Personality Disorders: What is an Antisocial Personality Disorder?

I watched an interesting BBC (2001) movie, The Hole, over the summer. The story begins with the main character Liz Dunn’s proposed version of the tragic deaths of her friends. We meet Liz giving her statement to the police and learn her perspective of what happened. It all started when four college students decided to spend a weekend in an underground military bunker instead of going on a school field trip. Liz had a crush on a fellow classmate and used this opportunity to get to know him better. As the story unfolds, however, it becomes apparent that Liz is lying and deliberately misleading, whereas the truth is much different.

The movie then retells the weekend events. Liz is revealed as a self-serving mastermind of the horrific events that led to the deaths of her friends. She callously ignores her best friend’s plea for help in order to spend more time with her love interest, kills another friend to keep him from revealing the truth about the weekend, and then threatens the police officer assigned to the case when the evidence doesn’t support Liz’s version of the events.

The character of Liz Dunn is a classic example of an Antisocial Personality Disorder (APD).  Approximately four percent of the adult population suffers from this condition. Liz is an unusual case since men are eight times more likely than women to manifest symptoms of APD. What is particularly noteworthy about this disorder is that legal difficulties is one of the dominate symptoms. Some researchers have proposed APD is not so much a psychiatric condition but rather a societal/legal problem. Martha Stout, in her book The Sociopath Next Door, defines individuals with APD as conscience-less. She writes, “It is not that this group fails to grasp the difference between good and bad; it is that the distinction fails to limit their behavior.”

This fall we will finish the series on personality disorders by exploring the psychiatric features of Antisocial Personality Disorder. We will look at the development and characteristics of APD, it effects on marriage and parenting, and APD’s receptiveness to treatment. But before addressing these aspects of APD, we must first consider our current definition of morality.  How do we define “good” and “evil?” What makes any particular behavior right or wrong? Our society is built on these distinctions. To understand APD we must first address the role conscience plays in our society.

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-The Sociopath Next Door by Martha Stout, PhD (2005) Broadway Books, p. 10