Antisocial Personality Disorder

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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• A personality disorder (PD) is a persistent pattern of thoughts, feelings, and behaviors that is significantly different from what is considered normal within the person's own culture.
• Personality disorders are grouped into clusters A, B, and C based on the dominating symptoms.
• Antisocial personality disorder is specifically a pervasive pattern of disregarding and violating the rights of others and may include symptoms such as breaking laws, frequent lying, starting fights, lack of guilt and taking personal responsibility, and the presence of irritability and impulsivity.
• Psychopathy is considered to be a more severe form of antisocial personality disorder. Specifically, in order to be considered a psychopath, an individual must experience a lack of remorse or guilt about their actions in addition to demonstrating antisocial behaviors.
• Psychopaths tend to be highly suspicious or paranoid, even in comparison to individuals with antisocial personality disorder, which tends to lead the psychopathic person to interpret all aggressive behaviors toward them as being arbitrary and unfair.
• Antisocial personality disorder is likely the result of a combination of biologic/genetic and environmental factors.
• Some theories about the biological risk factors for antisocial personality disorder include dysfunction of certain genes, hormones, or parts of the brain.
• Diagnoses often associated with antisocial personality disorder include substance abuse, attention deficit hyperactivity disorder (ADHD), and reading disorders.
• Theories regarding the life experiences that put people at risk for antisocial personality disorder include a history of childhood physical, sexual, or emotional abuse; neglect, deprivation, or abandonment; associating with peers who engage in antisocial behavior; or having a parent who is either antisocial or alcoholic.
• Since there is no specific definitive test that can accurately assess the presence of antisocial personality disorder, health-care professionals conduct a mental-health interview that looks for the presence of antisocial symptoms. If the cultural context of the symptoms is not considered, antisocial personality disorder is often falsely diagnosed as being present.
• Research indicates ethnic minorities tend to be falsely diagnosed as having antisocial personality disorder, inappropriately resulting in less treatment and more punishment for those individuals.
• Although antisocial personality disorder can be quite resistant to treatment, the most effective interventions tend to be a combination of firm but fair programming that emphasizes teaching the antisocial personality disorder individuals skills that can be used to live independently and productively within the rules and limits of society.
• While medications do not directly treat the behaviors that characterize antisocial personality disorder, they can be useful in addressing conditions like depression, anxiety, and mood swings that co-occur with this condition.
• If untreated, people with antisocial personality disorder are at risk for developing or worsening a myriad of other mental disorders. Antisocial personality disorder individuals are also at risk for self-mutilation or dying from homicide or suicide.
• Many people with antisocial personality disorder experience a remission of symptoms by the time they reach 50 years of age.