#dsm v

Knowing the DSM-V criteria is key to understanding the character behind the mask. If you know it, you'll see it.

Know what the passive-aggressive symptoms look like. That's how you stay 1 step ahead of the coverts and vulnerables.

Otherwise you won't see anything until they've made ruins of your life. Don't be a rube like I was.

Like, sorry for using the term that is most accurate to us??

?? Do they think that like.. disorders that are in the ICD-11 but not the DSM-V just.. don't exist in America or something?

I have been wondering whether I should get officially diagnosed, since the media and general societal representation of it doesn’t seem as reflecting of me (with exception of a few) but I do relate extremely closely to most of the diagnosing criteria. Although??? The physical aggression thing?? Like I have those impulses and plenty of them, but I just don’t follow through with most because of convenience. That sort of thing is one of the main things that makes me doubt whether I do actually have it. (Same with impulsive behaviors etc)

But my main point/ask is the age thing. As a very young child I was pretty sweet? Ig? Like I wasn’t an aggressive child, rather pretty passive. As far as I recall, my symptoms started when I was about 15-16, when I was starting to process that mine was a traumatic situation? and earlier than that I was just an edgy teen, I guess? I sure had some of the symptons way earlier, but the main ones/ the ones that I feel are more prominent in me didn’t show up until a bit later? I’m not sure. So my question is, does it mean it can’t be ASPD?

Also your page is lifesaving. Thanks man.

Note: due to the way copy and pasting criteria works on tumblr, this post will be written exclusively in plain text, as copying and pasting it all over again would take forever, but I want this post to be accessible still.

I haaaate the way the DSM phrases criteria. Absolutely no worries, it is confusing as heck and you wouldn't be the first person at all to ask about this.

So, the symptoms of Conduct Disorder or Oppositional Defiant Disorder (DSM criteria below) need to show by or before the age of 15. (I do not know if Intermittent Explosive Disorder satisfies this criteria, but it very well may.) That means they may start when you're a toddler, or they may start when you're 14.5. Anywhere in there, you have to qualify for one of those two disorders, but you also do not have to have been diagnosed with them.

Also, having had been an "edgy teen" definitely could have been those symptoms showing themselves. The reason ASPD can't be diagnosed before 18 is because teenage edginess could either be symptoms or be normal, and the only real way to tell is if it continues past teenage and into adulthood.

The diagnostic criteria of Oppostional Defiant Disorder is as follows, quoted from the DSM-V TR:

A. A pattern of angry/iritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months as evidenced by at least four symptoms from any of the following categories, and exhibited during interaction with at least one individual who is not a sibling.

Angry/lrritable Mood

1. Often loses temper

2. Is often touchy or easily annoyed

3. Is often angry and resentful.

Argumentative/Defiant Behavior

4. Often argues with authority figures or, for children and adolescents, with adults.

5. Often actively defies or refuses to comply with requests from authority figures or with rules

6. Often deliberately annoys others

7. Often blames others for his or her mistakes or misbehavior.

Vindictiveness

8. Has been spiteful or vindictive at least twice within the past 6 months

Note: The persistence and frequency of these behaviors should be used to distinguish a behavior that is within normal limits from a behavior that is symptomatic. For children younger than 5 years, the behavior should occur on most days for a period of at least 6 months unless otherwise noted (Criterion A8). For individuals 5 years or older, the behavior should occur at least once per week for at least 6 months, unless otherwise noted (Criterion A8). While these frequency criteria provide guidance on a minimal level of frequency to define symptoms, other factors should also be considered, such as whether the frequency and intensity of the behaviors are outside a range that is normative for the individual's developmental level, gender, and culture.

B. The disturbance in behavior is associated with distress in the individual or others in his or her immediate social context (e.g., family, peer group, work colleagues), or it impacts negatively on social, educational, occupational, or other important areas of functioning

C. The behaviors do not occur exclusively during the course of a psychotic substance use, depressive, or bipolar disorder. Also, the criteria are not met for disruptive mood dysregulation disorder.

[End quote]

Conduct disorder's criteria more clearly shows the lead-in to ASPD.

The diagnostic criteria for Conduct Disorder is as follows, quoted from the DSM-V TR:

A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:

Aggression to People and Animals

1. Often bullies, threatens, or intimidates others.

2. Often initiates physical fights.

3. Has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun)

4. Has been physically cruel to people

5. Has been physically cruel to animals

6. Has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery)

7. Has forced someone into sexual activity

Destruction of Property

8. Has deliberately engaged in fire setting with the intention of causing serious damage.

9. Has deliberately destroyed others' property (other than by fire setting).

Deceitfulness or Theft

10. Has broken into someone else's house, building, or car.

11. Often lies to obtain goods or favors or to avoid obligations (i.e., "cons' others).

12. Has stolen items of nontrivial value without confronting a victim (e.g. shoplifting, but without breaking and entering; forgery)

Serious Violations of Rules

13. Often stays out at night despite parental prohibitions, beginning before age 13 years.

14. Has run away from home overnight at least twice while living in the parental or parental surrogate home, or once without returning for a lengthy period

15. Is often truant from school, beginning before age 13 years

B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning

C. If the individual is age 18 years or older, criteria are not met for antisocial personality disorder.

[Skipping a bit of the quote which specifies codes for the various ages CD can present. It is worth noting that these are *not* criteria, they are specifications to be noted in the file of the person being diagnosed with conduct disorder to accurately describe their experience. As you'll see, these specifications are flags as to whether a child/teen with conduct disorder should be evaluated for ASPD upon reaching adulthood.]

