Understanding Antisocial Personality Disorder

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Antisocial personality disorder (ASPD) is a frequently misunderstood mental health condition. People who have this disorder can be helped with treatment, but they are unlikely to seek professional care on their own. Learning some basic facts about ASPD can help you identify warning signs in loved ones and connect them with appropriate therapeutic support.

What is Antisocial Personality Disorder?

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes 10 personality disorders, organized into three clusters.

Antisocial personality disorder is included in Cluster B, along with borderline, histrionic, and narcissistic personality disorders. The DSM-5 explains this grouping by noting that people who have these disorders typically act in a “dramatic, emotional, or erratic” manner.

Referring specifically to antisocial personality disorder, the DSM-5 describes this condition as “a pervasive pattern of disregard for, and violation of, the rights of others.” Though people are not typically diagnosed with ASPD until adulthood, most will have begun to exhibit symptoms as children or adolescents.

Experts believe that genetics play a significant role in determining a person’s risk for developing ASPD. Environmental factors such as having a history of adverse childhood experiences or developing either conduct disorder or ADHD at a young age can also increase the likelihood that someone will be diagnosed with antisocial personality disorder later in life.

Research indicates that the prevalence of ASPD may be as high as 4% of the general population (including 6% of men and 2% of women).

Levels of Antisocial Personality Disorder 

The impact that ASPD has on a person’s life can vary from one individual to the next. Here are examples of the two extremes on this spectrum:

High-Functioning Antisocial Personality Disorder

Someone who has high-functioning antisocial personality disorder may be viewed as driven, focused, charming, and persuasive. They may excel in careers that value these qualities, achieve financial success, and even get married and start a family. However, unless they get appropriate care, they will continue to be a manipulative and deceitful person who has little to no actual empathy for others.

Low-Functioning Antisocial Personality Disorder

A person with low-functioning ASPD will be unable to mask their symptoms and proclivities in order to achieve the outward trappings of success. They may struggle to keep a job for very long, and they will be unlikely to maintain even the appearance of a healthy relationship.

Is Someone With Antisocial Personality Disorder a Sociopath?

The word “sociopath” appears often in articles about antisocial personality disorder. Some sources even use this term as a synonym for ASPD. However, sociopath and sociopathy are not clinical terms, nor are they commonly used by mental health professionals. 

Some people continue to use sociopath and psychopath (another outdated non-clinical term) as informal negative descriptors of highly unpleasant people, but for clinical purposes it’s best to stay with ASPD.

Signs & Symptoms of Antisocial Personality Disorder

The following signs and symptoms may indicate that an individual has antisocial personality disorder:

  • They frequently engage in behaviors that could result in their arrest, such as destroying property or harassing other people.
  • They often lie to or otherwise deceive people, either for profit or simply because they enjoy doing so.
  • Their employment history includes several instances of quitting or being fired due to impulsive or irresponsible behavior. 
  • They rarely plan ahead, instead preferring to act with little regard for consequences or negative outcomes.
  • They have a pattern of financial malfeasance, which may include refusing to pay back loans or failing to make child support payments. 
  • They have a history of often getting into fights or physically attacking other people.
  • They demonstrate little concern for their own safety or for the safety of others, which may manifest as reckless driving, substance abuse, unsafe sex, and child neglect.
  • They show little to no remorse for having harmed or mistreated other people.


Important note: The only way to be certain that someone has ASPD (or any other mental health concern, for that matter) is for them to be assessed and diagnosed by a qualified mental health professional.

If someone that you care about has been exhibiting the signs and symptoms listed in this section, the best way to help them is to encourage them to consult with their doctor or schedule an assessment.

Difference Between Antisocial Personality Disorder vs. Borderline Personality Disorder

As we noted earlier in this post, antisocial personality disorder and borderline personality disorder (BPD) are both Cluster B personality disorders. 

This means that people who have these conditions may share certain characteristics, such as impulsivity and a pattern of unsuccessful relationships. Also, both ASPD and BPD are unfortunately linked with an elevated risk of early death.

However, there are a number of important differences between antisocial personality disorder and borderline personality disorder. For example:

  • People who have BPD often swing between idolizing and devaluing their partners (and their relationships). Individuals with ASPD consistently place little to no value on other people.
  • People with borderline personality disorder can feel shame or guilt related to their behaviors. Those with ASPD are highly unlikely to either feel or express these types of emotions.
  • Individuals with BPD are more prone to being victimized by others, while people with antisocial personality disorder are more likely to manipulate or take advantage of others.
  • According to the DSM-5, about 75% of people who are diagnosed with BPD are female, while the majority of those who are diagnosed with ASPD are male.

Can Antisocial Personality Disorder Be Treated?

Antisocial personality disorder can be treated, but the nature of this condition means that many people who have ASPD see no need to seek professional help. When a person with ASPD does agree to enter treatment, their care may include a variety of elements, including both medication and therapy.

Types of Treatment

There are currently no medications that treat antisocial personality disorder specifically. However, medication can be valuable for people who also have anxiety, depression, bipolar disorder, or another co-occurring mental health concern.

Psychotherapy (talk therapy) is typically the most common type of treatment for ASPD:

  • Cognitive behavioral therapy (CBT) is frequently employed, as this modality is designed to help people adopt healthier thought and behavior patterns. 
  • If a person’s ASPD symptoms are related to a history of untreated trauma, services such as EMDR therapy can be helpful. 
  • Therapy sessions that focus on anger management may also be beneficial.


Since many people with ASPD also struggle with addictions to alcohol or other drugs, appropriate mental health services to help patients end their substance abuse can also be extremely important.

Contact Montare at the Canyon About Our Personality Disorder Treatment Center

If someone in your life has been exhibiting the signs of ASPD or another personality disorder, Montare at the Canyon is here to help. Our personality disorder treatment center in Los Angeles, California, offers evidence-based services and close personal support at the inpatient, partial hospitalization, and intensive outpatient levels. 

With the care and guidance of our team of dedicated treatment professionals, your loved one can make sustained progress toward a healthier future. To learn more or to schedule a free assessment, please visit our Contact page or call us today.