Answer for NRNP 6665 Week 7 Controversy Associated with Personality and Paraphilic Disorders 

Controversies Surrounding the Disorder

Antisocial personality disorder (ASPD) is one of the cluster B personality disorders characterized by a pervasive pattern of disregarding or violating others’ rights that often begins in childhood or early adolescence and continues into adulthood. However, the diagnostic criteria, according to DSM-V, the diagnosis can only be made if an individual is 18 years old or when a conduct disorder was diagnosed before the age of 15 years (Marzilli et al., 2021). The criteria may be conflicting, especially when adolescents exhibit certain ASPD behaviors without a conduct behavior. In addition, persons with ASPD may have certain symptoms that overlap with other personality disorders, such as narcissistic and borderline personality disorder, which may lead to an undiagnosed comorbid psychiatric disease (Arble, 2023). The disorder is also overdiagnosed, especially when some individuals develop certain symptoms due to somatization or substance use.

Professional Beliefs about the Disorders

Most professionals believe that ASPD develops as a result of early adverse childhood experiences characterized by a lack of parental warmth, emotional support, and behavioral control, as well as unstable family environments. As a result, the patients in their childhood develop symptoms of conduct disorder such as mistrust, emotional deprivation, social isolation, and entitlement schemas and may engage in aggressive behaviors such as bullying, lying, and theft (Tesli et al., 2023). Such individuals in their late teen and early adulthood as a maladaptive response, often exhibit ASPD symptoms characterized by a pervasive pattern of behaviors that include deceitfulness, impulsivity, irritability and aggressiveness, failure to conform to social norms and lawful behaviors, disregard for the safety of self and others, irresponsibility, and lack of remorse (Wong, 2023). Most individuals with ASPD thus see themselves as loners, autonomous, and strong and perceive others as exploitative or vulnerable people and deserving of exploitation without remorse.

Strategies for Maintaining a Therapeutic Relationship

Maintaining a therapeutic relationship is critical in the management of antisocial disorders. The first crucial thing to develop is rapport, as both help build a connection between the patient and the therapist. Therapists must show interest in the patient’s symptoms and ensure confidentiality in all sessions with the patient (Lavik et al., 2022). In addition, it is vital to demonstrate empathy as it reassures the patient that the concerns about the condition are understood. Therapists need to promote effective communication by actively listening, asking patients open-ended questions to the patient, and encouraging transparency during every session (Hartley et al., 2020). As a result, the patients feel free to express themselves, are reassured that their concerns are met, and feel less judged. Lastly, the therapist should encourage collaboration and shared decision-making and encourage the client to give feedback on the process.

Ethical and Legal Considerations Related to the Disorders

Medical ethical principles apply to every patient, regardless of race, religion, mental status, and financial status. Thus, every patient should receive equal treatment without any associated discrimination. The first step in the management of patients with antisocial personality disorders and other disorders includes establishing whether the patients can make appropriate clinical decisions affecting their health and respecting their autonomy. If the patient is mentally unstable or underage, the therapist can consider involving the family or the social workers in decision-making. (Geppert et al., 2021).However, unconsented admission may be necessary in some instances, especially when the patient exhibits abnormal behavior that may place them and others in danger. Furthermore, therapists must maintain patient confidentiality but are obligated to warn the public through legal officers when the patient poses harm to the community, such as in theft and aggression. ASPD patients have a higher tendency to commit offenses, which poses a challenge in the legal process when determining whether they are fit to stand trial or even be sentenced (Avasthi et al., 2021). As a result, a forensic psychiatrist needs to establish whether the patient was mentally stable or not while committing the crime.

Conclusion

ASPD is an example of a personality disorder characterized by maladaptive social behavior. However, due to the controversies seen in the diagnosis, the disorder is often overdiagnosed, or comorbid personality disorders may remain undiagnosed. Most professionals believe ASPD develops as a maladaptive response to childh