The National Addiction: Lies and Deception Disguised as Mental Health

Buy for others

---

He may continue to minimize the harmful consequences of his actions, or he may simply indicate complete indifference. Back to top Diagnostic Features Individuals with Antisocial Personality Disorder ASPD have a pervasive pattern of disregard for and violation of the rights of others, occurring since age 15, as indicated by three or more of the following: Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest.

Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. Impulsivity or failure to plan ahead. Irritability and aggressiveness, as indicated by repeated physical fights or assaults. Reckless disregard for safety of self or others.

Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. The individual is at least age 18 years. There is evidence of conduct disorder with onset before age 15 years.

The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder. Like all personality disorders, Antisocial Personality Disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

In childhood, these individuals usually have Oppositional Defiant Disorder towards parents and teachers which develops into Conduct Disorder delinquency in adolescence. This delinquency takes the form of reckless thrill-seeking, physical violence towards people or animals , and law-breaking. These individuals become the school bullies, thieves, vandals, and drug-dealers. Most adolescent delinquents grow out of this behavior as they enter adulthood. However, those that increase their delinquent behavior as they enter adulthood have their diagnosis changed from Conduct Disorder to Antisocial Personality Disorder.

In adulthood, individuals with Antisocial Personality Disorder become more antagonistic.

Kinsey Is Wrong!

They show an exaggerated sense of self-importance, insensitivity towards the feelings and needs of others, and callous exploitation of others. Their increased manipulativeness, callousness, deceitfulness, and hostility repeatedly puts them at odds with other people. However, some individuals with this disorder rise to high positions of power in society by becoming masters of manipulation and deceit. There is a strong need to be independent, to resist being controlled by others, who are usually held in contempt.

There is a willingness to use untamed aggression to back up the need for control or independence. The [antisocial personality] usually presents in a friendly, sociable manner, but that friendliness is always accompanied by a baseline position of detachment. He or she doesn't care what happens to self or others". Neumann found that Antisocial Personality Disorder consists of 4 factors: Superficial charm, grandiosity, pathological lying and manipulation Callousness, lack of remorse, shallowness and failure to accept responsibility Impulsivity, sensation seeking and irresponsibility General rule breaking Conflict Individuals with ASPD often handle conflict in a very characteristic way: When they are attacked, they attack back harder.

They attack the character of their critics instead of answering their criticism. Whenever possible, they try to present others as being the villian, and themselves as being the victim. They never admit that they are wrong. If they have done wrong - they lie and deny everything. They show a serious lack of conscience. Have you seen President Trump display this type of behavior? Roger Stone, President Trump's close political advisor, wrote a book that praises exactly this type of behavior. He proudly wrote his "Stone's Rules" for politics: Waterloo full movie Napoleon full movie.

The Philippine tyrant, Rodrigo Duterte, has orchestrated the killing of 20, drug addicts since his election as president in Trump Has "No Conscience". Trump's behaviour is scarily similar to modern dictators. Trump Exposes Trump Trump boasts about his philanthropy. But his giving falls short of his words Trump's Trick: Present Present Present Irritability and aggressiveness , as indicated by repeated physical fights or assaults. Present Present Present Reckless disregard for safety of self or others. Present Present Present Is interpersonally exploitative , i.

Present Present Present Is often envious of others or believes that others are envious of him or her. Present Present Present Lacks empathy: Present Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior. Present Present Transient, stress-related paranoid ideation or severe dissociative symptoms. Fantic efforts to avoid real or imagined abandonment. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people or institutions Present.

Requires excessive admiration Present.

Learning Objectives

Has a sense of entitlement , i. Shows arrogant , haughty behaviors or attitudes Present. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. Affective instability due to a marked reactivity of mood e. Chronic feelings of emptiness. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest.

Present Deceitfulness , as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure. Present Consistent irresponsibility , as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.

Present Lack of remorse , as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another. Self-Control Irritability and aggressiveness , as indicated by repeated physical fights or assaults. Peacefulness Reckless disregard for safety of self or others. Caution Is interpersonally exploitative , i. Generosity Is often envious of others or believes that others are envious of him or her. Kindness Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

Life Having Purpose and Meaning Transient, stress-related paranoid ideation or severe dissociative symptoms. Trust Fantic efforts to avoid real or imagined abandonment. Confidence Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. Chronically unstable, antisocial and socially deviant lifestyle: Individuals with antisocial personality disorder lack the essential social skills of respect , responsibility , and honesty. They lack control of anger that is also lacking in individuals with borderline personality disorder. Dog is friendly towards unfamiliar people.

