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Antisocial personality disorder - NHS

Personality disorders are mental health conditions that affect how someone thinks, perceives, feels or relates to others.

Antisocial personality disorder is a particularly challenging type of personality disorder characterised by impulsive, irresponsible and often criminal behaviour.

Someone with antisocial personality disorder will typically be manipulative, deceitful and reckless, and will not care for other people's feelings.

Like other types of personality disorder, antisocial personality disorder is on a spectrum, which means it can range in severity from occasional bad behaviour to repeatedly breaking the law and committing serious crimes.

Psychopaths are considered to have a severe form of antisocial personality disorder.

The Mind website has more information about signs of antisocial personality disorder

Find out more about personality disorders

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), and other disruptive and aggressive behaviours.

Who develops 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 difficulties 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 antisocial personality disorder have been found to be 3 to 5 times more likely than women to misuse alcohol and drugs than those without the disorder. They also 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 personality disorder before the age of 15.

Antisocial personality disorder is diagnosed after rigorous detailed psychological assessment.

A diagnosis can only be made if the person is aged 18 years or older and at least 3 of the following criteria behaviours 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 are not part of a schizophrenic or manic episode – they're part of a person's everyday personality and behaviour.

This behaviour usually becomes most extreme and challenging during the late teens and early 20s. It may improve by the time the person reaches their 40s.

Treating antisocial personality disorder

In the past, antisocial personality disorder was thought to be a lifelong disorder, but that's not always the case and 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 remain. 

But antisocial personality disorder is one of the most difficult types of personality disorders to treat.

A person with antisocial personality disorder may also be reluctant to seek treatment and may 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 and whether there are 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.

Sometimes, substance misuse services and social care may also need to be involved.

National Institute for Health and Care Excellence (NICE): management and prevention of antisocial personality disorder

Talking therapies

Cognitive behavioural therapy (CBT) is sometimes used to treat antisocial personality disorder.

It's a talking therapy that aims to help a person manage their problems by changing the way they think and behave.

Mentalisation-based therapy (MBT) is another type of talking therapy that's becoming more popular in the treatment of antisocial personality disorder.

The therapist will encourage the person to consider the way they think and how their mental state affects their behaviour.

Democratic therapeutic communities (DTC)

Evidence suggests community-based programmes can be an effective long-term treatment method for people with antisocial personality disorder, and is becoming increasingly popular in prisons.

DTC is a type of social therapy that aims to address the person's risk of offending, as well as their emotional and psychological needs.

It's based around large and small therapy groups and focuses on community issues, creating an environment where both staff and prisoners contribute to the decisions of the community.

There may also be opportunities for educational and vocational work.

The recommended length of treatment is 18 months, as there needs to be enough time for a person to make changes and put new skills into practice.

Self-motivation is another important factor for acceptance on to this type of scheme. For example, the person must be willing to work as part of a community, participate in groups, and be subject to the democratic process.

Read more about DTC and working with offenders with personality disorder on GOV.UK

Medicine

There's little evidence to support the use of medicine for treating antisocial personality disorder, but certain antipsychotic and antidepressant medicines may be helpful in some instances.

Carbamazepine and lithium may help control symptoms such as aggression and impulsive behaviour, and a class of antidepressant called selective serotonin reuptake inhibitors (SSRIs) may improve anger and general personality disorder symptoms.

Further information

  • Personality disorders

Antisocial personality disorder: MedlinePlus Medical Encyclopedia

URL of this page: //medlineplus. gov/ency/article/000921.htm

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Antisocial personality disorder is a mental condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights of others without any remorse. This behavior may cause problems in relationships or at work and is often criminal.

The cause of this disorder is unknown. A person's genes and other factors, such as child abuse, may contribute to developing this condition. People with an antisocial or alcoholic parent are at increased risk. Far more men than women are affected. The condition is common among people who are in prison.

Setting fires and animal cruelty during childhood are often seen in the development of antisocial personality.

Some doctors believe that psychopathic personality (psychopathy) is the same disorder. Others believe that psychopathic personality is a similar, but a more severe disorder.

