What Is Antisocial Personality Disorder (ASPD)?

Antisocial personality disorder (ASPD) is a mental disorder in which there is a pervasive pattern of disregard for the rights of others. ASPD is characterized by reckless behavior, exploitation of others, and lying for personal gain with a lack of remorse.

This article will explain more about antisocial personality disorder, along with its symptoms, diagnosis, and treatment. 

Characteristics, Traits, and Symptoms 

A person with ASPD begins to show symptoms of the condition as a child or a teenager. They may often ignore rules or lie and steal. They may even get in trouble with the law and have criminal charges brought against them. 

A person with ASPD may have the following symptoms:

• Impulsive behavior 
• Disregard for others
• Not being responsible or refusing to take responsibility 
• Manipulative behavior
• Having a high opinion of themselves 
• Arrogance
• Ability to be charming 
• Being persuasive
• Lying
• Stealing
• Fighting
• Not showing any remorse 
• Anger  

Factors Related to Sex

People assigned male at birth have a higher risk of developing ASPD. This may be due to social or cultural factors. It is also possible that these people have a higher chance of having unchecked aggression and substance abuse, which are linked to ASPD. 

Diagnosis 

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) provides specific criteria to diagnose ASPD. A person must have at least three of the following characteristics since the age of 15:

• Disregarding the law and doing acts that could lead to arrest 
• Deceitful behavior that includes lying, using aliases, and conning others 
• Being impulsive 
• Being aggressive and getting into fights 
• Disregarding your own safety or other people’s safety 
• Not being responsible, such as not being able to work consistently 
• Not feeling any remorse or rationalizing hurting others 
  

In addition to the characteristics above, the DSM-5 also requires that a person meet all of the following three criteria: 

• Being at least 18 years old
• Showing symptoms of the disorder before the age of 15 
• Behavior is not caused by schizophrenia or bipolar disorder 
  

A healthcare provider may order tests to rule out other medical conditions that may be contributing to the presentation of ASPD, such as: 

• Physical exams
• Urine tests 
• Blood tests
• Electroencephalogram (EEG)
• Brain magnetic resonance imaging (MRI) or computed tomography (CT) scans 
  

For example, urine and blood tests can show if you have a substance abuse problem that may cause similar behavior to ASPD. 

Causes 

The exact cause of ASPD is not known. But there are factors that may increase the risk of having this condition, such as:

• Being born a male 
• Having trauma or abuse during childhood
• Having a first-degree relative with ASPD
• Having a parent with a substance use disorder 
• Being born with certain genetic factors 
• Having problems with substance abuse
• Having unusual levels of the brain chemical serotonin
  

Types 

Some people use the terms psychopath and sociopath when describing a person with antisocial personality disorder, although these terms are not exactly the same.

ASPD vs. Psychopathy

There is overlap between ASPD and psychopathy. However, some researchers believe that psychopathy is a more severe form of antisocial behaviors with significant deficits in emotional response, lack of empathy, and egotism.

Only about one-third of all people with ASPD also have psychopathy. It is also important to note that not all people with psychopathy have ASPD.

ASPD vs. Sociopathy

Sociopath is not a formal clinical term, but it is sometimes used to capture the characteristics of ASPD and psychopathy.

Treatment 

Treatment for antisocial personality disorder can be difficult because the person with the condition usually does not want to seek help. The costs of hospitalization or inpatient treatment for ASPD can be high, and it is generally not beneficial.

However, a person with ASPD is not a lost cause or destined to end up in the criminal justice system. Treatment through the use of medications and psychotherapy is possible.

Medications

There are no medications approved for the treatment of ASPD. However, medications may be prescribed for conditions associated with ASPD, including depression, anxiety, aggression, and substance use disorders. Medications for ASPD may include:

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

Psychotherapy

Long-term psychotherapy may be tried. Psychotherapy for ASPD may include:

• Cognitive behavioral therapy (CBT)
• Psychodynamic psychotherapy
• Group therapy
• Family therapy 
  

Coping

To help someone with ASPD cope with the condition, consider recommending that they see a therapist or psychologist who specializes in the disorder. 

Personal Development

It is important to attend therapy regularly and take the recommended medications. To get better, the person with ASPD must be willing to take actionable steps to address individual behavior patterns. 

Effect on Loved Ones 

Dealing with someone with ASPD can be difficult, so you have to set boundaries and stick to them. You may also want to come up with a crisis plan that includes your own therapy and support.  

Summary

Antisocial personality disorder is a mental condition that affects more men than women. A person with ASPD can manipulate or exploit other people without feeling any remorse. Treatment may include psychotherapy and medications. 

A Word From Verywell

ASPD is a complex condition that is difficult to treat, but those with it may benefit from certain interventions. If you or a loved one has antisocial personality disorder, it is important to find medical specialists who understand this condition from a clinical perspective and are willing to work with you.