Someone with an antisocial personality disorder, also known as ASPD, is often called a sociopath, someone who doesn’t experience remorse, guilt, and empathy in a way that most people do. In some people, this disorder can lead to a life of manipulation, lying, and distancing themselves from others.
They may struggle to pursue life goals like school or careers without knowing why. In many cases, the disorder may lead to run-ins with the law and prison time. In fact, the percentage of people with ASPD in prison is higher than in the general population.
Antisocial personality disorder is a tricky mental health issue to diagnose and treat. People with the disorder often don’t see a need for treatment unless it accompanies another diagnosis like bipolar disorder or depression. Sometimes they may seek treatment as a legal mandate after committing a crime, or they may do it to appease family members. In treatment, they may seek to manipulate clinicians or lie. However, there are some treatment options that may help someone better deal with ASPD symptoms.
Learn more about antisocial personality disorder and how it can be treated.
Antisocial personality disorder (ASPD), also called sociopathy, is a mental health problem that causes you to ignore the rights and feelings of other people. This often manifests in thoughts and actions that put you at odds with society, threatens relationships, and leads to financial instability.
Someone with the disorder is likely to act impulsively without worrying about consequences for themselves or other people. They may also intentionally antagonize others for amusement, with no thought to their feelings or any repercussions. Feelings of guilt and remorse may be foreign to someone with this disorder.
People with antisocial personality disorder are often alienated from other people, leading to social isolation. They may also find it difficult to maintain employment. Because of their impulsivity and carelessness when it comes to consequences, they may also have problems with the law. These symptoms often hamper any pursuits in education, career, and social relationships.
The disorder is sometimes associated with other complications, including instances of abuse, violence, homicide, and suicide. Impulsivity, combined with a lack of regard for the rights of others, can lead to serious outbursts of physical violence. However, not everyone with this disorder will physically harm themselves or others. They may verbally abuse or manipulate others. A lack of remorse and guilt may make it that a person with the disorder can’t learn from their mistakes. Instead, they may blame problems on other people in their life.
Antisocial personality disorders are thought to begin early in life, usually during childhood, though it may be difficult to notice in children. However, they generally start to show signs of a conduct disorder before they are 15 years old. In fact, to be diagnosed with the disorder, you have to have shown signs before 15, and you can’t be positively diagnosed until age 18. In many cases, the worst symptoms manifest in a person’s early 20s.
Conduct issues include aggression toward people and animals, destruction of property, theft, lying, and disregard for rules. Other signs of an antisocial personality disorder include:
These issues often lead to significant problems in a person’s life and the seeming inability to address them. Issues may be long-lasting, and it may affect multiple areas of life. Antisocial personality disorder is relatively common, affecting 1% to 4% of the general population. However, the prevalence is higher among prison populations, suggesting that the disorder significantly increases a person’s risk factor for being involved in crime.
The exact causes of antisocial personality disorder are unknown and may be a complicated combination of factors. It’s possible that it has its roots in both genetic and environmental factors, much like other mental health issues. People with ASPD are likely to have a parent with the disorder. It’s also possible that the disorder develops as the brain develops, which is why symptoms often appear in childhood and teenage years.
Because the causes of the disorder aren’t well understood, it’s difficult and unlikely to prevent ASPD. However, it does come with some risk factors that could increase a person’s likelihood of experiencing it. A family history of antisocial personality issues may mean a higher likelihood of experiencing the disorder. Disruptive factors during development may also lead to ASPD, including a chaotic or unstable home environment or being the victim of childhood abuse. Men are more likely than women to have ASPD.
Antisocial personality disorder is usually at its worst in young adults, but it’s considered a lifelong mental health issue. Still, some people seem to improve over time, and they especially seem more able to avoid legal issues. It’s unclear if the disorder improves because of aging or because of increased awareness about consequences through trial and error. Though it may be a chronic mental health problem, it can be treated through medical and clinical therapy options.
The first step in treating an antisocial personality disorder is diagnosing it. To diagnose ASPD, you may go through a psychological and medical evaluation. This may include a biopsychosocial assessment, which looks at your history with biological, psychological, and social issues. A doctor, clinician, or therapist will likely look at family history to see if there is a history of diagnosed mental health issues. If you have a history of conduct disorders in childhood, consistent symptoms, a family history of ASPD, or other factors, you may receive a positive ASPD diagnosis.
Treatment is often difficult because people with ASPD often deny problems or shift the blame for problems to others. It’s rare for someone with ASPD to seek help without prompting from others. However, if they do seek help, psychotherapy or behavioral therapies can help. Individual and group therapies that increase a person’s awareness of the problems and the consequences that they cause can help them improve their thoughts and behaviors.
In some cases, doctors may use pharmacotherapies like mood stabilizers to treat specific problems that come with ASPD, like anger issues. Certain antipsychotics may also be used to treat impulsive bursts of aggression. In recovery, people with ASPD can learn to interact with other people in a more productive way, even if they don’t experience empathy and other emotions in the same way as the people around them. This can help them maintain relationships and pursue goals that would otherwise be difficult.
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National Institute of Mental Health. (2018, February). Depression. from https://www.nimh.nih.gov/health/topics/depression/index.shtml
National Institute of Mental Health. (2020, January). Bipolar Disorder. from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
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