What Is Antisocial Personality Disorder?

Antisocial Personality Disorder, or ASPD, is one of 10 personality disorders, commonly but incorrectly referred to as sociopathy.

Chances are good that you know or have at least met someone with antisocial personality disorder (ASPD), one of 10 different types of personality disorders, according to the American Psychiatric Association (APA).

While the terms "sociopath" or "psychopath" are commonly used interchangeably as labels for people with ASPD, according to a 2020 study published in the Brazilian Journal of Psychiatry, neither are official clinical terms found in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the clinical handbook used by healthcare providers to diagnose mental health conditions.

In other words, a person can't be clinically diagnosed as a "sociopath" or "psychopath." There are, however, psychopathic tendencies and behaviors. About one-third of people diagnosed with ASPD meet the criteria for psychopathy, according to the same Brazilian Journal of Psychiatry study.

Who Is Affected by ASPD?

Approximately 2% to 4% of men and 0.5% to 1% of women have ASPD, according to a 2015 review of the literature published in the Canadian Journal of Psychiatry. The prevalence of ASPD peaks between the ages of 24 to 44; sometimes, symptoms improve on their own as the person enters their 40s, per the National Library of Medicine's resource, MedlinePlus.

According to the Canadian Journal of Psychiatry study, ASPD "is characterized by a pattern of socially irresponsible, exploitive, and guiltless behavior." People with ASPD also tend to have co-occurring and addictive disorders, including major depressive disorder, bipolar disorder, anxiety disorders, somatic symptom disorders, substance use disorders, gambling disorder, and sexual disorders.

This same study cites that the onset of ASPD begins early in childhood, with antisocial behaviors beginning by the age of 8. An adult diagnosis of ASPD usually requires a diagnosis of conduct disorder (CD) in childhood; approximately 24% of girls and 40% of boys diagnosed with CD in childhood will go on to have ASPD as adults.

There is a small percentage of people who are diagnosed with ASPD who do not have a history of a CD diagnosis during childhood; these people tend to have milder cases of ASPD, suggesting that the disorder is on a spectrum.

What causes someone to have ASPD is unclear, although according to MedlinePlus, there seems to be a genetic component. Other possible factors include being abused as a child and having a parent with substance use disorder.

Signs of ASPD

According to MentalHealth.gov, a resource of the US Department of Health and Human Services, the general rule is that people with ASPD exhibit the following traits:

  • Are able to act witty and charming
  • Are good at flattery and manipulating other people's emotions
  • Repeatedly break the law
  • Disregard the safety of self and others
  • Have problems with substance abuse
  • Lie, steal, and fight often
  • Do not show guilt or remorse
  • Are often angry or arrogant

Other typical traits of someone with ASPD include irresponsible actions, like defaulting on financial and work responsibilities. They may not stick with a job for too long either, said Stephen Salzbrenner, MD, assistant professor of psychiatry at the University of Nebraska College of Medicine in Omaha.

In general, people with ASPD are rule breakers, often breaking the law. According to the Canadian Journal of Psychiatry study, as many as 80% of people in correctional facilities have ASPD.

People with ASPD often lie—whether about something as significant as their identity or as seemingly trivial as where they spent the afternoon. It's a "pattern of calculated lying," said Dr. Salzbrenner. They also tend to exaggerate to make themselves look better and to deflect blame onto others.

While the lies may be calculated, people with ASPD also tend to be impulsive, not calculating long-term consequences. "They really don't have a very identifiable picture of what lies down the road if they do something wrong but are [instead] very responsive to immediate reward," said Dr. Salzbrenner.

And because people with ASPD tend to be charming and witty, they may not get caught, or they may avoid facing punishment if they are caught. In addition, people with ASPD tend to exhibit aggressive behavior, show no remorse, and be impulsive, according to MedlinePlus.

Treatment for People With ASPD

Treatment for ASPD is more effective for those with stronger family and relationship ties (including being married), according to the Canadian Journal of Psychiatry review.

According to the APA, certain types of psychotherapy and having self-care and coping strategies in place may also help. While there are no medications that specifically treat this personality disorder, medications may be used to help lessen the symptoms of ASPD or co-occurring conditions, such as depression.

However, it's possible that the person with ASPD may not want to engage with a therapist or seek help.

Loved ones of those with ASPD may find that a mental health professional can help them navigate the relationship with the person who has ASPD and learn to set boundaries to support their own mental health and safety.

Summary

ASPD is a personality disorder that can cause people to act without consideration for how their behavior affects others and any long-term consequences. They may be impulsive and aggressive and break rules or laws without taking responsibility for their actions.

Mental health professionals can recommend individualized treatment plans for those with ASPD—or some traits of it—and their loved ones. Treatments may include psychotherapy, self-care, coping strategies, and medications.

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