From the Guidelines
Antisocial Personality Disorder (ASPD) is characterized by problems in functioning of aspects of the self and/or interpersonal dysfunction, specifically dissociality, which is one of the maladaptive personality traits in the ICD-11 personality disorder diagnosis. According to the ICD-11, the diagnosis of personality disorders has shifted from a categorical approach to a more dimensional approach, with a single personality disorder diagnosis that can be specified by the presence of one or multiple maladaptive personality traits, including dissociality 1. This change reflects the complexity of personality disorders and the need for a more nuanced approach to diagnosis and treatment.
Key Characteristics of ASPD
- Problems in functioning of aspects of the self, such as identity
- Interpersonal dysfunction, such as managing conflict in relationships
- Presence of maladaptive personality traits, including dissociality
- Severity of the disorder can be classified as mild, moderate, or severe
Diagnosis and Treatment
The diagnosis of ASPD is based on the presence of specific symptoms and behaviors, including a lack of empathy, manipulative behavior, and a history of legal problems or aggressive behavior. Treatment typically involves psychotherapy, particularly cognitive behavioral therapy, as there are no medications specifically approved for ASPD 1. However, medications may be prescribed to address specific symptoms like aggression, anxiety, or depression.
Prognosis and Management
The prognosis for ASPD varies, with some individuals showing improvement in their 40s as impulsivity naturally decreases with age. Long-term management requires consistent therapy and sometimes involves legal interventions. It is essential to note that the exact cause of ASPD is unknown, but it likely involves a combination of genetic factors, brain chemistry abnormalities, and environmental influences such as childhood trauma or abuse 1.
From the Research
Definition and Characteristics of Antisocial Personality Disorder (ASPD)
- Antisocial Personality Disorder (ASPD) is a common condition associated with interpersonal and social violence, and current treatments are often unsatisfactory 2.
- ASPD is characterized by lifelong or recurrent behavioral problems that begin in childhood or early adolescence 3.
- Individuals with ASPD often have a history of harsh early childhoods that impaired their ability to trust in adulthood 4.
Causes and Risk Factors of ASPD
- The development of ASPD is influenced by psychosocial, biological, and cultural factors 4.
- Genetic factors play a significant role in the development of ASPD, with high heritability and linkages to genes associated with crucial brain regions 3.
- Brain imaging studies have linked cortical dysfunction to antisocial behavior in crucial brain regions 3.
Diagnosis and Treatment of ASPD
- Diagnosis of ASPD is based on the individual's history, as there are no diagnostic tests 3.
- Treatment of ASPD is often challenging, and various approaches have been attempted with varying success, including cognitive-behavioral therapy and mentalization-based therapy models 5, 3.
- Medication may be targeted at the individual's aggression and irritability, but a more rational approach is to target co-occurring disorders 3.
Outcomes and Prognosis of ASPD
- ASPD is a chronic and lifelong condition that typically lessens in severity with advancing age 3.
- Individuals with ASPD are at risk of poor mental health, criminality, substance use, and relationship difficulties 5.
- Antisocial individuals may age faster than non-antisocial peers, according to recent research 3.