Methods of Coping With Psychological Pain and Stress in Antisocial Personality Disorder

Abstract

Aim: Antisocial Personality Disorder (ASPD) is a personality disorder in which the person has difficulty controlling his behaviors and impulses, harming both himself and his environment. In our study, we aimed to examine the psychological pain experienced by people with ASPD and the methods of coping with the stress they use to combat it. Material and Method: Forty patients and 40 healthy control groups were included in the study. Sociodemographic Data Form, Beck Depression Scale (BDI), Beck Suicide Scale (BSS), Psychache Scale (PS), and Styles of Coping with Stress (SCSS) were administered to the participants. Results: The BDI (p=0.037), BSS (p=0.009), PS (p=0.008) and SCSS-helpless approach (p=0.01) scores of the patients in the patient group were significantly higher than the scores of the control group. On the other hand, the scores of SCSS-self-confident approach (p=0.001) and SCSS-searching for social support (p<0.001) were found to be significantly lower than the scores of the control group. In the patient group, there was a positive correlation between BDI and BSS, PS and SCSS-optimistic approach. On the other hand, there was a significant negative correlation between BDI and SCSS-self-confident approach and SCSS-seeking social support Conclusion: In our study, depression, suicide, and psychological pain were found to be significantly higher in people with ASPD compared to the control group, and it was determined that they used ineffective coping strategies. We think that early interventions for the treatment of psychological pain, such as suicidal ideation, determination of depression, and providing support for using effective coping strategies, may be effective in preventing self-destructive behaviors or suicides in ASPD, and therefore may change the course of the disease.

Keywords

• antisocial personality disorder
• psychache
• depression
• suicide; coping with stress

References

1. 1. Guy LS, Poythress NG, Douglas KS, Skeem JL, Edens JF. Correpondence between self-report and interview-based assessments of antisocial personality disorder. Psychol Assess. 2008;20(1):47–54.
2. 2. Aksoy A, Ögel K. Self harming behavior. Anadolu Psikiyatr Derg. 2003;4:226–36.
3. 3. Sinclair SJ, Roche MJ, Temes C, Massey C, Chung W, Stein M, et al. Evaluating chronic suicide risk with the Personality Assessment Inventory: development and initial validation of the Chronic Suicide Risk Index (S_Chron). Psychiatyr Res. 2016;245(1):443–50.
4. 4. Evrensel A, Ünsalver BÖ, Özşahin A. The relationship between aggression and serum thyroid hormone levels in individuals with antisocial personality disorder. Nöro Psikiyatr Arş. 2016;53:120.
5. 5. Krasnova A, Eaton WW, Samuels JF. Antisocial personality and risks of cause-specific mortality: results from the Epidemiologic Catchment Area study with 27 years of follow-up. Soc Psychiatry Psychiatr Epidemiol. 2019;54(5):617–65.
6. 6. Mee S, Bunney BG, Reist C, Potkin SG, Bunney WE. Psychological pain: a review of evidence. J Psychiatr Res. 2006;40:680–90.
7. 7. Bolger EA. Grounded theory analysis of emotional pain. Psychother Res. 1999;9:342–62.
8. 8. Jollant F, Voegeli G, Kordsmeier NC, Carbajal JM, RichardDevantoy S, Turecki G, et al. A visual analog scale to measure psychological and physical pain: a preliminary validation of the PPP-VAS in two independent samples of depressed patients. Prog Neuropsychopharmacol Biol Psychiatry. 2019;90:55–61.

