Understanding Antisocial Personality: The Stigma Tied to ASPD

A woman's eyes reflected in her rear view mirror while drivingAntisocial personality (ASPD) is one of the cluster B personality disorders, which typically involve emotional, impulsive, or dramatic thoughts and actions. This group of personality disorders is also significant because it includes borderline personality disorder (BPD) and narcissistic personality disorder, in addition to ASPD. These issues, and personality disorders in general, are among the most stigmatized mental health conditions.

Colloquially, many people use the terms psychopath and sociopath interchangeably with antisocial personality. A common assumption is that all people who have ASPD are incapable of emotion and feeling and will eventually commit violent crimes and harm others. It’s true many people living with ASPD typically don’t feel remorse or guilt. They may also lack empathy, struggle to understand the emotions of other people, or experience frequent legal issues, due to a tendency toward impulsive and often dangerous or illegal actions.

But sociopathy isn’t a mental health diagnosis, and not every person with ASPD will hurt other people or engage in violent acts. It’s possible for people who have ASPD to avoid actions that could harm others, especially when they have support from a compassionate therapist. In therapy, people can develop interpersonal skills along with coping techniques for impulsivity and aggression. These tools can benefit people who want to improve relationships and avoid illegal or dangerous activities and behaviors that harm others.

It’s possible for people who have ASPD to avoid actions that could harm others, especially when they have support from a compassionate therapist.

How Common Is ASPD?

The estimated prevalence of ASPD may vary depending on the study and criteria used. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), between around 0.2 and 3.3% of the population has ASPD in a given 12-month period. This condition is only diagnosed in people over the age of 18.

More than 90% of people diagnosed with ASPD also live with another mental health issue. Substance abuse is the most common co-occurring condition. Research suggests ASPD occurs much more frequently in men diagnosed with alcohol use disorder. Higher prevalence is also seen in prison settings, as well as population samples from impoverished areas. Other common co-occurring issues are anxiety and depression.

Though ASPD is far less common in women than it is in men, some research has suggested when ASPD develops in women, the condition may become more severe. Women living with ASPD are even more likely to abuse substances than men living with ASPD. However, research also indicates antisocial behavior may persist longer in men. Men who have ASPD also have an increased risk of early death.

Aggressive and violent behavior in childhood, such as that seen with conduct disorder, can be an indicator for ASPD. Not all children who have conduct disorder will go on to develop ASPD, but a history of conduct disorder is one of the diagnostic criteria for ASPD. These symptoms must appear before the age of 15. Parental neglect, abuse, or inconsistency and a lack of stability from primary caregivers can all increase the risk that a child with conduct disorder will develop ASPD.

Asocial vs Antisocial

It’s not uncommon to hear antisocial used to refer to people who prefer to be on their own and avoid spending a lot of time with others. But “asocial” is a more accurate way to define this lack of interest in social interaction. Asocial can describe a general disinterest in society and engagement with others, but it doesn’t indicate a person harbors any ill will or negative intent toward others.

Antisocial, on the other hand, goes beyond a general dislike or avoidance of society and community. People who meet criteria for a diagnosis of ASPD typically feel hostile toward other people. Even those who don’t have actively hostile feelings toward others may care very little for the safety, general well-being, and feelings of most other people. It’s also not uncommon for people who have antisocial traits to have significant disregard for their own safety.

It’s important to note that these feelings don’t necessarily translate to violent tendencies. Studies of people in prison do reveal high rates of ASPD, but this condition occurs on a spectrum, and not everyone living with the condition becomes violent or dangerous. Research has also observed that some people who display antisocial traits may have developed these behaviors in order to survive and protect themselves when growing up in difficult circumstances.

Many people use psychopathy as a synonym for ASPD, but this usage isn’t accurate. Psychopathy can best be considered a severe form of ASPD, rather than the most characteristic presentation of the condition. Most people who meet criteria for psychopathy according to the Psychopathy Checklist – Revised (PCL – R) do also meet criteria for ASPD. But only about 10% of people diagnosed with ASPD also meet criteria for psychopathy.

What Is Antisocial Personality Disorder?

