Some people seem to have no regard for others and can cause harm to them without any regret or feelings of guilt. When this behavior is pervasive, a person may have a chronic mental health condition known as antisocial personality disorder. Sometimes people with antisocial personality disorder are called “sociopaths.”

What is a sociopath? People with antisocial personality disorder are willing to use deception or manipulation to get whatever they want, such as power or money. They may con people and use an alias, and they may steal or use aggressive behavior to achieve their desires. Even when caught, they show no regret or guilt. They lack a sense of empathy and cannot consider the feelings of others without help. They also tend to act impulsively, which can lead to arrests and time in prison.

There is a common myth in popular culture that “sociopaths” tend to be successful, charismatic people who hold positions of power. It is true that there are high functioning sociopaths, but they are not the norm. While sociopath path traits can include persuasiveness or charm, most people with the disorder will struggle with irresponsibility. They’re less likely to take advantage of employment opportunities, less likely to pay bills on time, and are at high risk of incarceration due to impulsive behaviors. They’re also likely to have a shorter life expectancy due to impulsive behaviors like substance abuse and criminal activity.

Causes of Antisocial Personality Disorder

What causes antisocial personality disorder? Researchers believe that genetics plays some role, as having a parent with the disorder puts one more at risk. Research on adopted children of parents with the disorder indicates that environment may also be a factor, such as when children receive poor discipline, have negative role models, or are not taught to respect the rights of others. Children of an alcoholic parent are also at increased risk.

Children who have conduct disorder or attention-deficit/hyperactivity disorder before age 10 are at increased risk for having antisocial personality disorder as adults. This is particularly true for children with conduct disorder who are abused or neglected. Researchers estimate that 25% of girls and 40% of boys with conduct disorder will have antisocial personality disorder as adults.

Antisocial personality disorder occurs in roughly 3% of the U.S. population. The disorder occurs in men 6 times more often than in women. 80% of people with the disorder will have developed symptoms by the age of 11.

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Symptoms of Antisocial Personality Disorder

The most common signs of antisocial personality disorder are a lack of regard for the rights of others and an extensive pattern of violating them.

To receive a diagnosis of antisocial personality disorder, a person must exhibit at least three of the following symptoms:

  • Repeatedly performing unlawful acts
  • Lying or conning others for profit or pleasure
  • Acting impulsively
  • Repeated physical fights or assaults
  • Disregard for the safety of oneself or others
  • Irresponsibility at work or in financial obligations
  • Lack of remorse when mistreating others

At What Age Can Antisocial Personality Disorder Be Diagnosed?

A person must be at least 18 years old to receive a diagnosis of antisocial personality disorder. There must also be evidence that they qualified for a diagnosis of conduct disorder before the age of 15, as many of the symptoms of the two disorders are similar. A diagnosis of antisocial personality disorder will also not be given if the behaviors occur due to the symptoms of schizophrenia or bipolar disorder.

Treatment for Antisocial Personality Disorder

Treatment for antisocial personality disorder may prove challenging. Because the symptoms of the disorder ten to peak in a person’s early 20s, people may find that symptoms improve on their own as a person reaches their 40s and beyond.

Psychotherapy, or talk therapy, is usually the treatment recommended for antisocial personality disorder. A therapist can help a person manage negative behaviors and build interpersonal skills they may lack. Often the first goal is simply to reduce impulsive behaviors that can lead to arrest or physical harm. Family therapy might be a useful option to educate family members and improve communication, and group therapy may also help when limited to people with the disorder.

No medications have been approved by the U.S. Food and Drug Administration to treat antisocial personality disorder. Medication may sometimes be prescribed to help reduce aggressive or impulsive behaviors. Medications might include mood stabilizers or antidepressants.

Treatment should also address any co-occurring disorders, which often include attention-deficit/hyperactivity disorder, borderline personality disorder, and impulse control disorders such as gambling disorder or sexual disorders. Because a majority of people with antisocial personality disorder will also have a substance abuse disorder, a person may need to complete detoxification as the first step of treatment, with the substance abuse and personality disorder then treated simultaneously.

Coping When a Loved One Has Antisocial Personality Disorder

If you have a loved one with antisocial personality, it’s common to feel discouraged. Remembering that lack of remorse or empathy is a symptom of the condition can help you set realistic expectations for how your loved one can improve. With treatment, some people with antisocial personality disorder do learn to form positive relationships, be more responsible, and respect the boundaries of others. Others will not, and family members will have to consider how they want to respond to this challenge. One interesting fact is that people with antisocial personality disorder who are married tend to improve over time compared to single people.

If you have a loved one with antisocial personality disorder, make sure that you also prioritize your own health and safety—family members often find it useful to participate in individual counseling themselves to help manage emotions and learn to set appropriate boundaries with the family member.

If you think you might have antisocial personality disorder or have a loved one who does, don’t hesitate to reach out to your doctor or a mental health professional. They can provide information and connect you with the right resources to help you cope with this challenge.

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Last Updated: Dec 5, 2018