A presentation I had to give in nursing school.
Anti-social personality disorders encompass a myriad of associated disorders including sociopathic, psychopathic, dissocial, amoral, and asocial disorders. The definitions for and differences between these disorders vary depending on the evaluation system one uses (Putnam, 2008). The DSM-IV-TR makes no distinction between these related disorders and refers to all of them as "anti-social personality disorder" or ASPD (American Psychiatric Association, 2000). There is also significant overlap between ASPD and the other cluster B personality disorders which are borderline, histrionic, and narcissistic (Howland, 2007).
A generalized idea of how a sociopath operates is that a sociopath has no moral mechanism which prevents them from acting on whatever impulse they feel at the moment. An anti-social person only follows rules, laws, and social norms as it benefits their goals. An anti-social person tends to form relationships only as they are of personal benefit and to use people as tools to fulfill their own needs and desires. These people feel a strong sense of entitlement. Anti-social people feel that they are justified in any actions they take to receive things they are entitled to. Psychopaths tend to have higher then average IQs (Putnam, 2008).
Recent studies have indicated that psychopathic individuals have infiltrated high into the ranks of corporate America where their aggressive and amoral profit seeking behavior is highly desirable. For example Albert Dunlap, the former CEO of Sunbeam, was a legend in business circles described as "a sharpshooting corporate god." In 2001 it was revealed that Dunlap had been involved in false bookkeeping practices which cost the corporation millions. Dunlap also allegedly kept his first wife inside their home without access to food or money for days at a time. Dunlap has successfully published two books on corporate financing and leadership, remarried, and is major benefactor of the Munroe Regional Medical Center in Florida (Putnam, 2008).
Anti-social personality disorders are often thought of in conjunction with serial killers such as Richard Ramirez. However, imprisoned convicts are usually considered unsuccessful psychopaths. Successful sociopaths are able to control their impulses, manipulate people, and operate within systems of laws and rules so much so that they tend to rise to the top in many settings. Such people are often drawn to the corporate, legal, and political worlds in search of wealth and power (Putnam, 2008).
Although the ASPD client will lack any form of empathy, they may possess an excellent understanding of other's emotions and how to exploit them (Putnam, 2008).
A true psychopath will seek nothing but personal gratification from any relationship, but may also be a master of wit, charm, and charisma. Such persons may be able to hide their selfish intentions for years at a time until the perfect situation to victimize or use someone has came into place (Putnam, 2008).
Health care workers are likely to encounter so called failed sociopaths in clinical experiences. However health care workers are also likely find, in day to day life, equally amoral and dangerous psychopaths who are adept at hiding their true actions and intentions.
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