A person with antisocial personality disorder may:

  • Be able to act witty and charming
  • Be good at flattery and manipulating other people's emotions
  • Break the law repeatedly
  • Disregard the safety of self and others
  • Have problems with substance abuse
  • Lie, steal, and fight often
  • Not show guilt or remorse
  • Often be angry or arrogant

Antisocial personality disorder is diagnosed based on a psychological evaluation. The health care provider will consider how long-lived and how severe the person's symptoms are. To be diagnosed with antisocial personality disorder, a person must have had emotional and behavioral problems (conduct disorder) during childhood.

Antisocial personality disorder is one of the hardest personality disorders to treat. People with this condition usually don't seek treatment on their own. They may only start therapy when required to by a court.

Behavioral treatments, such as those that reward appropriate behavior and have negative consequences for illegal behavior, may work in some people. Talk therapy may also help.

People with an antisocial personality who have other disorders, such as a mood or substance use disorder, are often treated for those problems as well.

Symptoms tend to peak during the late teenage years and early 20s. They sometimes improve on their own by the time a person is in their 40s.

Complications may include imprisonment, drug use, alcohol use, violence, and suicide.

See a provider or a mental health professional if you or someone you know has symptoms of antisocial personality disorder.

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

Always take suicide attempts and threats seriously.

Sociopathic personality; Sociopathy; Personality disorder - antisocial

American Psychiatric Association. Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013;659-663.

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA, Hopwood CJ. Personality and personality disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 39.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Antisocial personality, sociopath (GDP) - Psychologos

The book "Introduction to Psychology". Authors - R.L. Atkinson, R.S. Atkinson, E.E. Smith, D.J. Boehm, S. Nolen-Hoeksema. Under the general editorship of V.P. Zinchenko. 15th international edition, St. Petersburg, Prime Eurosign, 2007.

Article from chapter 15. Psychology of anomalies

Film "Sherlock. A Study in Pink"

Antisocial individuals have little to no sense of responsibility, morality, or interest in others. Their behavior is almost entirely determined by their own needs. In other words, they have no conscience. Whereas the average person imagines at an early age that behavior has certain limits and that pleasure must sometimes be delayed in consideration of the needs of others, antisocial persons rarely take into account the desires of others but their own. They behave impulsively, strive for immediate satisfaction of their needs and cannot tolerate frustration. Antisocial behavior has a number of causes, including membership in a criminal gang or criminal subculture, a need for attention and elevated status, a loss of contact with reality, and an inability to control impulses. Most teenage criminals and adult criminals have some interest in other people (family or gang members) and some moral code (don't betray a friend). In contrast, the antisocial person has no feelings for anyone but himself, and feels no guilt or remorse, no matter how much suffering he has caused others. Other characteristics of an antisocial personality (a sociopath for short) include an unusual ease with which to lie, a need to agitate or arouse oneself without concern for possible injury, and an inability to change one's behavior as a result of punishment. Such individuals are often attractive, intelligent, charming people, very easy to manipulate others, in short - good masters of deception. Their competent and sincere appearance allows them to get a promising job, but they have little ability to stay on it. Their restlessness and impulsiveness soon leads to a failure that reveals their true nature; they accumulate debts, abandon their families, swindle the firm's money, or commit crimes. Once caught, they speak of their remorse so convincingly that they are often rescinded and given another chance. But the anti-social personality rarely lives up to his claims; what she said has nothing to do with her deeds and feelings.

Two characteristics of an antisocial personality are considered indicative:

  • a) lack of empathy and interest in others;
  • b) lack of feelings of shame or guilt, inability to repent of one's actions, no matter how reprehensible they were (Hare, 1980).

On the nature of the antisocial personality

What factors contribute to the development of the antisocial personality? Current research focuses on biological determinants, parent-child relationships, and thinking styles that contribute to antisocial behavior.

Biological factors

There is a lot of evidence in favor of the genetic causes of antisocial behavior, especially criminal. Twin studies show that identical twins have twice the concordance for criminal behavior than related twins, indicating that such behavior is partially heritable (Rutter et al. , 1990). Adoption studies show that adopted sons' criminal cases are more similar to those of their biological fathers than to their adoptive fathers (Cloninger & Gottesman, 1987; Mednick et al. 1987).