At the core of ASPD lies a consistent lack of regard for the rights of others, which generally includes impulsive, irresponsible, and reckless behavior. People may take action without considering potential consequences and experience little or no remorse for harm caused by their behavior. Theft, manipulation, and other deceit are common, and people living with ASPD also tend to rationalize or minimize their actions.

Antisocial behavior can include violent or criminal acts, but people living with ASPD aren’t always aggressive or violent. Similarly, while many people with ASPD lack empathy, this isn’t always the case. People living with ASPD often struggle to develop or maintain meaningful relationships, and they may cause emotional harm to their partners; but it’s still possible for people with ASPD to feel love and empathy, often for a select few people such as children, partners, or close family members.

Abuse, neglect, or absent caregivers can increase risk for ASPD when other factors are present, particularly early onset conduct disorder. In people who develop ASPD, early childhood mistreatment can reinforce the belief that no one else will look out for them, so they should do whatever they can to look after themselves and get their needs met. This belief commonly occurs with ASPD.

In recent years, a few people with ASPD have written about their experience living with the condition. This may have had a small effect on the stigma surrounding the condition, but many people still struggle to accept that ASPD doesn’t always mean a person is violent or “evil.” The stigma associated with personality disorders, ASPD in particular, may make it even more difficult for people who want to improve to get the help they need. Negative attitudes from caregivers and educators may begin early on, often when children first display signs of conduct disorder.

The stigma associated with personality disorders, ASPD in particular, may make it even more difficult for people who want to improve to get the help they need.One study of 202 kindergarten teachers found teachers were most likely to have a harsh response toward aggressive children. But negative attitudes, or writing children off as troublemakers or delinquents, can reinforce ideas such as, “I’m bad,” “I’ll never amount to anything,” or “No one cares what happens to me,” from early childhood. Some experts believe this can increase the chances aggressive behavior and disregard for others will continue and worsen.

Treatment for Antisocial Personality Disorder

Not everyone considers ASPD a mental health issue. Research has shown that many people believe people with this condition are:

  • Violent
  • Evil
  • Dangerous
  • Impossible to treat

Having a mental health issue doesn’t absolve a person of responsibility for their actions, but it’s an important factor in understanding why some people behave the way they do. When stigma perpetuates the idea of a group of people as evil, positive change becomes even more difficult to achieve.

Specific characteristics associated with ASPD, such as self-sufficiency, a tendency to externalize problems, disdain for authority, and general hostility, also make it less likely people with ASPD will ever reach out for help, complicating treatment and decreasing the chance of improvement.

When people with ASPD do enter treatment, it’s more often to get help for a co-occurring condition or because a legal authority or family member has steered them toward therapy. Among those who do get help, many drop out of treatment early. Negative attitudes among therapists or ineffective treatment methods can contribute to this.

It’s important for people with ASPD to work with therapists who offer compassionate support and are willing to try a range of approaches to find the most effective treatment. In many cases, people with antisocial traits can learn skills to cope with their condition and avoid acting in ways that negatively affect others. When people with a dual diagnosis seek treatment, it’s essential for therapists to recognize the ways ASPD can contribute to and worsen other mental health symptoms.

A key factor in successful therapy for ASPD is recognizing individual fault. People living with ASPD who can’t admit or accept their actions are harmful or that they have a role in the harm they’ve caused may not be able to improve. One approach to treatment that’s shown some promise is mentalization-based therapy. This approach helps people explore their state of mind, including emotions, desires, and feelings toward others. Once they better understand their thoughts, they can use this understanding to address impulses and control them.

Some research suggests schema therapy, an approach that helps people work to identify and address maladaptive behavior patterns and develop more effective ways of relating, may also be helpful for people with ASPD. It’s effective for other personality disorders, including BPD and narcissistic personality, and some research suggests people are less likely to drop out of this type of therapy than other approaches.

Research has shown treatment can help improve many of the behaviors associated with ASPD when a person is willing to work toward change. It’s important for future research to continue exploring the most helpful types of treatment for ASPD to increase the chances of people with the condition improving with treatment. Successful treatment can not only improve well-being and quality of life for people with ASPD, it can also have a positive impact on the people in their lives.

