Antisocial personality disorder, sometimes called sociopathy, is a mental health condition 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 purposely make others angry or upset and manipulate or treat others harshly or with cruel indifference. They lack remorse or do not regret their behavior.
People 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. They have difficulty consistently meeting responsibilities related to family, work or school.
Symptoms of antisocial personality disorder include repeatedly:
Adults with antisocial personality disorder usually show symptoms of conduct disorder before the age of 15. Symptoms of conduct disorder include serious, ongoing behavior problems, such as:
Antisocial personality disorder is considered a lifelong condition. But in some people, certain symptoms ― particularly destructive and criminal behavior ― may decrease over time. It's not clear whether this decrease is a result of the effect aging has on their mind and body, an increased awareness of the impact that antisocial behavior has had on their life, or other factors.
People with antisocial personality disorder are not likely to seek help on their own. If you suspect that a friend or family member may have the condition, you might gently suggest that the person seek help from a mental health provider 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. It's likely shaped by inherited genes as well as life situations and experiences.
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 and problems resulting from antisocial personality disorder may include:
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 see 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 not likely to believe they need help. But they may seek help from their primary health care provider because of other symptoms such as depression, anxiety or angry outbursts. Or they may seek treatment for problems with alcohol or drug use.
People with antisocial personality disorder may not give an accurate description of their symptoms. A key factor in diagnosis is how the person relates to others. With permission, family and friends may be able to give helpful information.
After a medical exam to help rule out other medical conditions, the health care provider may make a referral to a mental health provider with experience in diagnosing and treating antisocial personality disorder.
Diagnosis of antisocial personality disorder is usually based on:
Antisocial personality disorder usually isn't diagnosed before age 18. But some symptoms may occur in childhood or the early teen years.
Identifying antisocial personality disorder early may help improve long-term outcomes.
Antisocial personality disorder is challenging to treat, but for some people, treatment and close follow-up over the long term may help. Look for medical and mental health providers with experience in treating antisocial personality disorder.
Treatment depends on each person's situation, their willingness to participate in treatment and the severity of their symptoms.
Talk therapy, also called psychotherapy, is sometimes used to treat antisocial personality disorder. Therapy may include, for example, anger and violence management, treatment for problems with alcohol or drugs, and treatment for other mental health conditions.
But talk therapy is not always effective, especially if symptoms are severe and the person can't admit that they contribute to serious problems.
There are no medicines specifically approved by the Food and Drug Administration (FDA) to treat antisocial personality disorder. Health care providers may prescribe medicines for conditions that sometimes occur along with antisocial personality disorder, such as anxiety or depression, or for symptoms of aggression.
People with antisocial personality disorder often act out and cause others to suffer — with limited remorse. If you have a loved one with antisocial personality disorder, it's critical that you also get help for yourself.
A mental health provider 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. The provider also can recommend strategies for coping.
Look for a mental health provider who has training and experience in managing antisocial personality disorder. Ask your loved one's health care provider for a referral. The provider may be able to recommend support groups for families and friends affected by antisocial personality disorder.
If a medical exam rules out physical causes for the behavior, the primary health care provider can make a referral to a mental health provider, 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 provider that you don't think to bring up.
Before your appointment, make a list of:
Some basic questions to ask include:
Feel free to ask other questions during your appointment.
Your mental health provider is likely to ask you some questions, such as:
Be ready to answer questions so that you'll have time to talk about what's most important to you.