The term “antisocial” has become synonymous with someone who prefers alone time over group events, but add “personality disorder” to the term, and you arrive at something totally different. Antisocial personality disorder is a serious, DSM-documented mental health condition that warrants a clear overview to understand the signs, symptoms, and treatment options.
What is Antisocial Personality Disorder?
Antisocial personality disorder is associated with manipulating, exploiting, or violating the rights of others. This behavior is often criminal, and it impacts approximately three percent of men and one percent of women. Those who suffer from this mental health disorder may appear charming on the outside, but they are likely irritable, aggressive, and irresponsible in private. As they are routinely manipulative, it may be difficult to tell if people with antisocial personality disorder are lying or telling the truth.
According to the Mayo Clinic, symptoms usually appear by age 15. They may include:
- Disregard for right and wrong
- Persistent lying or deceit to exploit others
- Being callous, cynical, and disrespectful of others
- Using charm or wit to manipulate others for personal gain or personal pleasure
- Arrogance, a sense of superiority, and being extremely opinionated
- Recurring problems with the law, including criminal behavior
- Repeatedly violating the rights of others through intimidation and dishonesty
- Impulsiveness or failure to plan ahead
- Hostility, significant irritability, agitation, aggression, or violence
- Lack of empathy for others and lack of remorse about harming others
Antisocial personality disorder is known as a Cluster B disorder, a group of disorders with an underlying foundation of unusual emotional behavior that disrupts relationships and leads to difficulty relating to others. Narcissistic personality disorder, borderline personality disorder, and histrionic personality disorder are also Cluster B disorders.
Causes of Antisocial Personality Disorder
Since personalities are complex and many factors contribute to their formation, the cause of antisocial personality is unknown. Men, overall, are at greater risk than women. The highest rate of antisocial personality disorder is found among males who abuse alcohol or drugs or who are in prisons or other forensic settings.
There are some factors that increase the likelihood of developing antisocial personality disorder, however. Diagnosis of a childhood conduct disorder or a family history of personality and mental health disorders have been linked to this condition. Being a victim of abuse or neglect in childhood, plus an unstable or violent family life, are also contributing factors.
A study published in the American Journal of Psychiatry suggests that early intervention can potentially mitigate some of these risk factors. The U.S. Fast Track Prevention Program included 900 six-year-old children whose parents and teachers had reported violent or disruptive behavior. One half received no intervention, while the other half received treatment over the course of 10 years focused on improving social, educational, and decision-making capabilities, teaching them how to build friendships and improve communications skills, while coaching their parents.
They monitored the children’s progress to the age of 25. 69% of the children in the control group developed an adult psychiatric disorder, while 59% of those who received treatment developed a psychiatric disorder. It’s a relatively small difference, but members of the intervention group were one-third less likely to have a criminal conviction for violence or drug-related crime. They were also happier and less prone to risky sexual behavior.
Why Antisocial Personality Disorder is Unique
While only a small percentage of the population, people with antisocial personality disorder often earn a level of notoriety based on their notorious criminal activity.
When serial killer Ted Bundy was on trial more than 30 years ago, he was interviewed by Hervey Cleckley. Cleckley, known as the “father of psychopathy,” diagnosed Bundy as a psychopath, which falls under the umbrella of antisocial personality disorder.
“There has long been a fascination with psychopaths. Many of the more popular fictional characters exemplify psychopathy,” psychology expert Thomas Widiger said. “These persons often exemplify true evil and one is drawn to view that, like one slows down to observe a traffic accident or enjoys watching a violent or horror movie.”
Still others suffer quietly, like Andy Brill in the United Kingdom. He was adopted at age two from an unstable home and was a victim of sexual abuse by a friend’s older brother from ages 7 to 10.
“During and after the sexual abuse, I became more aggressive and violent. As a child, anger seemed to be my only way to express how I felt, although looking back I have no memory of any feelings,” he wrote in his story for a United Kingdom-based mental health awareness organization.
Even after seeing a clinical psychologist as a teenager, he didn’t receive a diagnosis and went on to live a double life as a young professional and a criminal. Faced with potential prison time for his crimes, he sought help and received an antisocial personality disorder diagnosis. His psychiatrist and family have helped him navigate each day, and Brill insists that there are many others like him who are not violent and live normal lives.
Treatment for any mental health disorder is complex, but antisocial personality disorder is especially challenging. Those diagnosed with antisocial personality disorder do not believe they have a problem and rarely seek out treatment without a court mandate.
Psychotherapy is often the top treatment, whether it be cognitive therapy, which focuses on changing a person’s thinking, or behavioral therapy, which aims to change actual behavior. Since antisocial personality disorder has a direct impact on relationships, group and family therapy is also often helpful.
Medication isn’t available to treat antisocial personality disorder directly, but it can help with specific symptoms of the disorder, like mood swings, impulsivity, and aggression. Ultimately, the best treatment starts as early as possible, before misaligned thinking and behavior patterns are established.
Rethinking how we use the term “antisocial” in everyday conversations, coupled with more research, will be key to better understanding and treating this rare mental health disorder.
Speaking with a licensed therapist can be a great first step in determining if further help is needed or in confirming a diagnosis. Consider trying online therapy today, to get started.