Personality disorders, which are persistent behaviors and internal experiences that significantly deviate from the expectations of the culture in which the person lives, are persistent disorders that manifest themselves in two or more of the areas of cognition, affect, interpersonal functioning, and impulse control, are inflexible, and cover a wide range of personal and emotional states. is a pattern. This persistent pattern causes clinically significant distress or impairment in social, occupational, or other important areas
A general look at the characteristics of APD shows that conduct disorder that begins at an early age has developed into antisocial behavior in adult life. ; It is stated that these people have weak behavioral control, lack conscience and empathy, and act irresponsibly, manipulatively and deceitfully. They consider themselves big and are self-centered. They have superficial charm but are unable to fulfill long-term personal promises. They are impulsive and angry.
Checkley's (1976) definition of psychopathy is as follows:
1. Superficial charm and good intelligence.
2. Absence of delusions or unrealistic thoughts
3. Absence of psychoneurotic symptoms
4. Distrust
5. Lying, insincerity
6. Absence of remorse and shame
7. Insufficiency
8. Failure to learn from experience and poor judgment
9. Pathological selfishness and inability to love
10. A general absence of many emotional responses
11. Lack of insight
12. Irresponsibility in interpersonal relationships
13. Fantastic behavior (sometimes with alcohol and substance use)
14. Rarely occurring suicidal behavior
15. Sexual life without choice
16. Failure to draw a life plan.
Etiology of Antisocial Personality Disorder (AKD)
1.Psychological Factors
Regarding the etiology of APD Psychological factors are addressed by psychodynamic and psychoanalytic theories, learning theories and cognitive theories. Both psychoanalytical and psychodynamic theories examine APD as a factor in superego development. It is attributed to deficiency or pathology. Psychoanalytic theorists argue that antisocial personality arises from a pathological grandiose ego, as in narcissistic personality, and that angry introversion is especially prevalent in APD. Accordingly, due to the parent's neglect or abuse of the child, the child internalizes the image of a hostile parent and finds the parent unreliable and hostile. When this situation is combined with the absence of a loving maternal object, the basic feeling of trust cannot be formed and a fixation occurs in the separation-individuation process.
Due to the mentioned process, the child cannot gain object permanence. Since the mother object is seen as an enemy and stranger, the child cannot establish relationships with his mother. The necessary attachment relationships and emotional experiences are dissolved and replaced by sadistic, destructive and control-based relationships with others.
Kernberg (2000), “malignant narcissism syndrome” or “antisocial He sees APD, which he calls "personality disorder", as a typical narcissistic personality disorder, and treats the disorder as pathological object relations and super-ego pathology. According to Kernberg, due to the lack of a constant relationship with the caregiver or traumatic experiences in childhood, these people develop a deficiency or pathology in their superego development.
2. Cognitive Approaches
The cognitive-behavioral formulation of the disorder reveals that these individuals make a number of self-serving cognitive distortions. These are, respectively, excuse-making (where wanting something or wanting to avoid something justifies behavior), thinking as belief (believing that thoughts and feelings are always true), personal rigidity (believing that one's choices are always good and right), accepting emotions as evidence. cognitive (thinking that one's behavior is justified because one feels it is right), thinking that others' opinions about one's decisions are unimportant, and low likelihood of outcome (believing that undesirable things will not happen or are none of one's business) These are the distortions revealed by these approaches.
According to cognitive-behavioral approaches, the person's beliefs about himself and others lie beneath the transferred cognitions. These people perceive themselves as strong and autonomous people who follow their own path (loner), and they see the world as a cruel, difficult place where they can be deceived at any moment. Their perception of others is that others are manipulative, exploitative, weak and weak. Therefore, individuals with APD believe that they must protect themselves and be more aggressive than others, otherwise others will manipulate them. (Beck and Freeman, 1990).
