Does ADHD Cause Antisocial Personality Disorder?

Medically Reviewed by Smitha Bhandari, MD on July 14, 2022
4 min read

Experts say it’s out of the ordinary for people with attention deficit hyperactivity disorder (ADHD) not to have other mental health conditions. In fact, many people who were not diagnosed with ADHD as children go to a doctor for symptoms of these other disorders and end up getting diagnosed with ADHD.

Suppose you have ADHD and show symptoms similar to antisocial personality disorder — like hostility, being in a bad mood a lot, easily lying to people, not caring about whether you hurt others, and disregarding the unwritten rules of how people are supposed to act. You might be concerned that you might have both conditions.

Attention deficit hyperactivity disorder (ADHD) is a mental health disorder that seriously and continually affects your ability to pay attention, stay still, and think before you act. This disorder is common in childhood but can follow a person into adulthood in about 65% of cases.

Your ADHD symptoms might change or become less intense as you grow older. For example, you might learn how to avoid being hyperactive in certain settings.

Symptoms of ADHD are grouped in three main themes: lack of attention, hyperactivity, and acting on impulse. To be diagnosed with ADHD, these symptoms must start before age 12, last for 6 months, and affect how you function in more than one place (for a child, for instance, home and school).

Adults with ADHD show symptoms including:

  • Difficulty staying on task
  • Trouble concentrating
  • Restlessness
  • Talking a lot
  • Poor self-control
  • Forgetfulness
  • Difficulty keeping promises
  • Making impulsive decisions
  • Trouble managing your time
  • Difficulty figuring out which things to do first
  • Mood swings
  • Low self-esteem
  • Putting things off
  • Easily frustrated

Antisocial personality disorder (ASPD) is a mental health condition that causes you to act in ways that seriously stray from the usual ways people are expected to act. About 1% to 4% of people develop ASPD.

People with ASPD break laws, take advantage of others, hurt people, and act recklessly or irresponsibly without feeling bad about their behavior.

Before a person can be diagnosed with ASPD, they must be at least 18 years old and must have been behaving very badly before age 15. Their behavior must not be tied to schizophrenia or bipolar disorder.

People with ASPD do at least three of the following, which shows they have no respect for other people’s rights:

  • Break rules and regulations
  • Constantly lie or take advantage of people
  • Make impulsive decisions
  • Become angry or aggressive easily
  • Act recklessly
  • Act irresponsibly
  • Show no guilt for or justify mistreating people

Studies suggest that as many as 90% of adults with ADHD have other mental health disorders.

ASPD is one of the most common mental disorders that happens with ADHD. One study showed that men with ADHD were more likely to have antisocial personality disorder than women with ADHD.

Other common mental conditions you can have with ADHD are:

ADHD and ASPD share symptoms linked with being impulsive that might make you confuse one with another.

Impulsiveness in people with ADHD may look like this:

  • Easily distracted
  • Poor planning, and trouble getting organized
  • Risky driving
  • Poor self-control
  • Talking a lot
  • Prone to taking risks

On the other hand, impulsivity in ASPD can show up as:

  • Acting recklessly or destructively
  • Breaking laws without caring about consequences
  • Disregarding responsibilities

People with ASPD consistently act in ways that hurt others and feel no regret for their actions. They might explain away these antisocial actions or blame victims. They might lie, steal, and commit crimes for no reason.

ADHD doesn’t cause ASPD, but many studies suggest that children with ADHD are more likely to develop ASPD when they grow older.

Experts are unclear why ADHD is a risk factor for ASPD. And researchers haven’t looked into whether treating ADHD during childhood reduces the chances they’ll get ASPD later on.

Treating a person with ADHD and ASPD can be complicated. Some experts suggest that when a person has ADHD and another mental disorder, a doctor should first treat the “weakened” condition.

In this context, that means your doctor might treat you for ADHD before ASPD. Treatment might include:

  • ADHD-specific cognitive behavioral therapy (learning to understand how you think and finding ways to change bad patterns), coaching, and exercises to help you build skills and routines to manage your symptoms
  • Stimulants like dexamphetamine, methylphenidate, and modafinil
  • Nonstimulant medications for treating people who can’t take stimulants, in combination with stimulants, and for treating disorders like anxiety and depression that you might have with ADHD. These nonstimulants include antidepressants, atomoxetine, clonidine, and guanfacine.

To manage ASPD symptoms, your doctor might use:

  • Psychotherapy or talk therapy
  • Medications like antidepressants, antipsychotics, antiseizure drugs, and mood stabilizers to treat symptoms like aggressiveness or impulsiveness

Jenny Okolo, a lead psychiatric occupational therapist working within the National Health Service (NHS) in the U.K., says that people with ADHD and ASPD may benefit from playing games, exercising, and engaging in adrenaline-pumping or stimulating activities to manage high-intensity thoughts – positive or negative.

If you have ADHD, you might also have other mental health conditions. If you’re concerned about developing ASPD or think you have symptoms of ASPD, speak with your doctor. They can give you a more accurate diagnosis and suggest treatment.