Antisocial personality disorder (ASPD) is characterized by a pervasive disregard for others. People with ASPD often engage in decietful or manipulative behavior. Aggression and unlawful activities are also common.
People with ASPD often mistreat people even when such behaviors aren’t in their best interest. They typically show little remorse for their actions. Their disregard for social norms can make it difficult to maintain relationships, keep a job, or stay out of jail. Antisocial personality disorder is treatable, but individuals are unlikely to seek treatment until they have already experienced serious consequences for their behavior.
What Are the Symptoms of Antisocial Personality Disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), antisocial behavior often begins in childhood or adolescence. Early behavior may fall into one of four categories:
- Aggression toward people or animals.
- Property destruction.
- Theft or lying.
- Severe rule-breaking that falls outside age-appropriate mischief.
However, children cannot be diagnosed with antisocial personality disorder until they are 18. Before then, they are likely to be diagnosed with conduct disorder. After age 18, an ASPD diagnosis requires at least three of the following symptoms:
- Aggression that often results in physical violence.
- Deceitfulness or frequently conning others for personal gain.
- Repeated unlawful behavior, such as theft or arson.
- Impulsivity or a failure to plan ahead.
- A disregard for one’s own safety or the safety of others.
- A severe lack of responsibility, such as ignoring bills or skipping work.
- A lack of remorse for hurting, offending, or inconveniencing others.
People with antisocial personality disorder are often skilled at charming or manipulating others. They may have exaggerated self-esteem and feel entitled to act how they want. They might mistreat others in order to get power, money, revenge, or simple amusement.
People with ASPD rarely show empathy for people they’ve hurt. If confronted about their behavior, they may deny or downplay the harm they caused. If that tactic doesn’t work, they might blame the victim for being naïve or weak.
Sociopathy vs. Psychopathy
According to the DSM-5, the terms “sociopathy,” “psychopathy,” and “antisocial personality disorder” are often used interchangeably. Neither sociopathy or psychopathy has a universally accepted definition. As such, many people use the terms as synonyms.
Others in the mental health community treat sociopathy and psychopathy as subtypes of antisocial personality disorder. According to this theory, the main differences between the conditions are:
- Impulsivity: Sociopaths are more likely to have fits of rage or commit crimes without planning. Meanwhile, psychopaths tend to use charm and aggression strategically. Since psychopaths tend to plan their crimes, they are less likely to be caught.
- Social bonding: Psychopaths often struggle to form emotional attachments to anyone. Their relationships tend to be shallow and/or won through manipulation. While sociopaths also have difficulties with relationships, they can develop bonds with a few individuals.
- Origin: Research suggests psychopathy is caused by abnormalities in the brain. Sociopathy, meanwhile, is believed to be caused by severe childhood abuse or trauma. Sociopaths are often more responsive to treatment.
While neuroimaging research does lend itself to the theory that sociopathy and psychopathy are distinct subtypes, more studies are needed before they can become official diagnoses.
What Causes Antisocial Personality Disorder?
The root cause for the development of antisocial personality disorder is still not well understood among mental health and medical professionals. It is believed to be a combination of early environment and genetics. Children who have a relative with ASPD are more likely to develop the condition. Nonbiological children who are adopted by parents with ASPD are also more likely to develop the condition.
The risk of developing antisocial personality disorder increases with exposure to traumatic events. A child is also more likely to develop ASPD if they developed comorbid conduct disorder and ADHD before age 10.
According to neurological findings, antisocial personality traits may be linked to deficits in the area of the prefrontal cortex. This may lead to difficulty empathizing with others or experiencing feelings of guilt or embarrassment. It may also dampen a person’s response to fear, leading to irresponsible or reckless behavior. However, these brain abnormalities in the prefrontal cortex have only been found in one third of people with ASPD (a population the study authors classified as “true psychopaths”). As such, neurological differences can’t explain most cases of ASPD.
Antisocial Personality Disorder and Co-Occurring Issues
Antisocial personality disorder often co-occurs with other psychiatric diagnoses. Compared to the general public, people with ASPD are:
- 4 times more likely to have a mood condition. (One in four people with ASPD have depression).
- 7 times more likely to have suicidal thoughts.
- 13 times more likely to engage in substance abuse.
They also have higher prevalence rates of anxiety and other personality disorders. Around half of people with ASPD have an anxiety-related diagnosis. Regarding other personality disorders, ASPD is most likely to co-occur with narcissism, borderline, and histrionic personality.
Co-occurring mental health issues can make ASPD harder to manage. Mental health treatment will likely address ASPD and additional diagnoses simultaneously. If you or a loved one has antisocial personality disorder, you can find a therapist here.
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