A person with antisocial personality disorder (ASPD) disregards the rights, feelings, and well-being of others. ASPD affects how they think, feel, and interact with others. People with ASPD often lie, cheat, manipulate, and exploit others to gain their own benefits. They may also act impulsively, aggressively, or violently without feeling guilty or remorseful.
The exact causes of ASPD are not fully understood, but they may involve a combination of genetic, biological, psychological, and environmental factors. Some possible risk factors include:
Having a family history of ASPD or other mental disorders
Having a history of childhood abuse, neglect, or trauma
Having a low level of serotonin, a brain chemical that affects mood and behavior
Having abnormalities in the brain structure or function, especially in the areas related to impulse control, emotion regulation, and moral reasoning
Having exposure to violence, crime, or substance abuse at an early age
ASPD usually begins in childhood or adolescence and persists into adulthood. Symptoms vary in severity and frequency depending on the situation and the level of stress.
Repeatedly violating the law or social norms
Lying, deceiving, or using aliases for personal gain or pleasure
Being indifferent or rationalizing the harm they cause to others
Being arrogant, self-centered, or having a sense of entitlement
Being easily bored, restless, or seeking thrills
Being irresponsible, unreliable, or failing to fulfill obligations
Being impulsive, reckless, or taking unnecessary risks
Being aggressive, hostile, or prone to fights or arguments
Being irritable, easily annoyed, or impatient
Being indifferent or lacking empathy for the feelings or needs of others
Being unable to form or maintain close or lasting relationships
Being contemptuous of authority or rules
Being cynical, pessimistic, or distrustful of others
In order to diagnose ASPD, a mental health professional, such as a psychiatrist or psychologist, must examine the symptoms, history, and behavior of the patient. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the person must:
Has a pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by at least three of the following:
Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest
Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
Impulsivity or failure to plan ahead
Irritability and aggressiveness, as indicated by repeated physical fights or assaults
Reckless disregard for safety of self or others
Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another
The person is at least 18 years old
There is evidence of conduct disorder with onset before age 15 years
The antisocial behavior does not occur exclusively during the course of schizophrenia or bipolar disorder
It is difficult to treat ASPD since many people with it do not seek help and do not recognize that they are suffering. Treatment may also help reduce the severity and frequency of the symptoms, and improve the quality of life of the person. However, they may also resist or manipulate the treatment process or drop out prematurely.
The purpose of cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), or schema therapy is to help a person identify and change their distorted thoughts, feelings, and behaviors, and to improve their coping skills and social skills.
Antidepressants, mood stabilizers, or antipsychotics may treat some symptoms, such as impulsivity, aggression, irritability, or anxiety, as well as co-occurring conditions, such as depression, bipolar disorder, or substance abuse.
A person may benefit from group therapy, family therapy, or couples therapy by improving their interpersonal relationships, communication skills, and conflict resolution skills, as well as receiving support and feedback from others.
Antisocial behavior may be addressed with anger management, stress management, or substance abuse treatment.
There is no sure way to prevent ASPD, but early intervention and treatment may help prevent or reduce the negative consequences of the disorder. Some possible preventive measures include:
Providing a safe, stable, and nurturing environment for children and adolescents
Identifying and treating conduct disorder or other mental disorders in children and adolescents
Providing appropriate guidance, discipline, and supervision for children and adolescents
Teaching children and adolescents social skills, empathy, and moral values
Encouraging children and adolescents to participate in positive activities, such as sports, hobbies, or clubs
Seeking professional help if there are signs of ASPD or other mental disorders in oneself or a loved one
