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A person with ASPD displays a pattern of disregard for the rights of others. Common features include deceitful, manipulative, and criminal behaviors. Every person has a distinct personality, which involves how they think, behave, and act. Some people develop unhealthy and rigid thinking, emotional, and behavioral patterns that affect their work and relationships. Individuals with ASPD do not follow social norms and show no regard for other people’s rights or feelings. People may sometimes refer to them as sociopaths. This article provides an overview of antisocial personality disorder, including its symptoms, causes, and treatments. It also explains how ASPD relates to psychopathy. Defining antisocial personality disorder Share on PinterestCredit Image: Westend61/Getty ImagesASPD is a mental health condition characterized by behavioral patterns that involve lying, manipulating and exploiting other people, and violating their rights. ASPD affects 1–4% of the population. A person with ASPD has thoughts and behaviors characterized by a disregard for — and violation of — the rights of others. This often manifests as:deceitful or manipulative behavior for personal benefitcriminal behaviora disregard for the safety and choices of othersirresponsible actions Individuals with ASPD do not show remorse for their behaviors, which may be criminal. They can appear indifferent to the consequences of hurtful actions or rationalize the reasons for hurting, mistreating, or stealing from others. ASPD is one of the 10 personality disorders that the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, text revision (DSM-5-TR) lists. The manual classifies personality disorders into three clusters. ASPD is one of the four disorders in cluster B. Cluster B personality disorders typically involve behaviors that many would consider unpredictable. Signs and symptoms Anyone can be deceitful or manipulative from time to time. These behaviors are pervasive and inflexible in people with ASPD. According to the DSM-5-TR, behaviors that may indicate ASPD include:breaking social norms, including the law, repeatedlydisplaying behaviors that are grounds for arrestdeceiving, stealing from, or manipulating others frequently for personal profit or pleasuremaking spur-of-the-moment decisionsbeing irritable or aggressivegetting into physical fightsassaulting others, including domestic abusedisregarding their own and others’ safetyshowing consistent, extremely irresponsible behaviorstruggling with commitments and financial responsibilitiesshowing no guilt or remorsedestroying propertyharassing otherspursuing illegal occupationsblaming victims to rationalize their behaviorbeing arrogant or having an inflated sense of selfpresenting as self-assured or cockyshowing superficial charm These behavioral patterns can make relationships challenging and make it difficult for people with ASPD to keep a job. People with ASPD tend to have a history of having many sexual partners, and many may never have sustained a monogamous relationship. They may also be irresponsible parents. A 2018 population-based study found that among teens aged 12–14 years, direct aggression was predictive of ASPD. Research also suggests that people with personality disorders may have a higher risk of attempting suicide than the general population. Suicide prevention If you know someone at immediate risk of self-harm, suicide, or hurting another person:Ask the tough question: “Are you considering suicide?”Listen to the person without judgment.Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.Stay with the person until professional help arrives.Try to remove any weapons, medications, or other potentially harmful objects. If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988. Click here for more links and local resources. Diagnosis Healthcare professionals diagnose ASPD by carrying out a psychological evaluation. The person must show symptoms of having a pervasive pattern of disregard for and violation of the rights of others. Although no recognized tests exist to diagnose the condition, doctors may request genetic and neuroimaging tests to look for potential causes of and patterns associated with ASPD. Criteria Healthcare professionals rely on the diagnostic criteria in the DSM-5-TR to diagnose ASPD. A person will only meet the criteria if they demonstrate at least three of the following:failure to conform to societal normsdeceitfulnessimpulsivityirritability or aggressivenessreckless disregard for the safety of themselves or othersconsistent irresponsibilitylack of remorse Minimum age for ASPD diagnosis According to the DSM-5-TR, doctors cannot diagnose ASPD in childhood. A person must be at least 18 years old to receive a diagnosis of this condition. However, signs should already be present before they reach the age of 18 years, with evidence of the onset of conduct disorder (CD) before 15 years of age. The antisocial behavior also cannot occur exclusively during the course of a person’s schizophrenia or bipolar disorder. Just because a person commits a crime, this does not mean that they have ASPD. The person should present with persistent and inflexible personality traits that cause distress or functional impairments. When a person with a substance use disorder displays signs of ASPD, they will not receive a diagnosis unless these signs were present in childhood. However, the two conditions can co-occur. Related conditions People with ASPD may have other associated conditions, such as:anxiety disordersdepressive disorderssubstance use disorderssomatic symptom disordera gambling addictionproblems with impulse control They may also have characteristics that meet the diagnostic criteria for other personality disorders, especially the other cluster B disorders:borderline personality disordernarcissistic personality disorderhistrionic personality disorder The DSM-5-TR notes that individuals who receive a diagnosis of CD before the age of 10 years and also have attention deficit hyperactivity disorder (ADHD) have an increased risk of developing ASPD. Sociopathy vs psychopathy People may use the terms sociopath and psychopath interchangeably, although neither is an official diagnostic term. However, an older study suggests that sociopathy is more appropriate when a brain