Antisocial Personality Disorder

Among the ten personality disorders, antisocial personality disorder often comes with a sense of fear. Personality disorders are stigmatized enough, but antisocial personality disorder often appears alongside terms like “sociopath” and “psychopath,” especially in movies and TV shows.

Hollywood usually sensationalizes the violence associated with this disorder, and people with antisocial personality disorder can pose significant risks to the safety of others. However, not all people with antisocial personality disorder turn to violence or crime.

Despite having empathy deficits compared to others, people with antisocial personality disorder still deserve the same treatment and care afforded to any other mental health condition.

What is Antisocial Personality Disorder?

Antisocial personality disorder (ASPD), also called sociopathy, is a mental health condition characterized by a consistent disregard for right and wrong. Contrary to the common belief that “antisocial” simply means “not social,” the term refers to how a person’s behavior goes against social norms. Individuals with this personality disorder may ignore the rights and emotions of others and tend to provoke or manipulate people to get what they want.

The American Psychiatric Association (APA) groups ASPD under Cluster B personality disorders, characterized by overly emotional, dramatic, and unpredictable thought patterns and behavior. People with antisocial personality disorder are known to violate the law, behave violently or impulsively, and have problems with substance abuse. They may also have issues with deceitfulness, such as lying or sneaking.

Personality Disorder Overview

Personality disorders are characterized by unhealthy, abnormal patterns of thinking and behaving that cause significant issues or limitations in all facets of life. These characteristics make it difficult for people with a personality disorder to understand or relate to their peers or particular situations.

Most individuals with personality disorders are unaware of their symptoms because their thinking seems natural. It’s common for family or friends to be the ones who ultimately point out their disordered behavior.

Healthcare professionals categorize personality disorders into three different clusters based on their characteristics.

These three personality disorder clusters include:

  • Cluster A (odd, eccentric)
    • Paranoid Personality Disorder
    • Schizoid Personality Disorder
    • Schizotypal Personality Disorder
  • Cluster B (dramatic or unpredictable)
    • Antisocial Personality Disorder
    • Borderline Personality Disorder
    • Narcissistic Personality Disorder
  • Cluster C (anxious, fearful)
    • Avoidant Personality Disorder
    • Dependent Personality Disorder
    • Obsessive-Compulsive Personality Disorder

Symptoms of Antisocial Personality Disorder

ASPD often stands out from other personality disorders due to its list of unpredictable and sometimes violent symptoms. At its core, antisocial personality disorder causes the individual to feel little or no remorse for hurting others or breaking laws.

It’s important to remember that while some people receive their diagnosis due to criminal behavior, others may never turn to violence or crime. This list of symptoms includes general symptoms but is not an exhaustive list or mandatory criteria to have this disorder.

Symptoms of antisocial personality disorder may include:

  • Disregard for right and wrong
  • Impulsiveness or failure to plan ahead
  • Acting cold, cynical, and disrespectful to others
  • Consistent irresponsibility and impairments in fulfilling work or financial obligations
  • Failure to consider the negative consequences of behavior or learn from them
  • Lying to exploit or con others
  • Using charm or wit to manipulate others for personal gain or personal pleasure
  • Arrogance or a sense of superiority
  • Recurring delinquency, including criminal behavior
  • Repeatedly violating the rights of others through intimidation or violence
  • Hostility, significant irritability, agitation, aggression, or violence
  • Lack of empathy or remorse about harming others
  • Unnecessary risk-taking or dangerous behavior regardless of safety for self or others
  • Poor or abusive relationships

Antisocial Personality Disorder VS Psychopathy

People sometimes confuse ASPD and sociopathy because they seem similar in certain ways. Both personality disorders have a poor sense of right and wrong and tend to engage in risky, violent, or criminal behavior. But despite being used interchangeably, sociopathy and psychopathy are different from each other.

