From the Guidelines
Antisocial Personality Disorder (ASPD) is characterized by a pervasive pattern of disregard for and violation of the rights of others, often manifesting as deceitfulness, impulsivity, irritability, aggressiveness, and a lack of remorse. The manifestations of ASPD are complex and multifaceted, involving a range of behavioral and emotional disturbances. Key features include:
- A history of conduct disorder before age 15, with behaviors such as bullying, physical cruelty, theft, or serious rule violations
- A pattern of deceitfulness, manipulativeness, and impulsivity
- Irritability and aggressiveness, with a tendency to engage in physical fights or exhibit aggressive behavior
- Reckless disregard for safety, both for themselves and others
- Consistent irresponsibility, as evidenced by failure to sustain work or honor financial obligations
- Lack of remorse for harmful behaviors, and a tendency to rationalize or blame others for their actions Although the provided study 1 focuses on oppositional defiant disorder (ODD) rather than ASPD, it highlights the importance of distinguishing between different types of disruptive behavior disorders, and notes that ODD is generally considered a milder form of psychopathology compared to conduct disorder (CD) and ASPD. In terms of treatment, while there are no FDA-approved medications specifically for ASPD, psychotherapy approaches such as cognitive-behavioral therapy and contingency management may be effective in reducing symptoms and improving functioning. Medications may also be prescribed for co-occurring conditions such as depression, anxiety, or aggression. It is essential to note that early intervention is crucial in the treatment of ASPD, as the disorder becomes more difficult to treat once firmly established in adulthood.
From the Research
Manifestations of Antisocial Personality Disorder (ASPD)
The manifestations of Antisocial Personality Disorder (ASPD) include:
- Persistent rule-breaking, criminality, substance misuse, unemployment, homelessness, and relationship difficulties 2, 3
- Violation of others' rights, related to the concept of psychopathy 4
- Conduct disorder (CD) before 15 years, with evidence of higher developmental vulnerability to develop ASPD 4
- Poor mental health, criminality, substance use, and relationship difficulties 5
- Aggression, impulsivity, and lack of prosocial emotions 4, 5
Associated Features
Associated features of ASPD include:
- Substance use disorders, such as cocaine and opioid dependence 2, 3
- Alcohol dependency and misuse 2, 3
- Impulsive and aggressive behavior, including physical and verbal violence 6, 5
- Poor social functioning, including difficulties with employment, relationships, and housing 2, 3, 5
- High rates of comorbidity with other mental health disorders, such as attention-deficit/hyperactivity disorder (ADHD) 4
Impact on Daily Life
The impact of ASPD on daily life includes:
- Difficulty maintaining employment and stable relationships 2, 3
- Increased risk of substance misuse, aggression, and impulsivity 2, 4, 3
- Poor mental health, including anxiety, depression, and suicidal ideation 4, 5
- Increased risk of reconviction and reincarceration 6, 5
- Difficulty with social functioning, including problems with daily living skills and social interactions 2, 3, 5