Personogenesis of antisocial personality disorder

Man is a bio-psycho-social structure, being the only perfectible being, through the lens of his ability to achieve new goals, to build himself and access new values.

The assertion that man is a biological being with a psyche that gives him in his specificity and a social dimension confirms the structural triad made up of consciousness, logos and spirituality. Human personality represents a set of psychological traits, permanent, specifically individual, built consciously or unconsciously, which are later reflected in almost all behavioral manifestations. It has a unique destiny, it correlates to the human being, to an authentic self, bringing together the vital principle, the principle of reason, consciousness and transcendence. The human person is sculpted individually by contemplating transcendence and by affirming the values of truth, good and beauty, which preserve and develop in it all that is eminently human⁽¹⁾.

Human existence is also dimensioned by the diversity of social roles and statuses, but also by its functioning in interpersonal relationships within institutionalized social practices. The human individual fulfills himself and matures in relationships with those around him, being subordinated to social norms and moral values.

In 1937, Allport identified a total of 49 definitions of personality, used both in theology, philosophy and law, as well as in psychology and sociology, adding one more definition: Personality is “the dynamic organization within the individual of those psychophysical systems that determine his unique adaptations to the environment that influence his characteristic behavior and thinking”⁽²⁾.

The personality gradually matures and exposes herself to the evaluation of others, challenging the world around her, not just adapting to it. It becomes capable of love, it feels confident, it accepts itself, giving it an extended meaning, and it surpasses the stage of a rational being by introjecting moral imperatives and developing a multifaceted motivation with conjunctural autonomy.

Looking at personality as a dynamic structure that changes from one age to another, personogenesis is primarily a succession of ages, being conditioned by the development of the psyche, the delimitation of personality traits, temperamental and characteristic, specific to each individual, which can be adaptive or maladaptive under the influence of various sociocultural environmental conditions, but also by the integrity of the central nervous system from a morphofunctional point of view. The pathological structuring of personality is associated with three determining factors: hereditary-constitutional factors, childhood peculiarities and experiences, and social factors⁽¹⁾.

Dysfunction of personality structuring includes the inability to integrate coherent representations about oneself (self), the difficulty of interpersonal relationships – considered pathognomonic in personality disorders – and the failure of functional adaptation in the social environment. Dysfunctional aspects of self-functioning include six pathological elements: inconsistency, diffuse boundaries, unstable self-concept, defective sense of self, lack of certainty and clarity of self, and lack of autonomy and initiative.

The age at the end of personogenesis remains a territory of relativity and subjectivism, since personological maturity is the result of moral maturity and the function of consciousness, which implies a structural harmony, but also a community harmony. The core of relationship, ethical behavior and attitude is believed to take place initially in the context of a direct interpersonal relationship between people significant to each other. A secure attachment in childhood will condition emotional stability, lack of anxiety, calmness, tranquility, self-assurance, but also investigative behavior and the entire balanced development of the psyche. Insecure or ambivalent attachment and the absence of a significant figure have serious consequences for early personogenesis. It was concluded that educational models from childhood can be the basis of distorted cognitions about the self and opinion about others, a fact that makes the person vulnerable, and reactivated in adulthood, they can give rise to abnormal behaviors. The influence of the parental family on the behavior of adolescents is considered to be much greater than the social environment, the family being the fundamental mediator between the individual and society. The quality of parental affection is thus positively correlated with children’s level of extroversion^(3,4).

The deficient aspects that disadvantage the inclusion of the subject in social roles and statuses are: manipulation, abuse of the other, neglect of peers, malignant duplicity, egoism and lack of generosity, lack of feeling of shame and guilt, irresponsibility and transfer of responsibility. The adjustment deficit, transitory or conjunctural, once it becomes persistent, will define and outline the characteristics of a personality disorder.

Disharmonious personalities are in tune with their way of being, generally accepting it, confirming it as ego syntonic. A significant element in the diagnosis of personality disorder is represented by the daily, continuous presence, throughout life, starting with adulthood, of “harmful” psycho-behavioral manifestations, harmful and maladaptive behavior, which although disrupts the interrelational functionality from a sociocultural point of view, it almost never interrupts it⁽⁵⁾.

