Help me figure out the differences between autism and antisocial personality disorder

Discussion in 'General Parenting' started by TerryJ2, Jun 18, 2012.

  1. TerryJ2

    TerryJ2 Well-Known Member

    The therapist and I are concerned that difficult child is exhibiting more antisocial personality traits than Asperger's. We can't tell if it's the medications (he's been off of Abilify for 10 days, and he had smoked pot, so he had some awful behaviors where the two drugs mixed) or if it's typical teen X 100, or if he's becoming more entrenched into his way of thinking. The therapist said time will tell.
    Of course, I'm reading every stupid thing out there ... but my gut reaction is that difficult child's manipulation is too blatant and stupid to be sociopathic. He is not smooth. He is pushy. And he gets taken advantage of by "Friends," but won't admit it because he wants to fit in. That does not sound sociopathic.
    But he really couldn't care less about other people's feelings, i.e. anyone at home, incl the dogs ("Get out of my way").
    When he does something spectacularly nice, like when he texted me that he was sorry about my dad dying, I am thrilled, but a part of me is suspicious. Then again, what would he gain by saying something nice like that? It's not like I'm going to buy him a video game because he said he was sorry my dad died.
    So many of the traits are so similar. Especially the fundamental lack of impulse control.

    Anyway, here's an interesting link I found, when I should have been cleaning my office or weeding the garden ...

    I also found this discussion:
    BACKGROUND: There is an overlap between the symptoms of psychopathy and autism
    spectrum disorders. AIM: To contribute to an adequate differential diagnosis of
    these disorders. METHOD: We reviewed the literature with the help of PubMed,
    using as key words: 'empathy', 'psychopathy', 'autism', 'aggression' and
    'antisocial' for the period 1980-2004. We also consulted papers listed in the
    bibliographic references for these articles. RESULTS: Empathic deficit is a core
    symptom of both disorders. In psychopathy there
    are signs of an emotional empathic deficit, an inability to feel along with
    another person (insensitivity).
    Research into autism spectrum disorders points to a cognitive
    empathic deficit, an inability to take the perspective of another person
    The antisocial behaviour that can accompany both disorders
    might be due to the type of empathic deficit. In psychopathy the antisocial
    behavior often involves insensitive manipulation and exploitation of another
    person. In autism spectrum disorders there is sometimes antisocial behaviour
    which could be caused partly by incorrect evaluation of social situations. In
    both psychopathy and autism spectrum disorders dysfunctioning of the
    orbitoftontal cortex and the amygdala is often mentioned as a possible cause of
    empathic deficit. CONCLUSION: An accurate diagnosis of the type of empathic
    deficit involved could help to differentiate psychopathy from autism spectrum
    disorders. Good diagnostic tools are not yet available.
    Last edited: Jun 18, 2012
  2. Liahona

    Liahona Guest

    I big part of antisocial is that they can and do know much about other emotions. They are charming people. They manipulate well. And they enjoy causing pain in others.

    Autism doesn't know about others emotions, they come across not charming, they don't manipulate well, and while they can be hurtful don't do it to cause pain in others.

    For example, both x and husband at one point or the other spent all the money so we couldn't get food. Same behavior. The big difference is in why they did it. x did it to punish me. I had spent money on something he didn't approve of. He knew very well how I would feel about his behavior; that was why he did it in the first place. To hurt me. He would get a look of pleasure on his face when he was hurting someone. Then he would apologize, tell you exactly how you were feeling, and do something to make it up to you. After I went a few weeks on very little food x took me to the grocery store and bought random items while I cried in gratitude. He was in complete control of my feelings.

    husband spent the money because of impulse control problems. He didn't know how his behavior would affect the rest of the family. He was upset by his behavior but he couldn't stop. He did it over and over again. He never apologized. I had to take control of all of the money. Fast forward a few years and he has gotten a lot better in this area. He still isn't perfect but he is better. It has taken him a lot of work.