Many studies have addressed the hypothesis that antisocial individuals have low excitability, which causes them to seek stimulation and the sensations that impulsive and dangerous actions bring to them (see Mogey, 1993). For example, one study compared two groups of male juvenile delinquents selected from a juvenile court detention cell. One group included adolescents with a diagnosis of an antisocial personality, and the other group included adolescents with adjustment reactions to negative life events. The experimenters measured their galvanic skin response (GSR) during stress (see Chapter 11). Fake electrodes were attached to both legs of the subjects and they were told that after 10 minutes they would receive a very strong but safe electric shock. The subjects were able to see a large clock, so they knew exactly when it was supposed to happen. In fact, there was no electric shock. At rest and in response to visual or auditory stimuli, there were no differences in GSR between these groups. However, within 10 minutes of waiting for an electric shock in the group with adaptive reactions, significantly more tension was manifested than in the group with antisocial behavior. At the moment when, according to the clock readings, an electric shock was supposed to take place, in the majority of subjects with adaptive reactions, GSR indicated a sharp increase in anxiety. None of the antisocial subjects had such a reaction (Lippert & Senter, 1966). Low excitability in response to disturbing stimuli can prevent antisocial individuals from learning the lesson of the punishment they have received, since they will not, like most people, experience it as a nuisance and will not worry about foreseeing it again.

Social factors

Although children who develop antisocial behavior may have a biological predisposition to it, studies show that they are also exposed to an environment conducive to antisocial behavior (Rutter, Qumton & Hill, 1990; Cadoret & Cain, 1980; Cloninger & Gottesman, 1987).

The quality of parental care received by a child who is prone to hyperactivity and behavioral problems greatly affects whether he develops a full-blown antisocial personality (Loeber, 1990). One of the best indicators of children's behavioral problems is the level of parental supervision: children who are often left unsupervised or poorly supervised for a long time are much more likely to develop a pattern of criminal behavior. A closely related variable is parental indifference: children whose parents do not participate in their daily lives (for example, do not know who their children are friends with) are more likely to become antisocial. When parents interact with children with behavioral problems, the interaction is usually characterized by hostility, physical abuse, and ridicule (Patterson, DeBaryshe & Ramsey, 1989). It seems that in such families, parents often ignore the child or are not at home, but, nevertheless, when the child commits an offense or otherwise angers the parent, he is given a severe spanking. Confirmation that these parental shortcomings are the cause and not just a correlate of children's behavioral problems is the fact that interventions aimed at overcoming these shortcomings can successfully deal with children's behavioral problems (Lochman et al, 1991). Biological and familial factors contributing to behavioral problems often overlap. Children with behavioral problems often have neuropsychological problems resulting from maternal drug use, poor intrauterine nutrition, pre- and post-natal toxicity, abuse, birth complications, and low birth weight (Moffitt, 1993). Such children are more irritable, impulsive, clumsy, overactive, inattentive, and learn material more slowly than their peers. This makes parental care more difficult for them, and they are at increased risk of abuse and neglect by their parents. In turn, the parents of these children are most likely teenagers or have psychological problems themselves that contribute to ineffective or rude, ineffective parenting. Therefore, in addition to having a biological predisposition to destructive antisocial behavior, these children experience parental treatment that encourages such behavior. In a study of 536 boys (Moffitt, 1990) found that those who had both neurophysiological deficiencies and an unfavorable home environment scored 4 times higher on the aggression scale than boys who had neither neuropsychological deficiencies nor an unfavorable home environment.

Personal factors

​ Children with behavioral disorders process information about social interactions in such a way that they develop aggressive reactions to these interactions (Crick & Dodge, 1994). They expect other children to be aggressive towards them, and interpret their actions based on this assumption, instead of relying on signs of a real situation. In addition, children with behavioral disorders tend to consider any negative action directed at them by their peers (for example, if someone took their favorite pencil) is not accidental, but deliberate. When deciding what action to take in response to a perceived peer provocation, a child with a behavioral disorder will choose from a very limited set of responses, usually including aggression. If such a child is forced to choose something other than aggression, he makes chaotic and ineffective reactions and, as a rule, considers everything except aggression to be useless and unattractive. Children who think of social interaction in this way tend to exhibit aggressive behavior towards others. Retribution may await them: other children beat them, parents and teachers punish them, and they are perceived negatively by society. These responses, in turn, reinforce their belief that the world is against them and cause them to misinterpret the future actions of those around them. This can create a vicious circle of interactions that support and inspire the child's aggressive and antisocial behavior.