The diagnosis of “personality disorder” is used after the age of 18 years old, with the exception of antisocial personality disorder (APD), which can be confirmed from the age of 15, if there is the presence of conduct disorders lasting at least in one year (APA, 1994). The basis of the description of antisocial personality disorder in DSM-III was Robins’ study (1966), which followed the evolution of children diagnosed with conduct disorders over time. But not all lead to antisocial personality disorder, corresponding to the complexity of its etiopathogenesis involving both genetic, psychological and sociocultural factors⁽¹⁾.

Psycho-behavioral manifestations begin before the age of 15, can last for over two decades, and their intensity usually decreases with age.

Child and adolescent conduct disorders are described as manifest in four areas: aggression toward people and animals, destruction of property, fraud or theft, and serious rule violations. The first two involve the manifestation of violence, finding criteria such as often initiating fights, forcing another person to sexual actions (including rape), using firearms, enjoying torturing people and/or animals, situations of tyranny and theft, confronting with the victim. Aggressiveness towards fellow humans can go as far as sadism or even murder, and towards property it can manifest itself through destruction, arson and vandalism^(5,6).

Other criteria include breaking into someone else’s home, stealing something of value and defrauding to obtain property. For the infantile-juvenile age, “serious violation of the rules” mentions criteria such as running away from home, skipping school, and missing home at night. The onset may be constant before or after the age of 10 years old, with the disorder negatively interfering with school integration, performance and interests. The diagnostic criteria mention that at least three of the 15 criteria must be be present in the past 12 months, and at least one criterion must be present in the past six months. The lack of empathy, remorse, guilt or reduced tolerance for frustration are frequently noted, young people with conduct disorders being behaviorally unstable, with frequent bouts of anger. From a developmental perspective, an early onset of alcohol consumption, smoking, illicit substance use, disordered sexual behavior, and risky and reckless acts are often described^(7,8).

Regarding the neurochemical substrate characteristic of antisociality/cluster B, increased levels of dopamine in the presence of low levels of serotonin biologically underpin the psycho-behavioral manifestations of extroversion, respectively neuroticism, with addictive tendencies and marked impulsivity. Also, the triggering of tantrums and aggressive behavior as a feature of antisocial personality disorder appear to be due to decreased serotonin levels and increased noradrenaline levels⁽⁹⁾.

The role of dopamine in the pathology of personality/psychopathological disorder was imposed, implicitly of the five genes corresponding to dopaminergic receptors. The search for the new involves curiosity, extravagance, impulsiveness, impatience and hyperexcitability. Genetic influences are also demonstrated by the cases of children with increased D4 receptor activity, who tend to have stressful life experiences due to the fact that their parents show increased levels of novelty seeking and, thus, neglect them. Children will be left to experience the novelty, thus favoring a dimension of the spectrum of antisociality.

At the same time, it was confirmed that the relatives of these patients developed pathologies with an impulsive or affective nature. The role of genetics in the transmission of mental traits is known, especially on the male line, from father to son, both in the general population, but especially in the case of antisocial personalities. There is a psychological and a biological heredity. Physical traits are genetically transmitted to a greater extent than mental ones (affective and cognitive), which are more complex^(9,10).

It is considered that, among mental traits, intelligence is one of the supreme attributes assigned to progressive maturation and that its hereditary transmission is in a proportion of 80%. In the case of temperament traits and simpler mental functions, the influence of heredity is greater and declines in late personogenesis in favor of social factors, learning and exercise.

There is significant genetic conditioning of behavior towards the educational/professional environment and towards congeners, as well as reactions to psychotrauma, again, or attitudes towards drugs or alcohol. Careless or abusive behavior, due to the dysfunctionality of the parental role, characteristic of unstable and aggressive parents, favors and facilitates the appearance of antisocial traits^(6,11).

In individuals from cluster B, especially in those with antisocial personality disorder, there is a decrease in the mass of the gray matter and abnormalities of the prefrontal cortex, both correlated with the degree of impulsivity, but also with the deficit of executive functions. Functional MRI studies demonstrate the morphofunctional substrate of antisocial aggression. This is controlled by an emotion regulation circuit involving the ventromedial cortex, hippocampus, amygdala, hypothalamus and other associated areas.

There are also biological markers common to personality disorders and Axis I of DSM-IV-TR psychopathological disorders.

In structuring the personogenesis of the antisocial, the accumulated experiences and experiences throughout childhood and adolescence intervene. Interpersonal relationships influence the personality dimensions of the five-factor model – parents vertically, and congeners horizontally. The Big Five dimensional approach to personality disorder identifies a correlation between personality disorder symptomatology and the Five-Factor Model of Personality (FFM). Most studies indicate that both poles of the five factors contain maladaptive forms. Thus, antisocial personality disorder is correlated with antagonism and a reduced level of neuroticism and conscientiousness^(1,12).