If you or a loved one is struggling with the effects of ASPD, know that help is available. Begin your search for a trained, compassionate counselor at GoodTherapy.


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  2. Antisocial personality disorder. (2017, November 20). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9657-antisocial-personality-disorder
  3. Antisocial personality disorder. (2018, May 25). NHS. Retrieved from https://www.nhs.uk/conditions/antisocial-personality-disorder
  4. Arbeau, K. A., & Coplan, R. J. (2007). Kindergarten teachers’ beliefs and responses to hypothetical prosocial, asocial, and antisocial children. Merrill-Palmer Quarterly, 53(2), 291-318. doi: 10.1353/mpq.2007.0007
  5. Brians, P. (2016, May 17). Asocial. Retrieved from https://brians.wsu.edu/2016/05/17/asocial
  6. Brill, A. (2017, June 16). Life with antisocial personality disorder (ASPD). Retrieved from https://www.mind.org.uk/information-support/your-stories/life-with-antisocial-personality-disorder-aspd/#.XMY0wJNKjOT
  7. British Psychological Society. (2010). Antisocial personality disorder: Treatment, management, and prevention. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK55333
  8. Hesse, M. (2010). What should be done with antisocial personality disorder in the new edition of the diagnostic and statistical manual of mental disorders (DSM-V)? BMC Medicine, 8, 66. doi: 10.1186/1741-7015-8-66
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  • Leave a Comment
  • C

    June 16th, 2019 at 7:34 PM

    I am not a therapist, but coming from an extremely dysfunctional family, I have married a man whom I love deeply, but has addiction issues and leans towards being quite antisocial. I love him and I want to help him any way that I can. Our first year of marriage has been a complete roller coaster. I have suffered his angry abuse and the beast that is his addiction to drugs and alcohol. He is in such deep denial. Please advise

  • Josh

    August 20th, 2019 at 1:57 PM

    There is no way of knowing if his behavior is caused by the drugs and alcohol, if he uses drugs and alcohol to deal with underlying issues, if he uses b/c of impulsivity caused by mood or thought disorder. I guess, my answer, without really knowing anything at all, would be that you seek EMDR therapy. It will help you work through some of your issues that landed you in this situation. It works pretty fast too. Clearly, he needs help but it sounds like he isn’t interested in that, so that is my suggestion for you. I’d also recommend leaving him but it doesn’t sound like you’re there yet. So, that’s why I recommend EMDR. Good luck.

  • G

    December 4th, 2019 at 10:28 AM

    I’m in love with someone who has a cluster b personality disorder. He has recently become aware of it and is seeking out treatment. He had used this diagnosis to explain (not excuse) his past infidelities. Is it really possible for a person to gain control of themselves and their lives through treatment? I just worry that the reckless/deceitful aspect of this illness makes the likelihood of sustained change quite slim. Is there any evidence of people with cluster b personalities going on to have healthy relationships?

  • Anonymous

    December 9th, 2019 at 10:54 AM

    I am telling you this as someone with a degree in psychology, and on a personal note I have dealt with many cluster b personality disordered individuals in my own family. They can not and do not change. This is simply who they are. Leave the man you are with. He is most likely still a cheater. You just haven’t caught him yet. How do I know? Men that cheat do so because they are able, for a variety of reasons:

    1. They are not demonized in society for doing so. Only women are, because of the patriarchal society we live in sees women as the Madonna/whore. A woman is only able to play one of two roles. The Madonna (good girl, saintly) or the whore (sexual deviant, naughty, bad girl). Men often marry the Madonna, but they always always go for sex with the whore.