Specify if:

With limited prosocial emotions: To qualify for this specifier, an individual must have displayed at least two of the following characteristics persistently over at least 12 months and in multiple relationships and settings. These characteristics reflect the individual's typical pattern of interpersonal and emotional functioning over this period and not just occasional occurrences in some situations. Thus, to assess the criteria for the specifier, multiple information sources are necessary. In addition to the individual's self-report, it is necessary to consider reports by others who have known the individual for extended periods of time (e.g., parents, teachers, co-workers, extended family members, peers).

Lack of remorse or guilt: Does not feel bad or guilty when he or she does something wrong (exclude remorse when expressed only when caught and/or facing punishment). The individual shows a general lack of concern about the negative consequences of his or her actions. For example, the individual is not remorseful after hurting someone or does not care about the consequences of breaking rules.

Callous-lack of empathy: Disregards and is unconcerned about the feelings of others. The individual is described as cold and uncaring. The individual appears more concerned about the effects of his or her actions on himself or herself, rather than their effects on others, even when they result in substantial harm to others.

Unconcerned about performance: Does not show concern about poor/problematic performance at school, at work, or in other important activities. The individual does not put forth the effort necessary to perform well, even when expectations are clear, and typically blames others for his or her poor performance.

Shallow or deficient affect: Does not express feelings or show emotions to others, except in ways that seem shallow, insincere, or superficial (e.g. actions contradict the emotion displayed; can turn emotions "on" or "off" quickly) or when emotional expressions are used for gain (e.g., emotions displayed to manipulate or intimidate others).

Specify current severity:

Mild: Few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause relatively minor harm to others (e.g., lying, truancy, staying out after dark without permission, other rule breaking)

Moderate: The number of conduct problems and the effect on others are intermediate between those specified in "mild" and those in "severe" (e.g. stealing without confronting a victim, vandalism)

Severe: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering).

[End of Quote]

As you can see, the criteria required before age 15 is not as intense as many professionals describe it. Remember that you are only required to have shown 3 out of the total 15 criteria in there. There is even a whole specifier for Conduct Disorder that is mild and only includes things like lying, basic rule-breaking, and/or staying out past curfew.

Acts of physical aggression are not actually required for ASPD at all, it's just that many prosocials see that being one of the possible symptoms and fixate on it, thus pushing everyone with ASPD into the box of physical aggresion. You absolutely can have ASPD and never act on any violent thoughts or urges.

I was also a very sweet and passive child, developing most of my externalized ASPD symptoms (rule breaking, disrespectful behavior/actions, challenging authority, etc) around age 13. However, the internal symptoms were there for me much younger - easily bored with poor handling of boredom, lack of empathetic reactions, difficulty apologizing/showing remorse due to not really feeling it, becoming very angry but not showing it, resulting for me in self destructive behaviors like cheek biting or controlled destructive behaviors like breaking something that wouldn't be missed (pencils and pens mostly for me).

Regardless of what symptoms were shown when, symptoms are still symptoms, and if you had enough for Conduct Disorder or Oppositional Defiant Disorder before your 16th birthday, you are well within possibility of having ASPD. Keep in mind that the lying, manipulation, etc that can qualify for Conduct Disorder doesn't have to be grandiose or destructive except where it is explicitly stated in the criteria that it does (such as fire setting only counting for the destruction of property criteria if you meant to damage something with said fire).

It's so easy to count yourself out of ASPD because you don't fit the stereotypes or public perception of ASPD, but I assure you that there are many, many ways something as complex as a personality disorder can show itself.

It is absolutely a great thing, however, that you are covering your bases and making sure to do the research to see if this is what you have. That is the basis of an informed self-dx, should you come to the conclusion that you have ASPD.

Now, as for actually getting diagnosed, your mileage may vary with professionals. Many have bias against pwASPD ingrained into their practice, and won't diagnose you with it even though you have it if you aren't/weren't violent, law-breaking, or if they just think you "seem far too kind to have ASPD" (a real quote a former professional said to me a few months before I was diagnosed by my long-time psychiatrist). This doesn't mean you don't have ASPD. If they can't give you other explanations that make sense, and if their reasons for denying you that diagnosis are based in stigma or anything other than actual criteria, then you are well within your rights to continue being self-dx.

A professional should be able to explain, using criteria, why you don't have a disorder you think you may have. If they're doing their job, they should be willing to explain to you what their reasons are and point you in the direction they think may be causing the symptoms. And no, "just acting like a teenager" isn't good enough if enough symptoms have persisted into adulthood for you to meet the criteria for ASPD.

The lived experiences I've heard of are consistently marked by shame and a lack of sense of self. Literally the opposite of a sense of entitlement or believing you're special and can only be understood by other special people.

As for "lack of empathy" do they mean the ability to read and understand others' emotions? The tendency to feel those emotions? The ability and willingness to help with those emotions? Because I get shit for my lack of cognitive and affective empathy all the time but I care a LOT and put a lot of effort into helping others.