Dog is friendly towards other dogs. When off leash, dog comes immediately when called.

Dog willingly shares toys with other dogs. Dog leaves food or objects alone when told to do so. Dog is dominant over other dogs. Dog is assertive with other dogs e. Dog behaves aggressively towards unfamiliar people. Dog shows aggression when nervous or fearful. Dog aggressively guards coveted items e. Dog is quick to sneak out through open doors, gates.

Dog works at tasks e. Dog works hard all day herding or pulling a sleigh if a "working dog" on the farm or in the snow. Dog seeks constant activity. Dog is very excitable around other dogs. Open To Experience "Open-Minded". Dog is able to focus on a task in a distracting situation e. Closed To Experience "Closed-Minded". Dog is slow to respond to corrections. Dog is slow to learn new tricks or tasks. Dog is attention seeking e.

Dog gets bored in play quickly. Dog tends to be calm. Dog is relaxed when greeting people. Dog adapts easily to new situations and environments. Dog behaves fearfully towards unfamiliar people. Dog exhibits fearful behaviors when restrained. Dog avoids other dogs. Dog behaves fearfully towards other dogs. Dog behaves submissively e. Modified from Jones, A. Development and validation of a dog personality questionnaire.

University of Texas, Austin. However, dogs and humans are quite different on the "Conscientiousness" factor - because the canine brain is designed for hunting, not building. That's why dogs don't build dog houses. For example, when a male approaches a female, the female must: Nevertheless, cats also show the "Big 5 Factors" of personality.

Enlarge Image Enlarge Image. The male to female ratio is 3: This disorder is characterized by pathological personality traits in the following domains: Antagonism , characterized by: Very selfish; self-esteem derived from personal gain, power, or pleasure. Goal-setting based on personal gratification; absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behavior. Lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or mistreating another.

Incapacity for mutually intimate relationships, as exploitation is a primary means of relating to others, including by deceit and coercion; use of dominance or intimidation to control others. Frequent use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one's ends. Dishonesty and fraudulence; misrepresentation of self; embellishment or fabrication when relating events.

Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful behavior. Disinhibition , characterized by: Disregard for — and failure to honor — financial and other obligations or commitments; lack of respect for — and lack of follow through on — agreements and promises.

Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans. Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard for consequences; boredom proneness and thoughtless initiation of activities to counter boredom; lack of concern for one's limitations and denial of the reality of personal danger.

Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another Like individuals with Narcissistic or Borderline Emotionally Unstable Personality Disorder , individuals with ASPD: Are impulsive in at least two areas that are potentially self-damaging e.

Are irritable and aggressive, as indicated by repeated physical fights or assaults. Show reckless disregard for safety of themselves or others. Are interpersonally exploitative, i. Are often envious of others or believe that others are envious of them. Individuals with BPD usually show empathy. Are preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love. Individuals with Antisocial Personality Disorder commonly: Are critical of others Get into power struggles Blame their own failures or shortcomings on other people or circumstances For this diagnosis to be given, the individual must be at least 18, and must have had some symptoms of Conduct Disorder i.

This disorder is only diagnosed when these behaviors become persistent and very disabling or harmful to others. The occurrence of its antisocial behavior must not be exclusively during the course of schizophrenia or bipolar disorder. ASPD begins early in life, usually by age 8 years. ASPD tends to improve somewhat when the individual reaches middle age. Earlier onset is associated with a poorer prognosis.

Other moderating factors include marriage, employment, early incarceration or adjudication during childhood , and degree of socialization. There is insufficient randomized controlled trial evidence to prove the effectiveness of any psychological intervention or medication for adults with this disorder. Lacking such evidence, it would be prudent to only offer crisis intervention or short-term psychotherapy, rather than long-term psychotherapy. Antisocial Personality Disorder can persist for a lifetime.

Usually their lawless and impulsive behavior persists into middle age; then these behaviors usually gradually decrease. Violence Before Age Often bullied, threatened, or intimidated others Often initiated physical fights Used a potentially lethal weapon in a fight Had been physically cruel to people Violence After Age Often was irritable and aggressive Disinhibited Disinhibition: Irresponsibility Before Age Had stolen while confronting a victim Sexually abused someone Deliberately engaged in potentially serious fire-setting Deliberately destroyed others' property other than fire setting Broke into someone else's house, building, or car Often lied Often stole without confrontation of a victim Ran away from home Before age 13, often stayed out at night despite parental prohibitions Before age 13, often was truant from school Irresponsibility After Age Often broke the law Often lied, used aliases, or conned others Often was impulsive or failed to plan ahead Often had reckless disregard for safety of self or others Often was irresponsible at work or with money Often lacked remorse SAPAS Personality Screening Test Individuals with this disorder would answer "Yes" to the red questions: In general, do you have difficulty making and keeping friends?

