Antisocial personality disorder: Causes, risk factors, & treatment options

Antisocial personality disorder can be a problematic mental health condition, both in its presenting symptoms and in how it’s discussed. In regard to matters of right and wrong, those with antisocial personality disorder may often choose to serve their best interests first, and the manipulative and antagonistic behavior they display toward others can be difficult to understand. 

But despite the fact that untreated adults with this personality disorder may display a complete lack of remorse for their actions, including for criminal behaviors, added stigmatization and demonization of this condition prevents the public from truly understanding its nature. For many individuals, sympathizable genetic, environmental, and familial factors in childhood and adolescence often contribute to their condition.  

Though the behaviors that comprise antisocial personality disorder are long-lasting, it’s treatable. And with rigorous talk therapy sessions, antisocial personality disorder symptoms can be minimized over time. 

 

What Is Antisocial Personality Disorder Like?

Someone with antisocial personality disorder who is not receiving treatment can be difficult, or (under the wrong circumstances) even dangerous to be around, particularly because (per the DSM-5 criteria) deceit and manipulation are central features to this disorder. These antisocial traits are often deeply ingrained; a part of their personality. 

It’s like few other disorders in this sense, as the following symptoms indicate sufferers may show: 

  • No regard for right and wrong.
  • Continuous lying and misleading others.
  • Callousness, pessimistic and disrespectful attitudes to others.
  • Use of charisma to manipulate others for personal gain or pleasure.
  • A sense of superiority.
  • Repeated problems with the law, including criminal behavior.
  • Continuous violation of the rights of other people.
  • Carelessness and lack of planning in everyday life.
  • Irritable and agitated demeanor.
  • Malice and violence toward others.
  • Lack of sympathy for others.
  • No guilt about hurting others.
  • Dangerous behavior without caring about the individual’s or other people’s safety.
  • Abusive or bad relationships.

For someone who has antisocial personality disorder, it may feel very natural to take advantage of others. Antisocial personality disorder might be useful for people in very high power positions, and mild features may actually be mildly advantageous for career growth. 

But less positively, individuals may also demonstrate a failure to conform to social norms in respect to lawful behaviors, and can end up in the corrections system. One of the challenges for those with this disorder and their loved ones is that the lack of remorse, of not understanding the consequences of their actions, or not caring, creates consistently irresponsible behavior and a disregard for the safety of others and themselves. 

What Causes Antisocial Personality Disorder?

The specific cause of antisocial personality disorder is unknown, but genetic and environmental factors are thought to play an important role. Genetic factors seem to be a cause because antisocial personality disorder is higher in individuals with close relatives who have antisocial personality disorder. 

Personality traits, such as those often seen in people with antisocial personality disorder, are primarily formed during childhood and 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 antisocial personality disorder include:

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

Antisocial personality disorder is more commonly seen to be associated with lower socioeconomic status, often because this puts them at greater risk of experiencing financial hardship, trauma, abuse, and more. In such intense situations, a child may learn that it is advantageous for their survival to be controlling and to take from those who can be easily exploited.

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Children with Symptoms of Antisocial Personality Disorder: What Does It Look Like?

Children, or minors below the age of 18, cannot be diagnosed with antisocial personality disorder. If someone below the age of 18 shows signs of antisocial disorder, this can be documented, but the leading diagnosis is often conduct disorder, as only adults 18 years and older can be diagnosed with antisocial personality disorder. 

Children with similar symptoms are typically diagnosed with conduct disorder, and with another disorder, because the aggression or other behaviors may overlap. Some of these 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

Some children with conduct disorder may have neurological differences, including:

  • Verbal comprehension skills and IQ levels—weak language processing, poor auditory memory.
  • Impaired social judgment.

As stated previously, conduct disorder often develops into antisocial personality disorder, and these individuals still may show the same kind of verbal listening and speaking skill deficits in adulthood. The lack of verbal understanding may be the factor for what appears to be impulsiveness. 

