Contrary to popular belief, an “antisocial” person is not someone who keeps to themselves or is shy in social gatherings. Instead, according to formal mental health criteria, someone with an antisocial personality disorder does not follow social norms or laws and frequently deceives others. Learning about antisocial personality disorder can guide how to navigate relationships with someone with the disorder and what treatments may help.
According to the American Psychological Association (APA), someone diagnosed with antisocial personality disorder ASPD exhibits chronic disregard for the rights of others. This disorder is also more commonly known as ASPD, sociopathic personality, or psychopathic personality. Although antisocial personality disorder is one of the most highly researched mental disorders, it is also the most difficult to treat.
People with antisocial personality disorder typically show pervasive:
Although people with ASPD can be charming and cunning, they often lack empathy for others. These people may not feel guilt or remorse for their deceptive behaviors.
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, also known as the DSM-5 TR, is used to help mental health professionals diagnose illnesses in an organized and coordinated manner.
According to the DSM-5 TR, the presence of the following signs and symptoms may lead to a diagnosis of antisocial personality disorder:
The DSM-5 TR classifies personality disorders into three clusters (A, B, and C). Antisocial personality disorder falls into the Cluster-B disorders, which also include borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder.
Many of the traits found in one Cluster-B personality disorder can be found in others. People diagnosed with narcissistic personality disorder, for example, may also mistreat others due to their feelings of superiority and self-importance. And, like ASPD, people with narcissistic personalities may take advantage of others to get what they want.
Out of all the personality disorders, ASPD is the only one that requires an individual to be 18 years old for a formal diagnosis of ASPD. Toddlers and young children are still learning how to behave and navigate the world around them. For this reason, people who receive a diagnosis of ASPD must be 18 years of age or older.
In addition, the presence of ASPD symptoms can’t be caused by other mental health disorders like schizophrenia or bipolar disorder. Because the symptoms of antisocial personality disorder may be similar to those of other mental health issues, it’s essential to have a licensed mental healthcare professional perform a thorough assessment and make the appropriate diagnosis.
Data from the National Library of Medicine indicates that about 1%-4% of the population has an antisocial personality disorder. For people who are or have been incarcerated, however, that percentage is much higher. A recent study published in BMC Psychiatry found that more than 30% of incarcerated people had ASPD. About 90% of individuals often have another mental health issue, with substance abuse being the most common co-occurring condition.
Other associated mental health problems are:
People with ASPD may also display characteristics that meet the criteria for other personality disorders, primarily the other Cluster B conditions like a narcissistic personality disorder.
The high rates of co-occurring mental health disorders combined with the nature of their symptoms make people with APSD more vulnerable than the general population to the following:
Because antisocial personality disorder can lead to criminal behavior and imprisonment, symptoms must be identified and treated as early as possible. Preventing adverse effects like substance abuse and criminal behavior may require mental health treatment for ASPD.
While the behaviors of someone with ASPD may drive away close friends and family, it’s important to remember that people with antisocial personality disorder have an illness. Furthermore, because such a high percentage of incarcerated people have ASPD, a stigma exists that all people with antisocial personalities are criminals.
It’s possible for people with ASPD to be law-abiding citizens and exhibit empathetic behaviors, especially with the support of a compassionate therapist or treatment program. During therapy, people with antisocial personality disorder develop the coping skills necessary to reduce their impulsivity and foster empathetic behaviors.
The fact is that not all people with an antisocial personality disorder will violently hurt others or engage in illegal behaviors. Moreover, people who have ASPD are also someone else’s son, daughter, or spouse and are just as deserving of care and respect as others. With the appropriate treatment, people with ASPD can go on to lead stable and productive lives.
At first, people with ASPD are unlikely to believe they need treatment for their disorder. Instead, they usually seek treatment for other disorders like depression or anxiety. Others are asked to see a therapist to maintain personal or professional connections.
One key factor in an accurate diagnosis of ASPD is a person’s relationship with others. With permission, accounts from family and friends can offer vital insight into whether a person’s behavior may signal the presence of ASPD.
There are currently no medications approved by the Food and Drug Administration (FDA) used to specifically treat ASPD. However, licensed mental health care providers may prescribe medications to alleviate some of the symptoms associated with ASPD, like depression or agitation. Working with an experienced provider when taking medication for ASPD reduces the potential for misuse and increases the chances for success.
The following psychotherapies are beneficial for people diagnosed with ASPD:
Although antisocial personality disorder is challenging to treat, knowledgeable and supportive clinicians can significantly impact therapy. With treatment and follow-up, individuals with ASPD can avoid the most problematic effects of the disorder.
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