Ongoing Clinical Trials for Antisocial Personality Disorder
Yes, there are ongoing clinical trials for antisocial personality disorder (ASPD), with the most significant being the Mentalization for Offending Adult Males (MOAM) trial, which has recently completed follow-up and demonstrated promising results for mentalization-based treatment (MBT-ASPD) in reducing aggressive behaviors in male offenders with ASPD 1, 2.
Current Trial Landscape
The MOAM trial represents the most robust recent evidence for ASPD treatment interventions. This multicentre randomized controlled trial enrolled 313 male participants with ASPD who were under probation supervision across 13 sites in England and Wales 2. The trial:
- Completed enrollment between January 2016 and August 2018
- Finished all pre-planned follow-ups through 24 months post-randomization
- Published primary results in 2025, showing significant reductions in aggression (adjusted mean difference of -73.5 on the OAS-M scale, p<0.0001) with a medium-to-large effect size of 0.74 2
Treatment Protocol Tested
The MBT-ASPD intervention consisted of:
- 12 months of weekly 75-minute group therapy sessions
- Monthly 50-minute individual sessions
- Focus on improving mentalization capacity (understanding mental states of self and others)
- Delivered alongside standard probation supervision 1, 2
Economic Evaluation
A parallel cost-effectiveness analysis demonstrated that MBT-ASPD plus probation as usual was associated with:
- Lower overall costs compared to probation alone
- Reduced aggression, with each unit reduction in aggression yielding approximately £93 in cost savings
- Cost-effectiveness across all willingness-to-pay thresholds for quality-adjusted life years (QALYs) 3
Additional Research Activity
Beyond the MOAM trial, there is emerging pilot work examining psychoeducational interventions for antisocial personality traits in prison settings. A 2026 pilot study with 26 male prisoners showed that group-based psychoeducational interventions led to significant decreases in aggression scores, particularly among those with lower rule-breaking tendencies 4.
Critical Context
ASPD remains severely under-researched despite its substantial health and social burden. The field has historically been characterized by therapeutic nihilism, with no established treatment of choice 1, 2. The MOAM trial represents a watershed moment, providing the first definitive evidence from a large-scale RCT that psychological intervention can meaningfully reduce aggressive behaviors in this population.
The trial's completion and positive findings suggest that future research will likely focus on:
- Generalizability to other forensic and non-forensic ASPD populations
- Sustainability of treatment gains beyond 24 months
- Adaptation for female offenders and community samples
- Implementation strategies for wider dissemination 2
For clinicians seeking to refer patients to ASPD trials, the MOAM trial has completed recruitment, but its success will likely catalyze new studies examining MBT-ASPD in different settings and populations.