Antisocial Personality Disorder in Women

Antisocial personality disorder is likely underdiagnosed in women, but currently, women suffer this disorder less frequently. The symptoms may not look different, but their severity may be less than seen in a male client. A disregard for the safety of oneself and others could be a possible sign, and women with antisocial personality disorder may get into a lot of fights, both physically and verbally. 

What Are the Consequences for People with Antisocial Personality Disorder Who Don’t Receive Treatment?

People with antisocial personality disorder risk numerous, severe consequences for untreated symptoms, including:

  • Abuse of a spouse or a child.
  • Neglect of a child.
  • Alcohol or substance abuse.
  • A jail or prison sentence.
  • Homicidal or suicidal behavior.
  • Developing another mental condition such as depression or anxiety.
  • Suffering from low social and economic status.
  • Homelessness.
  • Participation in a gang.
  • Death, often due to violence.

People with antisocial personality disorder 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. Typically considered lifelong, some of the symptoms such as criminal behavior and destructiveness, may lessen over time. 

Treatment of Antisocial Personality Disorder

People with antisocial personality disorder may be reluctant to seek treatment, and in this case, a close friend or family member should offer their encouragement, and the earlier, the better. If an individual does seek treatment, it’s usually because legal problems have disrupted their life, and they don’t have the ability to cope or deal with the stress and fallout. 

Of the known methods, dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT) has proven to be successful for people with antisocial personality disorder. It’s effective for individuals who regularly attend and are involved in the sessions and complete all work that’s assigned outside of office visits. 

People with antisocial personality disorder 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.  DBT assists by focusing on dialectical thinking (looking at more than one side of a problem) and can help the clients engage in more flexible thinking patterns. CBT helps them to understand how many problems are self-created and how his distorted perceptions hinder him from viewing himself the way other people do and thus changing. 

A therapist who is familiar with personality disorders and can anticipate the emotions of the person experiencing antisocial personality symptoms is ideal.

Table of contents

What Is Antisocial Personality Disorder Like?

What Causes Antisocial Personality Disorder?

Children with Symptoms of Antisocial Personality Disorder: What Does It Look Like?

What Are the Consequences for People with Antisocial Personality Disorder Who Don’t Receive Treatment?

Treatment of Antisocial Personality Disorder

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Kate Hanselman, PMHNP in New Haven, CT

Kate Hanselman, PMHNP-BC

Kate Hanselman is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC). She specializes in family conflict, transgender issues, grief, sexual orientation issues, trauma, PTSD, anxiety, behavioral issues, and women’s issues.

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Alexandra Cromer, LPC

Alexandra “Alex” Cromer is a Licensed Professional Counselor (LPC) who has 4 years of experience partnering with adults, families, adolescents, and couples seeking help with depression, anxiety, eating disorders, and trauma-related disorders.

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Jason Crosby

Jason Crosby is a Senior Copywriter at Thriveworks. He received his BA in English Writing from Montana State University with a minor in English Literature. Previously, Jason was a freelance writer for publications based in Seattle, WA, and Austin, TX.

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  • (June, 2012).DSM-IV and DSM-5 Criteria for the Personality Disorders. American Psychiatric Association. Retrieved May, 2023
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  • Pisano, Muratori, Gorga, Levantini, Luliano, Catone, Coppola, Milone, Masi, (September,2017).Conduct disorders and psychopathy in children and adolescents: aetiology, clinical presentation and treatment strategies of callous-unemotional traits. PubMed Central. Retrieved May, 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5607565/
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  • Alegria, Petry, Shang, Blanco, Skodol, Grant, Hasin ( April,2013). Sex Differences in Antisocial Personality Disorder: Results From the National Epidemiological Survey on Alcohol and Related Conditions. PubMed Central. Retrieved May 2023 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767421/

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  • Originally published June 19th, 2017

    Author: VT

  • Author: Jason Crosby

    Expert Author: Kate Hanselman, PMHNP

    Clinical Review: Alexandra Cromer, LPC

    Changes: Updated by a Thriveworks clinician in collaboration with our editorial team.

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