According to the DSM -V, Antisocial Personality Disorder (ASPD) is a “pattern of disregard for, and violation of, the rights of others” (639). Borderline Personality Disorder (BPD) is defined by the DSM-V as a “pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity” (639). Both disorders carry the potential to co-exist with substance abuse and impulsive behaviors (Nolen-Hoeksema, 12/2013). Aggressive behaviors, identity disturbance, and unstable interpersonal relationships are also similar symptoms of both BPD and ASPD (“Mayo Clinic”, 2016). However, the differences lie in the context of manifestation of the symptoms. Impulsive behavior in two potentially self-harming areas such as sex, spending, or substance abuse is consistent in BPD rather than planning failure as seen in ASPD (American Psychiatric Association, 2013). The impulsivity of ASPD often leads to arrest as they fail to comply with social norms and disregard the safety of themselves and others (“Mayo Clinic”, 2016). In ASPD, individuals typical target aggression toward others whereas individuals with BPD tend to partake in self-harm and suicidal ideations or tendencies. Researchers report 75% of individuals attempt suicide and 10% of those actually commit the act (Nolen-Hoeksema, 12/2013). Those with ASPD emit superiority and arrogance, but are rather deceitful to gain pleasure or personal profit at the expense of others (“Mayo Clinic”, 2016). Those with BPD tend to have a negative sense of self leading to constant feelings of emptiness and being worthless and undesired (“Mayo Clinic”, 2016). Additionally, treatment varies between both disorders. Treating ASPD can be difficult as the individual typically feels that nothing is wrong and no help is needed. Treatment is most beneficial through the use of teaching coping skills for anger and emotion control (Nolen-Hoeksema, 12/2013). BPD has several successful treatments including medication, cognitive behavior therapy to help the individual see themselves in a positive manner, and dialectical behavior therapy helps teach individuals problem solving skills and emotion regulation (Nolen-Hoeksema, 12/2013).
Forensic Mental Health Professionals need to be able to identify the differences between the two disorders in order to identify which, if either, personality disorder is present. The disorders are closely related and it is imperative to establish if motives are directed towards the self or others. It is also important to establish if a psychotic disorder underlies the personality disorder or if it’s possible the disorder manifested from substance abuse. In these disorders, individuals are unstable making the primary goal to stabilize mood and emotion which is achieved through developing a proper treatment plan which evolves from the identification of possible diagnoses.
The text implicated substance abuse as a piece of impulsive behavior associated with both disorders. It also said individuals with these disorders may be victims of physical or sexual abuse. Previously I learned that those who suffer from abuse, tend to bury the memory in an effort to escape it. However, there are unidentified triggers that allow the memories to surface with no evidence, not even the actual physical memory, outside of behavior and emotional disturbances. I think as individuals begin to understand they have something “abnormal” going on, they look for an escape, an easy one. I believe this desired escape leads to substance abuse as it has a quick effect on the individual.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Mayo Clinic. (2016). Retrieved from http://www.mayoclinic.org/
Nolen-Hoeksema, Susan. (12/2013). Abnormal Psychology, 6th Edition. [VitalSource Bookshelf Online]. Retrieved fromhttps://digitalbookshelf.argosy.edu/#/books/1259316335/