    If you feel your difficult child isn't connected with others feelings he isn't antisocial. I'm not saying his behaviors are good, just that in order to be antisocial you have to have an understanding of how others think.
  3. TerryJ2

    TerryJ2 Well-Known Member

    Well, my difficult child does a lot of stuff to bug me because he thinks it's funny. But he doesn't do it to a lot of other people. He would rather avoid other people.
    But he is more into breaking rules outside the home now.
    We can't figure out where this is coming from.
  4. Liahona

    Liahona Guest

    Last night difficult child 2 smashed a blanket into difficult child 3's face laughing. If I hadn't been there he would've done serious damage. difficult child 2 thought is was funny, but he didn't know he was cutting off his brothers air supply or that it would hurt him. We explained and difficult child 2 hasn't done it again. Sometimes difficult child 2 needs to know the consequence up front to make it no longer funny to him. For example, saying bad words is funny to him. Telling him to not do it doesn't do anything because he doesn't get the logic of how this is hurting someone. Telling him that is a bad word if you say it you will get time out and all of a sudden its very real to him. He doesn't say it again.

    What is your difficult child's emotional age? He is a very concrete thinker. Maybe he is pushing boundaries trying to find out what the rules really are? difficult child 1 does this. If he isn't caught and punished he tail spins because he doesn't know where the boundaries are.
  5. InsaneCdn

    InsaneCdn Well-Known Member

    I'm just spouting here, but... seriously?
    On one hand, this is just so absolutely 100% male typical teen stuff. Went through it with brothers. difficult child is now at that stage. Social ineptitude is part of male typical teen rites of passage. Many male TTs would "qualify" for sociopathic tendencies.

    And then there's the subtle theory out there - and I'm not so sure it is entirely wrong - that in some ways, Asperger's and High-Functioning Autism (HFA) are just... extreme male-ness.

    Lines in the sand again. Where does normal end and Aspie start? Nobody REALLY knows.

    But... I think it would be a stretch to say "sociopathic tendencies" with your difficult child.
  6. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Terry, I dont think your difficult child is antisocial but he could be showing some conduct disorder traits. I have thought that for awhile. Aspies tend to be rigid rule people. They may not quite understand why their are rules but they dont like to break rules. If you tell an aspie to do X, they do exactly X and not more or less than X. You have to be specific with them. Almost like computer programming them. Manipulation isnt their strong suit. Once they find out something is wrong, they will rarely do it again if they can help it like with the whole charging stuff on the phone.
  7. Methuselah

    Methuselah New Member

    Hi Terry. I don't have experience with autism, but both of my daughter's have been diagnosed with conduct disorder/ASPD and NPD, but I think they are psychopaths. :-( My daughters are very, very charming. They work very hard to cultivate an image of a good, sweet person…all to get away with their bad and/or to cause harm to others. They don't feel guilt, remorse, shame nor empathy. Never have, never will. Everything they do is deliberate and intentional. They manipulate with purpose, charm with purpose. It isn't a compulsion or an impulse. They have complete control and awareness of every choice and behavior; they just don't care it is wrong or that it hurts others. Never have, never will. No punishment nor reward changes their behavior. When caught, they just learn not to do it that way the next time. It isn't that they don't know better or are frustrated. They know; they just don't care. As long as they are getting whatever they want, all is good in their world, even if it harms others. In all of my 48 years, I have never met anyone like them before. I have never said this before: I will pray your son has autism.
  8. Liahona

    Liahona Guest

    I wonder if its possible to have autism co-morbid with something like a personality disorder (conduct disorder, antisocial, ect..) ? What would that look like? I'd almost think that would be conflicting diagnosis's. Be really hard to have one and the other at the same time. Or could some of autism's yuckier traits mixed with drug use look like conduct disorder?

