The diagnosis of antisocial personality disorder is usually based on a combination of a careful medical as well as psychiatric history and an interview with the patient. The doctor will look for recurrent or repetitive patterns of antisocial behavior. He or she may use a diagnostic questionnaire for APD, such as the Hare Psychopathy Checklist, if the patient's history suggests the diagnosis. A person aged 18 years or older with a
£ childhood history of disregard for the rights of others can "g be diagnosed as having APD if he or she gives evidence of three of the following seven behaviors associated with disregard for others:
^ • Fails to conform to social norms, as indicated by freo quently performing illegal acts or pursuing illegal occu-
al • Deceives and manipulates others for selfish reasons,
§ often in order to obtain money, sex, drugs or power.
•jS This behavior may involve repeated lying, conning or
An the use of false names.
• Fails to plan ahead or displays impulsive behavior, as indicated by a long succession of short-term jobs or frequent changes of address.
• Engages in repeated fights or assaults as a consequence of irritability and aggressiveness.
• Exhibits reckless disregard for safety of self or others.
• Shows a consistent pattern of irresponsible behavior, including failure to find and keep a job for a sustained length of time and refusal to pay bills or honor debts.
• Shows no evidence of sadness, regret or remorse for actions that have hurt others.
In order to meet DSM-IV-TR criteria for APD, a person must also have had some symptoms of conduct disorder before age 15. An adult 18 years or older who does not meet all the criteria for APD may be given a diagnosis of conduct disorder.
Antisocial behavior may appear in other mental disorders as well as in APD. These conditions must be distinguished from true APD. For instance, it is not uncommon for a person with a substance abuse disorder to lie to others in order to obtain money for drugs or alcohol. But unless indications of antisocial behavior were present during the person's childhood, he or she would not be diagnosed with antisocial personality disorder. People who meet the criteria for a substance abuse disorder as well as APD would be given a dual diagnosis.
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