An antisocial personality disorder is an official diagnosis found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but sociopathy and psychopathy have different diagnostic criteria. Instead, they fall under the ASPD diagnosis umbrella and can be used to describe whether or not the person has a conscience.

Sociopaths

Sociopaths have a weak sense of conscience and can form some close attachments, while psychopaths have no conscience and pretend to have close attachments. Sociopaths tend to be more rage-prone and erratic, likely developing due to childhood trauma.

Psychopaths

Psychopaths, on the other hand, are known for their cold, calculating behavior and ability to act normally. Still, they are more likely the result of brain differences due to genetics. Research shows psychopaths have underdeveloped brain components commonly responsible for emotion regulation and impulse control.

Causes of Antisocial Personality Disorder

It’s believed that genetic and environmental factors contribute to the development of antisocial personality disorder. An individual develops their personality traits mainly during childhood. Significant events or trauma can trigger the progression of ASPD early on, especially if someone is genetically predisposed to personality disorders.

Antisocial Personality Disorder Risk Factors

Because genetics and upbringing can put someone at risk of developing ASPD, it’s essential to be aware of any history of personality disorders in the family and/or prior trauma.

Research shows that certain factors can increase the risk of developing ASPD. These risk factors include:

  • Diagnosis of Conduct Disorder (CD) in childhood due to aggressive behavior and rule-breaking
  • Family history of personality disorders or mental health disorders
  • Being abused or neglected during childhood
  • Unstable, violent, or chaotic family life during childhood

How Common is Antisocial Personality Disorder?

An estimated 10% of adults in the United States have a personality disorder, the most common of which are obsessive-compulsive personality disorder, narcissistic personality disorder, and borderline personality disorder.

According to research from the World Health Organization World Mental Health (WMH) Survey Initiative, the estimated lifetime prevalence of ASPD amongst the general population falls between 1% to 4%. Men are 3 to 5 times more likely to be diagnosed with antisocial personality disorder than women.

Common Comorbidities and Related Conditions

It’s not uncommon for an individual to have symptoms of more than one personality disorder, especially within the same cluster. Regarding ASPD and comorbidities, research indicates a strong correlation between substance use disorder and the diagnosis of antisocial personality disorder.

Studies from the Journal of Substance Abuse Treatment show that about 40% to 50% of individuals with a substance use disorder meet the criteria for ASPD. In addition, approximately 90% of individuals diagnosed with ASPD also have a co‐occurring substance use disorder.

Antisocial Personality Disorder and Addiction

There’s strong evidence that addiction and ASPD commonly occur together. Because ASPD often includes risky behavior and a disregard for personal safety and the safety of others, many individuals with ASPD will also engage in substance abuse and alcohol use.

Research indicates symptoms from Cluster B personality disorders (antisocial, borderline, histrionic, and narcissistic) were significantly related to drug and alcohol abuse and dependence.

The highest rates of past-year alcohol dependence were found in those with Cluster B disorders, with antisocial symptoms, in particular, being significantly related to substance use diagnoses.

Diagnosis of Antisocial Personality Disorder

Each personality disorder has specific diagnostic criteria. Patients will need to be evaluated by a psychiatrist or similar mental health professional to make an accurate diagnosis and suggest a treatment plan.

To be diagnosed with ASPD, an individual must have shown symptoms of conduct disorder before age 15. Most adults with ASPD will have shown signs of conduct disorder in childhood or early adolescence. However, a formal diagnosis won’t occur until age 18.

Symptoms are usually at their worst during the late teenage years and 20s, sometimes improving as a person ages. Unfortunately, treating ASPD can be complicated, as patients typically don’t think there’s anything wrong, making them less likely to seek diagnosis on their own.

Treatment for Antisocial Personality Disorder

ASPD can be difficult to treat because patients seldom seek help, usually believing there’s nothing wrong with them.