    Sorry, just thinking out loud here.
  9. LittleDudesMom

    LittleDudesMom Well-Known Member Staff Member

    I must say I'm kinda with insane here. I certainly believe your difficult child is manipulative as heck and doesn't have a grasp on boundaries -- but I don't think those are necessarily sociopathic tendencies rearing in him. Thinking out loud here, but I wonder what a totally loaded with activities and structured summer camp program away from home would do for him? What are his plans this summer? The absolute worst thing would be for him to have no structure and all that time on his hands.

    Perhaps being away from home, away from the temptation of drugs and bad influences, gaming, texting (camps don't allow electronics) will be maturing for him.....just a thought.

  10. klmno

    klmno Active Member

    I'd have no idea how to answer your question but what Insane and LDM are saying makes a lot of sense to me, at least based on my own son's hx and changes over time. The juvie system and being on probation/parole, etc has never really done anything helpful for him. However, being away from home with strict structure that was consistently enforced and having enough brawn constantly around to back it up during the middle teen years sure seemed to help him mature. Plus, I think more and more this has a lot to do with the frontal lobe and brain development. I think more and more about people here who have said their sons seemed to get past many of their problems around their early 20's. A lot of these parents seemed to need the male teen out of the home a while during their middle teen years. What this tells me is that ALL the difficult child behavior couldn't have been a psychiatric or neuro disorder.

    So I don't know but maybe your son is neither a typical teen, aspie, or a budding sociopath. Maybe he's another who's just got too mmuch testosterone, an immature brain, and not in the 'right' structure he needs to keep him in control and on the right path right now. in my humble opinion, sometimes we parents 'allow' things at home to become more dysfunctional because it's the only way we can keep peace or maintain a semi-functioning household while going thru these teen years. I tried that but it didn't work and the price was astronomical in too many ways.

    I second LDM's suggestion of your son going somewhere for the summer- the military boarding school or a long, highly structured camp or something- maybe wilderness camp. I doubt you can fix this at home no matter how much structured activity you sign him up for or how consistent you are with him. He just knows how to push the right buttons at home and the family emotion prevents the type of authority it's going to take to change things right now. Just MHO. I definitely believe he's in control of more than what you think but that doesn't mean he knows how or can change that easily and he's not necessarily a budding sociopath.
  11. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Autistic kids tend to have very good hearts and consciences and get very upset when they do something wrong. That is my experience with my son and in the group of autistic kids I attend. Not all are as socially clueless as one would think...many can learn. However, autism does not mean they can not love or attach to people, just that often they have trouble showing it. My own son has a heart of gold. He is overly sensitive to when others are hurting. He may never give me a hug unless I ask for one, but he will say, "Mom, are you sad? Can I help?"

    Antisocials have no emotions toward people or animals other than as objects of their gratification. They do not get sad w hen people die or are hurt and they often cause the hurt. In extreme cases, they kill. Here is an interesting to an antisocial personality disorder forum. Do you really think your son thinks like these people do? Check out the answers. They say more than the questions.

    Having said that, I often wonder about your son and aspergers too. Do you think he has it? To me (and I'm a big Nobody) he seems more socially involved than most Aspie teens, but then again they are all so very different.
  12. TerryJ2

    TerryJ2 Well-Known Member

    Thank you all!
    Janet, on some medication boards, conduct disorder is the same as sociopathy. Now I'm totally confused.
    Methuselah, I am so very sorry for you and your girls. They were born that way. All you can do is create rules that they have to follow and have serious consequences.
    Which is what we are doing right now. difficult child has actually done some of the "what-ifs" that some of you have posted. :( More on that later. I'll start another thread when I have the energy.
    Meanwhile, difficult child is only going to two camps this summer so I'm working on lining up more.
    Thank you all so much!
  13. klmno

    klmno Active Member

    Terry, it's my undestanding that conduct disorder can be a precursor to anti-social behavior or sociopathic behavior, just like ODD can be a precursor to conduct disorder. That being said, it doesn't necessarily mean ODD definitely will become CD or that CD will definitely result in an adult sociopath. Most teens in Department of Juvenile Justice have CD but not all will be adult sociopaths as many, many have a conscious and some completely stay away from illegal activity and hurtful behavior after reaching a certain maturity level.
    Last edited: Jun 19, 2012
  14. Methuselah

    Methuselah New Member

    Thanks, Terry. It has been an absolute nightmare parenting them. I count the days until I don't have to do it anymore.

