What Is Antisocial Personality Disorder?

Antisocial personality disorder, or ASPD, is a mental-health condition in which individuals place little value on the rights, feelings, or welfare of others. Persons with ASPD are often cold, manipulative, reckless, and unconcerned with anyone’s well-being but their own, though they may cultivate a superficial charm to enlist aid when they need it. These individuals lack a moral compass, have little regard for human relationships, and are indifferent to the anxiety or pain that they cause. ASPD sufferers frequently engage in criminal behavior and often abuse drugs and alcohol. Men are more vulnerable to this condition than women.

ASPD affects about three percent of the population but runs much higher among those in prison. Nearly half of all male inmates and one-fifth of all female inmates are subject to this disorder. If a family member or loved one is displaying signs of antisocial personality disorder, the psychiatric specialists at Baptist Health may be able to help.

What Are the Symptoms of Antisocial Personality Disorder?

The symptoms of antisocial personality disorder include:

• Little or no sense of morality
• Boorish or callous behavior toward others
• Use of lies or deceit to manipulate people
• Lack of remorse regarding immoral conduct
• Haughtiness combined with an unearned sense of personal superiority
• Impulsiveness and reckless risk-taking
• A lack of foresight or planning for the future
• An inability to understand or empathize with other viewpoints
• Aggressive or violent tendencies
• A pattern of abusive relationships
• Rule and lawbreaking behavior

Antisocial behaviors of this magnitude have a variety of negative consequences. Persons with ASPD suffer from high rates of imprisonment, alcoholism and drug addiction, spousal and child abuse, homelessness, depression, anxiety, and premature death from suicide or other violent behaviors.

What Causes Antisocial Personality Disorder?

Personality can be defined as the thoughts, feelings, and behaviors that make each of us individually but recognizably human. Genes and environment both contribute, with early childhood experiences being especially important. ASPD is likely caused by hereditary and environmental factors that medical science has yet to identify. There may be certain combinations of genes, or unusual developments in brain growth, that limit a person’s ability to behave as a social animal.

Risk factors for antisocial personality disorder include:

• A family history of personality disorders
• Childhood abuse or neglect
• A chaotic or violent upbringing
• A childhood conduct disorder diagnosis

How Is Antisocial Personality Disorder Diagnosed?

Persons with an antisocial disorder rarely seek help. In the event that they do, here are the steps that a medical provider is likely to take:

• Symptoms documentation: A physician or mental-health provider will want a complete list of symptoms, which can be obtained during a detailed question-and-answer session.
• Family medical history: Because of the prevalence of mental-health conditions in some families, the physician will want to know the individual’s medical history.
• Physical exam: A physical exam is important as a means of ruling out an underlying physical or medical cause for the condition.
• Psychological evaluation: The patient might be asked to fill out a questionnaire with the purpose of documenting medical and behavioral evidence for ASPD. His or her physician can use this information, in conjunction with the criteria published in the Diagnostic and Statistical Manual of Mental Disorders, to make a diagnosis.

Persons with ASPD are not always truthful about their symptoms when speaking with a medical expert. With permission, the physician may call on family members or knowledgeable acquaintances for corroborating evidence concerning the patient’s condition.

How Is Antisocial Personality Disorder Treated?

The treatment of ASPD centers on different forms of psycho- or talk therapy. The primary methods are:

• Cognitive-behavioral therapy: Cognitive-behavioral therapy is a pragmatic approach to psychotherapy that identifies certain issues in daily living associated with a particular condition, and provides patients with the tools to confront them. It does this by altering the way they think about them, which leads to changes in emotional responses and behaviors.
• Mentalization-based therapy: This form of therapy emphasizes self-understanding, based on one’s behaviors. In other words, patients work back from what they do to the psychological reasons for doing it. Mentalization techniques are often used in conjunction with cognitive therapy.
• Therapeutic community: Therapeutic community is a user-led group approach that emphasizes the therapeutic nature of residential communities, including hospitals, mental institutions, and prisons. As pioneered in the United Kingdom, therapeutic community has shown some success in helping individuals with personality disorders, such as ASPD.

Therapy is the chief form of treatment for ASPD but is sometimes supplemented with medication. Antidepressants, the mood stabilizer lithium, and the anticonvulsant carbamazepine have been utilized to curb aggressive and suicidal behaviors in persons struggling with powerful antisocial impulses.

The outlook for persons with ASPD is uncertain. Much depends on the individual’s willingness to cooperate with therapeutic protocols and to enact necessary changes in behavior. Nevertheless, there is some evidence that persons with an antisocial personality disorder can get better over time, based either on medical treatment or a lessening of symptoms due to aging.

Can Antisocial Personality Disorder be Prevented?

There is no known means of preventing antisocial personality disorder. In fact, the American Psychiatric Association won’t allow a diagnosis to be made until the patient is at least 18 years old, though that diagnosis depends, in part, on evidence of antisocial behavior at a younger age. The best one can hope for is the early recognition of warning signs, with appropriate steps taken to counteract them.

Learn More About Antisocial Personality Disorder from Baptist Health

Antisocial personality disorder in a loved one is a difficult thing to face. Just remember: the caring providers at Baptist Health are on your side. If you’re looking for treatment options or more information about ASPD, please contact a behavioral health provider with Baptist Health today.