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FranzOren
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17 Mar 2022, 8:08 am

FranzOren wrote:

If most articles point out that mental illness is not a product of mental illness, and they really need to be specific about what mental disorders they are talking about, then it's ironic, because specific paraphilic disorders, Disruptive, Impulse Control and Conduct Disorders, especially Antisocial Personality Disorder includes elements of criminal behavior.



I meant to say that most articles point out that crime is not a product of a mental illness, and it's ironic, because certain mental disorders hightens the risk for criminal behavior.



FranzOren
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06 Sep 2022, 10:37 pm

funeralxempire wrote:
Ettina wrote:
Actually, many PDs should probably be diagnosed much younger, not older.

Borderline PD is detectable by early adolescence and relatively stable from adolescence until adulthood, so it'd actually make more sense to put the minimum age for diagnosis around 10 or so.

Antisocial PD is even more distinct, and can be detected as young as 3 or 4 years old. In children it's often renamed "callous-unemotional" personality, but it's basically the same thing, and relatively stable from preschool to adulthood.

However, since both of those conditions carry a lot of stigma, there's concerns about whether it'd actually be beneficial for a child to be diagnosed with either condition, even if the diagnosis is accurate.


My understanding has always been that ASPD can't be diagnosed in young children even if there will sometimes be warning signs that emerge early on. CU traits are a strong potential indicator that a child may develop conduct disorder or oppositional defiant disorder but not a guarantee. Not every kid who gets diagnosed with one or both of those goes on to meet diagnostic criteria for ASPD as an adult.

CU traits on their own aren't synonymous with ASPD and it would require a substantial redefinition of ASPD in order for that to change.



New diagnostic criteria for Antisocial Personality Disorder does not require Conduct Disorder before the age of 15, to be diagnosed.

Source:

https://www.psi.uba.ar/academica/carrer ... al/dsm.pdf



FranzOren
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07 Sep 2022, 8:49 pm

funeralxempire wrote:
FranzOren wrote:
The problem is that symptoms of Antisocial Personality Disorder includes elements of criminal behavior, and lets say there is stigma and discrimination on Antisocial Personality Disorder, it's based on reality of some of the traits of Antisocial Personality Disorder. When I looked at the diagnostic criteria for Antisocial Personality Disorder, it's looks bad. I am sorry to say.


I meant the problem in general with trying to discuss stigmatized conditions, not the problems associated with that specific one. Sorry if I was unclear.



I should have responded to this. I am sorry!

What you said actually makes sense. That is important to consider.



FranzOren
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07 Sep 2022, 8:59 pm

funeralxempire wrote:
FranzOren wrote:
I am very frustrated when I get falsely accused of stigmatizing mental illness when I explain that certain mental disorders highten the risk for criminal behavior, but the problem is that the blanket term "Mental illness" is too broad.


I think some of the problem also comes from people not really applying nuance when they hear of an elevated risk for whatever the concern might be. Instead of thinking increased likelihood it gets misunderstood as guaranteed that all individuals will.

Often the difference between average and increased risk isn't huge (even if significant) and the overall likelihood will often be quite low as well so even with all risk factors presenting the likelihood is still pretty minimal.


This actually makes sense. I was supposed to respond when you explained that. I am sorry!



FranzOren
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07 Sep 2022, 9:08 pm

autisticelders wrote:
To get disability help when youngsters are still growing, diagnosis is needed. By saying diagnosis should not happen until age 25 does not admit to struggles before that. Diagnoses are revised frequently as a child grows up, but there is a real need to define struggles long before we reach the age of 25. Diagnoses are not inflexible, and can and do change frequently.


There should be Young Adult-onset Conduct Disorder to capture long-term history of Conduct Disorder prier to age 18. The Young Adult-onset Conduct Disorder will also capture antisocial traits that young adults have, and once they turn 26 and six months old, then they will be given the diagnosis of (one or more) Personality Disorders.

For some reason, DSM-5-TR and ICD-11 did not emphasize that from ages 18-25, your brain and body as not exactly finished growing yet and that there should be Young Adult-onset Conduct Disorder for those age groups.



FranzOren
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07 Sep 2022, 9:16 pm

funeralxempire wrote:
Ettina wrote:
funeralxempire wrote:
Ettina wrote:
Actually, many PDs should probably be diagnosed much younger, not older.

Borderline PD is detectable by early adolescence and relatively stable from adolescence until adulthood, so it'd actually make more sense to put the minimum age for diagnosis around 10 or so.

Antisocial PD is even more distinct, and can be detected as young as 3 or 4 years old. In children it's often renamed "callous-unemotional" personality, but it's basically the same thing, and relatively stable from preschool to adulthood.

However, since both of those conditions carry a lot of stigma, there's concerns about whether it'd actually be beneficial for a child to be diagnosed with either condition, even if the diagnosis is accurate.


