Antisocial Personality Disorder

Overview

What is antisocial personality disorder?

Antisocial personality disorder is one of a group of conditions called dramatic personality disorders. People with these disorders have intense, unstable emotions, and a distorted self-image.

Antisocial personality disorder is further defined by irresponsible and aggressive behavior that often involves a disregard for others and an inability to abide by society’s rules. It is more common in men than in women. People with this disorder tend to behave impulsively and sometimes commit serious crimes. Further, they lack remorse for their actions.

A person with antisocial personality disorder might be described as lacking a conscience, making him or her unable to feel guilt. People with antisocial personality disorder are sometimes referred to as “sociopaths” or “psychopaths.”

Symptoms and Causes

What causes antisocial personality disorder?

The cause of this disorder is not yet known, but it is likely that a combination of factors might be involved. Heredity is suspected of playing a role in the development of antisocial personality disorder, more specifically, in increasing the risk of developing the disorder. For example, the disorder is more likely to occur in a person who has a parent with antisocial personality disorder.

People with this disorder also have shown an inability to learn from punishment or negative consequences. In addition, people with antisocial personality disorder tend to have a low threshold for boredom, making them seek greater and greater levels of excitement, even if it leads to dangerous or illegal activities.

Family function also is believed to play a role in the development of antisocial personality disorder. Research suggests that people with this disorder often had poor role models as children and often were inconsistently disciplined, leading to confusion about the difference between right and wrong.

What are the symptoms of antisocial personality disorder?

People with antisocial personality disorder display a long-standing pattern of disregarding authority and other people’s rights, often violating those rights and/or the law. Other symptoms of antisocial personality disorder include the following:

  • Failure to conform to social norms and acting out in socially unacceptable ways, such as repeated criminal behavior
  • Deceitfulness, such as repeatedly lying or taking advantage of others
  • Impulsivity
  • Irritability and aggressiveness, which might involve repeated fights or assaults
  • Reckless disregard for the safety of self or others
  • Consistent irresponsibility, such as being unable to keep a job or pay bills
  • Lack of remorse
  • Insincere charm and wit
  • Lack of true emotion

Diagnosis and Tests

How is antisocial personality disorder diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out a physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, healthcare professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

Management and Treatment

How is antisocial personality disorder treated?

Psychotherapy is the treatment of choice for antisocial personality disorder. Psychotherapy is a type of individual counseling that focuses on changing a person’s thinking (cognitive therapy) and behavior (behavioral therapy). Group and family therapy might also be helpful. Family therapy can increase understanding among family members of people with antisocial personality disorder. Group therapy is most beneficial if it is tailored to people with antisocial personality disorder. A person with the disorder might be more comfortable discussing his or her feelings and behaviors with individuals who face similar problems and issues.

Although medication is not used to treat the antisocial personality disorder itself, it might be used to help stabilize mood swings or treat some of the distressing symptoms of the disorder, such as impulsivity and violent aggressiveness.

Prevention

Can antisocial personality disorder be prevented?

At this time, there is no known way to prevent antisocial personality disorder. However, early detection and intervention might help reduce the disruption to the person’s life, family, and friendships.

Outlook / Prognosis

What are the complications of antisocial personality disorder?

People with antisocial personality disorder are at high risk for substance abuse. They also are more likely than the general population to be imprisoned for unlawful behavior and to die by violent means.

What is the outlook for people with antisocial personality disorder?

People with antisocial personality disorder rarely seek treatment on their own. For this reason, motivation to begin or stick with treatment tends to be low. The legal system is the most likely referral source for people with this disorder.

Another factor affecting the success of treatment is that people with this disorder often lack a connection between feelings and behavior. These patients also tend to have difficulties with authority figures and might mistrust the therapist. As a result of these factors, effective treatment for antisocial personality disorder is limited, and the outlook tends to be poor. However, symptoms of antisocial personality disorder, including aggressive and criminal behavior, tend to decrease with age.

Last reviewed by a Cleveland Clinic medical professional on 11/20/2017.

References

  • American Psychiatric Association. Chapter 69. Antisocial Personality Disorder. In: Meloy J. Reid and Yakeley Jessica, eds. Gabbard’s Treatments of Psychiatric Disorders, Fifth Edition. May 2014. Accessed: 11/22/2017.
  • Janowsky D. Chapter 30. Personality Disorders. In: Ebert MH, Loosen PT, Nurcombe B, Leckman JF. eds. CURRENT Diagnosis & Treatment: Psychiatry, 2e. New York: McGraw-Hill; 2008.
  • Gibbon S, Duggan C, Stoffers J, et al. Psychological interventions for antisocial personality disorder. Cochrane Database of Systematic Reviews 2010, Issue 6.

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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy