Affecting an estimated 1% to 4% of adults in the United States, antisocial personality disorder (ASPD) is a serious mental health condition that significantly impacts a person’s relationships and the ways that they act.
ASPD is also referred to as psychopathy, and the lack of awareness that is typically present in those with the condition means that often people with ASPD will not realize that they have it or see any issues with the ways they think or act.
In this article, we will provide a comprehensive overview of ASPD, addressing the signs and symptoms, potential causes, diagnostic processes, and treatment options.
What is ASPD?
ASPD can be traced back to the 19th century, with French physician Philippe Pinel and French psychiatrist Jean Etienne Dominique Esquirol being the first to make observations of behaviors that we now recognize as being signs of ASPD.
This mental health condition impacts the thoughts and behaviors of individuals. It is characterized by a long-standing pattern of disregard for others’ rights, as well as a lack of empathy or guilt for harmful actions.
ASPD can lead individuals to manipulate others for their own benefit or enjoyment, and ignore rules or laws, which can make it challenging for them to maintain healthy interpersonal relationships.
This personality order typically begins to show before the age of 15 and is more common amongst men than it is in women.
Living with untreated ASPD can result in harm (whether physical or emotional) to the individual with the condition as well as those around them.
What are the signs and symptoms?
People with ASPD often exhibit the following signs and symptoms.
- Chronic disregard for rules and social norms: In many cases, individuals with ASPD engage in illegal acts. Certain behaviors, such as setting fires and animal cruelty during childhood, are typically indicative of ASPD.
- Impulsivity and irresponsibility: Difficulty planning ahead, often engaging in reckless behavior without considering consequences.
- Aggression and irritability: Easily angered and often exhibiting aggressive behavior.
- Manipulative behaviors: Using others for personal benefit without concern for their well-being. Lying is common amongst people with ASPD, as is the use of wit and charm to manipulate others.
- Lack of empathy: Inability or unwillingness to recognize or care about the feelings of others. Often, individuals with ASPD will not show remorse or concern for their behaviors.
While these are common symptoms of ASPD, it is also important to note that each individual will present their ASPD differently, and that they may exhibit certain behaviors more than others.
What causes it?
While the exact cause of ASPD is unknown, several factors may contribute to the development of the disorder. Environmental factors such as early trauma are often linked to ASPD.
For example, individuals who experienced childhood abuse, neglect, exposure to violence, or a dysfunctional family environment may be more predisposed to developing ASPD.
This is also true of individuals who grew up with others who had ASPD or other mental health conditions. Additionally, research suggests that ASPD could be hereditary.
An estimated 20% of individuals with ASPD have a close relative with the disorder, although more research is needed to fully understand the role that genetics plays in ASPD.
What does a diagnosis include?
Healthcare providers who specialize in mental health, such as psychiatrists and those with the requisite online Masters in Mental Health Counseling, are equipped to evaluate an individual’s symptoms and diagnose this condition.
The process for diagnosing ASPD typically involves a psychological evaluation whereby the mental health specialist will evaluate the thoughts and behaviors of the patient to determine whether they fit the patterns attributed to those with ASPD.
To obtain a formal diagnosis, this evaluation is usually done with reference to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
The specialist will use different sources of information to make their diagnosis, for example, by delving into the patient’s history of behavior as well as into how the patient acts under different circumstances to understand how this translates to their day-to-day life.
As many symptoms of personality disorders can overlap with other conditions (such as substance abuse or other personality disorders), the specialist will need to rule out these other conditions before they make their diagnosis.
How is it managed and treated?
Treating ASPD can be complex, as individuals with the disorder often do not seek help voluntarily because they may not realize they have the condition or they may not see anything wrong with their thoughts and behaviors.
Treatment typically focuses on managing symptoms and improving functioning in daily life.
Psychotherapy
Cognitive Behavioral Therapy (CBT) is one of the most effective forms of psychotherapy for ASPD, helping individuals recognize negative thinking patterns and change destructive behaviors.
In CBT, individuals develop strategies to help them manage their symptoms and improve their interpersonal skills.
Group therapy is another form of psychotherapy that can also be beneficial for individuals with ASPD, as it offers opportunities for social interaction (and hence the development of social skills).
Group therapy can also help the individual understand the impact of their behavior on others.
Medication
While there is no one single approved medication to treat ASPD, certain types of medication can help to manage specific symptoms like aggression and mood changes.
For instance, a specialist may recommend taking antidepressants for low mood, antipsychotics for aggressive behavior, or mood stabilizers for severe mood changes.
Inpatient treatment
While most people with ASPD can be treated on an outpatient basis, in some cases, particularly for those with severe symptoms or a history of criminal activity, inpatient care may be necessary.
Inpatient treatment is usually reserved for cases where there are significant risks to the individual’s safety or the safety of others, or if outpatient treatment has not been successful in managing the condition.
Endnote
Recognizing the signs early and seeking help from qualified mental health professionals is crucial for managing the disorder.
By addressing the underlying causes and providing the right treatment, individuals with ASPD can work towards healthier and more functional behaviors, all of which contribute to a more fulfilling life.
If you or someone you know is experiencing symptoms of ASPD, it is important to consult with a healthcare provider to receive the appropriate diagnosis and treatment.