Evaluate the authorities' handling of the 'Alex Nord' case. How would you have handled this case - Essay Example

Harris Kamran Criminal Psychiatry 17 February 2008 The Alex Nord Case Background:according to the American Psychiatric Association's Diagnostic and Statistical Manual (1995), antisocial personality disorder is defined as, " a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood." It is not a very prevalent psychiatric disorder, and as such, its causes are yet not determined, however, it is believed that genetic and biological make up may play a role in putting a person to a greater predisposition to this disease (MedicineNet). The available cases might also not be very abundant in order to better understand and study the beginnings and symptoms of this disorder, and to determine its markers in children so that it can be prevented from developing later in life; only about 4% of the population seems to have this disorder, with men making up 3% of the total cases (American Psychiatric Association). More women could, in fact, have this disease, but they are often misdiagnosed as suffering from border-line personality syndrome instead of antisocial personality disorder (MedicineNet). The prognosis of this disease starts early on in life, with the child showing signs of delinquency, lying, truancy and substance abuse (MedicineNet). However, its diagnosis is limited to patients who are at least 18 years of age (MedicineNet). Many factors can play a role in a child's life leading to a development of this disorder. Disturbed childhood with numerous problems in the house and parent-child relationship can greatly put a child at the risk of developing this disease (Rutter 1998). If a parent is suffering from this disorder or AOD misuse disorder, this can provide the child with a role model to follow, and can enhance his abnormal activities (MedicineNet). Discord between parents or between a parent and the child, or asymmetric parent behavior and attention patterns to the child can trigger an inclination towards antisocial behavior in the child (Rutter 1998). The diagnosis of this disorder is a crucial and very serious matter, as this disease, whereas grave in its nature, has no definite treatment (MedicineNet). People suffering from this disease do not readily opt for treatment and therapy, and often have to be forced to do so, especially by the law (MedicineNet). Medication has proved to be an ineffective means of curing the disease, as firstly, there is no definite medication for this, and secondly, any medicines that may be given can be, and often are, abused or neglected by the patient, so they prove ineffective (MedicineNet). The only workable method if treatment is through psychotherapy of the patient, either individual or in groups_ depending upon the particular case and the needs of the individual_ combined with in-house and outpatient treatments, vocational training programs, and participation in long-term group therapies (MedicineNet). This treatment method, though not completely curable, does help tremendously in leading the individual toward a more normal lifestyle, and helping him pinpoint his problems and abnormal behavior so that he can make an effort to abstain from such activities in the future. Often this disorder wanes with age, with patients reduced to just substance abusers (MedicineNet). The Alex Nord Case: the case under consideration is that of a 24 year old man, named Alex Nord, who has been diagnosed with antisocial personality disorder, and has been sentenced to therapy. The provided case scenario gives many clear indications that the diagnosis of antisocial personality disorder is a valid diagnosis, and that the patient, Alex Nord, is indeed a deserving candidate for therapy and special care. What follows is a breakdown of his signs and symptoms that have been studied, on the basis of which the diagnosis rests. Each sign or symptom is proceeded by a typical behavioral pattern of such patients. This strategy would establish the diagnosis as appropriate: Alex Nord has had a difficult childhood, having been moved from one foster home to another, and never really been adopted or settled; such patients usually have a disturbing childhood, and an unsettled community life (Rutter 1998). He has had an unhealthy relation with his parents. His father abandoned him and then got killed, his mother did not show him consistent, protective, motherly love, she was not concerned; patients have issues with their parents, or have been victimized by tension between their parents. They have been affected by improper attention and love by their parents, and an absence of a proper family life (Rutter 1998). He was bored in school and dropped out; patients have a tendency of lacking commitment to school and so are excluded or dropped out of school (HomeOffice). Moreover, they consistently feel bored (Wikipedia 2008). He preferred to play truant with his friends; patients have had a difficulty in making and keeping friends, and have a tendency of truancy toward them (HomeOffice). He has had boyfriends who either neglected him or beat him; patients have been affected by community neglect and have been victimized by improper treatment, and therefore have had poor association with their community and neighborhood (HomeOffice). In his childhood, Alex Nord has been stealing from his neighborhood, and each time the article that was stolen was increased in price value, such as the from a 10-sped bicycle to an expensive racing bike; patients have a history of antisocial behavior in their childhood, and this inappropriate conduct leads to a perpetual