Like other personality disorders, antisocial personality disorder (ASPD) can present in different ways, with symptoms varying from person to person.
Personality disorders often affect how a person behaves, thinks, and relates to others.
Antisocial personality disorder (ASPD) is a type of personality disorder often characterized by little or no regard for others and no consideration for right or wrong.
A person with ASPD can be charming and witty, while at the same time devious and uncaring. Someone with ASPD may also act impulsively, recklessly, and sometimes violently.
It’s also common for a person with ASPD to disregard social rules and laws.
While these are all common behaviors of someone with ASPD, there’s so much more to know about the condition.
Antisocial personality disorder (ASPD) is a deeply ingrained pattern of behavior characterized by a disregard for the welfare of others. The actions of a person with ASPD tend to be exploitative, reckless, manipulative, and sometimes criminal.
An individual with ASPD tends to have a lack of remorse for their actions or empathy for others.
ASPD affects about
As the name suggests, a person with antisocial personality disorder engages in behaviors that go against social norms.
The latest version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies ASPD as part of the cluster B personality disorder group, along with borderline, histrionic, and narcissistic personality disorders. Cluster B personality disorders are those in which a person has trouble managing their emotions and behaviors.
Antisocial personality disorder exists on a spectrum, meaning that symptoms can range from mild to severe. Symptoms can vary from person to person. No two people with ASPD are alike.
Common symptoms and behaviors of a person with ASPD may include:
- acting in ways that are grounds for arrest
- lacking remorse, guilt, or empathy
- lying or deceiving others for personal gain
- having difficulty forming stable relationships
- acting aggressively or violently toward others
- having a tendency to blame others for their problems
- behaving in a way that defies societal norms
Individuals with ASPD are more likely to have:
- financial problems
- legal trouble or imprisonment
- unemployment or difficulties keeping a job
- substance use issues
- difficulty planning for the future
Remember that everyone with ASPD is unique, so you may not have the same symptoms as someone else with the condition.
Like many other mental health conditions, there’s no exact cause for ASPD. However, experts believe that there are factors that may make a person more likely to develop the condition.
Genetics may play a role in the development of antisocial personality disorder. Various studies have estimated that heritability for this condition ranges anywhere from
Environmental factors might also contribute to the development of ASPD. Some environmental factors that may significantly influence ASPD include adverse childhood experiences, such as physical and sexual abuse and neglect. Other environmental influences may include malnutrition, fetal exposure to smoking or alcohol, and having a parent with a substance use disorder.
Having childhood conduct disorder is also often predictive for ASPD.
Some research points to biological factors. Evidence suggests that the 2p12 region of chromosome 2 and a variation in a gene called the arginine vasopressin receptor 1A (AVPR1A) might contribute to ASPD. The AVPR1A gene is said to regulate a range of behaviors, including social bonding, stress management, and territorial aggression.
There’s still much to be learned about the causes of ASPD. Researchers are still trying to understand the condition and why some people get it when others don’t.
If you think you might have ASPD, consider talking with your primary care physician, if you have one. They can refer you to a mental health professional, if needed, for a complete evaluation.
According to the DSM-5, the criteria for an antisocial personality disorder diagnosis include a consistent pattern of disregard for the rights of others from the age of 15 years, as shown by three or more of the following behaviors:
- reckless indifference for the safety of self or others
- failure to follow social norms regarding lawful behaviors; engages in actions that are grounds for arrest
- lying, deception, use of aliases; cons others for personal profit or pleasure
- lack of remorse or empathy; is indifferent to or rationalizes hurting or mistreating others
- aggression and irritability; often physically violent
- consistent irresponsibility; cannot keep a job or meet obligations to others
There is no medical test, like a blood test, for ASPD. If you’re referred to a mental health professional, they might do a psychological evaluation along with a physical exam to make sure another condition is not the cause for your symptoms or behaviors.
A complete personal and medical history might also be taken, including any previous mental health conditions or medications you’re taking. You want to be honest when discussing your symptoms so that the doctor can make the right diagnosis and develop a treatment plan that fits your unique symptoms.
An extension of childhood conduct disorder
Although symptoms can start by the age of 8, ASPD is the only personality disorder that isn’t diagnosed in childhood.