    2. Personal experience proves above Theorem which I have presented you. I don’t even know you, but let me guess, your man is most likely one or a number of the following: charming, physically attractive, narcissistic, a mama’s boy, (remember Mama is the saint, no woman is as perfect and holier than thou as Mama, we can thank the God Damned Catholic Church for this misdirected version of Mary Deification), and also always here’s the big one, does your man have or has he ever had a porn problem? Porn is the destructor of most marriages and adult relationships. What kind of porn? Secondary question. If he is fascinated by anal porn, you also have a sexual deviant on your hands, who may or may not be a closet homosexual. Self hating homosexuals run rampant in modern society, surprising its 2019! They get married to beautiful women too for appearances purposes. Yet having side sex with men, or if not fantasizing about it. Do you want AIDS? Find out what kind of porn he likes if you want to stay, but if I were you I’d stop this nonsense altogether. A cluster B can’t be cured so forget the therapy hogwash he’s fed you. We, psychs make a lot of money off them as lifelong clients. They simply become better masterminds at cloaking and doing everything they can to save face to appear normal and upstanding in a society of other bad actors.

    Footnote- Sorry if this is not what you wanted to hear. I know it’s not positive, may even make you angry, sounds hopeless, but cluster Bs are. They are not capable of genuine permanent change because they were not born with healthy emotional role models (in most cases), and are emotionally incompetent and incapable of growth. They are extremely selfish, it’s just who they are. Most successful people are antisocial/sociopathic. That’s how you make it in this world, human value en made is based on a modern day like system (superficial), and financial status.

    My suggestion: If you want a good man open your eyes to the heart, instead of the charm. Being charming is easy. Having a good heart in a heartless world is like striking black gold. Best to you, and I’m so sorry you fell in love with a cluster B disordered person.

  • Jack

    October 23rd, 2023 at 4:46 PM

    Do you think maybe, just maybe you’re projecting? Maybe homophobic? Maybe that degree in psychology is helpful for you to earn a paycheck, but your out of office advice and opinions directly contradict the Hippocratic oath of doing no harm. You not only attacked queer people and people with addiction issues, you used one person who you have a romantic relationship and connection and obvious trauma from to tell *everyone* that it is absolutely hopeless and impossible to have aspd and change or be loved or have a decent life when in this article it’s considered a spectrum. I DARE you to sub aspd with any other spectrum disorder in your comment. Spectrum disorders are just that. A spectrum. And while you might have married someone with aspd, sounds like you also married an asshole. Not everyone with aspd is an asshole or desires to be. My best friend has aspd and I’m disabled physically, so it’s so frustrating when I have to see ableism like this. Your husband is not the gold standard for the disorder. Nor is your family. I’m willing to bet that you are neurotypical-wiling to bet that because you have zero understanding or compassion when that is literally your job. Loving someone with aspd is not easy. You need to be aware that you have the potential to be harmed, and you need to be open and honest with yourself and your partner and have a conversation about accountability and honesty and boundaries. My best advice for loving someone with aspd is to first fall in love with yourself. If the person with aspd values you, and you value yourself, it is possible to have a meaningful relationship. I highly doubt that anyone with a neurotypical brain would be able to handle someone with aspd but us neurodivergent folks who face the same filthy ableism you’re spewing from your own pain and perspective and your own inability to hold pain or hold your boundaries or hold your own peace or hold your tongue when you’re not being helpful and your enormous bias are absolutely contributing to the stigma which is directly contributing to loss of life in this country. If people with ASPD weren’t so stigmatized and treated like monsters when NOT A SINGLE ONE OF US HUMANS GOT TO DESIGN OR CHOOSE OUR BRAINS and someone could see the good things that they’re capable of no matter the motivation, or give good motivation-I’d bet my degree this country would be a better place. As a disabled queer person, your comment is more harmful than anything my pal with aspd has ever done. Maybe consider what your brain is contributing to society. I do not suggest dating anyone who denies their diagnosis, who isn’t willing to educate themselves and make a code or who doesn’t have anyone in their life that has been in their life for >5 years. Yes, it will be harder. But we have GOT to stop shaming people for the brains they didn’t choose and start listening. I guess I’m the weirdo here, I have autism and so when someone factually says something disturbing I don’t react to what they’re saying, I react to how distressing and disturbing the thoughts or impulses are and treat the human being like a human being because we are all human beings. I’m sorry anonymous got hurt, that sucks. I hope you didn’t go into that relationship blind, I hope you knew so you could set great boundaries and use them. I hope you heal, and I hope you find someone who sees your value unlike how you devalue an entire group of human beings. You are a part of the problem-and you’re choosing to be. You have a perfectly rational brain that doesn’t torture you with awful thoughts and impulses and still yet this is how you choose to act. While
    I understand you are trying to prevent harm, you caused it. The ableism has to go or no one will accept their disorder or seek help and people will just keep getting more and more desperate until someone gets worse than harmed. I’m disappointed in you anonymous, but I hope you heal.

