Antisocial personality disorder, sometimes called sociopathy, is a mental health illness in which a person demonstrates no discernment between right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to intentionally make others angry or upset and manipulate or treat others with cruelty or indifference. They do not feel remorse or regret their behavior.
People with antisocial personality disorder often break the law and become criminals. They may lie, behave violently or impulsively, and have problems with illicit drug and alcohol use. They have difficulty consistently fulfilling family, work or academic responsibilities.
Symptoms of antisocial personality disorder repeatedly include the following:
Ignore what is right and what is wrong.
Telling lies to take advantage of others.
Being insensitive or not respecting other people.
Using charm or wit to manipulate others for personal benefit or pleasure.
Having a sense of superiority and being extremely stubborn.
Being in trouble with the law, including criminal behavior.
Being hostile, aggressive, violent or threatening towards others.
Don’t feel guilty for hurting others.
Doing dangerous things without taking into account your own safety or that of others.
Being irresponsible and not meeting work or financial obligations.
Adults with antisocial personality disorder usually show symptoms of a conduct disorder before age 15. Symptoms of a conduct disorder include severe and persistent behavior problems, such as:
Aggression towards people and animals
Destruction of property
Lies and dishonesty
Serious rule violation
Antisocial personality disorder is considered a lifelong condition. But, in some people, certain symptoms (particularly destructive and criminal behavior) may decrease over time. It is not clear whether this decline is the result of the effect that aging has on the mind and body, a greater awareness of the life consequences of antisocial behavior, or other factors.
People with antisocial personality disorder are unlikely to seek help on their own. If you suspect that a friend or family member may have this condition, you can gently suggest that they seek help from a mental health care provider and offer your assistance in finding them.
Certain factors appear to increase the risk of antisocial personality disorder, such as:
Diagnosis of a childhood behavioral disorder
Family history of antisocial personality disorder, other personality disorders, or mental illness.
Abuse or neglect during childhood
Unstable or violent family life during childhood
Men are at greater risk of having antisocial personality disorder than women.
People with this disorder are unlikely to feel that they need help. However, they may seek help from their primary healthcare provider for other symptoms, such as depression, anxiety, or angry outbursts. They may also seek treatment for problems with alcohol or illicit drugs.
People with antisocial personality disorder may not provide an accurate description of their symptoms. A key factor in the diagnosis is the way the person relates to others. With proper authorization, family and friends can provide helpful information.
After a medical exam to rule out other illnesses, the health care provider may make a referral to a mental health care provider with experience in diagnosing and treating antisocial personality disorder.
The diagnosis of antisocial personality disorder is typically based on the following:
A mental health exam that includes talking about your thoughts, feelings, relationships, behavior patterns, and family history
Medical and personal history
Antisocial personality disorder is usually not diagnosed before age 18. However, there may be some symptoms during childhood or preadolescence.
Early identification of this disorder can help improve long-term outcomes.
Antisocial personality disorder is difficult to treat, but in some people, treatment and close long-term monitoring can help. Look for medical and mental health care providers with experience treating antisocial personality disorder.
Treatment depends on each person’s situation, their willingness to participate in treatment, and the severity of symptoms.
Talk therapy, also called psychotherapy, is sometimes used to treat antisocial personality disorder. Therapy may include, for example, anger and violence management, treatment for alcohol or illicit drug problems, and treatment for other mental illnesses.
However, talk therapy is not always effective, especially when the symptoms are severe and the person cannot admit that they are contributing to serious problems.
The Food and Drug Administration (FDA) has not approved specific medications to treat antisocial personality disorder. Health care providers may prescribe medications for conditions that sometimes occur along with antisocial personality disorder, such as anxiety or depression, or for symptoms of aggression.