Would you normally describe yourself as a loner? In general, do you trust other people?

Are you normally an impulsive sort of person? Are you normally a worrier? In general, do you depend on others a lot? In general, are you a perfectionist? However, this disorder often improves somewhat in middle age. Complications Individuals with Antisocial Personality Disorder have an increased risk of dying prematurely by violent means e. Prolonged unemployment, interrupted education, broken marriages, irresponsible parenting, homelessness, and frequent incarceration are common with this disorder.

Historically, this particular combination of three personality disorders was seen in all of history's worst tyrants e. These tyrants lust for wealth, fame and power, and callously destroy everyone that opposes them. As they gain more power, they become more grandiose, power-hungry, and paranoid. If unopposed, these tyrants initiate wars, which result in the mass slaughter of innocent civilians.

The tragedy is that the public is easily seduced by these tyrant's grandiose fantasies of national "greatness", and their paranoid hatred of some scapegoated minority e. These tyrants know that is easier to mobilize people by teaching them hatred and paranoia, than by teaching them love and forgiveness. Comorbidity Some other disorders frequently occur with this disorder.

Daniel J. Thompson (Author of Stellarcide)

Prevalence The prevalence of Antisocial Personality Disorder in the general population is 0. Outcome Individuals with Antisocial Personality Disorder don't see their behavior as being abnormal; hence they don't see the necessity of changing their personality. They have a callous disregard for the harm they cause to others. Usually their lawless and impulsive behavior persists into middle age; then their life of crime usually decreases after they have lost almost everything and "burned all their bridges".

Unfortunately, Antisocial Personality Disorder can persist for a lifetime if its criminal behavior is never punished. Familial Pattern The first-degree biological relatives of individuals with Antisocial Personality Disorder have an increased risk of having Antisocial Personality Disorder and Substance Use Disorders if they are male, and Somatic Symptom Disorder if they are female.

Adopted-away children resemble their biological parents more than their adoptive parents, but the adoptive family may decrease the risk of developing this disorder. This disorder is often associated with low socioeconomic status and urban settings. Controlled Clinical Trials Of Therapy Click here for a list of all the controlled clinical trials of therapy for this disorder. Psychotherapy Individuals with this disorder seldom voluntarily present for treatment.

Usually, apart from treatment for their substance use disorders, their only contact with a therapist is either to have a court ordered psychiatric assessment, or to try to manipulate the therapist into giving them an undeserved disability pension, insurance compensation, or favorable psychiatric assessment for some upcoming legal battle. Three therapies contingency management with standard maintenance; CBT with standard maintenance; 'Driving Whilst Intoxicated program' with incarceration appeared effective, compared to the control condition, in decreasing substance misuse.

However no study has reported improving the core features of Antisocial Personality Disorder. Anger management treatment in prison was found to increase verbal aggression post-treatment. Pharmacotherapy There are no medications specifically approved by the Food and Drug Administration to treat antisocial personality disorder. There are no randomized controlled trials that show that any pharmaceutical treatment is effective in improving the core features of Antisocial Personality Disorder. However, there is some evidence that nortriptyline an antidepressant can help people with antisocial personality disorder to reduce their misuse of alcohol.

There is conflicting evidence that anticonvulsants can help to reduce the intensity of impulsive aggressive acts in people with antisocial personality disorder. Vitamins and dietary supplements are ineffective for all Personality Disorders. The most intensive psychosocial intervention ever fielded was a multi-component prevention program targeting antisocial behavior. The intervention identified children at school entry and provided intervention services over a year period. This study concluded that these intensive youth prevention services did not significantly reduce antisocial behavior.

Fortunately, this disorder often slowly improves after age Documentary Are Certain Televangelists Psychopaths? The Murder of Tim Bosma: The Devil Had a Name - Sometimes our media gives almost a celebrity status to some psychopaths. This minute documentary does the opposite.

Kundrecensioner

It solely focuses on how the senseless murder of a man affected his wife. This documentary explores how evil some psychopaths are, as measured by the pain they cause to others. How to spot social predators before they attack - By Robert Hare, Psychology Today Business Insider has excellent, very readable, articles on psychopaths a variant of Antisocial Personality Disorder: A scientist who studies psychopaths found out he was one by accident — and it completely changed his life Here's what it's like to be married to a psychopath 20 Signs That You Are A Psychopath 'The Hare Psychopathy Checklist': Big Five personality traits - Wikipedia A former FBI agent reveals 8 ways to spot a liar 11 Signs Someone Is Lying To You One of the world's foremost experts on crime reveals 7 telltale signs when someone is trying to con you 16 questions that doctors use to figure out if you're a sociopath How Dark Is Your Personality?

