Antisocial Personality Disorder

Medically Reviewed by Smitha Bhandari, MD on March 13, 2024
3 min read

People with antisocial personality disorder (ASPD) can be witty, charming, and fun to be around -- but they can also lie and exploit others. People with ASPD appear uncaring and don’t show remorse for their actions. Someone with the disorder may act rashly, destructively, and unsafely without feeling guilty when their actions hurt other people.

Modern diagnostic systems consider ASPD to include two related but not identical conditions: A "psychopath" is someone whose hurtful actions toward others tend to reflect calculation, manipulation and cunning; they also tend not to feel emotion and mimic (rather than experience) empathy for others. It is a severe form of ASPD.They can be deceptively charismatic and charming. By contrast, "sociopaths" are somewhat more able to form attachments to others but still disregard social rules; they tend to be more impulsive, haphazard, and easily agitated than people with psychopathy. ASPD affects 2% to 4% of the population and is more common in men.

People with ASPD may often do the following;

  • Lie, con, and exploit others
  • Act rashly
  • Be irritable and aggressive
  • Fight or assault other people
  • Break the law and accepted social norms
  • Not care about the safety of others or themselves
  • Not show signs of remorse after hurting someone else
  • Fail to meet money, work, or social duties

Antisocial personality disorder affects more men than women. Experts don’t know for sure what causes it, but genetics and other biological factors are thought to play a role (especially in psychopathy), as can growing up in a traumatic or abusive environment (especially in sociopathy). Brain defects and injuries during developmental years may also be linked to ASPD, research shows.

Possibly because people with ASPD often break the law, a lot of prisoners have ASPD. As many as 47% of male inmates and 21% of female inmates have the disorder, research shows. Children and adolescents with conduct disorder are more likely to develop ASPD. Conduct disorder is similar to ASPD but is diagnosed in young people who repeatedly violate social norms and the rights of others.

To be diagnosed with ASPD, a person would have to have shown symptoms of conduct disorder before age 15. A diagnosis can’t be made until age 18, though. Often, adults with ASPD will have shown signs of conduct disorder in childhood or early adolescence. Symptoms are usually at their worst during a person’s late teenage years and in their 20s, but may improve on their own over time.

The disorder is hard to treat. People with ASPD rarely seek help on their own, because they often think they don’t need it.

When treatment is sought, behavioral therapy or psychotherapy in individual or group settings may help. Doctors sometimes use certain psychiatric medications like mood stabilizers or some atypical antipsychotics (off label) to treat symptoms like impulsive aggression and associated disorders. The FDA has not approved any medications specifically for antisocial personality disorder.

If someone close to you has ASPD, consider attending a support group, or seek help from a psychiatrist, social worker, or psychologist. You won’t be able to change your loved one’s behavior, but you can learn coping skills to help you set boundaries and protect yourself from harm.