Another core belief is that they are always right; Therefore, they do not feel the need to question their behavior. Again, because of their distrust of others, they do not seek advice or guidance regarding their past, present, or future behavior. Since they focus only on the present, they cannot predict the future consequences of their behavior (Beck and Freeman, 1990).
3.Learning Approaches
Learning approach From this perspective, it is seen that individuals with APD do not learn conditioned fear reactions, therefore these individuals have difficulties in learning fear and avoidance reactions aimed at reducing fear. Additionally, individuals with APD may have been operantly conditioned to aggressive behavior due to the traumatic experiences they were exposed to during the early periods of their lives. When it is remembered that people with APD have fears that they will be harmed or deceived by others, it has been suggested that their hostile, oppositional, and manipulative behaviors serve as a negative reinforcement to reduce the possibility of the above-mentioned negative expectations coming true, thus serving to continue the disorder (Millon & Everly, 1985). p>
4.Attachment Theory
Attachment theory has an important place in explaining AUD as well as in explaining many psychopathologies. The attachment experience with the primary caregiver affects the child's representations of self and others, as well as It affects the thought and behavioral strategies associated with crying. At this point, negative experiences such as loss or abuse may cause the child to develop negative representations of self and others, or to develop certain thought and behavioral strategies that predispose the child to psychopathology.
Long-term separations with caregivers may cause the father to become antisocial or antisocial. It is known that experiences that disrupt the attachment relationship, such as deviant behavior or a mother's lack of warmth and neglectful care, are associated with APD.
A study by Zanarini (1989) showed that 89% of individuals with APD had it at some point in their childhood. It shows that they have experienced long-term separations from their caregivers, and many of them have been subjected to physical abuse or harsh disciplinary practices. Other studies also show that individuals with APD have dismissive or fearful attachment styles, indicating that they have not been able to establish a secure attachment experience.
5. Psychosocial Factors
When psychosocial factors are evaluated in general, research findings show that people with AUD are mostly from low socioeconomic levels and rural areas; that they migrated to cities or foreign countries and lived under difficult conditions in unbuilt slums; They come from disorganized, fragmented, chaotic families where family conflicts are common, with parents who are inclined towards alcoholism, gambling, crime and excessive beating; They were exposed to sexual and physical abuse and neglect in their childhood and adolescence; It is seen that these people have a history of parental loss/separation and emotional deprivation, especially in the first years of life (Türkçapar, 2002).
Parental attitudes seem to have a very important role among psychosocial factors. . Accordingly, parents' hostile attitudes, being inadequate role models (lack of an authority figure at home or parents providing little guidance to the child), inconsistent disciplinary behavior, abusive behavior, reinforcement of the child's anger behaviors, etc. Factors play an important role in the development of the disorder by interacting with biological predispositions (Patterson, 2002).
Another factor related to parental attitudes that plays a role in etiology is the parents' "competence", which is generally considered the opposite of antisocial behavior. It is related to its effect on the process of gaining competence. It has been understood that parenting characteristics such as control, discipline, closeness and positive reinforcement are related to variables such as academic ability, good peer relations and self-esteem, which indicate the acquisition of competence. On the other hand, the parenting styles mentioned above prevent individuals with APD from gaining competence.
Research results show that sexual, emotional and physical abuse and neglect experienced in childhood are the most important factors that play a role in the etiology of AUD, along with many other disorders. indicates that there are important factors. It is known that physical and emotional abuse is associated with lower scores on intelligence tests, less empathy, cognitive deficits, higher levels of depression, and difficulties in relationships with both family and peers. It is also reported that abused children are much more aggressive towards their peers, and some of them become “abusive” while they are victims.
Approaches that explain the etiology of personality disorders in general, and APD in particular, have evolved over time. They have turned to a biopsychosocial and holistic framework.
These approaches seem to approach the disorder from a perspective that integrates with object relations and attachment theories, including explanations for interpersonal relationships, and make a cognitive-interpersonal formulation.
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