People with Antisocial Personality Disorder (APD) disregard right and wrong and are often manipulative and antagonistic to others. Adults with the disorder may display a complete lack of remorse for their actions, including criminal behavior. People with APD don’t have a problem with bending or breaking laws for their own needs. They may pretend they feel bad for breaking laws if they think it will benefit them.

People with APD may have an exaggerated opinion of themselves, such as feeling they’re too good for regular work. Often egotistical, these people may put on a charming act and appear articulate by using words they think will impress other people who don’t know much about a particular topic.

The behaviors that comprise APD are long-lasting, and its beginnings can be found in adolescence or early adulthood. A diagnosis of APD is not given to people under the age of 18 unless there’s a history of symptoms of conduct disorder prior to the age of 15.

With an estimated three percent of men and one percent of women with APD, it’s been found that there are higher percentages of the disorder in people in prison.

What Causes Antisocial Personality Disorder?

The specific cause of APD is unknown, but genetic and environmental factors may be a part of its development. Genetic factors seem to be a cause because APD is higher in individuals with an antisocial parent. An individual who has a parent with antisocial tendencies as a role model is more apt to develop them. Certain situations in life are thought to trigger the development of APD.

Personality encompasses thoughts, emotions and behaviors–the way people view and relate to the world and how they see themselves. Personality is formed during childhood and is shaped through the experiences people have in their lives, as well as inherited tendencies and environmental factors. Some of the risk factors that may increase the chance of developing APD include:

  • Diagnosis of a childhood conduct disorder.
  • Family with a history of APD, other types of personality disorders or mental illness.
  • Abused or neglected as a child.
  • Unpredictable, violent or tumultuous family life during childhood.

Children with Symptoms of APD

Children with conduct disorder are often diagnosed with another disorder, because the traits of aggression or their behaviors may overlap. Some of the signs and symptoms include the following:

  • Aggressive to people and animals
  • Destruction of property
  • Lying
  • Bullying
  • Assaults
  • Fights
  • Arson
  • Shoplifting
  • Behavior problems at school
  • Severe violation of rules
  • Truancy

Neuropsychological deals with the relationship between the brain and behavior, and some of children may have deficiencies in the following areas:

  • Verbal comprehension skills and IQ levels—weak language processing, poor auditory memory.
  • Impaired social judgment.
  • Conduct disorder often develops into APD, and these individuals all show the same kind of verbal skill deficits. The lack of verbal understanding may be the factor for what appears to be impulsiveness in these children. They may act on their own will when they aren’t able to comprehend what is going on.

Adult Antisocial Behavior ( V71.01 Z72.811)

Adults with APD usually display symptoms of conduct disorder prior to the age of 15. The following behaviors are displayed in adults with APD:

  • No regard for right and wrong.
  • Continuous lying and misleading others.
  • Callousness, pessimistic and disrespectful to others.
  • Using charisma to manipulate others for personal gain or pleasure.
  • Very opinionated.
  • Sense of superiority.
  • Repeated problems with the law, including criminal behavior.
  • Continually violating the rights of other people by intimidating them.
  • Carelessness and the lack of planning.
  • Irritable and agitated.
  • Mean and violent toward others.
  • Lack of sympathy for others.
  • No guilt about hurting others.
  • Taking risks that are unnecessary.
  • Dangerous behavior without caring about the individual’s or other people’s safety.
  • Abusive or bad relationships.
  • Doesn’t think about negative outcomes of behavior and doesn’t learn from them.
  • Continuously irresponsible; failure to fulfill assignments at work or with financial commitments.
  • Unethical and immoral.

Consequences for People with Antisocial Personality Disorder

People with APD—and others–risk numerous, severe consequences, including:

  • Abuse of spouse or child.
  • Neglect of child.
  • Alcohol or substance abuse.
  • Jail or prison sentence.
  • Homicidal or suicidal behaviors.
  • Having other mental disorders like depression or anxiety.
  • Low social and economic status.
  • Homelessness.
  • Participating in a gang.
  • Death, often because of violence.

Treatment of Antisocial Personality Disorder

People with APD have behaviors that extend to their personal and social lives, leading to a great amount of distress and problems with relationships, at work and in other areas. Considered lifelong, some of the symptoms of APD, such as criminal behavior and destructiveness, may lessen over time. However, it isn’t clear if these behaviors lessen because of aging or if the person is more aware of the consequences.

It’s most likely that people with APD will only seek treatment for the disorder if they’re encouraged by family members or somebody close. If an individual does seek treatment, it’s usually because problems have disrupted his life, and he doesn’t have the ability to cope or deal with the stress.

Cognitive Behavioral Therapy (CBT) has proven to be successful for people with APD. It’s effective for the individual who regularly attends and is involved in the sessions and completes work that’s assigned outside of the office visits. Individuals who use therapy as a means to avoid a jail term are not trying to improve their behavior and, instead, are trying to get out of the consequences of their behavior. People with APD tend to blame other people, have a low threshold for frustration and don’t usually have trusting relationships with others, making it difficult to work with them. In addition, they may have little motivation to improve.

CBT helps the patient understand how he creates his problems and how his distorted perceptions hinder him from viewing himself the way other people do. Therapists who are familiar with APD and can anticipate the emotions of the person are ideal.

To read about the Causes, Symptoms, Treatment of Conduct Disorder DSM-5 312.89 (F91.9), click here!