well. So therefore I am going to breakdown the criteria then make my conclusion on whether I think I have ASPD. After all I know myself better than anyone else. I wonder what I will conclude.

There are 2 types of ASPD the DSM version which is ASPD and the ICD version called dissocial personality disorder. I will start with the DSM.

DSM-Iv

A)     There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following:

1.       Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;

Ok so in my life time I have committed a crime, who hasn’t? I wouldn’t say I repeatedly engage in acts that are grounds for arrest. The crimes I have committed are minor; possession of cannabis and occasionally a few other drugs, criminal damage and weapon carrying. These are all on my criminal record and I’ve been done for them. Cautions for possession of cannabis and criminal damage and a 12 month conditional discharge for possession of an offensive weapon. However except for the cannabis possession (which I can’t really blame my mental health for, or can I?) I committed these crimes because I was mentally unwell for other reasons. I have 2 cautions for criminal damage. The first being while living in halls and “losing it” and smashing the place up. The second for smashing the ward up while I was under section. Yes that’s right I was detainable at the time and therefore mentally unwell. So wouldn’t these acts of crime be due to my other personality disorder (BPD)?

2.       Deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;

This is not me at all. I am a very honest person. Often too honest for my own good. I’ve never used an alias and I’ve never conned others for personal profit or pleasure.

3.       Impulsiveness or failure to plan ahead;

Well yes I am impulsive. I cannot argue with that. But isn’t impulsiveness a criteria for BPD?

4.       Irritability and aggressiveness, as indicated by repeated physical fights or assaults;

I get mildly irritable at times, nothing major. I have been aggressive in the past this was mainly whilst in hospital. I was mentally unwell due to other reasons at the time and was releasing anger that had built up over my entire life. In normal situations I am not aggressive at all. I had one fight, if that’s what you can call it, at school and one in hospital with a fellow patient. I also “assaulted” another patient in hospital. But again was that because I was unwell for other reasons other than ASPD?

5.       Reckless disregard for safety of self or others;

This is a weird one. In some situations, yes. In everyday situations I am very conscious of my safety and of others. I sometimes neglect my safety in other ways such as self-harm, overdoses, drinking, taking drugs etc. Again could this not be down to my BPD.

6.       Consistent irresponsibility, as indicated by repeated failure to sustain consistent work     behavior or honor financial obligations;

Well basically I can agree with this. This fits. I cannot argue.

7.       Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another;

I suppose this can be me. Not the stealing bit though. But I hate to admit it but at times I do have a lack of remorse. If I am brutally honest I sometimes fake remorse in order to make myself feel better about myself because I know it is very cold of me. Not always though, I can genuinely be remorseful sometimes.

B)      The individual is at least age 18 years.

Well yes I am 24

C)      There is evidence of conduct disorder with onset before age 16 years.

I was never diagnosed with conduct disorder when I was younger. But from what I know about it there is a possibility I had it. I was a very naughty teenager, I constantly was getting into trouble and I had a serious problem with authority.

D)     The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.

I do not have schizophrenia nor have I ever been manic

ICD-10

The World Health Organization's International Statistical Classification of Diseases and Related Health Problems, tenth edition (ICD-10), defines a conceptually similar disorder to antisocial personality disorder called (F60.2) Dissocial personality disorder.

It is characterized by at least 3 of the following:              

1.       Callous unconcern for the feelings of others

Not really no. maybe at times but I wouldn’t say it’s callous.

2.       Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.

Maybe. Occasionally. But to what extent would a disregard for social norms be? Maybe I could fit into this criterion in a minor way. I wouldn’t say I did in an extreme way and not in a way that causes me problems and definitely not gross and persistent.

3.       Incapacity to maintain enduring relationships, though having no difficulty in establishing them

No, I have friends. Some of them I’ve had for years, since I was a young child. Romantic relationships are another story but I don’t think it necessarily means romantic ones.

4.       Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.

Pretty much the same criterion as DSM. At times yes, although maybe this is when I’m mentally unwell due to other things.

5.       Incapacity to experience guilt or to profit from experience, particularly punishment.

Yes. I cannot argue with this. I never learn from experience.

6.       Markedly prone to blame others or to offer plausible rationalizations for the behavior that has brought the person into conflict with society.

Not necessarily prone to blame others but I do rationalize my negative behaviors.

So there we have it, the criteria for both ASPD and DPD. I will now conclude.

ASPD

The first criterion states I must meet 3 of the 7 sub criteria. I can only say for certain I meet 2. A few others are borderline or slight. I meet the second criterion being that I am over 24. The 3^rd is evidence of conduct disorder before 18. This is a possibility although I was never diagnosed. The 4^th criterion is the absence of schizophrenia or manic episode. I meet that one. So therefore I cannot be diagnosed with ASPD as I only meet 2 of the 3 needed sub-criteria for criterion A.

DPD

I can only say I meet 1 of the criterion for definite for DPD. Others again are borderline or slight. Therefore I cannot be diagnosed with DPD.

In hospital I did a bit of psycho-education. What I learnt is that a personality disorder must be problematic, persistent and pervasive (the 3 P’s). None of the criteria above are really problematic, persistent or pervasive. So that further goes against a diagnosis of ASPD or DPD.

According to my own little diagnosis thing that I’ve done here I do not have ASPD or DPD. A friend once told me in hospital that if you have ever committed a crime then it’s easy for them to label you with ASPD. How reliable is the IPDE? I must admit I don’t really trust the results of my IPDE. This is because I did mine with the nurse therapist in hospital. Apparently she was trained in conducting them but she was a pretty useless nurse. I know for a fact if I did it again my results would be different. But whatever labels they would like to give me I don’t really care. I will not let them define me. From doing this I have realised how stupid diagnosis’ can be. How can you condemn someone to such a negative diagnosis through a set of bullshit criteria? What do half the criteria actually mean anyway? It’s all subjective anyway. None of it can be concrete. One psychiatrist’s opinion will vary from another. Diagnoses are basically unreliable.

What do you think?

Brokenmind

X