    Whether they were born this way or not, they have complete awareness/control of their behavior. It isn't something like mental retardation. They know what they are doing and why they are doing it; they are aware society frowns on their choices and behaviors, so they charm everyone and do everything covertly. Everything. Neither one has ever been truly expressed anger overtly--they just stare you down and aggress when your back is turned. Needless to say, I'm worn out.
  15. TerryJ2

    TerryJ2 Well-Known Member

    Methuselah, I've been reading a lot about sociopathy and it is definitely brain wiring. You can definitely teach these kids rules, so that they can function in society. But it is estimated that between 1% and 3% of corporate CEOs are sociopaths, which actually helps them in their jobs. IOW, if you have to lay off 20,000 workers, it's a biz decision and you won't lose one wink of sleep. on the other hand, you can do insider trading and end up in jail.
    It's a spectrum, just like bipolar and autism. But the differences do show up on brain scans.

    Hmm ... new kitchen floor or MRI ... that's a tough call ...

    Anyway, many, many hugs. I can hardly imagine how exhausted you are. I mean, I'm exhausted with-one kid like that, who is a "maybe." You must be totally worn out.
    Just a few more yrs, if you're lucky ...
  16. DaisyFace

    DaisyFace Love me...Love me not


    I don't know if this helps or not....BUT

    In my own difficult child, I have always seen what i would consider "Aspie Traits". There are some things that she has always been super-rigid about. There are some things that she is genuinely clueless about (such as that other people have different points of view or that certain colors match and certain colors do not).

    I am beginning to think that these "deficits' (for lack of a better term) were not extreme enough to be considered a form of Autism or Pervasive Developmental Disorder (PDD)....but WERE detrimental enough to prevent her from interacting positively with people around her as she was growing up - thus creating (in her mind) an invalidating environment....thus leading to the development of a personality disorder. The PD has resulted from difficult child's maladaptive way of dealing with her world.

    Is it possible, that this same sort of thing may be happening with your son? Just thinking out loud...
  17. SomewhereOutThere

    SomewhereOutThere Well-Known Member

  18. TerryJ2

    TerryJ2 Well-Known Member

    MWM, he's married and has two girls? Eeek. I feel so badly for them when he finally commits and gets caught doing something truly awful and they have to live with-the horror of it.
    I agree, kids can be severely affected by drugs or alcohol that can cause similar damage to the brain.

    Thanks for not thinking difficult child is that bad. :) It's really hard to tell from my point of view here. We're in the thick of it. I'll post more this week on another thread.
    But he does seem to have some remorse ... he's just not apologizing that much, and seems so needy. IOW, HE needs the hugs for doing something awful when he's caught. There is something missing there. I really want a better diagnosis.

    Daisy, yes, that thought process is a possibility. I wonder and wonder which open window I missed during his early development, but then again, he was so adept at faking it that he even flew under my radar. Sigh. He wouldn't have admitted anything because he knew enough to know he was different, Know what I mean?? Very sad but totally understandable. So in many ways, we have to go back and teach him what he should have learned to begin with.
    It makes me dizzy.
  19. Methuselah

    Methuselah New Member

    "It's a spectrum, just like bipolar and autism. But the differences do show up on brain scans."

    I'm sure my daughter's brains would have hot spots on scans, but my point is they are very much in control of their behavior, unlike autism or bipolar. They patiently wait for the most opportune time to do their bad with lowest probability of getting caught. If they have to wait 5 minutes or 5 weeks, they can and will and not feel badly for one second. Yes, it is on a spectrum. There are psychopaths who are violent and those who aren't; just like there are violent people who are psychopaths and violent people who aren't.

