Antisocial Personality Disorder Signs

You might have heard the term "sociopathic" in reference to a character from a movie or book, maybe even a real person. The descriptor is actually linked to a mental health condition known as antisocial personality disorder, or ASPD.

The disorder is characterized by patterns of reckless—often criminal—behavior, deceit, aggression, and a disregard for people's feelings. As such, the personality disorder makes it difficult for people to have stable work or personal relationships.

Up to 4% of adults in the US are estimated to have ASPD, with males much more likely to be diagnosed with the disorder than females. To be diagnosed with the condition, a mental health professional must observe long-term patterns of so-called "sociopath" traits.

Signs of Antisocial Personality Disorder

While specific signs can vary a bit by person, the following list of behaviors and tendencies can signal a potential case of ASPD based on criteria listed in the psychiatry handbook, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

Lack of Empathy and Remorse

One of the signature signs of ASPD is a lack of empathy. People with ASPD have an inability to acknowledge or identify with how another person may be feeling. This includes showing little to no remorse for their actions—regardless of how harmful those actions may be to others.

On top of having no remorse or being indifferent to how they mistreated someone, a person with ASPD might also try to rationalize the way they acted.

Impulsivity

Acting out impulsively without considering the consequences is another common behavior pattern linked to ASPD. This is not to be confused with an occasional spur-of-the-moment decision, like changing your mind about where to eat lunch. Instead, a person with ASPD will impulsively act in their own self-interest—often harming themselves or others in the process. Failing to plan is the norm.

Chronic Lying or Manipulation

Most everyone tells a white lie every now and then. But people with ASPD are pros at stretching the truth, especially when it benefits them.

Whether it be for fun or for personal profit, someone with ASPD might misrepresent the truth, repeatedly lie, use aliases, manipulate, or trick others for personal fun or profit. The manipulation and conning may be done through methods like lying, cheating, or stealing. Many times, manipulation is accomplished through superficial charm or charisma, as people with ASPD are known to hide personality traits to appear likable.

Aggressiveness

Acts of aggression or violence—especially in the form of physical fights and assaults—are key aspects of ASPD. One study found that higher aggression levels in childhood are linked to an ASPD diagnosis later on. This hostility might look like cruelty toward people or animals, spiteful behavior, irritability, and uncontrollable angry outbursts.

Irresponsibility

Routinely ignoring professional obligations and social commitments are examples of repeated irresponsible behavior commonly seen in people with ASPD. They often have consistent patterns of skipping work, disregarding deadlines, and failing to pay bills.

Risk-Taking

Someone with ASPD might be particularly prone to taking big risks that would seem dangerous to most others. Risky activities like alcohol abuse, drug use, and unsafe sexual practices are not uncommon. Because of this, people with ASPD are at higher risk for certain viral infections and sexually transmitted infections.

The accidents and traumatic injuries that come from certain risks are also why people with ASPD have untimely deaths at higher rates. The disregard might not be just for their own safety, but also the safety of others.

Ignoring Social Norms and Laws

From a young age, someone who has ASPD usually gravitates toward rule-breaking, cheating, and stealing rather than following societal rules and norms. For example, someone with ASPD might have committed arson or animal cruelty in childhood. This can translate into heavy criminal activity, though that's not always the case. Criminal activity—and its severity—is usually highest in the late teen years or in early adulthood.

When to See a Healthcare Provider

If you're concerned that you or a loved one may have ASPD, consider speaking to a healthcare provider. They can refer you to a trained mental health care provider—such as a psychiatrist or psychologist—for an official diagnosis.

To be diagnosed with ASPD, a person must be at least 18 years old and have a history of behavioral and emotional problems not linked to another condition—like schizophrenia or bipolar disorder— since at least age 15. From there, healthcare providers will look for evidence of at least three of the traits listed above to help make a diagnosis.

Oftentimes, people with ASPD don't get treatment on their own but instead start court-mandated therapy only after getting into legal trouble.

ASPD is one of the most difficult personality disorders to treat. There are no drugs or psychological methods that have been proven to treat ASPD itself. However, options like long-term talk therapy and medications might help target certain symptoms (like mood or aggression). It's also worth noting that while ASPD symptoms may seem extremely challenging in the late teens and early adulthood years, they can sometimes improve around age 40.

A Quick Review

It's pretty normal to go through rough patches in life where your mood, actions, and relationships seem a little off. But explicit, repeated patterns of reckless behavior, lying, impulsivity, aggression, and manipulation of others could potentially point to a more serious issue, like ASPD. Check with a healthcare provider for an official diagnosis—and know that professional mental health support is available to cope with whatever the outcome may be.

For anyone struggling with ASPD or another mental health issue, the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline (1-800-662-4357) can provide support, resources, and information about treatment facilities in your area.