  • no

    November 23rd, 2020 at 9:34 AM

    hey, as a person with a cluster b personality disorder, shut up. you can claim to have a degree in psychology while i’m over here being told i’m a monster for having a personality disorder BECAUSE I WAS ABUSED and being told i’m a monster. just stop talking. some of us are minors and actually are mentally ill because i got abused by a cult, but according to you i’m a gross grown man addicted to porn. what is wrong with you. @ the anonymous who supposedly has a a ‘degree in psychology’. your degree doesn’t make you an expert.

  • Colom

    December 29th, 2020 at 2:06 PM

    Ignore him. Everyone gets biased in some way …

  • Seriously?

    December 8th, 2021 at 3:21 PM

    I’m sorry but the Anonymous is completely wrong in regards to people with cluster b personality disorders. You are wielding your supposed psychology degree as an excuse in order to stigmatize and discriminate against all cluster b personalities. It’s not our fault that because of genetics and environment (the majority of us experiencing some sort of abuse, neglect, or toxicity growing up) that we developed a personality disorder. It’s not our fault at all. If you actually had a degree in psychology or if you at least paid ATTENTION when getting your degree (if you truly do have one which I doubt based on the bs you spewed) then you would understand and emphasize with people who have cluster b personalities and that we are capable of GENUINE CHANGE. Saying that we’re “not capable of genuine permanent change” and “are emotionally incompetent and incapable of growth” and selfish is 100% discriminatory. Your personal experience with cluster b personalities is not an excuse to be awful to us and overgeneralize that all of us are apparently awful, irredeemable jerks who are manipulative monsters. Don’t talk about how you understand psychology because you supposedly have a degree in it when you clearly show that you have NO understanding of psychology AT ALL based on the bs you said about us. So many cluster bs are capable of genuine, permanent change. You say we’re not capable of genuine, permanent change but perhaps it’s YOU that’s not capable of genuine, permanent change. Stop hiding behind anon and educate yourself.

  • Adrian, again

    December 18th, 2021 at 1:05 PM

    I also want to add that the doctor probably isn’t that educated to not only be spreading ableist biases but homophobic ones as well; queer people are not inherently cheaters with AIDs, just so you know.

  • Adrian

    December 18th, 2021 at 1:07 PM

    Seriously done with hearing mental health “professionals” stigmatize disorders and generalize people with those disorders. To the woman asking if it’s possible to love someone with a Cluster B disorder, it is possible. We are capable of love. We’re not just manipulative porn addicts who want to destroy relationships. Some people with a Cluster B personality disorder aren’t good people and excuse that with their disorder, but those people are over-represented by ableist people who want to make neurotypicals sound like the best people in society just because they can fit the societal norm.
    No one chooses to have such a debilitating disorder that affects relationships and behaviours. Cluster B disorders are caused by trauma, and no one chooses to have to live a traumatic childhood. There are people who do become better masterminds through therapy, but there are so many people who just want to be better people and want to be considered normal. Ever since learning about my disorder, I became more conscious and aware. It causes me to bottle up a lot of emotions because I’m trying my best to mask, which isn’t good for me, but with that information in mind, know it’s possible for someone with a personality disorder to have a moral code.
    I will say this; don’t take everything from mental health professionals. A lot of the information they learn is from doctors without the disorder. The healthcare system is terrible in terms of mental health, which is the real reason why people don’t get better. There are so many ableist psychologists out there, so make sure you’re getting information from first-hand sources as well.
    I also want to add that the doctor probably isn’t that educated to not only be spreading ableist biases but homophobic ones as well; queer people are not inherently cheaters with AIDs, just so you know.

    I’m not sure if the comment function is working so I put my 2 comments in one comment. Sorry if you see the same words twice, I don’t want to seem like a spammer.

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