Antisocial Personality Disorder (ASPD)

What is antisocial personality disorder?

Antisocial personality disorder, sometimes previously referred to as psychopathy or sociopathy, is a mental disorder where a person has very little to no concept of right or wrong. ^[2] They will tend to:

• Ignore the feelings of others
• Deliberately antagonize people
• Treat others with indifference
• Show little understanding or care for the consequences of their actions

People with ASPD are likely to develop a substance use disorder and break the law. ^[3] Treatments vary based on the case’s seriousness, but most have to manage it their whole lives.

It is estimated that up to 3% of men and 1% of women experience this personality disorder ^[4]. It is most prevalent in people aged between 24 and 44 years old. ^[5]

Symptoms of antisocial personality disorder

People with ASPD will show some of these significant symptoms:

Addiction

They are likely to develop drug and alcohol use disorders because of their impulsive nature and difficulty understanding the consequences of their actions. This puts them at risk of related issues such as overdoses, diseases transmitted through needles, and heart and liver disease. ^[3]

Criminal behavior

People with ASPD tend to experience more convictions and spend more time in jail than people who do not have ASPD because of their lack of understanding of the consequences of their actions and little regard for the well-being of others. For these reasons, assault and violent crimes tend to be the most common. ^[6]

Emotions

Many with ASPD tend to have trouble understanding and expressing their feelings as well as the emotions of others. They will show a lack of empathy and may have tried to manipulate other people’s emotions for their gain. In addition, they will have little respect for social norms or rules.

Impulsivity

This negatively affects their own lives and those around them. They tend not to consider the safety of themselves or others and will do risky things frequently.

Diagnosing antisocial personality disorder

To be diagnosed with ASPD, you will need to be evaluated by a medical professional. They will run what is known as a ‘differential diagnosis’ where they will assess whether your symptoms are ASPD or a result of different mental disorders such as PTSD or generalized anxiety.

To be diagnosed with antisocial personality disorder, you must be at least 18 and have shown at least 3 of the following symptoms before the age of 15: ^[7]

• Not following social norms, usually shown by constant law-breaking
• Continuous lying for your personal gain
• Impulsive behavior
• High amounts of physical aggression, sometimes getting into fights
• No care for your safety or the safety of others
• Financial or social irresponsibility
• A lack of remorse after physically or emotionally hurting someone

Causes of antisocial personality disorder

There are no known definite causes for someone to develop an antisocial personality disorder. However, risks for developing ASPD often involve biological and environmental factors that begin in early childhood.

• Genetics may make you more likely to develop the disorder
• Traumatic events in childhood, including child abuse, could have disrupted the average production of hormones (such as testosterone, which affects aggression and impulsivity)
• Physical trauma may affect brain development, like a blunt force to your head as a child
• Family environment (studies have found children are more likely to display antisocial or violent behavior if their parents do) ^[8]

Treatments for antisocial personality disorder

Treating ASPD is complicated and depends on how willing the person is to get help and how severe their case is. It is essential to support someone you think may have ASPD, support as it is less likely they will seek out the treatment themselves.

Psychotherapy

Psychotherapy may help address some symptoms, such as substance abuse. It can help patients to recognize what emotions they are feeling as well as the emotions of others and when and how to act upon them.

Medication

As of yet, no medication has been approved by the FDA specifically for treating ASPD. However, some doctors will prescribe medication such as antidepressants or antipsychotics to help regulate mood and deal with some symptoms you may be experiencing. ^[9]

Prevention of antisocial personality disorder

Prevention of ASPD is complicated because the causes are often out of your control. For example, genetic and many environmental factors cannot be changed. Hence, it is essential that if you suspect a young person of having ASPD, you keep track of any observations of symptoms you make to aid future diagnosis.

Therapy in childhood can also prevent antisocial personality disorder from developing in early adulthood by building mechanisms to help them deal with symptoms.

Helping Someone with antisocial personality disorder

Due to the nature of the psychiatric disorder, someone with it is unlikely to look for help on their own. Usually, treatment is offered once they get into legal trouble. People with a strong social and family support network tend to have the best outlook on the disorder as they do not need to wait until the intervention is forced. ^[10]

If you have a loved one or know someone with the disorder, you must speak to a health professional for your well-being and theirs. As people with ASPD lack understanding of the consequences of their actions, they sometimes end up hurting their friends and family.

• Individual therapy can help to establish coping mechanisms and set boundaries so you do not get hurt.
• Group therapy can also help. Meeting people in similar situations to you who may care for someone with antisocial personality disorder could be beneficial.