9. 9. Lear MK, Stacy SE, Pepper CM. Interpersonal needs and psychological pain: the role of brooding and rejection sensitivity. Death Stud. 2018;42(8):521–8.
10. 10. Orbach I, Mikulincer M, Sirota P, Gilboa-Schechtman E. Mental pain: a multidimensional operationalization and definition. Suicide Life Threat Behav. 2003;33:219–30.
11. 11. Verrocchio MC, Carrozzino D, Marchetti D, Andreasson K, Fulcheri M, Bech P. Mental pain and suicide: a systematic review of the literature. Front Psychiatry. 2016;7:108.
12. 12. Leibenluft E, Gardner DL, Cowdry RW. The inner experience of the borderline self-mutilator. J Pers Disord. 1987;1:317–24.
13. 13. Tossani E. The concept of mental pain. Psychother Psychosom. 2013;82:67–73.
14. 14. Osmond H, Mullaly R, Bisbee C. The pain of depression compared with physical pain. Practitioner. 1984;228:849–53.
15. 15. Atkinson RL, Atkinson RC, Smith EE, Bem DJ, NolenHoeksema S. Introduction to psychology. Yavuz A. (Çev). Ankara:1996.
16. 16. Grech LB, Kiropoulos LA, Kirby KM. Target coping strategies for interventions aimed at maximizing psychosocial adjustment in people with multiple sclerosis. Int J MS Care. 2018;20:109–19.
17. 17. Saleh Baqutayan SM. Stress and coping mechanisms: a historical overview. Mediterr J Soc Sci. 2015;6:479–88.
18. 18. Olszewska S, Spryszyńska M. Personality and styles of coping with stress of security service managers. Opusc Sociol. 2013;5:62–73.
19. 19. Dong Y. The more stressful life events an IBS patient experiences, the less predictable the relationship is between changes in symptom severity and quality of life. Neurogastroenterol Motil. 2020;32:e13706.
20. 20. Hisli N. Validity and reliability of Beck depression inventory for university students. Psikol Derg. 1989;7(23):3–13.
21. 21. Beck AT, Kovacs M, Weissman A. Assessment of suicidal intention: the scale for suicide ideation. J Consult Clin Psychol. 1979;47(2):343–52.
22. 22. Ozcelik HS, Ozdel K, Bulut SD, Orsel S. The reliability and validity of the Turkish version of the Beck scale for suicide ideation (Turkish BSSI). Bull Clin Psychopharmacol. 2015;25(2):141–50.
23. 23. Holden RR, Mehta K, Cunningham EJ, Mcleod LD. Development and preliminary validation of a scale of psychache. Can J Behav Sci. 2001;33(4):224–32.
24. 24. Demirkol ME, Güleç H, Çakmak S, Namlı Z, Güleç M, Güçlü N, et al. Reliability and validity of the Turkish version of the psychological pain scale. Anadolu Psikiyatr Derg. 2018;19:14–20.
25. 25. Folkman S, Lazarus RS. If it changes it must be a process: study of emotion and coping during three stages of a college examination. J Pers Soc Psychol. 1985;48(1):150–70.
26. 26. Şahin NH, Durak A. The scale of coping styles with stress: adaptation for university students. Türk Psikol Derg. 1995;10(34):56–73.
27. 27. Azevedo J, Vieira-Coelho M, Castelo-Branco M, Coelho R, Figueiredo-Braga M. Impulsive and premeditated aggression in male offenders with antisocial personality disorder. PLoS One. 2020;15(3):e0229876.
28. 28. Mueser KT, Crocker AG, Frisman LB, Drake RE, Covell NH, Essock SM. Conduct disorder and antisocial personality disorder in persons with severe psychiatric and substance use disorders. Schizophr Bull. 2006;32(4):626–36.
29. 29. Akçay BD, Akcay D. What are the factors that contribute to aggression in patients with co-occurring antisocial personality disorder and substance abuse?. Arc Clin Psychiatr. 2020;47:95–100.
30. 30. Glenn AL, Johnson AK, Raine A. Antisocial personality disorder: a current review. Curr Psychiatry Rep. 2013;15(12):1–8.
31. 31. Hodgins S, De Brito SA, Chhabra P, Côté G. Anxiety disorders among offenders with antisocial personality disorders: a distinct subtype?. Can J Psychiatry. 2010;55(12):784–91.
32. 32. Greitemeyer T, Sagioglou C. Predictors of nonsuicidal selfinjury: the independent contribution of benign masochism and antisocial personality. Pers Individ Dif. 2021;168:110380.
33. 33. Beach SR, Brody GH, Gunter TD, Packer H, Wernett P, Philibert RA. Child maltreatment moderates the association of MAOA with symptoms of depression and antisocial personality disorder. J Fam Psychol. 2010;24(1):12–20.
34. 34. Deakin JFW. Depression and antisocial personality disorder: two contrasting disorders of 5HT function. Neuropsychopharmacology. 2003;64:79–93.
35. 35. Kene P, Hovey JD. Predictors of suicide attempt status: Acquired capability, ideation, and reasons. Psychiatr Q. 2014;85(4):427–37.
36. 36. Douglas KS, Lilienfeld SO, Skeem JL, Poythress NG, Edens JF, Patrick CJ. Relation of antisocial and psychopathic traits to suicide-related behavior among offenders. Law Hum Behav. 2008;32(6):511–25.
37. 37. Verona E, Patrick CJ, Joiner TE. Psychopathy, antisocial personality, and suicide risk. J Abnorm Psychol. 2001;110(3):462–70.
38. 38. Meerwijk EL, Shattell MM. We need to talk about psychological pain. Issues Ment Health Nurs. 2012;33(4):263–5.
39. 39. Flasbeck V, Enzi B, Brüne M. Altered empathy for psychological and physical pain in borderline personality disorder. J Pers Disord. 2017;31(5):689–708.
40. 40. Martens WH. The terrorist with antisocial personality disorder. J Forensic Psychol Pract. 2004;4(1):45–56.
41. 41. Fertuck EA, Karan E, Stanley B. The specificity of mental pain in borderline personality disorder compared to depressive disorders and healthy controls. Borderline Personal Disord Emot Dysregul. 2016;3(1):1–8.
42. 42. Caes L, Uzieblo K, Crombez G, De Ruddere L, Vervoort T, Goubert L. Negative emotional responses elicited by the anticipation of pain in others: psychophysiological evidence. J Pain. 2012;13(5):467–76.
43. 43. Pastwa-Wojciechowska B, Kaźmierczak M, Błażek M. Selfesteem and styles of coping with stress versus strategies of planning in people with psychopathic personality disorders. Med Sci Monit. 2012;18(2):CR119–24.
44. 44. Ireland JL, Brown SL, Ballarini S. Maladaptive personality traits, coping styles and psychological distress: A study of adult male prisoners. Pers Individ Dif. 2006;41(3):561–73.
45. 45. Watson DC, Sinha BK. Stress, emotion, and coping strategies as predictors of personality disorder pathology. Imagin Cogn Pers. 2000;19(3):279–94. 46. Bijttebier P, Vertommen H. Coping strategies in relation to personality disorders. Pers Individ Dif. 1999;26(5):847–56.