A Guide to Mental Disorders

Antisocial Personality Disorder ☆

Antisocial personality disorder (ASPD) is a mental health condition that can affect the way you think and interact with others and lead you to:
- Manipulate or deceive people.
- Exploit or take advantage of someone else for your own benefit.
- Disregard the law or the rights of other people.
- Feel no remorse for your actions.

It's common for people diagnosed with ASPD to show a lack of respect toward others, break the law, ignore the consequences of their actions or refuse to take responsibility. ASPD can be dangerous since you're at a high risk of causing physical or emotional harm to yourself and those around you.

Antisocial personality disorder is one of many personality disorders. Personality disorders affect the way you think or behave.

How common is antisocial personality disorder?
Antisocial personality disorder affects an estimated 1% to 4% of adults in the U.S.

What are the symptoms of antisocial personality disorder?
Symptoms of antisocial personality disorder may include:
- Physical aggression, hostility or violence toward others.
- Reckless or impulsive behavior.
- Breaking the law or disregarding rules and social norms.
- Feeling angry, more powerful or better than others.
- Using wit, flattery and charm to manipulate, lie or deceive others for personal gain or enjoyment.
- Not taking responsibility for actions or behaviors.
- Not showing remorse, regret or concern for behaviors.

Antisocial personality disorder may look different for each person who experiences it. You might lean more toward certain behaviors than others.

If at any point, you feel the urge to hurt yourself or others, reach out for help. Contact a healthcare provider or call the Suicide and Crisis Lifeline by dialing or texting 988 (U.S.). Someone is available to talk with you 24 hours a day, seven days a week. If you or a loved one is in immediate danger, call 911 or your local emergency services number.

What age does antisocial personality disorder develop?
Antisocial personality disorder usually begins before age 15. The initial diagnosis is conduct disorder. Children with conduct disorder show a pattern of aggressive or disobedient behavior that can harm others. They may lie, steal, ignore rules or bully other children. Two behaviors that are warning signs of ASPD during childhood are setting fires and animal cruelty.

Sometimes parents or healthcare providers miss the signs of conduct disorder. The signs may overlap with other conditions, like:
- Attention-deficit/hyperactivity disorder (ADHD).
- Depression.
- Oppositional defiant disorder (ODD).

When a conduct disorder diagnosis occurs and treatment begins early in childhood, there's a chance the behaviors may not continue into adulthood. If they do, the diagnosis becomes antisocial personality disorder after age 18.

Studies suggest that symptoms of ASPD are the worst between ages 20 to 40 and tend to improve after age 40.

What causes antisocial personality disorder?
Healthcare providers aren't sure of the exact cause of antisocial personality disorder. Research suggests it may involve many different factors, from your genetic composition to certain experiences you had growing up. One leading factor is brain biology. You may have abnormal levels of serotonin in your brain. Serotonin is a chemical that regulates your mood and feelings of happiness. Changes to the amount of serotonin in your brain may cause antisocial personality disorder behaviors.

Is antisocial personality disorder genetic?
Your genetic makeup may make it more likely for you to develop antisocial personality disorder. Research is ongoing to learn more about how your genes can contribute to this condition, but the exact genes responsible are yet to be identified. Studies found that your risk increases if you have a biological relative with ASPD.

What are the risk factors for antisocial personality disorder?
Antisocial personality disorder can affect anyone. You may be more at risk of developing the condition if you:
- Had a conduct disorder diagnosis before age 15.
- Are assigned male at birth (AMAB).
- Experienced trauma or abuse in early childhood.
- Experience substance use disorder (SUD) or have a biological relative who has the condition.
- Have a history of mental health conditions in your biological family.
- Have a lower academic performance compared to your peers.
- Spent time in jail or prison.

What are the complications of antisocial personality disorder?
Antisocial personality disorder is a dangerous, often life-threatening condition to the affected person and others around them. It can lead to the following complications:
- Abuse or cruelty.
- Neglect.
- Suicide.
- Substance use disorder.
- Alcohol use disorder.
- Arrest and incarceration.
- Health complications.
- Other mental health conditions (depression, anxiety, etc.).
- Inability to meet personal, social, work or academic commitments.

How is antisocial personality disorder diagnosed?
A healthcare provider who specializes in mental health conditions, like a psychologist or psychiatrist, will diagnose antisocial personality disorder. They'll perform a psychological evaluation. This is a method to evaluate a person's thoughts and behaviors which look for patterns that relate to antisocial personality disorder. Providers refer to the diagnostic criteria listed in the fifth edition of the Diagnostic and Statistical Manual of Mental Illnesses, or DSM-5-TR (in the latest version, "TR" stands for "text revision"). This is the American Psychiatric Association's professional guide to mental health conditions.