My understanding has always been that ASPD can't be diagnosed in young children even if there will sometimes be warning signs that emerge early on. CU traits are a strong potential indicator that a child may develop conduct disorder or oppositional defiant disorder but not a guarantee. Not every kid who gets diagnosed with one or both of those goes on to meet diagnostic criteria for ASPD as an adult.

CU traits on their own aren't synonymous with ASPD and it would require a substantial redefinition of ASPD in order for that to change.


The redefinition of ASPD you're talking about has already occurred. DSM-V ASPD is essentially synonymous with CU, and is very distinct from DSM-IV ASPD.


Funny you say that when I was using DSM 5 as a resource.

I've included the relevant portion from DSM 5, pay attention to portions B and C since they're what I mentioned in my first post and they're what you seemed to claim was no longer part of the criteria despite clearly being within the DSM 5 criteria.

Quote:
Symptoms & Criteria for Antisocial Personality Disorder

According to the DSM-5, there are four diagnostic criterion, of which Criterion A has seven sub-features.

A. Disregard for and violation of others rights since age 15, as indicated by one of the seven sub features:

Failure to obey laws and norms by engaging in behavior which results in criminal arrest, or would warrant criminal arrest
Lying, deception, and manipulation, for profit or self-amusement,
Impulsive behavior
Irritability and aggression, manifested as frequently assaults others, or engages in fighting
Blatantly disregards safety of self and others,
A pattern of irresponsibility and
Lack of remorse for actions (American Psychiatric Association, 2013)

The other diagnostic Criterion are:

B. The person is at least age 18,

C. Conduct disorder was present by history before age 15


D. and the antisocial behavior does not occur in the context of schizophrenia or bipolar disorder (American Psychiatric Association, 2013)
Onset

The DSM-5 notes that Antisocial Personality Disorder cannot be diagnosed before age 18, so while an adolescent may display antisocial features, prior to age 18, if diagnostic criteria are met, the appropriate diagnosis would be Conduct Disorder (American Psychiatric Association, 2013).


Further, scholarly articles regarding ASPD consistently include phrases like:

Quote:
The DSM-5 definition of ASPD requires a history of childhood CD, the diagnosis used for persistent and serious childhood behaviour problems. Once the child passes age 18 years, if the behavioural problems have persisted the diagnosis changes to ASPD. An estimated 25% of girls and 40% of boys with CD will later meet criteria for ASPD.


It really doesn't seem as though Callous and unemotional traits = ASPD, at least not according to DSM-5.



He is actually correct, there are new diagnostic criteria for each personality disorders. The old alternative model for personality disorders is completely different from DSM-5-TR and although old personality disorders are in DSM-5-TR, the new alternative model includes different diagnostic criteria and fewer personality disorders than before. There is 4 out of 9 personality disorders in the new alternative model in DSM-5-TR.

I don't agree with diagnosing young adults and mirrors with personality disorders, because you are not developed at those developmental stages.



FranzOren
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07 Sep 2022, 9:40 pm

Ettina wrote:
Actually, many PDs should probably be diagnosed much younger, not older.

Borderline PD is detectable by early adolescence and relatively stable from adolescence until adulthood, so it'd actually make more sense to put the minimum age for diagnosis around 10 or so.

Antisocial PD is even more distinct, and can be detected as young as 3 or 4 years old. In children it's often renamed "callous-unemotional" personality, but it's basically the same thing, and relatively stable from preschool to adulthood.

However, since both of those conditions carry a lot of stigma, there's concerns about whether it'd actually be beneficial for a child to be diagnosed with either condition, even if the diagnosis is accurate.



I think personality disorders should be diagnosed in infancy, that is if and only if there is genetic proof that causes personality disorders, but I don't think that it's practical to do that.



FranzOren
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07 Sep 2022, 10:00 pm

Another problem is that most of the diagnostic criteria for Conduct Disorder includes serious violation of rules, but it's possible to have Antisocial Personality Disorder without having delinquency and criminal records.



There is only 2 diagnostic criteria for Conduct Disorder that are not necessarily criminal:

* Has run away from home at least two times

* Has been truant before age 13

And I think there should be more antisocial behaviors that are not necessarily criminal.



Symptoms of Conduct Disorder and Antisocial Personality Disorder without history of criminal behaviors:

* Non-criminal sadism: Enjoying others being hurt without doing anything or by pretending to care about the victim

* Constistent arguments, manipulations and deceptions that is not criminal in nature, but is very immoral thing to do

* Non-criminal impulsivity or irritability: Being impulsive or acting out in anger, but not to the point of criminal behaviors

* Constantly bulling or annoying others

Note: This is a gray line, as bullying or annoying others may or may not be criminal in nature, but it depends on the situation.

* Being a bit asocial: Being inappropriately odd and eccentric

* Impaired empathy or remorse, but may be empathetic not to commit crimes