pathoscribe

Written by Kirsten Batitay | Art by Anoushka Pandya

Also known as sociopathy, antisocial personality disorder (ASPD) is a mental health condition in which someone consistently shows a lack of regard for right and wrong and ignores the feelings of others. As with many other personality disorders, ASPD falls on a spectrum, ranging in severity from occasional misbehavior to repeatedly committing crimes and breaking the law.

Given its name, many of the symptoms of antisocial personality disorder relate to how a person treats others. Symptoms include repeatedly ignoring right and wrong, lying to take advantage of others, manipulating people for pleasure or personal gain, and being aggressive or hostile towards others. Such symptoms may lead to complications such as early death due to violence, other mental health conditions like depression and anxiety, and financial, educational, or social problems.

Even with such severe symptoms, people with antisocial personality disorder may not believe that they need help or may not accurately describe their symptoms, so loved ones can often provide useful information. The diagnosis of ASPD is usually based on a mental health exam, symptoms, and one’s personal and medical history. Although ASPD is not often diagnosed before age 18, symptoms may occur before then. The determining factor for diagnosing someone is that they exhibit at least three critical behaviors as part of their daily behavior and personality. These include repeatedly breaking the law, being deceitful, irritability and aggressiveness, and showing a lack of remorse.

Furthermore, some risk factors for developing ASPD may include a combination of genes and environment, as some genes may increase vulnerability to its development. Some life events, especially neglect and abuse, can trigger development. It is also important to know that men are at a greater risk of having ASPD compared to women.

Regarding treatment, those most at risk of antisocial personality disorder are children who show signs of having a conduct disorder, so it is important to identify them and intervene early. Treatment for ASPD varies depending on a person’s situation, willingness to participate, and the severity of their symptoms. One treatment is talking therapy or psychotherapy, which may include anger and violence management and treatment for other mental health conditions.

A common talking therapy is cognitive behavioral therapy or CBT, which aims to help people manage their problems by changing their thought and behavior processes. Unfortunately, there are no specific medications for ASPD approved by the FDA, but certain antidepressants or antipsychotics may be of help.

Considering that someone with an antisocial personality disorder may be reluctant to seek treatment, it is one of the most difficult personality disorders to treat and loved ones often play an active role in deciding treatment and care. However, there is still hope as even if major characteristics like a lack of empathy remain, evidence implies that ASPD behavior can improve over time with therapy.

Sources:

Mayo Clinic Staff. “Antisocial Personality Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 24 Feb. 2023, http://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/diagnosis-treatment/drc-20353934.
Mayo Clinic Staff. “Antisocial Personality Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 24 Feb. 2023, http://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928.
NHS Staff. “Antisocial Personality Disorder.” NHS Choices, NHS, http://www.nhs.uk/mental-health/conditions/antisocial-personality-disorder/.