Borderlines

Over the past two decades, borderline personality disorder has been the subject of considerable attention in popular print, clinical and research publications in psychology. The diagnostic category for borderline personality disorder was only included in the third edition of the DSM in 1980. However, clinicians have long used the term "borderline" to refer to people who appear to be teetering on the edge between severe neurotic manifestations (such as emotional instability) and bouts of psychosis (Millon, 1981). See →

Anti-social personalities: who are they? | Psychology

Intriguing?

Yes, that's exactly what the heroes of this article do: they create a legend around themselves. And science - personal psychology - as always, spoils all the romance, uniting such extraordinary people into one group. So, meet...

Anti-social personalities

The main thing to remember about these people is that they tend to go beyond, break the rules. Any rules. This ability helps them a lot to earn money, create something new, promote a product or service, boldly go where others would be afraid or ashamed.

But the same trait manifests itself in the violation of other norms and rules. For example:

1. In compliance with the agreements.

These people have very, VERY big problems with this. Antisocials are afraid to fall into the "trap" of obligations, to bear responsibility for something. Therefore, they either try not to make any promises (they remain silent, give vague answers, cunning, dodge), or do not comply with the agreements, or fulfill their promises exactly as long as it is beneficial for them.

2. In observance of the rules of the road.

Anti-social drivers can be seen from a kilometer away. They drive either dangerously or in such a way that they interfere with everyone around: they drive a car in the style of “turn signals for cowards”, rush through the city at breakneck speed, cut, park where they see fit.
Photo: Depositphotos

3. In adultery.

Such people often cheat on their partners or deceive them in other ways. In the relations of anti-socials there is always an element of use. For them, relations based on mutual interest and respect are impossible: there is always some kind of deceit, inequality of partners, attempts to cheat and manipulate.

4. In devotion to friends and partners.

Such individuals make friends and cooperate solely for their own benefit. As long as this benefit exists, the anti-social will be there, but as soon as he no longer needs you, he will immediately evaporate, betray or set you up.

5. Being ethical.

An anti-social person is not embarrassed that he is deceiving someone, that his actions can be harmful or dangerous to others. For example, such a person can easily advertise himself as an expert in any field, without having the necessary education.

6. In violation of the law.

As you may have guessed, antisocial individuals often become criminals.
Photo: Depositphotos

7. In violation of the psychological boundaries of other people.

Such people can read other people's correspondence, put a person in an awkward position, enter without knocking, disrupt plans, force others to do what they do not want.

In addition to being prone to breaking rules, nature tends to endow anti-social people with intelligence. With such abilities, they can be successful businessmen, and swindlers, and excellent PR people, and gigolos, and journalists, and thieves, and policemen. In short, this talent can be used in various areas, not necessarily destructive. After all, in order to catch criminals, you need to be able to think like a criminal ...

How to recognize an antisocial

1. They are very charismatic, it is easy to fall in love with them. Both their behavior and appearance are designed specifically to shock others, to be bright, unforgettable, to seem successful and extraordinary person. Photo: Depositphotos

2. There are many individuals with antisocial traits among wealthy people, but not because “money spoils”, but because their ability to profit is very developed. To take from the world what he wants, to get acquainted with influential people, to acquire the “necessary” connections - they know how to do this very well. They are attracted to power and everything that can elevate them above others - money, connections, expensive things.

3. They often retaliate more than they were offended (or maybe they didn't even have time to offend them, but they are already taking revenge). If the wife does not serve dinner on time, the anti-social husband may hit her. And he will be sure that he is right: he was offended! He does not consider it necessary to correlate the inflicted insult and the scale of his own revenge. The logic is like the thinking of a criminal: "I killed him because he looked askance at me. "

4. Antisocials are risk-averse: they seem to have a poorly developed self-preservation instinct. They are often partial to gambling, drugs and alcohol, adventure, dangerous hobbies. From the outside, it looks like they either do not value their lives, or consider themselves invulnerable. And everyone around is suffering or in danger. Photo: Depositphotos

  • Guess what kind of people most often buy sports convertibles to drive on our roads for two whole warm days a year?
  • Who on the first date shocks, engraves in memory and sinks into the soul?
  • Who will sit without a stable income, dressed from head to toe in obscenely expensive clothes?
  • What kind of lady would hang herself on someone else's husband in front of his wife?

Yes, yes, all this is done by individuals with antisocial traits.

On the other hand…

Antisocial traits in and of themselves are not unambiguously harmful. They are bad when there are too many of them. They also have good things: