Antisocial personality disorder (ASPD): definition and support

Understanding ASPD – exploring characteristics, causes and therapeutic approaches.

Call Us
Tap on a number to call
Enquire

Page medically reviewed by Dr Oluwagbenga Odeyemi (MBBS, MPH, MRCPsych), Consultant Psychiatrist at Priory Wellbeing Centre Birmingham, in April 2024.

Antisocial personality disorder (ASPD) is a condition that affects how people think, feel and behave. It's characterised by a pattern of behaviours that often break the rules and rights of others. People with ASPD might act impulsively, lie often, and show little concern for other people’s feelings.

Here, we explore what ASPD looks like, how it feels for people who are experiencing it, what causes it, and ways to manage it through therapy.

Common characteristics of ASPD

ASPD is a type of personality disorder that falls within the Cluster B category. Personality disorder clusters are categories of personality disorders that have been grouped together because they share similar symptoms and characteristics. It has a range of characteristics that can shape the behaviour and experiences of people affected by this condition.

People with ASPD will typically be manipulative, deceitful and reckless. They often engage in dangerous and sometimes illegal behaviours, which can result in them receiving criminal records. They repeatedly do things they know to be wrong and that other people find difficult to accept.

As with other types of personality disorder, ASPD can be thought of as being on a spectrum. This means that it can vary in severity, with some people only demonstrating occasionally bad or reckless behaviour, whereas others with this diagnosis repeatedly break the law, hurt other people, and engage in serious crimes on a regular basis.

  • Abuse substances, such as drugs and alcohol, which can lead to addiction
  • Struggle to meet their responsibilities when it comes to work, school and family
  • Not care about following rules or sticking to what society sees as right. This can lead to them breaking the law, and ignoring what’s right and wrong
  • Do or say things impulsively, without considering the consequences of their actions. This can lead to reckless and destructive behaviours, and poor decision making
  • Be aggressive, hostile, violent, confrontational and threatening towards other people
  • May treat other people cruelly or with indifference
  • Manipulate other people for their own personal gain, whether this is for financial, emotional or social reasons, or simply for their own enjoyment. They might tell lies to get what they want
  • Believe that they’re superior or more powerful than other people
  • Be skilled at lying and manipulating others to get what they want
  • Make other people upset or angry on purpose, and don’t appear to feel guilty or remorseful when their actions hurt others
  • Appear charming, even though this tends to be surface-level. They might use this superficial charm and charisma to take advantage of other people
  • Exude confidence and self-assurance, presenting themselves as capable and in control, even when their behaviour suggests otherwise

The signs of ASPD usually begin to become apparent in childhood or early adolescence. There’s thought to be a strong link between ASPD and conduct disorder. Conduct disorder is a childhood disorder that’s characterised by serious and persistent behavioural problems. Young people with conduct disorder might violate other people’s rights and engage in a range of antisocial and harmful behaviours, such as:

  • Deliberately hurting animals and other people
  • Bullying other children
  • Lying
  • Theft, arson and other criminal activities
  • Refusing to follow rules or obey authority figures

Many people with ASPD have a history of conduct disorder during childhood or adolescence. Not everyone with conduct disorder will go on to develop ASPD, but the presence of conduct disorder symptoms before the age of 15 can contribute to the likelihood of someone developing ASPD in adulthood.

How do people with ASPD feel?

People with ASPD often have a limited awareness of their personality disorder, if any at all. While some people might recognise that their behaviour is different from others, many might not consider their actions to beg problematic. This lack of insight can make it challenging for people with ASPD to get help or understand the impact of their behaviour on people around them.

Causes of antisocial personality disorder

There’s no single definitive cause of ASPD. However, there are some factors that might increase the likelihood of someone developing ASPD at some point in their lives. These include:

  • Genetics – some traits relating to ASPD, such as being impulsive and aggressive, can run in families, which can lead to people developing ASPD. This might be down to inheriting these traits, or being exposed to these behaviours as they were growing up
  • Childhood experiences – adverse childhood experiences, such as trauma, neglect or inconsistent parenting, can lead to people developing antisocial behaviours, which can contribute to ASPD. In addition, showing the symptoms of conduct disorder during childhood and adolescence has been linked to the development of ASPD
  • Social factors – social factors, such as being exposed to things like violence or drug use in the community, can also play a role in ASPD developing
  • Brain chemistry – it’s thought that people with ASPD may have an abnormal amount of the neurotransmitter, serotonin, in their brain, which may lead to antisocial behaviour

These factors all interact with each other in complex ways, and while they can increase the chances of someone developing ASPD, it’s important to understand that not everyone who experiences them will develop this personality disorder.

Management and treatment

People with ASPD may need support from loved ones to reach out for the support they need. This is because the very nature of ASPD might mean that these people don’t see anything wrong with their behaviours, which is why supportive family members and friends can play a crucial role in encouraging treatment-seeking behaviours. 

Despite the reluctance that people with ASPD may face when it comes to getting help, there are a number of approaches for managing ASPD.

Treatment and therapy for antisocial personality disorder might involve:

  • Psychotherapy – talking therapies, such as cognitive behavioural therapy (CBT) or dialectical behaviour therapy (DBT) can help people with ASPD to learn new coping strategies, develop empathy and improve impulse control
  • Family intervention – involving family members in therapy can help to improve communication, address relationship issues and provide support for the person with ASPD and their loved ones. It can also help the person with ASPD to see how their behaviours are affecting those closest to them
  • Social skills training – learning and practising social skills can help people with ASPD navigate interpersonal relationships and day-to-day interactions more effectively, and reduce conflict
  • Medication – while there aren’t any specific medications that have been approved to treat ASPD itself, medications such as mood stabilisers or antidepressants may be prescribed to manage any co-occurring symptoms of ASPD, such as impulsivity. They can also help to balance out levels of serotonin, which may reduce antisocial behaviours

ASPD is a lifelong condition and there’s no ‘cure’. However, early intervention and ongoing support can help people with ASPD to function more effectively in their daily lives.

Contact us to make an enquiry or for more information

Call Us
Tap on a number to call
Enquire