but i will not mourn for you (cofmanynames) wrote in little_details,
but i will not mourn for you
cofmanynames
little_details

Antisocial Personality Disorder in an American teenager in the 1980s-1990s, treatment and diagnosis

Hello all! Sometime lurker, first-time poster, etc. etc.

I've been trying to work out the backstory for an alternate universe (real person fic, bandom, if anyone wants to know) where the main character has some form of Antisocial Personality Disorder. Let's call him Henry.

Research done: I've read a bit more than a hundred entries back on this very community's psychiatry tag, asked a friend who's had to do similar research for fiction of her own, and looked up antisocial personality disorder, sociopathy, and psychopathy on Wikipedia. In addition I've used some of the resources here, like the GAF scale. The plot points I"ve figured out so far and elements of his worldview are based on this research.

At the point that I need to figure for, it's 1989 and we're in the US, Montana to be specific; he's 15 years old and, after a history of minor crimes (shoplifting, threatening classmates and teachers; he collects knives), has injured a girl in his school, apparently having tried to kill her, after she teased him about the way he talks.

That's the vaguest part of this, what it is that brings law/medical attention down on him (since he's previously been dismissed as just being a very strange kid, and his parents overlook a lot because they don't want to see it and because he's extremely bright, which they considered to be a kind of consolation) -- I was previously thinking he'd try to burn down his school, but that seems more difficult, what with the acquisition of materials and all.

The important thing is that he ends up in some kind of juvenile detention facility or psychiatric hospital, against his will, until the age of about eighteen (1992).

What I need to know is:

1. Where would he end up? And some details about life inside a facility like that, if possible.
2. What would he be diagnosed with? It doesn't matter what it has to do with what he actually has -- what would everyone think? (Under this list I tried to sketch out how his mind works.)
3. What conditions would he have to satisfy to be released? Would there be laws in his favour once he's a legal adult?
4. As an adult, he's interested in music. Would this be encouraged at all by doctors/etc. as a seemingly normal interest? If he writes songs (he does) with violent lyrics (murder, rape, despite an apparent disinterest in sex otherwise), how would this be considered (worth looking at at all y/n)?
5. What would he have to do to be restrained for some degree of time? (I'm thinking short, and probably attempting to injure others -- very unlikely himself.) How would he be restrained if so? How much freedom would he have in general?
6. During these years he develops something along the lines of insomnia, a habit of staying up for days at a time which he claims to be voluntary. How easy would this be to notice, and what would the consequences be (would they try to make him sleep)?
7. What kind of records would be kept of this kind of thing? Who, in the future, could see them? For example, in the case of police: if he's arrested, will they be able to see some amount of this? How about if he's reported as a missing person?
8. What would doctors assume about his ability to relate to others? I'd like there to have been some kind of tacit assumption, whether interpreted on Henry's part or actually there, that he'd never be able to relate to anyone, ever; him considering the fact that he does have friends of a sort and, later, a son to be proving them wrong wouldn't be out of character.
9. Speaking of his son, can APD be inherited? Suggestions for long-term effects having Henry for a father might produce would be appreciated, but keep in mind that while distant (and often absent) he does consider him to be "real" and acts (how he considers to be) accordingly. The boy is certainly distanced from others, but other than that I don't know.
10. As mentioned above (sorry about the jumping all over, I'm writing these as I think of them), he seems to be abnormally disinterested in sex at age fifteen. If asked (and required to answer), he says he considers it disgusting and below him. Would the doctors lend any significance to this?

Some facts about our Henry:

1. He does not consider others to be truly people, including his parents; to his mind human beings serve mostly to be an audience. He's expressed, repeatedly, once asked, the belief that he is possibly the only real human being in the world, and has trouble believing others exist when he can't see them. (The concept that people have lives he is not aware of and cannot understand distresses him when he thinks about it.) In addition, as a young man he was prone to injuring himself in accidents produced by his belief that as the only real person in the world he couldn't be hurt.
2. Much of what he's done (shoplifting, threatening and hitting classmates, setting fires in the woods behind his house...) as a child/young man has been excused because teachers like him and think if anything the other children are attacking him.
3. He has an expansive vocabulary and tends to talk with overly formal and archaic phrasing.
4. Later in life he is capable of forming emotional attachments to a degree; it's more a matter of not having anyone he would have considered to also be human than any progression on his part, I think.
5. At age 15, from what I can tell, he'd manage a GAF of around 40-45 at most, due mostly to the impaired relationships with family and lack of friends, and the probability of harm to others (and accidental harm to himself due to carelessness).
6. In the future, he does not consider himself to be completely a person either, unless he is performing (musically, to some degree any time people are paying attention to him) or killing someone.
7. As long as he's not required to particularly care about anyone other than the five (later six) people who he considers to be people, he is fairly charming, if coming off as -- off.
8. He very rarely accepts personal responsiblity. The times when he does seem to be random; for example, using the above circumstances, he considers himself perfectly in the right having stabbed the girl who was good-naturedly teasing him, but sees it as a grave mistake to have shouted at a nurse because that's rude.
9. He gets extremely upset when someone attempts to take his knives away, and rarely fails to carry at least one.

Most of the story takes place while he's between the ages of 26 and 36, by which time he's gotten somewhat better at at least blending in a bit, and eventually acquires five sort-of friends (in real life, the rest of his band and his then-girlfriend) who as concepts help ground him. But since I want to be able to reference backstory at least a bit, and write one chapter in a fic having to do with his interpretation of the events surrounding his hospitalisation (mostly to highlight the way he believes nothing involved was truly his fault).

As an adult he works essentially as a mercenary, after having lost an equally dubiously legal job after having been framed for the murder of a coworker, with four of the people mentioned above; they use being a band, to some degree, as cover.

I'm sorry if any of this was unclear; I was trying to proportion as much information as I could in case it would help or something you-all said gave me ideas.

Bonus question: There's another character in this story whose family was killed in a fire when she was around five. She survived due to a luck of placement and things falling on top of her that protected her, though she had some possibly permanent lung damage due to the smoke. I haven't done much research on the subject yet, due to that this plot point's fairly unclear and other than PTSD I don't know where to start, but if I can manage it I'm thinking she'll have some kind of amnesia relative to it -- if possible, to have no memories before the age of twelve (at which point she was placed in a different foster home, after some kind of problems with a previous one -- I don't know which, either mental issues on her part or a complication due to abuse) but a great aversion to anything associated with fire. This is mostly in passing, and I haven't worked out enough of it yet to know what to research, as said -- though she may have fainted upon seeing a friend of hers sit in a fireplace.

Note to mod(s): I wasn't sure how/what to tag; I hope these do.

Sorry for the huge post, and thank you!
Tags: ~psychology & psychiatry (misc)
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