Antisocial personality disorder (ASPD) is one of the most challenging and misunderstood mental health conditions. This is because adults with ASPD often show an ongoing pattern of disregarding others, engaging in manipulative or deceitful behavior – seemingly without remorse.
A diagnosis of ASPD carries notable stigma, with many people confusing this clinical diagnosis with media portrayals of violent criminals and sociopaths. Yet, while some people with ASPD do engage in criminal behavior, others hold down steady jobs and maintain relationships while grappling with the core features of this disorder.
Understanding more about the actual behavioral patterns of ASPD and how it’s diagnosed and treated is important for those affected and their loved ones. Despite its reputation, adults with ASPD can access specialized treatment to reduce harmful behaviors.
If you or a loved one have received a diagnosis or suspect you have ASPD, a mental health professional can provide support and guidance on treatment. This page can also help by exploring several key aspects of ASPD symptoms and treatment, including:
The disorder involves a fundamental lack of empathy, along with the potential for repeated deception and impulsivity, irritability, aggression, and consistent irresponsibility in work and financial obligations.
People with ASPD can often be charming and likable yet demonstrate a callous disregard for others’ feelings and safety. Aside from this trait, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) requires several criteria to be met for an official diagnosis. These are:2
The person must be at least 18 years of age
Personality disorders (PDs) like ASPD are deeply ingrained, rigid patterns of thinking and behavior that are typically much different than societal norms and cause major distress or impairment.3
A personality disorder is an enduring aspect of someone’s personality, usually developed earlier in life and remaining stable over time. This is unlike conditions such as depression, which can develop later in life and do not necessarily reflect someone’s personality).3
These disorders can be challenging because the person suffering often doesn’t recognize their patterns as problematic. While someone with depression usually knows they feel depressed and seeks relief, people with PDs usually view their outlook as normal, seeing problems being caused by those around them instead.
This lack of insight can make treatment more challenging because the person must first acknowledge that these patterns are creating problems that are worth changing.4
The Potential Causes of ASPD
The development of ASPD is thought to involve several complex interactions between genetics, brain development, and environmental factors. Research has shown strong hereditary components, with twin studies finding double the rates for identical twins than fraternal twins.1
Childhood experiences are also thought to play a large role in potential genetic predispositions, translating into a personality disorder. For instance, abuse, neglect, inconsistent parenting, and early trauma are all thought to cause increased risk.1
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Further, the condition is much more common in prison populations, with some studies suggesting anywhere from 40 to 70% of inmates meet the DSM criteria for ASPD.6
Having said that, many people with this disorder never interact with the criminal justice system. Yet they may function in daily life and society while causing harm to those around them via manipulation, exploitation, financial irresponsibility, or abusive relationships.
ASPD carries perhaps the heaviest stigma of just about any mental health diagnosis. For example, popular culture likes to portray those with the condition as remorseless criminals or corporate psychopaths who manipulate and destroy everything around them.
These sensationalist depictions can create further fear and misunderstanding, making it even harder for the antisocial traits adults with ASPD show to be accepted. Therefore, these adults may find it challenging to seek help without facing judgment. Unfortunately, even some people within the mental health community view ASPD as “untreatable” or “unworthy” of compassionate care.
As a result, people who recognize antisocial traits in themselves can have a much harder time sharing these concerns with clinicians. Yet treatment can make a major difference to their outlooks, behaviors, and relationships.
Despite these obstacles, research suggests that there are interventions that can help to reduce harmful behaviors and improve functioning for people struggling with antisocial personality disorder. This is particularly the case when treatment focuses more on making behavioral changes rather than developing new emotional insights.7
For example, cognitive-behavioral therapy adapted for ASPD focuses on identifying thoughts and beliefs that justify harmful behavior toward others. It also examines the consequences of antisocial actions and works to develop impulse control strategies. In other words, CBT emphasizes practical self-interest in reducing impulsive and aggressive behaviors that avoid unwanted outcomes.
