Antisocial Personality Disorder

(Psychopathy; Sociopathy)

Definition

Antisocial personality disorder is a psychiatric condition. It leads to an ongoing pattern of manipulating others and violating their rights. People with this disorder do not follow society’s norms. They also tend to be careless about other people's feelings and pain. They also show a pervasive pattern of no regret, together with irresponsible decisions.

Seeking treatment is important to help the person with the disorder, but also to protect other people who may be affected by the behavior.

Causes

The exact cause is not clear. Life event, family environment, and genes may all play a role.

Prefrontal Cortex

Prefrontal cortex brain
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Risk Factors

Antisocial personality disorder is more common in men. It is also more common in those with:

  • History of conduct disorder as a child
  • Family history of the disorder
  • History of abuse or neglect
  • Antisocial behavior in the father
  • Family dysfunction

Symptoms

Behaviors common to those with antisocial personality disorder include:

  • Repeated law breaking
  • Deceitfulness, repeated lying
  • Bullying or cruelty to animals and/or other humans
  • Destruction of property
  • Theft

People with antisocial personality disorder tend to have:

  • Impulsiveness
  • Irritability and aggression
  • Inability to feel sympathy or empathy for others
  • Disregard for safety of oneself or others
  • Irresponsibility regarding work, family, or finances
  • Lack of guilt over hurting others
  • Lack of concern for consequences of actions/behavior
  • Inability to learn from experience or change behavior based on past events

Diagnosis

The doctor will ask about behaviors and problems that have happened. Some specific questions will help the doctor focus the diagnosis. A person must be at least 18 years old to have a diagnosis of personality disorder. Conduct disorder causes similar symptoms in those younger than age 15.

A psychiatrist or other mental health professional will likely make the diagnosis. A complete mental health exam will be done. It will look for other mental health issues that may be present.

Treatment

Antisocial personality disorder is a chronic condition. However, some symptoms, especially criminal behavior, may decrease slowly on their own with age. This disorder can be difficult to treat. People with antisocial personality disorder are not likely to seek treatment on their own. It often comes as part of a criminal justice system.

Psychotherapy are used with antisocial personality disorder. Examples are:

  • Group therapy—to learn skills to interact with others.
  • Cognitive behavioral therapy and behavior modification—to change patterns of thinking that are causing problems. Will also encourage positive behaviors.

Treatment will also be needed for any other mental health issues like substance abuse. It can improve quality of life.

Medicine may be part of the treatment plan. They can help manage some symptoms such as irritability or impulse control. The type of medicine will depend on the individual needs.

Prevention

There are no steps to prevent antisocial personality disorder since the cause is not clear.

RESOURCES:

National Alliance on Mental Illness
https://www.nami.org
National Institute of Mental Health
https://www.nimh.nih.gov

CANADIAN RESOURCES:

Canadian Psychiatric Association
https://www.cpa-apc.org
Canadian Psychological Association
https://cpa.ca

References:

Angstman KB, Rasmussen NH. Personality disorders: review and clinical application in daily practice. Am Fam Physician. 2011 Dec 1;84(11):1253-60.
Bateman AW, Gunderson J, Mulder R. Treatment of personality disorder. Lancet. 2015 Feb 21;385(9969):735-43.
Gask L, Evans M, Kessler D. Clinical Review. Personality disorder. BMJ. 2013 Sep 10;347:f5276.
Overview of Class B personality disorder (ASPD). EBSCO DynaMed website. Available at: https://www.dyname.... Accessed January 31, 2020.
Last reviewed March 2020 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 8/13/2020

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