People with antisocial personality disorder may behave in ways that go against societal rules, but it’s important to separate myth from fact.

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Someone who lives with antisocial personality disorder (ASPD) may disregard the law or social norms. They may also put themselves and other people in harm’s way.

Behaviors associated with ASPD can include:

  • impulsive or reckless behavior
  • aggression
  • lack of remorse
  • behavior others perceive as irresponsible or deceptive

It may be easy to think you understand ASPD and how it might affect a person living with the condition. But there are many myths about ASPD that may be potentially harmful.

Fact: People with ASPD have a medical diagnosis with biological and psychological roots.

Researchers now know that people with ASPD have brains that work differently than those who don’t have the condition. Scientists are still studying this condition, but they have discovered there may be a biological basis for ASPD.

In people with ASPD, parts of the brain may be smaller or have a different shape. There’s evidence that with ASPD, parts of the brain may not talk to each other in the same way as happens in people without ASPD.

The condition may also be genetic. In about 38% to 69% of people with the condition, one or both parents also met the criteria for an ASPD diagnosis.

In addition to brain structure and genetics, there’s a connection between childhood experiences and ASPD. Living through sexual or physical abuse or neglect can be associated with ASPD in adulthood.

Many people who develop ASPD lived as children with adults who had inconsistent or tough parenting styles or who had substance use disorder.

Fact: Most people with ASPD do not meet the definition of psychopathic behavior.

Recent research has found that about one-third of people with ASPD also live with psychopathy.

A person might receive a diagnosis of ASPD with a range of behaviors. Occasional irresponsible or challenging behaviors are at the more moderate end of the spectrum, whereas psychopathic behavior might be the most severe form of ASPD.

The criteria for an ASPD diagnosis are in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-5). Mental healthcare professionals use this to diagnose the condition.

However, psychopathy is not listed in the DSM-5. Instead, psychopathic behavior is measured using different tools, such as the Hare Psychopathy Checklist.

Psychopathy is not necessarily a diagnosis as much as it is a group of traits and behaviors, such as:

  • impulsiveness
  • lacking empathy or remorse, especially after hurting someone
  • tendencies toward intense aggression and anger
  • lacking deep emotional connections
  • possessing a “superficial” charm

Other research questions whether all people with psychopathy have ASPD or whether they’re living with different personality disorders. Thus, psychologists and researchers are still debating this topic.

Fact: Many people with ASPD live in their communities and not in prisons.

Research estimates that between 40% and 70% of people in prisons live with ASPD, compared with 1% to 3% of the general population.

But just because ASPD is overrepresented in prisons does not mean every person with ASPD will become a criminal.

The DSM-5 does not require that a person engage in unlawful activity to receive a diagnosis of ASPD.

To receive a diagnosis of ASPD, a person needs to meet at least three of the seven criteria for the condition that are listed in the DSM-5, as well as having evidence of conduct disorder in childhood.

Repeatedly engaging in unlawful acts is one of these seven criteria. However, it’s possible to receive a diagnosis without having this behavior.

Fact: Newer treatments can help people with ASPD function better in society.

Therapists and researchers once thought people with ASPD couldn’t recover. However, that perception has changed.

While ASPD is typically a lifelong diagnosis, people with this condition can be helped in learning how to restrain impulses and adopt more socially acceptable behaviors.

Some research recommends tailoring a treatment approach to accommodate the unique characteristics of ASPD, such as helping the person find the motivation to change their behaviors.

Doctors come up with a treatment plan on an individual basis. That means they work closely with the individual who has ASPD to determine the best therapies.

Some options include talk therapy and treatment for other diagnoses the person may have at the same time, like substance use disorder.

Many people with ASPD do not typically seek out treatment on their own. For some people with the condition, recovery often begins after they encounter the justice system and the court orders them to receive treatment.

Often, the person’s friends and family play a role in a treatment plan and may help make decisions about care. People with ASPD who have family and social support are more likely to achieve remission, according to research.

Doctors and therapists don’t typically use medications to treat ASPD or any personality disorder.

However, if someone with ASPD also has other conditions, such as anxiety or depression, doctors may recommend medications to help treat those conditions.

There are many myths about ASPD and about people who live with the condition. But the facts tell a different story.

For example, people with an ASPD diagnosis often have biological or environmental factors that lead to the condition. Not all engage in law-breaking behavior.

ASPD can be a challenging condition, but it is treatable. Many people with ASPD live well-balanced lives with the proper support.

Treatment options often include therapy and, in rare cases, medication. Treating ASPD may have more success when paired with social or family support, as well.

Like all mental health conditions, you may have to try multiple strategies before finding what works best for you. Talking with a therapist or doctor is often the first step to getting help.

If you’re ready to get help, you can visit Psych Central’s guide to finding mental health support.