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Antisocial personality disorder

Definition

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 associated with criminal behavior.

Causes

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 health care providers believe that psychopathic personality (psychopathy) is the same disorder. Others believe that psychopathic personality is a similar, but a more severe disorder.

Symptoms

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

Exams and Tests

Antisocial personality disorder is diagnosed based on a psychological evaluation. The 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.

Treatment

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.

Outlook (Prognosis)

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.

Possible Complications

Complications may include imprisonment, misuse of prescription or over-the-counter medicines, illegal drugs, alcohol, violence, and suicide.

When to Contact a Medical Professional

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.

References

American Psychiatric Association. Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

Blais MA, Rivas-Vazquez R, Ruchensky JR, Stein MB. Personality and personality disorders. In: Stern TA, Wilens TE, Fava M, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 3rd ed. Philadelphia, PA: Elsevier; 2025:chap 37.

Substance Abuse and Mental Health Services Administration website. Antisocial personality disorder. www.samhsa.gov/mental-health/antisocial-personality-disorder. Last updated April 24, 2023. Accessed September 1, 2024

Review Date: 7/17/2024

Reviewed 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.