What Is Antisocial Personality Disorder?

Medically Reviewed By Danielle Wade, LCSW
Was this helpful?
4

Antisocial personality disorder (ASPD) is a type of mental health condition that is characterized by a disregard for “right” and “wrong” behavior. It is also known as sociopathy. Personality disorders affect how people behave and relate to the world around them. With ASPD, people typically exhibit characteristics that others may view as manipulative, deceitful, or reckless. Sometimes, they can also endanger themselves and others around them.

However, it is important to note that these traits and behaviors are not exclusive to ASPD.

This article explains what ASPD is. It also describes the symptoms, causes, and treatment options related to the condition.

What is antisocial personality disorder?

woman looking into mirror
Studio Marmellata/Stocksy United

According to the National Health Service (NHS), ASPD is a pattern of ingrained behavior displayed by a person in which they continually disregard the rights and safety of others and themselves. It is one of the most difficult personality disorders to treat.

People with ASPD may behave aggressively and impulsively, ignoring what are usually considered social norms.

Psychiatrists do not diagnose ASPD in people under the age of 18 years old. Symptoms begin to appear in childhood, and people with ASPD often start with a diagnosis of conduct disorder.  

What is a personality disorder?

A personality disorder is a combination of personal experiences and behaviors that deviate from expected cultural norms.

This pattern is inflexible and becomes part of someone’s personality fabric. Sometimes contributing to distress and difficulty functioning, personality disorders typically have their onset during a person’s teenage years or early adulthood.

There are 10 types of personality disorders. Without treatment, personality disorders will be lifelong and affect at least two areas, including:

  • how the person views themselves and others
  • the person’s emotional response
  • how the person relates to others
  • the person’s control or lack of control of their behaviors

A person can have more than one personality disorder.

What are the signs and symptoms of antisocial personality disorder?

There are many signs and symptoms that may point to ASPD. These can include:

  • not considering the consequences of your actions
  • lying, cheating, or stealing
  • being able to charm others, often in the realms of exploitation or manipulation
  • having a callous regard or disrespect for others
  • lacking remorse and empathy for others
  • displaying arrogance
  • having a tendency toward abusive relationships
  • not fulfilling work or financial obligations
  • having issues with substance use
  • experiencing aggression and hostility
  • setting fires or displaying cruelty toward animals in childhood

Examples of antisocial personality disorder

Some more specific examples of ASPD-related behaviors may include:

  • stealing from a friend
  • engaging in public vandalism, such as graffiti
  • driving under the influence of drugs or alcohol
  • bullying
  • using violence or aggression against friends or strangers
  • breaking into properties
  • manipulating money out of friends or family members

When should you contact a doctor for antisocial personality disorder?

Due to the personality characteristics of ASPD, a person who has it is unlikely to realize that they may have a problem. As a result, they are less likely to seek treatment independently.

If someone suspects ASPD, family members or friends may gently suggest that the person seeks treatment.

What causes antisocial personality disorder?

The exact cause of ASPD is unknown. However, some research suggests that ASPD can be due to both genetic and environmental factors. 

Genetics is a contributing factor in 38–69% of cases, according to several studies. Existing genetic research has focused on identifying the exact gene associated with ASPD.

Environmental factors that may contribute to the development of ASPD include:

  • childhood abuse, including physical and sexual abuse
  • childhood neglect
  • family dynamics

What are the risk factors for antisocial personality disorder?

ASPD is more common in men than women. Other risk factors include:

  • growing up with a parent or caregiver who misused alcohol
  • growing up with a parent or caregiver who used drugs
  • having a parent or caregiver with the same condition
  • having a traumatic childhood

How do doctors diagnose antisocial personality disorder?

A specific test for diagnosing ASPD does not exist. Instead, ASPD diagnoses come from a psychiatrist using a set of criteria based on personality characteristics and behaviors. Anyone under 18 years old cannot receive a diagnosis.

