How Alcohol Abuse Can Mask Antisocial Personality Disorder

Antisocial personality disorder (ASPD) is a relatively common mental disorder. As many as one in 100 women and three in 100 men may suffer from ASPD. Even though it is prevalent, diagnosis of antisocial personality disorder can be difficult to make. Alcoholism can make the disorder even harder to discover because it provides a kind of camouflage for many of the disorder’s key indicators.

Fundamental Differences between Alcoholism and ASPD

As they evaluate their clients’ needs, mental health practitioners use the clinical definitions in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) to make diagnoses. The differences between alcoholism and ASPD are dramatically illustrated by looking at official descriptions of the two disorders.

The DSM-IV points to a set of outward behaviors to define ASPD. That is to say, the person’s actions are the heart of the diagnosis. Someone who exhibits enough defining behaviors may be designated as having ASPD. These repeated actions constitute a pattern of behavior that is destructive to the sufferer and the people around him or her.

Alcoholics behave destructively too, but the DSM-IV’s definition of alcoholism zeros in on the relationship between alcohol and that destructive behavior. In evaluating someone for alcoholism, mental health practitioners look for patterns of alcohol abuse leading a person directly to exhibit destructive actions.

Overlapping Behaviors

Although these two disorders are very different, some of the destructive actions of their sufferers can be very similar. Among other things, alcoholism may commonly lead its sufferers to engage in the following behaviors:

  • Repeated violence
  • Dereliction of responsibility
  • Emotional manipulation
  • Reckless endangerment of others, such as driving while drunk
  • Acting on impulse instead of judgment
  • Lying
  • Stealing

These behaviors arise as an alcoholic’s moral principles are pushed aside by the need for alcohol.

A Disorder in Hiding

Each of these behaviors is also among the habits that can indicate ASPD. That is why alcoholism can mask ASPD. If an individual is an alcoholic, it’s possible for all of his or her symptoms of ASPD to be simply seen as a consequence of alcoholism. Mental health professionals are, after all, scientists. One explanation to any one problem is usually all that is needed. If alcoholism can explain all of the problems in the patient’s life, no one may look for more disorders.

Unmasking the Hidden Disorder

Treating one disorder, however, will not give the individual suffering from both ASPD and alcoholism the results he or she deserves. It would be a little like giving someone half a life raft; the individual will still sink.

Because of the relatively high co-occurrence of these two disorders, a treatment professional or psychologist may look for evidence of ASPD after a diagnosis of alcoholism is reached. The medical professional can look for the link between alcohol use and the destructive behavior. If alcoholism is the only problem, then it has to be the only cause for the destructive behavior. If someone is cruel, dishonest and thieving even in moments of sobriety, alcohol cannot be solely to blame. The medical professional can also look into the patient’s childhood history. The DSM-IV indicates that someone must have suffered from conduct disorder during childhood in order to be diagnosed with ASPD.

Once the full story of alcoholism and antisocial personality disorder is brought to light, the two disorders can effectively be treated as co-occurring disorders.

Treat the Whole Person

If you or your loved one is an alcoholic, you may feel that the whole problem has still not come to light. Call our toll-free, 24 hour helpline to find out more about how alcoholism can mask antisocial personality disorder.

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