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Antisocial Personality Disorder: Symptoms, Treatment, Causes, and More

Looking to learn more about the personality disorder known as antisocial personality disorder? This article covers symptoms, treatment, and more.

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selective focus photography of man's reflection in broken mirror
Fares Hamouche

A ‘personality‘ constitutes the various patterns of thought, emotion, and behavior that a person uses to understand and connect with the world around them. This means that when a person is suffering from a personality disorder, their personality traits and patterns of thought, emotion, and behavior inhibit them from correctly interacting with the world around them, inclusive of their personal, social, and professional lives. Despite 13% of the world’s population suffering from some sort of personality disorder, they are deemed as an “ego-syntonic” mental illness, meaning the person suffering is unaware of their disorder.

Currently, there are ten certified personality disorders that are categorized into three clusters (Cluster A, Cluster B, and Cluster C) by the Statistical Manual of Mental Disorders (DSM-5). However, it’s common for personality disorder symptoms to overlap in a patient, leading them to have more than one disorder and be diagnosed as having a “personality disorder not otherwise specified (PDNOS)“. To further examine the patient’s symptoms, doctors often use a procedure called “differential diagnosis” to ensure that all variables are assessed.

Personality Disorder Clusters

  • Cluster A: The disorders within this cluster include paranoid personality disorder, schizoid personality disorder, and schizotypal personality disorder, which are often all characterized by “odd, eccentric thinking or behavior”.
  • Cluster B: The disorders within this cluster include antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder, which are often all characterized by dramatic, impulsive, excessively emotional thinking or behavior.
  • Cluster C: The disorders within this cluster include avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder, which are often all characterized by thinking or behavior that is fearful, anxious, or paranoid.

Antisocial Personality Disorder

Sometimes referred to as ‘sociopathic personality disorder’, antisocial personality disorder (ASPD) is a mental health condition that causes the person suffering to think and act in reckless ways that defy legal morals or empathy for other human beings. Due to the high rate of impulsivity and lack of ethics this mental health disorder stimulates, many of those suffering, exhibit conduct issues their whole life, leading them to a life of crime, unstable job history, difficulty with intimate relationships, frequent deceptiveness, and manipulation for personal gain. According to the National Center for Biotechnology Information, between 1-4% of the world’s population suffers from antisocial disorder with over a third of incarcerated males and females proving to have ASPD to some extent.

Antisocial personality disorder is commonly measured on a scale that ranges from minor to severe. This range of extremity is why some ASPD patients can function in society while others, like violent offenders and murderers, are considered to demonstrate behaviors similar to a psychopathic personality or psychopathic traits. However, it is important to note that while society often uses the term ‘psychopath’ to label those who display antisocial behavior, the two mental health issues are distinct in their diagnostic criteria.

To learn more about the differences between ASPD and psychopathy, visit this source. Furthermore, personality disorders are similar but different than mood disorders such as depressive disorder or bipolar disorder. To learn more about the difference between personality disorders and mood disorders, visit this source. To learn more about the daily life and symptoms of people living with antisocial personality disorder, visit this source or watch the video below.

Antisocial Personality Disorder Symptoms

While the symptoms and signs of ASPD vary from patient to patient, they can include but are not limited to:

  • Displaying a consistent lack of moral judgment.
  • Frequent lying, deceit, and manipulation of others for personal gain or satisfaction.
  • Disrespecting the emotions and boundaries set by others.
  • Condescending and dominant attitudes, tones, and behavior to others.
  • Criminal behavior despite the potential negative consequences of fines or jail time.
  • Consistent aggravation, impulsive aggression, irritability, and/or violence shown towards other people or animals.
  • Unstable job history and/or intimate connections with people.
  • Displaying an inconsistent ability to plan for the future and an increased likelihood to act on impulsive behavior.
  • Showing no empathy or remorse about the intent to or action of harming others.
  • Displaying risky behaviors or habits with alcohol, drugs, or self-harm.

Although the reasoning is unclear, oftentimes, an ASPD patient’s aptitude for violent crime or destructive behavior is said to decrease over time. It is also noted that symptoms of antisocial personality disorder are often recognized and diagnosed more often in males rather than females.

DSM-5 Diagnostic Requirements for ASPD

According to the DSM-5 diagnostic requirements for antisocial personality disorder, to be deemed a sociopath, a patient must meet the following criteria:

  • The patient is at least 18 years of age.
  • Ties to a conduct disorder during or before they were 15 years of age.
  • A consistent lack of morality displayed since the age of 15 as designated through three or more of these behaviors:
    1. Regularly steering away from legal social norms and/or participating in unlawful behavior that qualifies for arrest.
    2. Consistent lying, deceit, and manipulation of others for personal gain or pleasure.
    3. Demonstrating an inconsistent ability to plan for the future and an increased likelihood to act impulsively.
    4. Irritability, aggravation, or aggression that may lead to or have led to physical fights or assaults.
    5. No consideration for the safety of oneself or others.
    6. Proving an inability to keep a consistent job or comply with monetary obligations such as bills or payments.
    7. Showing no empathy or remorse towards those they have mistreated, harmed, or hurt; sometimes even rationalizing their damaging behavior.

Causes of Antisocial Personality Disorder

While there is no precise way to determine what prompts ASPD to develop in a person, research points towards an amalgam of causes ranging from environmental factors to the anatomy of a person’s brain.

  • Environmental Influences: Child abuse and neglect are commonly listed as a risk factor in developing antisocial personality disorder. A child displaying signs or being diagnosed with conduct disorder (CD) or attention deficit hyperactivity disorder (ADHD) is also tied to the eventual development of ASPD in some cases.
  • Biological Influences: ASPD has proven to be hereditary so due to genetic factors, those who have a parent with antisocial personality disorder are predisposed to develop it themself. It has also been found that many ASPD patients have links to an alcoholic parent.
  • Brain Anatomy: Researchers have noted that the brain structures that mediate violence, found in the prefrontal cortex of the frontal lobe, tends to be a different volume size in ASPD patients. Neurobiologists state that this could either be a cause for the mental disorder, or a result of environmental factors/experiences on an ASPD patient.

Treatment for Antisocial Personality Disorder

Differential Diagnosis

Prior to receiving treatment for antisocial personality disorder, it’s important to have an accurate diagnosis. Due to the overlap or comorbidities of most personality disorders, diagnosing antisocial personality disorder may be difficult for a mental health professional or doctor. The common differential diagnoses for this psychiatric disorder include narcissistic personality disorder due to its similar symptom of exploitativeness, borderline personality disorder due to its similar symptom of manipulation, and substance use disorder due to it commonly causing impulsivity.

Treatment Plans

The primary plan to treat those suffering from antisocial personality disorder is what as ‘psychotherapy’ or ‘talk therapy’ in an outpatient setting. Cognitive behavioral therapy (CBT) is commonly used to help those with ASPD as it aims to help a person manage their problems by altering their thought and behavior patterns. Another common treatment is through democratic therapeutic communities. Communal talk therapies center around addressing each patient’s risk of offending alongside their emotional and psychological needs in hopes of long-term recovery.

While there are no medications to specifically treat ASPD, antipsychotics can be used to null aggressive behavior, and/or anticonvulsants can be taken to aid impulsive desires. Other drugs may be used as well to treat comorbid conditions such as ADHD, substance misuse, or other common mental health disorders such as anxiety disorder, schizophrenia, etc. It’s important to note that with ASPD patients, there is an increased risk for self-harm and suicidal thoughts or actions in which a patient may have to be hospitalized for treatment.

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About the author

Katee Fletcher

Katee’s passion for writing and fascination for language has forever guided her path in life.