injury, neurological differences, or a belief system contributes to antisocial behavior. Meanwhile, psychopathy refers to a defined set of traits, and experts almost exclusively investigate psychopathic traits within criminal populations. The DSM-5-TR describes psychopathy as a variant of ASPD. It defines psychopathy as marked by:deficient emotional responseslack of empathypoor behavioral controla lack of anxiety or feara dominant, bold interpersonal style that can mask harmful behaviorslow levels of anxiousness and withdrawalhigh attention-seekingcallousness Some researchers believe that psychopathy is a subtype of ASPD with a more severe presentation. Researchers estimate that about one-third of those with ASPD meet the criteria for psychopathy. A 2014 study contrasts the two conditions by their cause, noting that psychopathy may be a consequence of genetics or indirect factors such as trauma, while sociopathy is due to environmental factors such as poor parenting. Learn more about the differences between psychopathy and sociopathy. Causes and risk factors Researchers do not know the exact cause of ASPD, but genetic, environmental, and cultural factors may all play a role in its development. According to the DSM-5-TR, ASPD is more common among first degree biological relatives, with heritability estimates in the range of 38–69%. Some environmental factors linked with this disorder include adverse childhood experiences, such as neglect and physical and sexual abuse, and having CD and ADHD during childhood. Males are three to five times more likely to receive a diagnosis of ASPD than females. Treatments Treating ASPD is not straightforward. People with ASPD rarely seek treatment, usually only starting therapy when a court requires it. There is a lack of evidence to support the effectiveness of psychological and pharmacological treatments for ASPD. However, medications can help with co-occurring conditions, such as aggressive behavior and impulsivity. Managing the symptoms can be difficult, and there is a relatively high rate of people stopping their treatment early. Drug or alcohol use is likely to increase the risk of aggression and impulsivity. Treating any substance misuse can, therefore, have significant benefits. Treatment focuses on achieving specific short-term goals, such as avoiding negative consequences for illegal behavior, rather than trying to change the person. Psychotherapy can help a person work around disruptive thought patterns, behaviors, and ways of relating to others. Group-based therapy can help address impulsive actions, antisocial behavior, and challenges relating to others. This type of therapy may take place within community-based or institutional care. Friends, family members, and healthcare professionals can find it difficult to care for people with ASPD. The National Alliance on Mental Illness offers advice for family members and caregivers on how they can support someone with a mental health condition while looking after themselves. Outlook ASPD is a lifelong condition. A doctor cannot diagnose it until a person reaches the age of 18 years, but its characteristics may present a few years earlier. The severity of the symptoms and associated crimes tends to be highest in a person’s late teens, improving as they reach their mid-30s. Research suggests that those who present with antisocial behaviors at a later age show less severe behavioral problems. People with ASPD who have never been incarcerated or have only experienced short-term imprisonment have higher remission rates. Summary Antisocial personality disorder is a serious mental condition characterized by inflexible patterns of behavior that disregard other people’s feelings and rights. There is no clear cause of ASPD, but a combination of genetic and environmental factors likely plays a role. It is difficult to treat, primarily because people with the condition are unlikely to seek treatment. There is also still no established treatment protocol. However, treatments are available to help people manage the symptoms and relieve co-occurring conditions, such as aggression. Working with a caring therapist and solid social support can help a person make meaningful changes to their behavior, complementing other treatments. Last medically reviewed on September 27, 2022Mental HealthNeurology / NeurosciencePsychology / Psychiatry 10 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Abdalla-Filho, E., et al. (2020). Does every psychopath have an antisocial personality disorder?https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7236162/Anderson, N. E., et al. (2014). Psychopathy: Developmental perspectives and their implications for treatment.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4321752/Ansell, E. B., et al. (2015). Personality disorder risk factors for suicide attempts over 10 years of follow-up. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4415153/Chapter 7: Interventions for people with antisocial personality disorder and associated symptoms and behaviours. Antisocial Personality Disorder: Treatment, Management and Prevention.https://www.ncbi.nlm.nih.gov/books/NBK55350/Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). (2022).https://psychiatry.org/psychiatrists/practice/dsmFamily members and caregivers. (n.d.).https://www.nami.org/Your-Journey/Family-Members-and-CaregiversFisher, K. A., et al. (2022). Antisocial personality disorder. https://www.ncbi.nlm.nih.gov/books/NBK546673/Pemment, J. (2013). Psychopathy versus sociopathy: Why the distinction has become crucial [Abstract].https://www.sciencedirect.com/science/article/abs/pii/S1359178913000542?casa_token=0z5XxNwkmAUAAAAA:0oW85fWRaxir37p4nF4m6wer7LV3hgehI7dUPzHupZpjU1jhg2yQZXqSpKZmO_Pb2z9UCaVKWerner, K. B., et al. (2015). Epidemiology, comorbidity, and behavioral genetics of antisocial personality disorder and psychopathy.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4649950/Whipp, A. M., et al. (2018). Early adolescent aggression predicts antisocial personality disorder in young adults: A population-based study.https://link.springer.com/article/10.1007/s00787-018-1198-9FEEDBACK:Medically reviewed by Matthew Boland, PhD — By Jamie Smith and Rachel Ann Tee-Melegrito — Updated on September 27, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? 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