Oct 23rd 2023
Antisocial personality disorder is a condition that can include disruptive and harmful behaviors. It typically emerges in adolescence and affects more men than women, although it can occur in people of any gender or age. Women with antisocial personality disorder often present differently than males with the condition and may require different types of treatment.
Antisocial personality disorder (ASPD) is a mental health condition that impacts a person’s mood, behavior, relationships, and functioning. Signs and symptoms of ASPD often emerge in childhood, with a condition called conduct disorder. Common traits of individuals with ASPD include a lack of empathy, aggressive and criminal behaviors, and issues forming and maintaining relationships .
ASPD is around three times more common in males than females. It is believed to occur in about 6% of males in the general population and about 2% of females in the general population. It is not known why the condition is more common in males, although this difference may partly be related to diagnostic criteria, risk factors, and differences in presentation .
Psychopathy, which many professionals consider a severe presentation of ASPD, is also more prevalent among males than females. For example, studies have found that half as many female prisoners meet the criteria for psychopathy as male prisoners . Again, this may partly be due to criteria, as the Psychopathy Checklist (PCL-R) was designed to identify psychopathy in males .
When diagnosing ASPD in females, clinicians will utilize diagnostic criteria from the DSM-5. Diagnostic criteria for ASPD include :
Qualified clinicians will take a complete mental and physical health history, including gathering information about any abuse or adverse events that occurred in childhood. They will ask questions about the individual’s symptoms, such as their mood, behaviors, and current mental state, when symptoms emerged, and how they affect their quality of life and functioning.
If their symptoms meet diagnostic criteria, the individual will receive a diagnosis of ASPD. However, in some cases, this process may lead to misdiagnosis, as females with ASPD often present differently from males and may be less likely to have a diagnosis of conduct disorder in childhood. As such, women may experience barriers to receiving an appropriate diagnosis .
Treating ASPD can be challenging, as many people with this condition do not seek professional diagnosis or treatment. As such, evidence for the most effective treatments for ASPD is limited. Additionally, there is little evidence for gender-specific treatments for ASPD, highlighting a need for further research into this topic .
Many studies recognize the importance of early intervention, such as social support and psychotherapy, particularly in children with behavioral issues. Early intervention may help to prevent the onset of ASPD in adulthood, thus reducing the need for later treatment .
It is believed that females with ASPD have different treatment needs than males with ASPD. For example, women are found to have reduced social support and more functional impairments while also experiencing more mental health comorbidities. As such, females may require more extensive treatment for ASPD than males .
Potentially effective treatments for ASPD include cognitive behavioral therapy (CBT) and mentalization-based therapy, which can help identify and adjust harmful thoughts and behaviors. Therapy may also be beneficial in managing comorbid conditions, such as alcohol or substance use disorders and mood or anxiety disorders .
There are no FDA-approved medications for the treatment of ASPD, although various medications may be prescribed to help manage symptoms of ASPD or comorbid conditions. This may include antidepressants, mood stabilizers, and antipsychotics .
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