Antisocial Personality Disorder is a Spectrum
The question that people most commonly ask, while they're trying to figure out if they may have ASPD, or if the diagnosis they received is an accurate one, is: "Can I even have ASPD if I don't do *specific symptom*?"
Even people who have been diagnosed, or medically recognized, for years, still continue asking themselves, if ASPD is the correct diagnosis, based on how they perceive other people's presentation of the condition compared to their own.
Its a worry, that makes sense, since people with ASPD do often have experienced being invalidated in their childhoods, being told they're just choosing to misbehave and also continue being confronted with stereotypes as the "only valid & talked about presentation".
People who question whether they may have this disorder and whether it may be worth it to bring this concern up with a psychologist, often feel intimidated by the public's insistence on ASPD being solely defined by violence and law breaking.
Similarly, people who are diagnosed with ASPD, often feel as if they are not violent enough, or do not break laws often enough, in order to really have this diagnosis.
Other common worries/questions often circle around the lack of empathy, the lack of guilt/remorse, overall emotional intensity, impulsive behavior, having relationships, being manipulative, etc.
There's simply a sort of pattern, where people are concerned whether they have enough of the common experiences, or whether they have experiences, that automatically mean they do not have ASPD.
In the end, the answer to those questions, is relatively easy! ASPD exists on a spectrum, just as any other disorder/condition does.
You need to meet 3 out of the 7 criteria points (in the DSM-5) in order to be diagnosed with ASPD. Those criteria points are only met if your experiences are: not "normal" for your cultural/regional background, cause you impairment in your daily life, have been there for a certain duration of time and are not better explained by other conditions/episodes/etc.
In the case of ASPD, that means that you can meet criteria if you, as an example, check off the symptoms for impulsivity, irresponsibility and aggression OR check off the symptoms for the disregard for others, lack of remorse and law breaking OR...you get the picture. Theres a really big amount of combinations for the symptoms alone and an even bigger amount when it comes to how severely you experience each symptom.
Lets look at this with the example of lacking remorse! You can theoretically have ASPD without ever meeting this criteria point, if you meet enough of the others AKA you can have ASPD and still feel a shitload of guilt for the things you do. You can also partially meet it, by lets say, not feeling remorse for people unless they're really close to you, or only for specific actions/situations. You can have problems with feeling remorse emotionally, or you can have problems with understanding the concept cognitively, or both.
If you deal with episodic apathy due to other conditions, you may also experience a lack of remorse without that ever being caused by ASPD, but it may cause you to meet other criteria points to a higher/more frequent degree during those episodes. You may, as an example, break laws more frequently or have a higher amount of impulsive behaviors during which you disregard other people. Which could be symptoms you already experienced before, but now that you don't feel sorry for it, it happens more often until the apathy episode ends. In these cases ASPD symptoms and symptoms from other conditions influence each other and cause a complex individual presentation.
This is true for every single symptom, for every single person. A lack of one specific symptom doesn't immediately disqualify you from having ASPD. Thats just not how the criteria works.
Additionally theres a lot of experiences that, while associated with ASPD & used to support the diagnosis, are not in the criteria list themselves. So they aren't technically necessary, even if they are observed in a lot of cases (this includes the lack of empathy and muted emotions).
Now, while all of that is true, theres also a point to be made, that ASPD, in criterion A is characteterized as a pattern of "disregard for and violation of the rights of others, occuring since age 15". This pattern is then "indicated by three or more of the following" seven criteria points. Your symptoms, therefore, do need to form said pattern and be present relatively often and in a way, that indicates, that this is your day to day reactions and not something that just happens once in a while.
Another thing, thats maybe important to think about, is that the DSM-5 only mentions a few possible ways symptoms can present. It cannot and will not cover the whole range of possibilities.
Which means, that you may meet the criteria points without even realizing it, because you simply present in a way that deviates a lot from the common stereotypes.
Did you know that you can meet the criteria point for aggression, if you're only verbally aggressive? Or if your immediate reaction is aggression, but you let it out on yourself or in ways that just are not visible for other people? A lot of people think its only physical fights, or obvious lashing out, that get you to meet this criteria point, but theres a lot more to it and this is true for all the symptoms!
Impulsivity/failure to plan ahead, can absolutely look like the more stereotyped reckless spending, reckless driving and dyeing your hair a bunch of colors, but it can also be stuff like: saying things before you stop to think about them, booking a ticket to another country for in an hour without considering whether you can get there in time or how you'll fly back, leaving the house in a rush because you see your friends are in town and forgetting your keys and phone inside and having to call a locksmith from your neighbours house at 3am, frequently staying up at night because you wanna just play one more game or read one more book and failing to consider that you have work in the morning, calling in sick because you dont wanna get up and it sounds like a good idea but its actually the thing that gets you fired etc.
A lot of this can also tie into irresponsibility, which is more than just not showing up to work, or not paying your debts back. Irresponsibility can range from not caring for your children properly, to consuming unsafe things, to not caring properly for yourself while you're ill, to putting off repairs on the house because you can't be bothered to do it until its too late.
So yes, you can have ASPD as long as you meet 3 criteria points and criterion B-D. Yes, even if:
• you develop deep bonds to others
• you love cute things and "childish" stuff
• you have hobbies you're passionate about
• you've not broken the law (tho you need to make sure you still meet "conduct disorder prior to age 15" requirements in other ways here!!)
• you're not impulsive at all
• you can hold down a job
• you have children you love
As long as you meet criteria, despite things like that, you have ASPD and no uneducated "but ASPDers never care and never feel and never do x" opinions can change that.
Do keep in mind, that personality disorders usually affect all three: thoughts, emotions and behaviors! If your actions are cruel, but you experience no lack of prosocial emotions or thought patterns, your experience will likely not be grouped under ASPD. If it was, every bully or asshole in this world would be diagnosed with ASPD, but they usually are motivated by prosocial thoughts and emotions as well (just to the detriment of a few specific groups of people).
In my opinion, theres a clear difference between someone with ASPD, that has an overall disregard for people and a bigot, who has a specific disregard for a specific group of people due to a misguided belief, that he is actually helping "his group" by opressing that "other group" => prosocial motivations can be harmful, but harmful prosocial motivations are not antisocial.
That being said, as an antisocial person, it can be hard to differentiate between a disregard for specific groups and an overall disregard, especially if people treat it as the same and use the same terms for it, so its not surprising to me, that many people can't tell the difference.
• ASPD exists on a spectrum because every person has an individual presentation
• As long as you meet 3 criteria points and criterion B-D, you have ASPD, even if you dont conform to stereotypes, or if you do something that people think is an immediate disqualifier
• The DSM-5 only lists examples and not every possible presentation and it acknowledges this itself
• ASPD symptoms are not equal to bigotry, because bigotry is not antisocial. Its harmful prosociality, which makes it that much more attractive to people, because they aren't against society, they are for a BETTER society for THEIR people and thats much harder to argue against. Which may seem irrelevant to the topic, but trust me its especially important right now, because I for one would love it, if people could stop calling people "sociopaths" or "psychopaths" when they're actually bigots, thank you very much.
first posted on my instagram (same @)
