From the Guidelines
Antisocial Personality Disorder (ASPD) is a serious mental health condition characterized by a pervasive pattern of disregard for the rights of others, beginning in childhood or adolescence and continuing into adulthood, with key diagnostic features including failure to conform to social norms, deceitfulness, impulsivity, irritability and aggressiveness, reckless disregard for safety, consistent irresponsibility, and lack of remorse. Key points to consider in ASPD include:
- Failure to conform to social norms, as evidenced by repeatedly performing acts that are grounds for arrest 1
- Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure 1
- Impulsivity, irritability, and aggressiveness, as shown by repeated physical fights or assaults 1
- Reckless disregard for safety, consistent irresponsibility, and lack of remorse, as demonstrated by a failure to sustain consistent work behavior or honor monetary obligations 1
- The diagnosis of ASPD requires individuals to be at least 18 years old and have shown evidence of conduct disorder before age 15 1
- Treatment of ASPD is challenging, as individuals rarely seek help voluntarily and often lack insight into their behavior, but psychotherapy approaches such as cognitive-behavioral therapy, mentalization-based therapy, and schema therapy may be effective in managing symptoms 1
- No medications are specifically approved for ASPD, but pharmacotherapy may target specific symptoms like aggression or impulsivity, or comorbid conditions 1
- Prognosis varies, with some evidence suggesting symptoms may diminish with age, particularly the more overt antisocial behaviors, and early intervention for conduct problems in childhood offers the best opportunity for preventing the full development of this persistent and difficult-to-treat personality disorder 1
From the Research
Antisocial Personality Disorder Key Points
- Antisocial Personality Disorder is characterized by a pattern of disregard for others' rights, lack of empathy, and impulsivity 2
- Selective serotonin reuptake inhibitors (SSRIs) have been used to treat various disorders, including depression, anxiety, and impulse control disorders 3, 4
- SSRIs, such as fluoxetine, sertraline, paroxetine, fluvoxamine, and citalopram, have been shown to be effective in treating mood and other disorders 4
- The efficacy of SSRIs in treating Antisocial Personality Disorder is not directly addressed in the provided studies, but they have been used to treat impulsivity and aggression in personality disorders 2
- Fluoxetine has been shown to be effective in reducing impulsivity and aggression in patients with personality disorders, particularly those with the l/l genotype of the 5-HTTLPR polymorphism 2
- SSRIs have also been used to treat substance use disorders, including opioid, alcohol, cocaine, cannabis, and nicotine use disorders, and have been shown to reduce depressive and anxiety symptoms, as well as facilitate abstinence 5
- The use of SSRIs in combination with psychotherapy, such as cognitive behavioral therapy (CBT), may be effective in preventing recurrence of major depressive disorder 6