How can you tell whether your partner is emotionally abusive? Mine, not his of course. He, for all his beauty and vivacious charm really had no heart to break. If he hadn't taken six years of my life, hundreds of thousands of dollars, comprised my health, destroyed my self confidence and self esteem I'd feel sorry for a man born without normal feelings. As it is I am just so grateful to be free of his detrimental influence.

In the beginning I was amazed at the many things we had in common and told him secrets about myself no other person had ever heard. He accepted me and told me I was remarkable, stunning and perfect. Especially compared to his previous girlfriends which for some reason he kept bringing up. I know much more about these women than they would ever want someone to know and right now I will bet you hard cold cash that some woman is getting her ears filled with stories of me.

His hair was greasy, his fingernails were long and dirty, and one of the lenses of his eyeglasses had a small crack. He made poor eye contact and focused his gaze on his tablet computer for most of the interview.

Limitations of Self-Diagnosis

His affect was withdrawn and had minimal range. He answered all questions in a matter-of-fact tone and showed very little range of affect. He evaded further discussion of his mood symptoms by spontaneously offering details of his social history. When asked to provide a collateral contact, he reported that both of his parents, multiple siblings, and cousins had died during his early childhood.

The patient was accompanied by a male friend who was casually but neatly dressed and of approximately the same age. Although, the patient initially reported that both parents were deceased, his father was listed as an emergency contact in his medical record. When confronted with this, the patient said that this was his step-father and gave consent for contact. The father reported that, five years ago, his son graduated with poor grades from a university which does not have a Division I football team. He confirmed the patient had played football in high school and had sustained multiple concussions.

The year after graduation, the patient had lived with his parents briefly, but because of escalating narcotic use and lack of employment was asked to leave. Since then, he has suffered from severe opioid use disorder and has been homeless and unemployed. He has travelled to various hospitals within the city and even out of state to seek pain medication and care and has told a similarly fictional narrative to other physicians. We obtained information from a local emergency community outreach agency which indicated that the patient had presented with the chief complaint of suicidality to multiple emergency departments in the city resulting in two previous inpatient psychiatric stays over the past year.

We obtained records from his most recent inpatient psychiatric hospitalization about six months ago, where he presented with depression related to his girlfriend's putative recent breast cancer diagnosis. He was discharged on an antidepressant, a mood stabilizer, and oxycodone for chronic back pain.

When gently confronted with these inconsistencies, the patient appeared unperturbed and easily provided further elaborate details to explain them. Despite this, he continued to state that he felt very depressed and would not be able to maintain his safety in the community. The term pseudologia fantastica was first coined by the German physician, Anton Delbrueck, in to describe the phenomenology of a group patients who told lies that were obviously extreme and fantastical with a clear departure from reality to the observer, yet perceived by the patients themselves as within the realm of possibility [ 1 ].

Delbrueck described a case series of five patients whose tales could not be solely attributed to ordinary lying, false memory, or delusions. Since then, pseudologia fantastica has undergone subsequent further study, and while there is no current gold-standard definition of this entity, subsequent reviews [ 3 — 7 ] have identified key characteristics, including the following:.

Reviews of pseudologia fantastica indicate that the pseudologue is typically of normal intellect but of superior verbal ability. Although pseudologia fantastica is not coded in the DSM 5, it has historically been associated with factitious disorder.

Passar bra ihop

Factitious disorder imposed on self frequently referred to as Munchausen syndrome is defined as the falsification of physical or psychological signs or symptoms and the presentation of self as ill, impaired, or injured in the absence of obvious external rewards [ 8 ]. In cases in which the tales all relate to presenting himself as ill, impaired, or injured, factitious disorder might apply.

However, the pseudologue typically tells tales on a wide range of themes, some of which do not have any relation to feigned physical or psychological signs or symptoms. Moreover, sometimes there may be obvious external rewards, such as getting shelter or medications; but the stories are out of proportion to any obvious external rewards.

Pseudologia fantastica has sometimes been equated with malingering. Pseudologic tales are often qualitatively far too dramatic and colorful to be considered adaptive to acquire an external incentive. In fact, the level of dramatism and clear departure from reality actually lead to discovery of the falsification. In addition, as with factitious disorder, malingering in DSM 5 focuses on physical or psychological symptoms. Lies or stories that were not about symptoms would not be covered. Delusional disorder or other psychotic disorders might be in the differential if a patient has full conviction in an unreal story; however, the stories are nonbizarre, the patient's thought process is well-organized, and the tales do not reach the level of conviction required to be considered a delusion.

