Antisocial personality disorder, sometimes called sociopathy, is a mental disorder in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior.
Individuals with antisocial personality disorder often violate the law, becoming criminals. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. Because of these characteristics, people with this disorder typically can't fulfill responsibilities related to family, work or school.
Antisocial personality disorder signs and symptoms may include:
Adults with antisocial personality disorder typically show symptoms of conduct disorder before the age of 15. Signs and symptoms of conduct disorder include serious, persistent behavior problems, such as:
Although antisocial personality disorder is considered lifelong, in some people, certain symptoms — particularly destructive and criminal behavior — may decrease over time. But it's not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.
People with antisocial personality disorder are unlikely to seek help on their own. If you suspect that a friend or family member may have the disorder, you might gently suggest that the person seek help from a mental health professional and offer to help them find one.
Personality is the combination of thoughts, emotions and behaviors that makes everyone unique. It's the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood, shaped through an interaction of inherited tendencies and environmental factors.
The exact cause of antisocial personality disorder isn't known, but:
Certain factors seem to increase the risk of developing antisocial personality disorder, such as:
Men are at greater risk of having antisocial personality disorder than women are.
Complications, consequences and problems of antisocial personality disorder may include, for example:
There's no sure way to prevent antisocial personality disorder from developing in those at risk. Because antisocial behavior is thought to have its roots in childhood, parents, teachers and pediatricians may be able to spot early warning signs. It may help to try to identify those most at risk, such as children who show signs of conduct disorder, and then offer early intervention.
People with antisocial personality disorder are unlikely to believe they need help. However, they may seek help from their primary care provider because of other symptoms such as depression, anxiety or angry outbursts or for treatment of substance misuse.
People with antisocial personality disorder may not provide an accurate account of signs and symptoms. A key factor in diagnosis is how the affected person relates to others. With permission, family and friends may be able to provide helpful information.
After a medical evaluation to help rule out other medical conditions, the primary care provider may make a referral to a mental health professional for further evaluation.
Diagnosis of antisocial personality disorder is typically based on:
Though typically antisocial personality disorder isn't diagnosed before age 18, some signs and symptoms may occur in childhood or the early teen years. Usually there is evidence of conduct disorder symptoms before age 15.
Identifying antisocial personality disorder early may help improve long-term outcomes.
Antisocial personality disorder is difficult to treat, but for some people, treatment and close follow-up over the long term may be beneficial. Look for medical and mental health professionals with experience in treating antisocial personality disorder.
Treatment depends on each person's particular situation, their willingness to participate in treatment and the severity of symptoms.
Psychotherapy, also called talk therapy, is sometimes used to treat antisocial personality disorder. Therapy may include, for example, anger and violence management, treatment for alcohol or substance misuse, and treatment for other mental health conditions.
But psychotherapy is not always effective, especially if symptoms are severe and the person can't admit that he or she contributes to serious problems.
There are no medications specifically approved by the Food and Drug Administration to treat antisocial personality disorder. Doctors may prescribe medications for conditions sometimes associated with antisocial personality disorder, such as anxiety or depression, or for symptoms of aggression. Certain drugs are usually prescribed cautiously because they have the potential for misuse.
People with antisocial personality disorder often act out and make other people miserable — with no feeling of remorse. If you have a loved one with antisocial personality disorder, it's critical that you also get help for yourself.
A mental health professional can teach you skills to learn how to set boundaries and help protect yourself from the aggression, violence and anger common to antisocial personality disorder. He or she can also recommend strategies for coping.
Seek a mental health professional who has training and experience in managing antisocial personality disorder. Ask your loved one's treatment team for a referral. They may also be able to recommend support groups for families and friends affected by antisocial personality disorder.
If a medical evaluation rules out physical causes for your behavior, your primary care provider may make a referral to a mental health professional, such as a psychiatrist or psychologist.
Take a family member or friend along to your appointment, if possible. With your permission, someone who has known you for a long time may be able to answer questions or share information with the doctor that you don't think to bring up.
Before your appointment, make a list of:
Some basic questions to ask your doctor include:
Don't hesitate to ask any other questions during your appointment.
Your doctor is likely to ask you a number of questions, such as:
Be ready to answer these questions to reserve time to go over points you want to spend more time on.