Antisocial personality causes are complex, but may be associated with environmental factors as well as genetics.
When you hear the words “antisocial personality disorder,” you might think of someone who is uncomfortable around others or someone who prefers to be alone.
But this is not the case. Instead, antisocial personality disorder (ASPD) is a complex mental health condition characterized by disruptive behavior that can negatively affect a person’s life and those around them.
Not much is known about what causes someone to develop this mental health condition or what treatments work best.
People with antisocial personality disorder (ASPD) often experience a pattern of manipulating, disregarding, or deceiving others. They may also have difficulty feeling remorse or guilt for these actions.
Someone with this condition may not respect the rights or boundaries of others, which can sometimes lead to an increased risk of engaging in unlawful behaviors.
Symptoms of ASPD can look different from person to person and may include:
- using manipulation tactics to control others
- the tendency to be charming, witty, or arrogant
- patterns of irritability, anger, or impulsivity
- legal troubles, financial problems, or employment difficulties
- a disregard for safety
- engaging in violent or aggressive behavior
- a lack of empathy, guilt, or remorse for their actions
- blaming others for their actions or minimizing the impact of their behavior
Diagnosis
It is estimated that
Criteria for an ASPD diagnosis includes:
- a previous diagnosis of conduct disorder before age 15
- the presence of at least three symptoms of ASPD since the age of 15
- symptoms that occur outside of any coexisting schizophrenia or bipolar disorder-related episodes
Cluster B personality disorders
In the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), ASPD falls under the umbrella of cluster B personality disorders, which also includes:
The cause of ASPD is not well understood. Researchers and medical professionals debate whether this condition is a stand-alone diagnosis. Some say ASPD significantly overlaps with psychopathy, while others believe that psychopathy could be a more severe subtype of ASPD.
Despite this, researchers have several theories on what may cause ASPD, including:
- genetic components
- environmental factors
- childhood trauma
Genetic risk factors
According to a 2019 study, genetic factors play a role in 38-69% of ASPD diagnoses.
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- Dopamine system: regulates mood, motivation, and reward
- Serotonin system: responsible for impulse control, sleep, and regulating feelings and behavior
- Epinephrine/norepinephrine system: controls nervous system activity, such as the fight or flight response
Environmental factors
In addition to genetic factors, 2021 research published suggests environmental factors can play a significant role in the development of ASPD.
According to this research, many environmental risk factors for ASPD are linked to experiences in pregnancy and early childhood:
- Risk factors related to pregnancy and infancy: smoking or substance misuse during pregnancy, experiencing stress and anxiety during pregnancy, complications during delivery, infant malnutrition, heavy metal exposure
- Childhood trauma: negative parent-child interactions, verbal and physical abuse, inconsistent or coercive discipline
- Social risk factors: growing up in an under-resourced community, exposure to peer groups that engage in anti-social-like behavior, experiencing social violence
Related conditions
Antisocial personality disorder can commonly co-occurs with certain related conditions, including:
- substance use disorders
- behavioral addictions (such as gambling)
- depression
- anger management issues
Treatment plans for ASPD may be more impactful if they also address common related conditions in addition to antisocial behaviors.
Antisocial personality disorder is a treatable mental health condition. But according to a 2020 review, researchers are currently unclear on which treatments work best.
Sometimes, ASPD can be challenging to treat due to the nature of the disorder. People with ASPD may not believe they are experiencing behavioral difficulties or acknowledge the need for intervention.
Like all mental health conditions, it takes time. You may have to try several strategies before discovering what works best for you. Working with your doctor and therapist can guide you in the right direction.
According to a 2015 study, the earlier treatment begins, the better. Researchers found that early intervention resulted in 59% of participants displaying ASPD-related symptoms at age 25, versus 69% of participants who did not receive treatment.
Scientists also believe that early intervention may help lessen ASPD behaviors in a young person at risk. But these treatment programs are most effective if they include the person’s family and social group.
Therapy
Therapy is often the first line of treatment after an ASPD diagnosis:
- Cognitive behavioral therapy (CBT): Psychotherapy, focusing on changing thinking patterns and behavior, may be the most effective form of therapy used for ASPD.
- The Incredible Years Program: Therapeutic intervention, with a focus on developing positive relationships between children and their caregivers, can prevent and treat behavior problems which may lead to ASPD.
- Multisystemic Therapy (MST): Group therapy for families to address serious ASPD with criminal or illegal behavior in adolescents between 12 and 17.
- Functional Family Therapy (FFT): Family-based therapy for at-risk youth between the ages 11 and 18 with a focus on harm reduction and increasing protective factors within the family.
Medications
Researchers currently do not have enough evidence that medications work effectively for treating ASPD. More often, medications are prescribed to treat underlying conditions co-occurring with ASPD.
Typically, these prescribed medications are used to treat aggression in people with ASPD, including:
Behaviors associated with ASPD can negatively impact the person with the disorder and the people around them. However, with the right intervention, ASPD is treatable.
Some studies suggest ASPD has a genetic cause, but environmental factors from childhood experiences may also play a major role in its development.
Identifying young people who may be at risk can be a beneficial first step in preventing full development of ASPD symptoms.
Early intervention addressing environmental factors may help reduce the risk of a person with ASPD engaging in behaviors that may harm themselves or others.
If you’re ready to get help but don’t know where to start, you can check out our find a therapist tool for guidance.