Antisocial personality disorder
Antisocial personality disorder is a type of personality disorder characterised by impulsive, irresponsible and often criminal behaviour. Someone with it will typically be manipulative, deceitful and reckless. Like other personality disorders, antisocial personality disorder is on a spectrum, and can range in severity. It’s more common in men than women.
Signs of antisocial personality disorder
A person with antisocial personality disorder may:
- exploit, manipulate or violate the rights of others
- lack concern, regret or remorse about other people's distress
- behave irresponsibly and show disregard for normal social behaviour
- have difficulty sustaining long-term relationships
- be unable to control their anger
- lack guilt, or not learn from their mistakes
- blame others for problems in their lives
- repeatedly break the law
A person with antisocial personality disorder will have a history of conduct disorder during childhood, such as:
- truancy (not going to school)
- delinquency (for example, committing crimes or substance misuse)
- other disruptive and aggressive behaviours
Further information is available at:
People who develop antisocial personality disorder
Antisocial personality disorder affects more men than women.
It's not known why some people develop antisocial personality disorder. But both genetics and traumatic childhood experiences, such as child abuse or neglect, are thought to play a role.
A person with antisocial personality disorder will have often grown up in difficult family circumstances. One or both parents may misuse alcohol, and parental conflict and harsh, inconsistent parenting are common.
As a result of these problems, social services may become involved with the child's care.
These types of problems in childhood will often lead to behavioural problems during adolescence and adulthood.
Effects of antisocial personality disorder
Criminal behaviour is a key feature of antisocial personality disorder, and there's a high risk that someone with the disorder will commit crimes and be imprisoned at some point in their life.
Men with the disorder have been found to be more likely than those without it to:
- misuse alcohol and drugs
- have an increased risk of dying prematurely as a result of reckless behaviour or attempting suicide
People with antisocial personality disorder are also more likely to have relationship problems during adulthood and be unemployed and homeless.
Diagnosing antisocial personality disorder
To be diagnosed with antisocial personality disorder, a person will usually have a history of conduct disorder before the age of 15.
Antisocial personality disorder is diagnosed after psychological assessment.
A diagnosis can only be made if the person is over 18 years old and at least three of the following criteria apply:
- repeatedly breaking the law
- repeatedly being deceitful
- being impulsive or incapable of planning ahead
- being irritable and aggressive
- having a reckless disregard for their safety or the safety of others
- being consistently irresponsible
- lack of remorse
These signs must not be part of a schizophrenic or manic episode. They must be part of the person's everyday personality.
This behaviour usually becomes most extreme during the late teens and early twenties. It may improve by the time the person reaches their 40s.
Treating antisocial personality disorder
Antisocial personality disorder was thought to be a lifelong disorder, but that's not always the case. It can sometimes be managed and treated.
Evidence suggests behaviour can improve over time with therapy, even if core characteristics such as lack of empathy are still there.
Potential treatments include:
- cognitive behavioural therapy (CBT)
- democratic therapeutic communities (DTC) - a type of social therapy that aims to address the person's risk of offending, as well as their emotional and psychological needs
- medication - there's little evidence to support the use of medication for treating antisocial personality disorder, although certain antipsychotic and antidepressant medications may be helpful in some cases
Although treatment is available, antisocial personality disorder is one of the most difficult types of personality disorders to treat.
A person with the disorder may be reluctant to seek treatment and only start therapy when ordered to do so by a court.
The recommended treatment for someone with antisocial personality disorder will depend on their circumstances, taking into account factors such as:
- age
- offending history
- any associated problems, such as alcohol or drug misuse
The person's family and friends will often play an active role in making decisions about their treatment and care. In some cases, substance misuse services and social care may also need to be involved.
Support
Ask your GP about support groups for personality disorders near you. You should also check what mental health services are currently available within your health and social care trust.
- Belfast Health and Social Care Trust - mental health
- Northern Health and Social Care Trust – mental health
- Western Health and Social Care Trust – mental health
- South Eastern Health and Social Care Trust - mental health
- Southern Health and Social Care Trust - mental health
More useful links
- Personality disorder
- How to use your health services
- Mind
- Royal College of Psychiatrists
- Minding your head
The information on this page has been adapted from original content from the NHS website.
For further information see terms and conditions.