Environmental factors determine the humanization of the individual, confirming the structuring of consciousness and spirituality. The type of society can stimulate, deform or inhibit delinquency, aggression or crime.

The discrepancies between socioeconomic levels cause young people from disadvantaged backgrounds to develop frustrations and antisocial behaviors: aggressive, abusive and manipulative. This is how the framework of disharmonious antisocial structuring appears.

The contemporary sociocultural context is dominated by various facets of pragmatism and nonconformism, promoting relativism and easy hedonism corresponding to ephemeral doctrines and values. The continuous search for progress and the search for the new has diminished the role of the importance of traditions, stable ideologies and old norms of community life.

Community life is dominated by associations, clubs or foundations as an expression of ideological relativism that seeks to revitalize the human being’s sense of belonging, security and self-image.

Society currently has two major models of the successful life: a superior/important social status and the highest possible financial power. However, the contemporary person is more concerned with “having” than “being”. Moral values and community traditions have been replaced by contemporary mottos such as “anything is possible”, “here and now”, and old customs have been turned into spectacle or even ignored.

The cultural motto “everything is transient” stimulates the superficiality of affective traits that take the form of a show. Its viewers, whether cultured or not, remain an inert mass that can be manipulated and become victims of their own subjectivity. In this context, behavioral patterns can be very different and appear at an overwhelming rate, leading to the development of a hypertrophied but extremely vulnerable Self.

Increased urbanization and labor mobility have also contributed to the process of disintegration of the family unit, thus providing false existential patterns. Parents are overworked, single-parent families dominate, and the moments when the family is together, on various occasions, traditions or holidays, are increasingly rare. The existence of a “technological mother” – TikTok, Instagram, video games (Minecraft, consoles), TV, radio – has replaced the natural mother, and the stories told by grandparents are less and less heard. Adolescent education falls to instructors who are alien to classical pedagogical values. Educational offers overburden young people, but satisfy the parental Ego⁽¹⁾.

The inability of adolescents to determine their relationships with peers and to differentiate themselves from their parents can become a major vulnerability factor in the harmonious structuring of the personality. Marked deficiency of Superego development along with following and imitating the behaviors of the entourage/those around lead to increased aggression and hostility.

Individualism is cultivated, children being taught from early childhood to highlight the differences between themselves and others. The conflicting emotions and attitudes that misunderstandings between parents cause children to internalize repeatedly lead to the accentuation/deepening of vulnerability.

Young people come into contact with extremely different behavioral patterns, full of contrasts, by which they are strongly influenced, pressured and disoriented. Classic parental models are ignored, and by internalizing the fluctuations of the family structure, the satisfactions of the “here and now” are preferred over an uncertain future. Ignorance of true community values and norms, introjection of offers from the mass media and receptivity to new presented and idealized models increase, and false hedonism is created by the availability of drugs and alcohol.

The low economic status is a source of deprivation and rejection, the poor sociocultural conditions maintaining the feeling of insecurity and favoring the tendency to avoid the entourage followed by isolation⁽¹³⁾.

The constant search for balance between self-esteem and self-image, related to illusory models or contemporary gods, leads man to selfish introspection and undermines empathic openness to those around him. Mutual influences against the background of attitudinal and psychoemotional instability will lead to the compensatory emergence of manipulative tendencies, arrogance, aggression and cruelty in relations with others⁽¹⁴⁾.

Aickham (cited by Lăzărescu and Nireştean, 2007⁽¹⁾) described the deviant behavior in psychoanalytic terms, by emphasizing the deficiency of Superego development and the inability to assimilate moral values that prompt the antisocial to primitive defensive mechanisms, favoring aggression and hostility. Thus, it was observed that psychopaths do not have feelings of guilt or anxiety regarding their behavior. Within antisocial personality disorder, a reduced capacity for self-knowledge is described, especially in the area of deficient introspection.

From a cognitive perspective, characteristic of the antisocial is the hypertrophied Ego and the beliefs of omnipotence, uniqueness and personal superiority. The intimate and the real self-harmonize, being dominated by grandeur and aggression.