In this patient's case, when confronted he was able to relinquish his tale, further differentiating this from a delusion. In addition, cases consistent with the phenomenology of pseudologia fantastica have been described with comorbid substance use disorder [ 9 ], developmental delay [ 10 ], gender disturbance [ 11 ], posttraumatic stress disorder [ 12 ], mood disorder [ 6 ], and personality disorder [ 6 , 13 — 15 ].

Patients who present with pseudologia fantastica may additionally present with borderline, antisocial, or other personality disorder traits. In the case of this patient. Many of his stories were on the themes of grandiose professional, academic, and athletic achievement, highlighting the need for excessive admiration and preoccupation with a fantasy of unlimited success and power. His inability to understand why his providers in the emergency department were attempting to address the lack of veracity of his stories, as well as his goal to obtain inpatient hospitalization and narcotic medications, demonstrate a lack of empathy and an interpersonally exploitative quality.

Thus, in addition to his stories being characterized as pseudologia fantastica, the patient also met diagnostic criteria for a substance use disorder and likely narcissistic personality disorder. In summary, the chronic pattern of storytelling seen in pseudologia fantastica cannot be wholly accounted for by any single standard DSM 5 diagnosis and, in fact, may present in the context of multiple DSM 5 diagnoses. We propose that pseudologia fantastica be viewed as a construct used to describe a particular pattern of storytelling that crosses but does not neatly fit into multiple diagnostic categories, including the somatic symptom and related disorders factitious disorder , malingering, and psychotic disorders delusional disorder.

This notion is reminiscent of Delbrueck's initial description of pseudologia fantastica as the mixture and coexistence of lies and delusions [ 2 ]. Finally, patients presenting with pseudologia fantastica should be carefully evaluated for comorbid psychiatric diagnoses including substance use disorders, mood disorders, and personality disorders. In reviewing the case report literature on the subject [ 4 , 6 , 7 , 9 — 15 ], we identified a compensatory enhancing of self-esteem in the face of shame as a common qualitative theme among many of the stories.

For example, Teaford et al. From a psychodynamic perspective, pseudologic tales may be conceptualized as manifestations of a constellation of primitive defenses against painful affects that may be seen in a range of psychiatric disorders. Not only do pseudologues reject reality, but they also actively create a new reality that allows for wish fulfillment.

Dissociation, temporary but drastic modification of one's personal identity to relieve distress, is also a hallmark defense of pseudologia fantastica. The pseudologue moves between conscious deceit and delusion, at times believing his tales while at others able to acknowledge their mendacity, thereby demonstrating a dissociative quality.

As summarized by Deutsch, the psychic function of storytelling in pseudologia fantastica is not focused on achieving goal-directed external gain, but rather on the gratification inherently tied to the communication of the story itself. Communicating pseudologic daydreams as if they were reality serves the function of relieving the pseudologue of the obligations of real life [ 16 ].

With few case studies and no clinical research on this subject, the optimal management strategy for pseudologues remains controversial and unclear. Two possible avenues of interaction have been described, with the first being confronting the pseudologue with his deceptions, and the second being showing disinterest in the tales but maintaining interest in the patient himself. Both Teaford et al. In the literature on factitious disorder, a similar problem led Hollender and Hersh to recommend having the primary care physician confront the patient so the psychiatrist can avoid the prosecutorial role [ 18 ].

In the same vein, an interpretation that captures the underlying dynamics of the pseudologue without directly confronting the stories is more likely to be successful than a prosecutorial approach [ 19 ]. We were confronted with the challenge of determining the patient's disposition from the emergency room in the face of his elaborate deception. As we have noted, recognition of pseudologia does not preclude underlying psychiatric disorders.

Even after acknowledging his previous deceptions, the patient staunchly stood by his suicidality. Ultimately, the decision was made to hospitalize the patient on a dual-diagnosis inpatient unit to achieve opioid detoxification and diagnostic clarification and to attempt to engage him in treatment beyond what was possible in the emergency department setting.

• Corporate Management in Action - Nestlé and Globalisation
• The Light in the Middle of the Tunnel
• Mános Encounter with the Gods Amourán
• Clay Masonry Family Fallout Shelters (1961) Illustrated
• Sozialistische Theorien zu Ökonomie und Politik im 19. Jahrhundert (German Edition)
• Life Is Not Promised
• WHY?...BCUZ