Antisocial Personality Disorder

About Antisocial Personality Disorder

Antisocial personality disorder is a pervasive pattern of disregard for and violation of the rights of others, occurring since age 15. Diagnosis requires that the person is at least 18 years old and that there is evidence of conduct disorder beginning before age 15. Features include repeated unlawful behavior, deceitfulness, impulsivity, irritability and aggressiveness, reckless disregard for the safety of self or others, consistent irresponsibility in work or finances, and lack of remorse. It is diagnosed far more often in men, commonly co occurs with substance use disorders, and is associated with higher rates of imprisonment, injury and early death. The concept overlaps with psychopathy, a related construct that emphasizes emotional features such as shallow affect and lack of empathy and is assessed with tools such as the Hare Psychopathy Checklist, though the two are not identical. Genetic factors, childhood adversity and early behavioral difficulties all contribute to risk. Some antisocial behaviors tend to decrease with age, particularly from middle adulthood. Treatment is difficult and research is limited; approaches that show some promise include cognitive behavioral programs targeting problem behaviors, treatment of co occurring substance use, and structured programs in forensic settings. Prevention efforts focus on early intervention for childhood conduct problems, such as parent management training.