    "Adults LOVED him. His foster parents who had him for five years before us swore he was their favorite foster child ever and that he just loved to help around the house and with the daycare kids (I'll bet he liked to help with the daycare kids. He was a sexual predator). I don't think they ever believed us when we told them about him. NOBODY could believe it. Because he acted like such an angel to adults"

    This is the most frustrating part! My difficult children present as wonderful, kind, sweet girls and my husband and I come off as lunatics who don't support or believe in their daughters! No matter how many ways we show and prove their sad truth, people still don't believe us. We had one family, whom difficult child 2 stole from their daughter and difficult child 1, at 16, was already to let their kindergartner get a beating with a belt for something she did, say to us after each of those episodes "We still love them!!!" I am still dumbfounded that they still fall for their koi, even when I worn them it is koi. That's how good at conning and charming my daughter's are. :-(
  20. buddy

    buddy New Member

    It is such an interesting question. My thoughts go all over the place on this and I imagine my response here will reflect that. I do think kids can have more than one diagnosis. If you take a kid who has Down's for example then disrupt their bond with neglect and abuse how can they not also have emotional challenges. People with neurological conditions have no immunity to chemical imbalances, genetic conditions, brain injuries from accidents and illnesses, so I do think some kids are just that lucky, they get to have more than one thing happen to them.

    The thing about any kid is they can learn things, so kids with autism/asperger's clearly can learn or why bother with therapy at all?? I know for sure Quin has learned not always from direct copying but from doing something maybe random and impulsive or echoic or imitative at first, but over time it got him something....mostly attention that he craves so much but is so inept at getting using higher cognitive skills. When you look at manipulation in terms of the broadest definition, even a baby/toddler does that, it is how they get their needs and wants met. I think even kids who are not cognitively delayed academically can be at a very immature level emotionally and use toddler laws to get what they want. Are some people who fit the definition of antisocial really very delayed?
    I DO believe kids with autism can have certain mental health diagnoses, I absolutely believe Q's early history of chronic pain and disrupted parenting caused attachment problems. He would panic and need to have the last of every food item when younger, would cry if I ate the last of my food without sharing some. If he saw a box was nearing empty he would cry. Kids with autism and healthy bonding are different with their parents, much closer than with other people even if it does not look developmentally normal. We have had to teach that here, and work hard at any degree of secure bonding. I know for sure Q feels things and he gets overwhelmed by his feelings. I dont think he is a sociopath, but he is definitely egocentric and he will smile and laugh inappropriately at sad things. Many kids with autism do that and many people with brain injuries do that. He still is upset over his cat dying two years ago. Yet, he did things that were unkind to him at times. He heard a little girl singing on the radio and said, awww that is so cute! He has said really sweet things, like your difficult child when he called to say sorry your dad died....asking to go check on my mom after her surgery and then when he arrived he actually went up to her and said, So, how are you feeling today? Then even waited for the answer! HE has no abiliy to hide or sneak for long. Doesn't get that other people can see through what he is doing so easily, and he does not have that classic Reactive Attachment Disorder (RAD) symptom of being superficially charming and then terrible to me or sneaky. But it gets so weird when he realizes he is really upsetting me then gets a smile on his face like, good! I got you! Sometimes I think it is defensive because he has never wanted people to know if he is hurt, upset, needs help, etc. But I know it can be just an automatic symptom that happens with his kind of brain injury too. And he has that I'm gonna not care about you before you get a chance to not care about me control thing going on sometimes. But after an issue happens, in his quiet thoughtful moments (car rides, on the way to falling asleep) I hear him ask questions like, do you think they will still be my friend if I show them that I wont do that again? He tries to think of things he can do to make them feel better, etc. He has on his own written me sorry letters.

