Dissocial disorder: symptoms, causes and treatments

This disorder appears during childhood, and is related to aggressiveness in boys and girls.

We are gregarious beings, and the fact that we live in society makes it necessary to establish a series of basic rules to guarantee a healthy coexistence that respects the basic rights of each fellow citizen, both legally and ethically. Most of us obey most of these rules, or at least the latter, often almost unconsciously, having internalized them.

However, there are people who manifest a behavioral pattern characterized by consistent rejection of them and indifference to the basic rights of others.

Probably, after this description we can think that we are going to talk about adults with antisocial personality disorder. But the truth is that these patterns are also seen in childhood, in those children with dissocial disorder. It is this disorder that we are going to talk about in this article.

Defining dissocial disorder

Dissocial disorder, now referred to as conduct disorder in the latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), is an alteration characteristic of minors (it can begin at different times of infantile-juvenile development) who throughout their childhood present a continuous pattern of behavior characterized by the presence of a systematic violation of social norms and the rights of others for at least twelve months.

Specifically, this pattern of behavior is identified by the presence of aggressive behaviors against people (which may include the use of weapons) or animals (torture and/or execution of small animals and pets being frequent), the use of fraud and theft of small objects or breaking and entering, serious non-compliance with general social norms of coexistence and/or vandalism.

Children with this disorder suffer from significant impairments in a variety of areas such as social life and at school. They usually present low levels of empathy, ignoring the rights and feelings of others. It is also common for them to have a sense of hardness of character, as well as preconceived ideas about society and rejection. They are also characterized, in general, by acting without thinking about the consequences and in an impulsive manner, with risky behaviors and with low capacity for delayed gratification and frustration tolerance.

Generally, their actions do not go unnoticed by the environment, which can also lead to socialization problems and frequent problems at school and with the law. Despite this, some behaviors tend to go initially unnoticed, being hidden or inconspicuous (such as the torture of animals). They may show disregard for their performance, superficial affection, lack of empathy and a low or non-existent level of remorse for the consequences of their actions, although these characteristics do not occur in all cases.

Relationship to antisocial personality disorder

Dissocial disorder has historically been considered, and in fact has sometimes been confused with antisocial personality disorder. It should be emphasized that the two are not synonymous, although in some cases there is syndromic continuity and the diagnostic criteria for both disorders have few divergences beyond the age of onset (antisocial disorder requires the subject to have already formed a personality, the turning point being considered to be 18 years of age, although antisocial behavior patterns must appear before the age of 15).

In fact, although most of the disorder disappears upon reaching adulthood and developing more elaborate behaviors and capacities (especially in those cases in which the manifestation of the disorder has a rather adolescent onset), a considerable percentage of these children will eventually develop an antisocial personality disorder. In this case we are largely dealing with subjects who have had an earlier onset dissocial disorder, further fixing and limiting their behavioral repertoire and their outlook on life.

Possible causes associated with this psychological phenomenon

Since the conception of this disorder, the scientific community has been trying to find an explanation for this type of behavioral disorder. It is considered that there is not a single cause of this disorder, but rather that multiple factors that influence its genesis..

From a Biological perspective, the possible existence of behavioral inhibition problems derived from a lack of development or underactivation of the frontal area together with an excess of activation of the limbic system and the brain reward system has been suggested. The existence of a lack of moral development, of the capacity for empathy and immaturity, which may be due in part to elements intrinsic to their biology and in part to poor socialization, has also been considered. and partly due to deficient socialization.

On a more psychological and social level, it has been observed that many of these children come from homes with behavioral problems and marginalization. The presence of continued intrafamily conflicts may be associated by the children as a natural way of proceeding, acting as a model, while at the same time it may condition the child to learn not to trust others.. Social rejection has also been linked to the emergence of this disorder, and it has been observed that they tend to have problems in relating to and solving problems.

The type of parenting pattern is also linked: authoritarian and critical parents with a punitive manner of acting or excessively permissive parents whose indications are unclear and do not allow learning discipline or the need to comply are more likely to teach their children to act covertly or that their will must always be done. This does not necessarily imply a dissocial disorder, but may facilitate it.

Attempts have also been made to explain this problem as an aspect based on conditioning: throughout their lives, the child has observed that performing aggressive acts serves to fulfill their goals. has observed that the performance of aggressive acts serves them to fulfill their goals, with the consequences of such acts being appetitive.The consequences of such acts being initially appetitive and reinforcing the repetition of the same behavior.

Treatment

Dissocial disorder is a problem whose treatment is not yet well established. A variety of multimodal programs are often used, involving both the child and the parents and services in contact with the child, and requiring the collaboration of professionals from different fields. and services in contact with the child, and which require the collaboration of professionals from different disciplines and with an eclectic approach.

At the psychological level, a program that includes training in social and communication skills, as well as problem solving, is usually recommended. Reinforcement of prosocial behaviors, behavioral contracts, modeling and emotional expression are also useful. Cognitive-behavioral programs are generally used.programs are generally used, trying to teach positive ways of relating and to generate alternative behaviors to those inherent to the disorder.

Parent training and psychoeducation are also elements to be taken into account that can contribute to reassure and teach guidelines for acting and learning with the child.

In very extreme cases and especially in those subjects whose behavioral alterations are due to the experience of emotional discomfort, in addition to a treatment dedicated to modify the elements that generate discomfort or the perception of them the use of some drugs, such as SSRIs, may be recommended. such as SSRIs.

Bibliographic references:

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
• Ladrón, A. (2012). Psicología Clínica Infantil. Manual CEDE de Preparación PIR, 0. CEDE: Madrid.
• Pérez, M.; Fernández, J.R,; Fernández, I. (2006). Guide to effective psychological treatments III. Childhood and adolescence. Pirámide: Madrid.