There are no medications that treat ASPD directly, but some psychiatric medications can help to address any potential co-occurring conditions (such as depression or anxiety). A psychiatrist or licensed prescriber can carefully evaluate whether medications might help to manage any specific symptoms contributing to dangerous, harmful behaviors.
Ultimately, as with many mental health conditions, ASPD cannot be “cured,” but it can be managed for many people. Success often requires you to have the motivation to engage (rather than avoiding consequences), and having access to specialized providers can help.
Treatment providers may offer free and confidential assessments for the mental health conditions that they treat. There are also free evaluation tools and quizzes accessible online. However, these resources are generic and not as specific. It is important to find a personalized assessment that is done by trained and qualified professionals for accuracy.
A Mission For Michael (AMFM) provides a private and free assessment of the conditions we treat, including personality disorders. Our clinical team assesses your current symptoms, level of impairment, and mental health history to determine an appropriate treatment recommendation. We encourage you to call us at AMFM today for your free evaluation.
Inpatient treatment personality disorder programs can offer you the most intensive level of care for adults with ASPD, especially when antisocial behaviors are creating immediate safety concerns.
Residential ASPD programs are designed for the unique challenges you or your loved one face. Staff receive training in recognizing manipulation and maintaining consistent boundaries, avoiding the enabling behavior that you and your loved ones might be struggling to maintain. They can also provide family therapy to help you learn new ways of relating.
Intensive therapy for ASPD in a residential setting occurs daily rather than weekly, allowing for more immediate feedback and consistent reinforcement. Therapy for personality disorders place an emphasis on skill-building, including anger management, impulse control, problem-solving, and recognizing how harmful behaviors create difficult, unwanted consequences.
Essentially, residential programs don’t aim to fundamentally transform your personality. They focus on reducing the most dangerous behaviors, and success means you leave treatment with a better ability to manage anger and improve your recognition and problem-solving skills.
A Mission For Michael provides residential treatment and a full spectrum of care for adults with complex needs at our facilities in California, Virginia, and Washington. Our structured programs offer the best in evidence-based care and wraparound support, including treatment for those with ASPD and other challenging mental health issues.
AMFM accepts most insurance plans and can help you verify your coverage when you call. Reach out today to explore if our residential treatment program might be a good fit for your recovery needs.
A Mission For Michael (AMFM) provides treatment for adults experiencing various conditions. Personality Disorder support is a phone call away – call 866-478-4383 to learn about our current treatment options.
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The aim of this page was to help you better understand ASPD symptoms and treatment options, but it’s both normal and understandable to have continuing concerns. For this reason, we’ve provided some answers to FAQs on the topic.
Adult sociopathy and psychopathy vs. ASPD have long been debated in the mental health field, which can be confusing for the general population. Psychopathy and sociopathy aren’t official diagnostic terms in the DSM – they’re concepts used in forensic and research settings, as well as in entertainment.
Psychopathy, measured through tools like the Psychopathy Checklist, emphasizes personality traits like callousness and manipulativeness. Meanwhile, the term “sociopath” is used less formally, often describing people whose antisocial behaviour comes from environmental and childhood factors rather than being inherited traits.
Relationships with someone who has ASPD are usually typified by manipulation and exploitation, rather than genuine mutual care. The lack of empathy and disregard for others’ feelings can make healthy relationships difficult.
However, some people with ASPD are able to maintain long-term relationships, depending on many different factors. Milder presentations of ASPD can often allow for more functional relationships, though the core features of the disorder can still conflict with the empathy, trust, and consideration healthy partnerships require.
Antisocial personality disorder can’t be officially diagnosed until the age of 18, though clear warning signs usually appear much earlier.
The diagnosis requires evidence of conduct disorder – a disorder that displays a pattern of violating rules and others’ rights – before the age of 15.
Mental health professionals don’t diagnose ASPD in teenagers because personality is still developing, and some antisocial behaviors during adolescence don’t necessarily persist into adulthood.
Early intervention during adolescence, before antisocial patterns become fully entrenched, can offer the best opportunity for preventing the progression of conduct disorder to adult antisocial personality disorder.
