Antisocial personality disorder is a mental health condition involving longstanding patterns of manipulation and disregard for others. It’s only diagnosed in those over the age of 18.

Every personality is unique. In some cases, a person’s way of thinking and behaving can be destructive — both to others and to themselves. People with antisocial personality disorder (ASPD) have a mental health condition that causes patterns of manipulation and violation of others around them. This condition overwhelms their personality.

ASPD typically begins during childhood or early adolescence and continues into adulthood. 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 don’t care if they break the law. They may lie and place others at risk without feeling any remorse.

A study in Alcohol Research and Health states that about 3 percent of men and 1 percent of women have ASPD. The condition is much more common in men than in women.

The exact cause of ASPD is unknown. Genetic and environmental factors may play a role. You may be at greater risk of developing the disorder if you’re male and you:

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

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

  • being angry often
  • being arrogant
  • manipulating others
  • 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 misuse. Research has linked alcohol use to increased aggression in people with ASPD.

A diagnosis of ASPD cannot be made in people younger than 18. Symptoms that resemble ASPD in those people may be diagnosed as a conduct disorder. People older than 18 can be diagnosed with ASPD only if there’s a history of conduct disorder before the age of 15.

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.

You 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 don’t occur only during schizophrenic or manic episodes (if you have schizophrenia or bipolar disorder)

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


Your psychologist may recommend different types of psychotherapy based on the your situation.

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

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


No medications are specifically approved for the treatment of ASPD. Your doctor may prescribe:

  • antidepressants
  • mood stabilizers
  • antianxiety medications
  • antipsychotic medications

Your doctor may also recommend a stay in a mental health hospital where you can receive intensive treatment.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

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It’s hard to watch someone you care about exhibit destructive behaviors. It’s especially hard when those behaviors may directly affect you. Asking the person to seek help is even more difficult. This is because most people with ASPD don’t 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.

People with ASPD have an increased risk of going to jail, misuing drugs, and suicide. They often do not get help for ASPD unless they face legal troubles and a court forces them into treatment.

The symptoms of this condition tend to get worse 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.

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you think someone is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Sources: National Suicide Prevention Lifeline and Substance Abuse and Mental Health Services Administration