Overview

What is antisocial personality disorder (ASPD)?

Antisocial personality disorder (ASPD) is a mental health condition. People with ASPD show a lack of respect toward others. They don’t follow socially accepted norms or rules. People with ASPD may break the law or cause physical or emotional harm to the people around them. They may disregard consequences or refuse to take responsibility for their actions.

ASPD is one of many personality disorders. Personality disorders affect the way someone thinks or behaves.

How common is antisocial personality disorder (ASPD)?

Research suggests that ASPD affects about 1% to 4% of people in the U.S.

Is having antisocial personality disorder (ASPD) the same as being a sociopath?

Sometimes the terms “sociopath” or “sociopathy” get used to describe ASPD. Healthcare providers don’t use these terms as clinical diagnoses. But traits of ASPD and sociopathy overlap, including a general lack of conscience.

Symptoms and Causes

What causes antisocial personality disorder (ASPD)?

There is no single cause of ASPD, but the following factors may increase a person’s risk of developing the disorder:

Biology: People with ASPD may have unusual levels of serotonin. Serotonin is a chemical in the brain that regulates our mood and feelings of happiness.
Environment: Trauma or abuse early in childhood increases the risk of developing ASPD later in life.
Genetics: There may be some genetics factors that can predispose some individuals to develop ASPD. However, there is no one genetic factor that is thought to be responsible for the condition.
Lifestyle: About half of people with ASPD also have problems with drug or alcohol abuse.
Sex: Men are more likely than women to develop ASPD.

At what age does antisocial personality disorder (ASPD) develop?

Traits of ASPD usually develop during late childhood or the early teen years. Before age 18, the condition gets diagnosed as conduct disorder. Children with conduct disorder may lie, steal, ignore rules or bully other children.

Sometimes parents or healthcare providers miss the signs of conduct disorder. The signs may overlap with other conditions like attention-deficit/hyperactivity disorder (ADHD), depression or oppositional defiant disorder.

When children get diagnosed and treated early, the condition may not continue into adulthood. If the behavior does continue, the diagnosis becomes antisocial personality disorder at age 18.

What are the signs and symptoms of antisocial personality disorder (ASPD)?

People with antisocial personality disorder may:

Be physically aggressive.
Behave recklessly.
Blame others for their problems.
Break the law.
Destroy property.
Manipulate or deceive others.
Show no remorse for hurtful actions.

Diagnosis and Tests

Is there a test for antisocial personality disorder (ASPD)?

There is no blood test or imaging exam that can diagnose ASPD. A healthcare provider will consider your health history, perform a physical exam and assess your symptoms.

You may see a healthcare provider who specializes in mental health disorders. A psychiatrist or psychologist evaluates your behavior. They look for patterns of:

Disregard for the rights of others.
Impulsive actions with no concern for consequences.
Irresponsible or reckless actions.

What is a differential diagnosis?

A differential diagnosis means distinguishing between several health conditions with similar symptoms. Certain disorders may mimic ASPD, so it’s important for your healthcare provider to make the right diagnosis. These disorders include:

Borderline personality disorder, or unstable moods and manipulative behavior.
Narcissistic personality disorder, or an inflated sense of self-importance.
Substance abuse disorder, or an addiction to drugs or alcohol.

Management and Treatment

What is the treatment for antisocial personality disorder (ASPD)?

There is no set treatment for ASPD. Therapies such as medication or psychotherapy may help control specific behaviors, though. Studies suggest that symptoms of ASPD are worst around ages 24 to 44, then tend to improve after age 45.

Are there medications for antisocial personality disorder (ASPD)?

Medication generally only helps people with aggression, depression or erratic moods alongside ASPD. Your healthcare provider may recommend:

Antidepressants, which can regulate serotonin levels in your brain. Examples include sertraline and fluoxetine.
Antipsychotics, which can control violent behavior or aggression. Examples include risperidone and quetiapine.
Mood stabilizers, which help manage severe changes in mood or behavior. Examples include lithium and carbamazepine.

How can psychotherapy help antisocial personality disorder (ASPD)?

Cognitive behavioral therapy is a type of counseling that focuses on changing a person’s thinking and behavior. Therapy for ASPD may help people think about how their behavior affects others. Someone with ASPD may benefit from individual therapy, group therapy or family therapy.

Prevention

Can antisocial personality disorder (ASPD) be prevented?

There isn’t a way to prevent ASPD. But if conduct disorder gets caught early in childhood, therapy may prevent the development of ASPD in adulthood.

Outlook / Prognosis

Will antisocial personality disorder (ASPD) go away?

There is no cure for antisocial personality disorder. People generally manage the condition throughout their lives. But medication and therapy can help you cope with certain aspects of the disorder. The right treatment may help you adjust your behavior and reduce harm to those around you. Maintaining healthy relationships and a support system are key factors in managing ASPD long term.

Living With

When should I call my doctor about ASPD?

If you or someone you know has any of the following symptoms, seek medical attention right away:

Extreme changes in mood.
Self-harm.
Suicidal thoughts.
Violent behavior.

You can call the Suicide and Crisis Lifeline at 988. This hotline connects you to a network of local crisis centers that provide free and confidential emotional support. The centers support people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. In an emergency, call 911.

A note from Cleveland Clinic

ASPD causes people to act without thinking how they're affecting others. Someone with ASPD may break rules or laws. They often show no remorse and take no responsibility. Psychotherapy and certain medications may help people with ASPD. With treatment, they may be able to control their thoughts and behavior. Healthcare providers, such as psychiatrists and psychologists, do thorough assessments to diagnose ASPD. They can recommend the right treatment plan.

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Antisocial Personality Disorder (ASPD)