habit of stealing, which grows to an impulsive obsession, a lack of regard for other people's rights and property, and a lack of regard for the law (Wikipedia 2008). He has never been bothered by the idea that what he's stealing belongs to others and that such an action might effect others adversely; patients show a disregard for other people's rights and feelings, violating their boundaries and having a lack of remorse for this misconduct or for other people's feelings or for having hurt them (Wikipedia 2008). He has been charged for stealing twice; patients have an impulsive habit to steal and show unlawful behavior, going against the norms of society (Millon 1998). He feels bored unless he steals something, which gives him a "kick"; sufferers have a tendency of feeling consistently bored and being incapable of tolerating it (Wikipedia 2008), so they indulge in activities that make them feel alive, such activities being often unlawful or detrimental personally or socially. He tends to manipulate his therapy sessions in order to rationalize his stealing habits; patients show a lack of remorse and a disregard to people's rights, feelings, and the established law of the society by trying to rationalize their unlawful behavior and by manipulating others and opportunities for their benefit (Wikipedia 2008). He thinks of himself as a great writer and comes across as a bright and intelligent person; patients show an affected and superficial charm and wit (MedicineNet 2004). He abandoned his writing projects and lost interest in them; patients show lack of commitment to their job or work (HomeOffice), and have an attitude of disregard or irresponsibility toward their duties, engagements, jobs, or financial obligations (Wikipedia 2008). Discussion: a person suffering from antisocial personality disorder needs to be counseled and rehabilitated, and, hence, he needs therapy. However, this therapy, as discussed earlier, involves a whole range of different activities and procedures that are adopted depending upon the individual's needs and requirements. Counseling is the first step, and this should be accorded to the patient right away. Afterwards, his progress needs to be monitored. In the case of nil progress, or a possibility of recession or violent behavior, further and more intense therapy should be provided, with activities such as long-term individual and group sessions. Jail can also be a part of the therapy process (MedicineNet 2004). The court sentenced Alex Nord to therapy instead of jail. This was the right step to be taken, as antisocial personality disorder patients need instant therapy so that their future activities could be curbed. Jail as the first resort is not the best approach for dealing with such patients. However, the fact that his therapy was stopped midway on the assumption that he would not indulge in such activities again is questionable, and the court should have objected to that. This led to his stealing of cars and car parts, and his second run-in with the law. The second time, too, he was sentenced to therapy. Again, this is a better approach. However, his second therapy should have been more intense (MedicineNet 2004). On the contrary, the psychologist, seeing how he manipulates the sessions to appear superior to her, resorted to stop his sessions and work with him only enough to keep him out of jail. this, and the act that the psychologist, assuming he would be rid of the disorder because he had established the cause in the first sentence, let go of the therapy, should have been handled differently. For instance, the first time that he was sentenced to therapy, his sessions should not have been stopped. Often patients ask for a break in sessions, or to stop them all together, but the therapists need to be alert if the patient's request is genuine or just a consequence of their illness (MedicineNet 2004). This can lead to an aggravation of their disease, as was apparent in the Alex Nord case when he started steeling cars. Moreover, the second time that he was sentenced, he should have been subjected to a tougher therapy and should have been made clear about his misconduct and the effect it had on him and the society, with the possibility of jail (MedicineNet 2004) if he did not try to mend his ways. Individual counseling and group sessions should never have been abandoned. References (2004, September 24). Antisocial Personality Disorder Symptoms and Causes. MedicineNet. Retrieved February 17, 2008, from http://www.medicinenet.com/antisocial_personality_disorder/page2.htm#causes (2004, September 24). Antisocial Personality Disorder Treatment. MedicineNet. Retrieved February 17, 2008, from http://www.medicinenet.com/antisocial_personality_disorder/page3.htm#treatment (2004, September 24). Definition of Antisocial Personality Disorder. MedicineNet. Retrieved February 17, 2008, from http://www.medicinenet.com/antisocial_personality_disorder/article.htm (2008, February 15). Antisocial Personality Disorder- Wikipedia: The Free Encyclopedia. Retrieved February 17, 2008, from http://en.wikipedia.org/wiki/Antisocial_personality_disorder. American Psychiatric Association (1995). Diagnostic and Statistical Manual of Mental Disorders (4rth Ed.). Washington, DC: American Psychiatric Association. Anti-social behavior: What is ASB- HomeOffice. Retrieved February 17, 2008, from http://www.homeoffice.gov.uk/anti-social-behaviour/what-is-asb/. Rutter, M. (1998). Antisocial Behavior by Young People. Cambridge: Cambridge University Press. Millon, T. (1998). Psychopathy: Antisocial, Criminal and Violent Behavior. New York: Guildford Press. Read More