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Antisocial personality disorder

Antisocial personality disorder is a mental health condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights of others. This behavior is often criminal.

Alternative Names

Sociopathic personality; Sociopathy; Personality disorder - antisocial

Causes, incidence, and risk factors

Cause of antisocial personality disorder is unknown. Genetic factors and environmental factors, such as child abuse, are believed to contribute to the development of this condition. People with an antisocial or alcoholic parent are at increased risk. Far more men than women are affected. The condition is common among people who are in prison.

Fire-setting and cruelty to animals during childhood are linked to the development of antisocial personality.

Some doctors believe that psychopathic personality (psychopathy) is the same disorder. Others believe that psychopathic personality is a similar but more severe disorder.

Symptoms

A person with antisocial personality disorder may:

  • Be able to act witty and charming
  • Be good at flattery and manipulating other people's emotions
  • Break the law repeatedly
  • Disregard the safety of self and others
  • Have problems with substance abuse
  • Lie, steal, and fight often
  • Not show guilt or remorse
  • Often be angry or arrogant

Signs and tests

Antisocial personality disorder is diagnosed based on a psychological evaluation that assesses the history and severity of symptoms. To be diagnosed with antisocial personality disorder, a person must have had conduct disorder during childhood.

Treatment

Antisocial personality disorder is one of the most difficult personality disorders to treat. People with this condition rarely seek treatment on their own. They may only start therapy when required to by a court.

Behavioral treatments, such as those that reward appropriate behavior and have negative consequences for illegal behavior, may hold the most promise. Certain forms of talk therapy are also being explored.

Persons with antisocial personality who have other disorders, such as a mood or substance disorder, are often treated for those problems as well.

Expectations (prognosis)

Symptoms tend to peak during the late teenage years and early 20s. They sometimes improve on their own by a person's 40s.

Complications

Complications can include imprisonment, drug abuse , violence, and suicide.

Calling your health care provider

See your health care provider or a mental health professional you or someone you know has symptoms of antisocial personality disorder.

 

References

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA. Personality and personality disorders. In: Stern TA, Rosenbaum JF, Fava M, Biederman J, Rauch SL, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia, PA: Elsevier Mosby; 2008:chap 39.

Updated: 11/10/2012

David B. Merrill, MD, Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University Medical Center, New York, NY. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.


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