According to the DSM-5, for a diagnosis of ASPD, the person has to be at least 18 years old and have had a previous diagnosis of conduct disorder by age 15.
Conduct disorder is a childhood behavioral disorder marked by breaking social standards and rules. If these antisocial behaviors persist, the diagnosis converts to ASPD at age 18.
Among children with conduct disorder, about
Conduct disorder is a reliable predictor of ASPD. Kids who reach age 15 without a diagnosis of conduct disorder will not likely develop ASPD. The small number of adults with ASPD who never met the diagnostic criteria for conduct disorder tend to have less severe symptoms.
Psychopathy, sociopathy, and antisocial personality disorder are often used interchangeably, but there are differences in each condition.
ASPD is a diagnosable mental disorder based on behavioral symptoms. Psychopathy and sociopathy, on the other hand, are not listed as actual disorders in the DSM-5 but may be thought of as traits or tendencies. Some people with ASPD may have psychopathic or sociopathic traits.
So, what’s the difference between psychopathy and sociopathy?
Psychopathy is considered to be more biologically based, while sociopathy is more influenced by one’s environment.
Psychopathy is cold and calculating, as well as charming and manipulative. Nearly all cases of psychopathy meet the criteria for ASPD, but only a small percentage of people with ASPD meet the
A person with sociopathic traits, on the other hand, is more emotional and impulsive. They tend to engage in less severe crimes than those with psychopathic traits, but are more likely to get caught because they don’t plan ahead.
ASPD shares symptoms with several other mental health conditions. Because of this, other conditions may co-occur along with ASPD or, in some cases, be misdiagnosed.
Some conditions have symptoms similar to or overlapping with those of ASPD. These include:
- Narcissistic personality disorder. This is a cluster B personality disorder. This condition is defined by exploitativeness and a lack of empathy. However, people with the disorder typically aren’t aggressive or as pathologically deceitful.
- Borderline personality disorder. This is also a cluster B personality disorder. People with this condition may be manipulative, but often for reassurance and affection rather than for personal gain.
- Substance use disorder. This condition very commonly co-occurs with ASPD. However, it’s important to differentiate between impulsivity and irresponsibility due to substance use versus being part of someone’s typical behavioral pattern.
Other conditions may also co-occur with ASPD, such as:
There isn’t enough evidence to support the use of any particular medication or therapy for antisocial personality disorder. Currently, the most effective and least expensive treatment is
People with ASPD aren’t likely to seek treatment on their own, as their behaviors are a deeply ingrained part of their personality and may be difficult to see as objectively wrong.
It’s important that we find better preventative treatments, as many people with ASPD are only seen after they’ve harmed someone and are facing incarceration.
However, a person with ASPD may seek help for co-occurring disorders, particularly for conditions that feel personally uncomfortable, such as depression or anxiety. Others become evaluated for a court-ordered assessment.
Medications may also be prescribed for co-occurring conditions, such as aggression or impulsivity. Some people with ASPD might be motivated to seek help for anger management therapy or substance use disorder treatment, as these can also help them stay out of the criminal justice system.
Hospitalization provides little to no benefit for those with ASPD, but it can be used to treat co-occurring conditions such as substance use disorder or suicidal behavior.
Antisocial personality disorder is a lifelong condition. However, symptoms tend to decrease after middle age. Those who begin with milder symptoms tend to show even more improvement as they age.
Crime rates tend to reflect this as well, as fewer severe crimes are committed by older people. People who had a later onset of ASPD tend to have less severe behavioral difficulties.
Remember that symptoms of ASPD can look different in each person. Just because you have ASPD does not mean you’ll act in violent ways or in ways that might lead to an arrest.
Not everyone with ASPD breaks the law or hurts others.
Though treating the condition can be a challenge, it’s not impossible. There are ways to help manage and live with your condition.
If you think you may have ASPD, there are a number of resources available for you.
A good place to start is with your physician or family doctor, if you have one. They can refer you to a specialist who will be able to do an in-depth evaluation and make a diagnosis.
If you don’t have a family doctor or physician, consider talking to a physician at a local clinic. Friends or family members you trust might also be able to give you a referral. You can also try one of these find-a-therapist tools:
If telehealth is a better option for you, you can find information about online therapy and mental support services by going to the following pages: