What Is Antisocial Personality Disorder (ASPD)?

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What Is Antisocial Personality Disorder?

Antisocial personality disorder (ASPD) is a condition characterized by a lack of empathy and regard for other people. People who have antisocial personality disorder have little or no regard for right or wrong. They antagonize and often act insensitively or in an unfeeling manner. Individuals with this disorder may lie, engage in aggressive or violent behavior, and participate in criminal activity.

Symptoms

People with antisocial personality disorder:

  • May begin displaying symptoms during childhood; such behaviors may include fire setting, cruelty to animals, and difficulty with authority
  • Often have legal problems resulting from failures to conform to social norms and a lack of concern for the rights of others
  • Often act out impulsively and fail to consider the consequences of their actions
  • Display aggressiveness and irritability that often lead to physical assaults
  • Have difficulty feeling empathy for others
  • Display a lack of remorse for damaging behavior
  • Often have poor or abusive relationships with others and are more likely to abuse or neglect their children
  • Frequently lie and deceive others for personal gain

These characteristics often lead to major difficulties in many life areas. At its core, the inability to consider the thoughts, feelings, and motivations of other people can lead to harmful disregard for others.

As adults, the disorder can be destructive to both the person living with it and those who come into contact with them. People with antisocial personality disorder are more likely to engage in risk-taking behaviors, dangerous activities, and criminal acts. Those with the disorder are often described as having no conscience and feel no regret or remorse for their harmful actions.

Diagnosis

Symptoms of antisocial personality disorder often begin during childhood although the condition is often not diagnosed until later in life. As children, it is common for those who develop this disorder to experience violent bursts of anger, show cruelty towards animals, and be described as bullies by their peers.

While the condition may begin in childhood, it cannot be officially diagnosed before the age of 18. Kids who display these symptoms are diagnosed with conduct disorder. In order to be diagnosed with ASPD, a person must display a disregard and violation of the rights of others before the age of 15. This disregard is indicated by displaying at least one of seven symptoms:

  • Disregard for the safety of the self and others
  • Failure to obey laws
  • Impulsive behavior
  • Irritability and aggression
  • Lack of remorse for actions
  • Lying or manipulating others for profit or amusement
  • Pattern of irresponsibility

In addition to displaying at least one of these symptoms, the person must be at least 18 years old and not display antisocial behavior as a result of another condition such as bipolar disorder to schizophrenia.

According to some critics, the DSM diagnostic criteria are too focused on behaviors related to criminal actions. Concerns have been raised that the diagnosis may at times be misapplied to individuals in low socioeconomic or urban settings in which seemingly antisocial behavior may be a part of a protective survival strategy.  Because of this, it is possible that the prevalence of this disorder has been overstated.

According to the DSM-V, 0.2% to 3.3% of U.S. adults have antisocial personality disorder and the condition tends to affect men more than women.

Causes

The exact causes of antisocial personality disorder are not known. Personality is shaped by a variety of forces including nature and nurture.

Genetics

ASPD is more common among the first-degree biological relatives of those with the disorder than in the general population. Research suggests that ASPD is likely strongly linked to inheritance and that environmental influences probably exacerbate its development.

Upbringing

Upbringing can also have an important influence. Childhood abuse, neglect, and trauma have also been linked to the onset of ASPD. If a child's parents are abusive and dysfunctional, children may learn such behavioral patterns and later display them with their own kids.

Kids who grow up in disorganized and neglectful homes also lack the opportunities to develop a strong sense of discipline, self-control, and empathy for others.

Brain Differences

A number of factors have been found to increase the risk of the disorder including smoking during pregnancy and abnormal brain function. Research suggests that people with ASPD have differences in the frontal lobe, the area of the brain that plays a role in planning and judgment.

People with the disorder also tend to require greater stimulation and may seek out dangerous or even illegal activities to raise their arousal to an optimal level.

Treatments

Antisocial personality disorder is difficult to treat for a number of reasons. People with the disorder rarely seek out treatment on their own. Those who do generally receive treatment only after some type of altercation with the legal system.

While people with ASPD often come into contact with the criminal justice system, research suggests that incarceration and other punitive measures are largely ineffective since people with the condition are usually unresponsive to punishment.

Psychotherapy

Cognitive behavioral therapy (CBT) can be useful in helping individuals gain insight into their behaviors and to change maladaptive thought patterns. Effective results usually occur only after long-term treatment. Group and family therapy as well as mentalization-based therapy, which targets the ability to recognize and understand the mental state of oneself and others, have also been studied for ASPD and show promise.

Medication

Medications may be used to treat some of the symptoms that a person with ASPDl may experience. Some of the medications that may be prescribed include:

  • Anti-anxiety medications
  • Antidepressants
  • Antipsychotics
  • Mood stabilizers

Coping

Antisocial personality disorder often has a significant impact on a person's ability to function, which can make it difficult to cope with many aspects of life.

  • According to the DSM-5, the condition can result in incarceration, injury, or death due to harmful or criminal actions.
  • It affects an individual's ability to work and maintain relationships.
  • The disorder also has the potential to cause harm to friends, family members, co-workers, and strangers who may be harmed by the person's actions.

Most people with ASPD do not seek help on their own and intervention likely only happens due to legal problems. Research suggests that those who have the best outlook are those who have stronger social support and better spousal and family ties. 

If you have a loved one who has ASPD, you may find it helpful to talk to a mental health professional. They can help you learn coping skills that will help you set boundaries to protect yourself from harm. Group therapy and support groups may also be helpful resources of support and information.

If you or a loved one are struggling with antisocial personality disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database.

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