According to the Diagnostic and Statistical Manual of Mental Disorders, the criteria required for diagnosing ASPD indicate a pervasive pattern of disregard for and violation of the rights of others. In addition, diagnostic criteria dictate that this pattern of behavior begins at the age of 15 years and meets three or more of the following characteristics:

  • not conforming to socially acceptable norms concerning lawful behaviors, such as performing illegal acts
  • displaying behaviors that may be deceitful, lying, using aliases, manipulating people, and “conning” others for pleasure or profit
  • not planning things or having a tendency toward impulsiveness
  • displaying irritability or aggressiveness and getting into physical fights or assaults
  • having a reckless disregard for the safety of themselves and others
  • having difficulty being responsible or able to sustain work behaviors or honor monetary obligations
  • displaying a lack of remorse, being indifferent, or rationalizing hurting, mistreating, or stealing from another person

It is important to note that any appearance of antisocial behavior cannot exclusively occur during schizophrenia or bipolar disorder

How do you treat antisocial personality disorder?

The treatment of ASPD or any psychiatric disorder involves the participation of the person receiving treatment. This is participation in the form of a willingness to recognize the issue, come to therapy, and follow medication recommendations.

Therapies for antisocial personality disorder

Psychotherapy used to treat ASPD can be helpful. However, the basis of psychotherapy is the relationship and trust between the therapist and the person engaged in the therapy.

Therefore, psychotherapy will only be able to help someone if they show an interest in receiving help and are actively participating.

The types of therapies that a psychologist may use include:

  • Cognitive behavioral therapy (CBT): One of the main challenges of ASPD is that the person has a false perception of themselves and the world around them. CBT involves efforts to change their thinking and behavioral patterns.
  • Mentalization-based therapy: This is a form of talk therapy that encourages a person to identify their thoughts and feelings and not solely focus on the behaviors of others. It teaches the person to think before acting, allowing improvement in interpersonal relationships. 
  • Democratic therapeutic community treatment: This is a form of group therapy that focuses on the role of attachment. The aim of group therapy is for the participants to begin to take responsibility for themselves.
  • Dialectical behavior therapy: This is a type of therapy designed for people with intense emotions. The therapist will focus on teaching the person how to handle crises, personal relationship techniques, skills to manage emotions, impulse control, and mindfulness.

Medications for antisocial personality disorder

Clinical studies have not allowed researchers to successfully determine a specific medication or medication regimen to treat ASPD.

However, you can use medications to treat co-occurring conditions of the disorder, such as aggression.

Medications may include second-generation antipsychotics such as risperidone and quetiapine. Your doctor may also suggest antidepressants such as SSRIs, mood stabilizers such as lithium, and anticonvulsants that help with impulsivity.

What are the complications of antisocial personality disorder?

The consequences of untreated ASPD include worsening physical and mental health implications, including:

  • depression
  • drug or alcohol misuse
  • suicidal behaviors
  • difficulty functioning at home
  • problems with relationships
  • issues keeping employment
  • homelessness
  • recklessness
  • premature death

Other frequently asked questions

Here are some other commonly asked questions about ASPD. Danielle Wade, LCSW, has provided the answers.

How long does antisocial personality disorder last?

ASPD is considered chronic

and lifelong, with moderations shown with advancing age.

Is antisocial personality disorder curable?

There is no one-size-fits-all remedy or treatment plan for ASPD. Treatments that intervene early in the development of this condition are the most effective and least costly.

The more severe the baseline symptoms and behaviors, and the longer they persist, the more difficult they are to address.

What effects does antisocial personality disorder have on a person’s relationships?

People with ASPD may not feel or experience empathy as others do, so forming relationships may prove difficult. With therapy, however, behavioral and thinking patterns can improve.

Summary

Antisocial personality disorder (ASPD) is a personality disorder characterized by reckless behaviors and a disregard for what most people consider social norms. It can range from mild to severe.

A person with ASPD may lack concern when causing others distress, have irrational anger, partake in unlawful behaviors, and be unable to maintain relationships and a sense of order in their life.

Therapy is the best course of action for personality disorders, as evidence suggests that personality disorders can improve with various therapies.

Was this helpful?
4
Medical Reviewer: Danielle Wade, LCSW
Last Review Date: 2022 Jun 10
View All Mental Health and Behavior Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.