Antisocial Personality Disorder: Symptoms, Causes and Treatment

What is Antisocial Personality Disorder?

Antisocial personality disorder is a mental health disorder consisting of many behaviors and patterns that cause distress and disruption for the affected patient and the society in which they live. The Diagnostic and Statistical Manual 5, Text Revision (DSM-5-TR) defines antisocial personality disorder as:

An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture.

Typically, this behavior pattern manifests in multiple areas: cognition, affectivity, interpersonal functioning, and impulse control.  While many people have deviations from standard societal norms throughout their lives, those who suffer from antisocial personality disorder display these behaviors and patterns over the long-term and across all interpersonal situations. Another important distinction is that these patterns and actions significantly impact the patient’s functioning, often leading to serious employment and relationship difficulties.

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Signs and Diagnostic Criteria of Antisocial Personality Disorder

Antisocial personality disorder appears different among affected patients, but there are some key signs and features:

  • Poor impulse control
  • Lack of empathy and remorse, leading to:

o   Poor interpersonal skills and relationships

  • Exhibiting and rationalizing unlawful/hurtful behaviors
  • Deceitfulness and manipulation

Many patients with antisocial personality disorder have had trouble with law enforcement and may have a history of conduct disorder in childhood. These patients may have ongoing issues with substance abuse, getting into fights, and reckless sexual behaviors.

It is important to note that mental health professionals cannot diagnose antisocial personality disorder before 18 years of age. Many teenagers may exhibit poor impulse control or reckless behaviors through average growth and development, but typically real antisocial personality signs are apparent by age 15. These behaviors are pervasive and inflexible, and a critical differentiation between teenage development and antisocial personality disorder is the complete lack of empathy and remorse for their actions.

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What Causes Antisocial Personality Disorder?

As with many disorders, research points to a combination of genetic, neurobiological, and environmental factors as causes of antisocial personality disorder. There is no sole, definitive cause but many factors that can lead to someone developing this disorder. Patients with a 1st-degree relative with antisocial personality disorder have a higher incidence of developing it themselves, though it is not guaranteed. Children who grew up in poverty or with higher exposure to violence and abuse or neglect also have an increased risk of antisocial personality disorder.

Treatment of Antisocial Personality Disorder

Further research is needed on effectively treating antisocial personality disorder. Treatment for antisocial personality disorder requires an individualistic approach and may include targeted psychotherapy and pharmacologic interventions, though there is no sole treatment method that has been proven effective. A major part of treating antisocial personality disorder is assessing and mitigating risk of suicide and violence. Patients with this condition should receive a personalized approach to treatment that addresses co-morbidities and individual risk factors.

Antisocial Personality Disorder: A Serious Condition

Antisocial personality disorder signs and behaviors are often severe and can lead to dangerous situations if not addressed with proper care and treatment. Patients exhibiting antisocial personality symptoms should be evaluated appropriately by mental health professionals and assessed for other co-occurring disorders. Anyone who observes these behaviors should take them seriously, and the patient’s safety and the safety of others must always remain the top priority when planning care.

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Written by Jessica Dzubak, MSN, RN