Antisocial Personality Disorder

Written by Rose Kivi | Published on June 23, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

What Is Antisocial Personality Disorder?

Every person’s personality is unique. However, in some cases a person's way of thinking and behaving can be destructive—both to others and to the person him or herself. In the case of antisocial personality disorder (ASPD), a person's personality becomes overwhelmed by a mental health condition that causes patterns of manipulation and violation of others around them.

ASPD typically begins during childhood or early adolescence and continues into adulthood. According to the National Institutes of Health (NIH), people with ASPD display a long-term pattern of:

  • disregarding the law
  • violating the rights of others
  • manipulating and exploiting others

People with the disorder commonly do not care if they break the law. They may lie and place others at risk without feeling any remorse (NIH, 2010).

Lees McRae College states that about 2.5 to 3.5 percent of people have ASPD. The condition is much more common in men than in women (Lees McRae College).

What Causes Antisocial Personality Disorder?

The exact cause of ASPD is unknown. However, genetic and environmental factors may play a role. You may also be at greater risk of developing the disorder if you are male and if you:

  • were abused as a child
  • grew up with parents who have ASPD
  • grew up with alcoholic parents

What Are the Symptoms of Antisocial Personality Disorder?

Children with ASPD tend to be cruel to animals and set fires illegally. Some symptoms in adults include:

  • often being angry
  • being arrogant
  • manipulating others to get what they want
  • acting witty and charming to get what they want
  • lying frequently
  • stealing
  • acting aggressively and fighting often
  • breaking the law
  • not caring about personal safety or the safety of others
  • not showing guilt or remorse for actions

People who have ASPD have a higher risk of substance abuse. The National Institute on Alcohol Abuse and Alcoholism has linked alcohol use to increased aggression in people with ASPD (NIAAA).

How Is Antisocial Personality Disorder Diagnosed?

A diagnosis of ASPD cannot be made before the age of 18. Symptoms that resemble those of ASPD may be diagnosed as a conduct disorder in those under the age of 18.

A mental health provider can question individuals who are over 18 years about past and current behaviors. This will help detect signs and symptoms that could support a diagnosis of ASPD.

One must meet certain criteria to be diagnosed with the condition. This includes:

  • a diagnosis of conduct disorder before the age of 15
  • documentation or observation of at least three symptoms of ASPD since the age of 15
  • documentation or observation of symptoms of ASPD that do not occur only during schizophrenic or manic episodes (if you have schizophrenia or bipolar disorder)

How Is Antisocial Personality Disorder Treated?

ASPD is very difficult to treat. Typically, doctors will try a combination of psychotherapy and medication. However, it is hard to assess how effective the available treatments are in dealing with ASPD’s symptoms.

Psychotherapy

Doctors may recommend different types of psychotherapy based on the specific situation.

Cognitive behavioral therapy can help reveal negative thoughts and behaviors and teach ways of replacing them with positive ones.

Psychodynamic psychotherapy can increase awareness of negative, unconscious thoughts and behaviors, so that the person can change them.

Medications

No medications are specifically approved for the treatment of ASPD. However, doctors may prescribe:

  • antidepressants
  • mood stabilizers
  • anti-anxiety medications
  • antipsychotic medications

Doctors may also recommend a stay in a mental health hospital where intensive treatment can be administered.

Asking Someone with ASPD to Seek Help

It is hard to watch someone you care about exhibit destructive behaviors. It is especially hard when those behaviors may directly affect you. However, asking the person to seek help is even more difficult. This is because most people with ASPD do not acknowledge that they have a problem.

You cannot force a person with ASPD to get treatment. Taking care of yourself is the best thing you can do. A counselor may help you learn to cope with the pain of having a loved one with ASPD.

Long-Term Outlook

The NIH states that people with ASPD have an increased risk of going to jail, abusing drugs, and committing suicide. People often do not get help for ASPD unless they face legal troubles and a court forces them into treatment (NIH, 2010).

The symptoms of this condition tend to worsen during late teenage years to early twenties. Treatment may help improve symptoms. Symptoms can improve with age for some people, allowing them to feel and act better by the time they reach their forties.

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