The behavioral items of antisocial personality are manipulation, dominance, violence, hostility, criminal and delinquent potential, uncontrollable need for extreme situations and thrills, along with absolute superiority. Characteristic is the pattern of violating and disregarding the fundamental rights of other people, the low control threshold of aggressive, including violent manifestations, which is frequently associated with the repeated committing of acts that constitute reasons for arrest – repeated attacks and physical fights with total disregard of the risks. Promiscuity and attitudinal disinhibition explain early delinquent behavior, from the period of puberty^(8,15).

Affective relationships with peers are superficial, and the absence of anxiety, boredom and disgust accentuates self-interest, self-centered motivations, and immorality. Affective life is dominated by shallow feelings, lack of respect, indifference and inability to relate empathetically, which prevent the engagement in stable marital or friendship relationships, with a large number of individuals preferring celibacy. Emotional detachment is pathognomonic and implies major interpersonal attachment difficulties. Psycho-behavioral and oscillating instability, incisiveness, continuous tendency to blackmail and lying, dishonesty and inability to make plans, honor financial obligations and obey social norms and rules are defining, while also influencing professional life, which it is a chaotic, disorderly one, in which many find themselves among the unemployed.

Arrogance and egophilia maintain the pathological pride, and against the background of intolerance to frustration, anger, marked irascibility and manifest impulsivity appear, without apparent motivation. The absence of humor and sensitivity makes notable the inconsistent behavior, chaotic, selfish destiny, the inability to learn from experience, the inclination/tendency to blame, denigrate and control those around them, with the fulfillment of their own strictly egocentric needs and desires. Ignorance of risk, morbid desire for self-affirmation, self-satisfaction, lack of remorse, the uncompromising and mythomaniac discourse of the antisocial always reconfirm their characteristic irresponsibility^(2,8).

Thus, a series of predominantly moral-behavioral criteria are corroborated that define a personological structure with predominantly affecting the male gender, where statistically highly significant correlations were found, with p>0.0001 values and with the earliest manifestations from the perspective temporal, in approximately 35% being detected before the age of 20 years old.

From a methodological perspective, the co-occurrence between the disorders on Axes I and II is evidenced factually. Cluster B, that of flamboyant and dramatic personality disorders, shows the strongest correlation with drug and alcohol dependence and impulse control disorders. Regarding affective, food instinct or stress disorders, a moderate relationship was revealed. In the Epidemiologic Catchment Area Study, a percentage of over 90% of patients with antisocial personality disorder had an additional diagnosis on Axis I, largely related to alcohol abuse.

In the study done by Oldham (cited by Lăzărescu and Nireştean, 2007⁽¹⁾), it was identified that there are increased chances of associating anxiety disorders, psychotic disorders or substance addictions in individuals in cluster B. Polydrug addiction is correlated in all statistics with antisociality. Thus, chronic use of drugs and alcohol can emphasize the initial personality traits and alter the personality, secondarily. Due to the diversity of psycho-behavioral manifestations and the diversity of comorbid pathologies, the diagnosis of antisocial personality disorder can lead to false positive results.

The antisocial structural conformation advocates complex reciprocal interconditionings with the psychopathic personality, representing extreme expressions of individual identity facets. Among the common traits of the antisocial and psychopathic personality, there are boldness, behavioral disinhibition and affective detachment. Moreover, the antisocial personality is considered to be an unremarkable, “unfulfilled” and “unsuccessful” psychopathic personality. Low levels of conscientiousness, common to antisocial and psychopathic personalities, favor substance abuse and impulse control disorders.

Sexual promiscuity, charm and emotional superficiality represent interferences of a histrionic nature, and the feelings of superiority/grandeur and the sense of omnipotence maintained by megalomaniac fantasies often fueled by conjuncture, the absence of empathy, arrogance, self-reference, manipulative tendencies and hostility corresponding to the absence of desired gratifications, approach that of the absence of desired gratifications

The antisocial personality misrepresents and caricatures the human condition in accordance with self-awareness and self-knowledge, norms of common sense, interpersonal relationships, and genuine moral and affective values. The adaptive deficit and the pathological features of the antisocial personality can be blurred or shaped by accessing moral values, capitalizing on coexisting talents and skills, engaging in rewarding relationships, and by the compassion and tolerance of the social community, all of which create a favorable environment both for them and for society, but antisocial personality disorder cannot benefit from genuine happiness.

Autori pentru corespondenţă: Aurel Nireştean E-mail: aurelnirestean@yahoo.com

CONFLICT OF INTEREST: none declared.

FINANCIAL SUPPORT: none declared.

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