Understanding Antisocial Personality Disorder

Antisocial Personality Disorder (abbreviated ASPD) is another commonly misunderstood diagnosis. Like other personality disorders, people with ASPD cannot control their symptoms however people with ASPD are often seen as in control of their symptoms.
 

People who are introverted are not antisocial.

Basics

Antisocial Personality Disorder is a personality disorder characterized by a lack of empathy and understanding for others and frequent disregard or violation of the rights of others. Put simply, people with ASPD often use others to meet their own needs and do not care about the other person. ASPD is the only disorder I have encountered requiring another diagnosis in order to be diagnosed (Conduct Disorder).
 

Diagnostic Criteria

In order to be diagnosed with any personality disorder, you must meet criteria for both a general personality disorder, as well as the criteria for the specific personality disorder.

General Personality Disorder Criteria

Unlike other mental health disorders, personality disorders all have the same core criteria. There are 5 core criteria that must be met, as well as criteria for the specific personality disorder. The 5 core criteria are:

  • Significant impairments, problems with self-identity or self-direction, as well as interpersonal functioning (think intimacy or ability to empathize)
  • One or more pathological (“bad”) personality trait (detachment from others, disinhibition, antagonism, psychoticism, or negative affectivity)
  • The same impairments are relatively stable across situations and time
  • The impairments are not better explained by the normal developmental stage or the culture of the person
  • The impairments are not due specifically to drugs or another medical condition (such as trauma to the head)

 

Antisocial Personality Disorder Criteria

To be diagnosed with Antisocial Personality Disorder, you must have a continuous pattern of disregard for and violation of the rights of others, beginning by age 15.
In addition, you must have 3 of the following:

  1. Failure to follow social norms by repeatedly engaging in illegal behaviors
  2. Deceitfulness in the form of frequent lies, use of aliases, and/or conning others for personal gain or amusement
  3. Impulsivity or lack of planning ahead
  4. Irritability and aggressiveness, taking the form of repeated fights or assaults
  5. Reckless disregard for the safety of self or others
  6. Consistent irresponsibility (not honoring agreements, not holding a job, etc.)
  7. Lack of remorse
  • You must be 18 years old before Antisocial Personality Disorder can be diagnosed
  • You must display symptoms of Conduct Disorder by age 15.
  • Antisocial behavior does not occur solely during schizophrenic or bipolar episodes.

 
 

Conduct Disorder Criteria

To be diagnosed with Conduct Disorder, you must have a continuous pattern of disregard for the basic rights of others or age-appropriate rules and customs.
You must have 3 of the following during the past 12 months, with at least present within the last 6 months:
Aggression to People or Animals

  1. Often bullies, threatens, or intimidates others
  2. Often starts physical fights
  3. Has used a weapon (knife, bat, gun, etc.) to cause serious harm to others
  4. Has been physically cruel to people
  5. Has been physically cruel to animals
  6. Has stolen from a person while confronting them (mugging, purse snatching, extortion, armed robbery, etc.)
  7. Has forced someone to into sexual activity

Destruction of Property

  1. Has started a fire with a plan to cause serious damage
  2. Has intentionally destroyed someone’s property (without fire)

Deceitfulness or Theft

  1. Has broken into someone’s house, car, or building
  2. Often lies to get goods or favors, or to avoid obligations (i.e. conning)
  3. Has stolen of value without confronting someone (shoplifting, forgery)

Serious Violation of Rules

  1. Often stays out at night regardless of parental curfew (beginning by age 13)
  2. Has run away from home overnight at least twice without returning for a lengthy period of time
  3. Is often truant from school, beginning by age 13
  • Your behavior disturbance causes significant problems at home, school, and/or work
  • If you are over 18, you cannot meet criteria for Antisocial Personality Disorder

 
 
 

Common Struggles

People with ASPD are referred to as “sociopaths” or “psychopaths.” People with ASPD are often incredibly charming and can easily manipulate others using this charm. People will often manipulate or exploit others, taking money, food, shelter, or other valuable items.
People with ASPD are frequently perpetrators of serious crimes, such as murder, rape, assault, etc.
People with ASPD are often neglectful of the safety of everyone around them, such as reckless driving, neglecting to care for a child, or dangerous crimes. People with ASPD often rationalize their behaviors of hurting others by making statements such as “he deserved it” or “she had it coming.”
People with ASPD often display a level of arrogance or self-righteousness, often leading to irresponsible behaviors. People with ASPD will leave jobs without warning and no plan for other employment. People with ASPD can be irresponsible parents, often neglecting the needs or safety of a child.
People with ASPD are often untrustworthy due to a history of deceitfulness. People with ASPD often have numerous sexual partners and rarely engage in monogamous relationships.
 

Cause

There is no definitive cause for Antisocial Personality Disorder.
The primary theory of cause is a history of childhood trauma (smoking during pregnancy, physical abuse, or head trauma).
There is also a strong genetic link. Studies have shown people with parents or siblings with ASPD are significantly more likely to develop ASPD than people with a biological relative.
There is an environmental link, too. Adoption studies have shown the adoptive family environment can influence if the disorder develops.
 

Treatment

Medications are rarely effective in treating personality disorders. There has been little research on how to effectively manage or treat ASPD and there is currently no common treatment method applied.
 

Facts

  • Antisocial Personality Disorder symptoms occur on a spectrum: some people with ASPD only occasionally perform “bad things,” some people with ASPD are serial killers, and many people with ASPD are in between.
  • Antisocial Personality Disorder is significantly more common in men than women. 75% of people diagnosed with ASPD are male.
  • People with Antisocial Personality Disorder often lie about their symptoms and go undiagnosed.
  • 2-3.3% of the U.S. adult population has ASPD, according to random samples throughout the country.
    • The highest percentage found has been 80%. This was found using a sample of male inmates with an alcohol abuse disorder.
  • There is a much higher percentage of people with ASPD in the federal prison system: Up to 80% of males and 65% of females in federal prison are diagnosed with ASPD.
  • People with ASPD are more likely than others to die prematurely due to violence (suicide, homicide, or accident).
  • Many CEOs of major companies demonstrate antisocial personality traits.
  • Antisocial Personality Disorder cannot be diagnosed until adulthood (age 18).
  • Antisocial Personality Disorder requires a person to be diagnosed with Conduct Disorder before age 15 to meet criteria.

 
Understanding Antisocial Personality Disorder
 
 

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