    But how can we not wonder, worry, no matter the diagnosis, how this is gong to play out for their lives in the long run? Some ARE vulnerable to predators...people who will suck them in and use them to do their dirty work. (and yes some become predators). That has already happened to Q. I suspect Terry, your difficult child has been manipulated many times too. He makes choices but is not really able to make choices that will benefit him in the long run. His choices are pretty short term goal oriented. And if a "friend" asks, he will do many things and would probably say your are stupid to think they are using him. I am guessing this based on his history not just current things, I is not like he has sudden behavior issues, right? So, if he has improved in his ability to handle some Aspie issues, can get himself into "friend" groups (maybe...again, are they using him??? hard to say)....then the same symptoms may now look more straight antisocial, rather than more egocentric. Of COURSE puberty adds to it, again, disabled kids are not immune to the effects of that, but it can be more dramatic since they already have those tendencies. Quin will say yes to anything if he thinks someone will pay attention to him and he can be "one of the guys". I have heard many kids with autism in social skills groups say things like, I just want him to play with me, or why wont the kids let me join the game? It is heart breaking. They also most certainly can try and like the feeling of drugs, and for them it becomes so super complex because they already had impulse control issues or judgement challenges, etc.

    So, what can we do but look at each area of deficit or problem behavior and work to teach the skills needed in a way that matches their learning style? If their learning style involves direct teaching, role play, writing out the rules or behaviors expected and then discussing how that looks in real life and practicing it??? Well, then so be it. If they show that they are vulnerable or prone to chronic behavior issues, then they need increased monitoring and supervision and rules.

    Easy said, BUT for so many, when it is not obvious to others (professionals) that this is what is going on, especially the severe end of the spectrum Reactive Attachment Disorder (RAD) kids, kids who really do not feel for others and despite the knowledge that the parents have that they were exposed to chemicals or alcohol, that they had disrupted bonding histories when very young infants thru preschool years, etc.....there is so little help. Their brains may be just as disordered as a child with CP but because they have behaviors that hurt others, or they can fake it in public or around decision makers, the help and support to increase supervision is not there unless you can independently pay for that all day every day.

    It sometimes feels just too overwhelming.

    I dont think your son is a sociopath. Just MHO, does that mean his behaviors or his developmental status isn't just as challenging right now? NOPE. I'd agree that he has lost the chance for now to make decisions about where he goes and what he does without supervision. And I would not trust the parents of his "friends" since clearly there are issues you have mentioned several times with supervision in those homes too.

    I wonder for him about day treatment of some kind? Even public school is not going to provide the level of supervision he needs unless they agree to his having an aide nearby, but there is the bus too (or if he walks, rides bike etc...) and those are the danger times.

    I think switching him to one of those really limited phones is a super smart idea, he is vulnerable and does need to contact you but if that doesn't stop some of the things he does, then he simply has to follow the schedule you provide and is agreed on ahead of time or he does not get to do anything. I am at that point with Q so I do not say that lightly. Even as limited as his choices were, they are nearly gone. Everything that has a chance of his being around people who know him is supervised directly. If I am at a mall or something, he can walk to different stores and then come check in with me, but when he doesn't know people he has tunnel vision and doesn't notice anyone so not worried about that yet. He is too afraid of strangers. I can't imagine doing this if he had been as independent as your son, but my sister is dong that with her son who recently got into some issues (he has adhd) and yeah, stinks to be him right phone, no iPod, no computer, no going to friends houses, no going anywhere without the family group right now. He is adjusting now but not thrilled for sure. (this is the kid who gave or sold...jury is still out but I have MY opinion...I think it is a combo...his Concerta that the nurse gave him to bring home at the end of the was wrong to do that, but he still has to deal with the consequences).

    I wish it was an easy answer, it obviously is on my mind a lot too as you can tell by my post which again, I am sure makes little sense, but it is just where my mind goes when so overwhelmed and hoping there is not a bleak future for my son...or any of our gifts from God.

    I do worry that people will see Q more as a thug as he gets older. Maybe he will act more like one too??? It is really scary.