Month: April 2021

A trophy wife is a wife who is regarded as a status symbol for the husband. The term is often used in a derogatory or disparaging way, implying that the wife in question has little personal merit besides her physical attractiveness, requires substantial expense for maintaining her appearance, is often unintelligent or unsophisticated, does very little of substance beyond remaining attractive, and is in some ways synonymous with the term gold digger. A trophy wife is typically relatively young and attractive, and may be a second, third or later wife of an older, wealthier man. A trophy husband is the male equivalent, although this is rarer.

Referring to a spouse as a trophy wife usually reflects negatively on the character or personality of both parties.

• You never have to worry about money.
• You don’t have a job
• You have never worked
• You have restraining orders out against your stalkers
• You have haters
• There will always be someone with more money than you, so your always pushing your husband to make more money.
• Your ring does not adhere to the 3 month rule. Diamonds are like penises – the bigger the better.

Although the precise etiology is unknown, both genetic and environmental factors have been found to play a role in the development of ASPD. Various studies in the past have shown differing estimations of heritability, ranging from 38% to 69%. Environmental factors that correlate to the development of antisocial personality disorder include adverse childhood experiences (both physical and sexual abuse, as well as neglect) along with childhood psychopathology (CD and ADHD).[4]

Other studies stress the importance of both shared and non-shared environmental factors, including both family dynamics and peer relations on the development of ASPD. Research has focused on establishing the exact gene contributing to ASPD, and much evidence is pointing toward the 2p12 region of chromosome 2 and variation within AVPR1A. Interactions of specific genes with the environment have been an area of study as well, with evidence of variation in the oxytocin receptor gene (OXTR) contributing to the broad ranges of behavior elicited in antisocial personality disorder due to its effect on the influence of deviant peer affiliation.[5]

https://www.statpearls.com/articlelibrary/viewarticle/17712/?utm_source=pubmed&utm_campaign=reviews&utm_content=17712

• Antisocial personality disorder is one of the best-documented disorders in all of literature pertaining to psychiatry, including etiology, epidemiology, pathophysiology, neuroanatomy, heritability, and interventional treatment. However, an established treatment algorithm and specialized psychopharmacology currently fail to exist.
• Better preventative measures are necessary as many of those with ASPD may only have an evaluation upon incarceration after inflicting harm. One is not apt to seek help for ASPD symptomatology. Many only seek assistance for co-occurring mental disorders or only present for court-mandated assessments.  
• Even with the remission rates in advanced ages, antisocial personality disorder causes much turmoil to the patient and the patient’s surrounding community. The lives of those with ASPD remain negatively impacted even after remission.

https://www.ncbi.nlm.nih.gov/books/NBK546673/

History and Physical

Before performing a comprehensive psychiatric assessment of the patient, a careful history and physical examination is necessary.   “The DSM-5 diagnostic criteria for Antisocial Personality Disorder 

1. A pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three (or more) of the following:
   1. Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
   2. Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
   3. Impulsivity or failure to plan.
   4. Irritability and aggressiveness, often with physical fights or assaults.
   5. Reckless disregard for the safety of self or others.
   6. Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.
   7. Lack of remorse, being indifferent to or rationalizing having hurt, mistreated, or stolen from another person.
2. The individual is at least age 18 years.
3. Evidence of conduct disorder typically with onset before age 15 years.
4. The occurrence of antisocial behavior is not exclusively during schizophrenia or bipolar disorder.”

• https://www.ncbi.nlm.nih.gov/books/NBK546673/

Antisocial personality disorder (ASPD) is a deeply ingrained and rigid dysfunctional thought process that focuses on social irresponsibility with exploitive, delinquent, and criminal behavior with no remorse. Disregard for and the violation of others’ rights are common manifestations of this personality disorder, which displays symptoms that include failure to conform to the law, inability to sustain consistent employment, deception, manipulation for personal gain, and incapacity to form stable relationships.[1]

The Diagnostic and Statistical Manual of Mental Disorders (DSM 5) classifies all ten personality disorders into three clusters (A, B, and C). Antisocial personality disorder falls into 1 of 4 cluster-B disorders, which also includes borderline, narcissistic, and histrionic. All of these disorders characteristically present with dramatic, emotional, and unpredictable interactions with others.[2] Antisocial personality disorder is the only personality disorder that is not diagnosable in childhood. Before the age of 18, the patient must have been previously diagnosed with conduct disorder (CD) by the age of 15 years old to justify diagnostic criteria for ASPD.[1]

Many researchers and clinicians argue this diagnosis, with concerns of significant overlap with other disorders, including psychopathy. However, others counter that psychopathy is simply a subtype of antisocial personality disorder, with a more severe presentation. Recent literature states that although a heterogeneous construct that can subdivide into multiple subtypes that share many similarities and are often comorbid but not synonymous, individuals with ASPD must be characterized biologically and cognitively to ensure more accurate categorization and appropriate treatment.[3]

https://www.ncbi.nlm.nih.gov/books/NBK546673/

So it’s possible there will be a DSM-5.1 before there is a DSM–6. “After publication of DSM-5, the APA decided to shift the model of revision that had existed until that point in time,” 

The Past, Present, and Future of the DSM – Medscape

DSM-5 task force was formed in 2007
•  Composed of world-renowned leaders in psychiatric research, dx, and treatment 

•  Had 13 work groups
•  160 members

•  97 psychiatrists, 47 psychologists, paediatricians neurologists, epidemiologists, social work, paediatric nursing, speech therapy and consumer groups

•  More than 300 outside advisors
•  Public input through the DSM-5 website

To be diagnosed with antisocial personality disorder, a person will usually have a history of conduct disorder before the age of 15.

Antisocial personality disorder is diagnosed after rigorous psychological assessment.

A diagnosis can only be made if the person is aged 18 years or older and at least 3 of the following criteria apply:

• repeatedly breaking the law
• repeatedly being deceitful
• being impulsive or incapable of planning ahead
• being irritable and aggressive
• having a reckless disregard for their safety or the safety of others
• being consistently irresponsible
• lack of remorse

These signs must not be part of a schizophrenic or manic episode – they must be part of the person’s everyday personality.

This behaviour usually becomes most extreme and challenging during the late teens and early 20s. It may improve by the time the person reaches their 40s.

https://www.nhs.uk/mental-health/conditions/antisocial-personality-disorder/

Risk factors

Certain factors seem to increase the risk of developing antisocial personality disorder, such as:

• Diagnosis of childhood conduct disorder
• Family history of antisocial personality disorder or other personality disorders or mental health disorders
• Being subjected to abuse or neglect during childhood
• Unstable, violent or chaotic family life during childhood

Men are at greater risk of having antisocial personality disorder than women are.

https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928