Treatment for ASPD usually includes a combination of behavioral therapy or psychotherapy in individual or group settings and psychotropic medications. Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT) are the most common types of psychotherapy used in treating personality disorders. They can help identify problematic or illegal behavior to avoid in the future.

The FDA has not approved any medications specifically for antisocial personality disorder. However, healthcare providers sometimes prescribe medications to treat symptoms like impulsive aggression and mood swings, including mood stabilizers, antidepressants, or antipsychotics.

Get Treatment For Antisocial Personality Disorder and Addiction

Managing antisocial personality disorder can be difficult, especially for friends and family impacted by its most harmful symptoms. Despite ASPD’s reputation, individuals with this condition still deserve a happy, fulfilling future. People with ASPD can flourish and live productive lives with the right therapy methods, medications, and support.

FAQs about Antisocial Personality Disorder

What causes antisocial personality disorder?

Antisocial personality disorder (ASPD) is thought to be caused by genetics and upbringing. An individual with a family history of personality disorders may be vulnerable to developing ASPD due to a significant event or trauma from childhood.

Who is most likely to develop antisocial personality disorder?

Men are 3 to 5 times more likely to develop ASPD than women. To receive a diagnosis, the patient must have shown symptoms of conduct disorder before age 15. Individuals with a history of personality disorders in their family and past trauma are particularly susceptible to developing ASPD.

What are the signs of antisocial behavior?

Individuals with ASPD generally disregard right and wrong and show a lack of remorse or guilt when hurting others or breaking laws. Impulsive aggressiveness and persistent lying to achieve one’s goals are also common.

What is the difference between a sociopath and an antisocial personality?

They generally mean the same thing. The term sociopath refers to the diagnosis of ASPD. While sociopathy isn’t its diagnosis, many people still use it when referring to the symptoms associated with ASPD.

How is antisocial personality disorder treated?

ASPD treatment includes a combination of psychiatry and medications to lessen the severity of symptoms. The most common forms of treatment are Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT), as well as mood stabilizers and antipsychotics to help with impulsive aggression.

Reviewed by:Kent S. Hoffman, D.O.

Chief Medical Officer

  • Fact-Checked
  • Editor

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is Co-Founder and Chief Medical Officer of Addiction Guide and ensures the quality of our website’s content and messaging.

Written by:

Content Manager

Jessica Miller is a USF graduate with a Bachelor’s Degree in English. She has written professionally for over a decade, from HR scripts and employee training to business marketing and company branding. In addition to writing, Jessica spent time in the healthcare sector (HR) and as a high school teacher. She has personally experienced the pitfalls of addiction and is delighted to bring her knowledge and writing skills together to support our mission. Jessica lives in St. Petersburg, FL with her husband and two dogs.

6 references
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  2. Haase, J. M. (2009). Co-occuring Antisocial Personality Disorder and Substance Use Disorder: Treatment Interventions. Marquette University. Retrieved November 16, 2022, from https://epublications.marquette.edu/cgi/viewcontent.cgi?article=1022&context=gjcp

  3. Haley, L. D. (n.d.). Psychopathy vs Sociopathy. Mental Health America of Eastern Missouri. Retrieved November 16, 2022, from https://www.mha-em.org/im-looking-for/mental-health-knowledge-base/conditions/127-psychopathy-vs-sociopathy

  4. Mayo Foundation for Medical Education and Research. (2019, December 10). Antisocial personality disorder. Mayo Clinic. Retrieved November 16, 2022, from https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928

  5. Pagán, C. N. (2022, March 16). Antisocial personality disorder: Symptoms, causes, diagnosis, treatment. WebMD. Retrieved November 16, 2022, from https://www.webmd.com/mental-health/antisocial-personality-disorder-overview

  6. U.S. National Library of Medicine. (2010). Antisocial personality disorder: Treatment, management and prevention. National Center for Biotechnology Information. Retrieved November 16, 2022, from https://pubmed.ncbi.nlm.nih.gov/21834198/

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