Antisocial Personality Disorder

Antisocial personality disorder is a complex mental health condition that impacts a person’s ability to form healthy relationships and function within societal norms.

Antisocial personality disorder can be described as a mental health condition in which individuals ignore or violate the rights and feelings of others. This behavior starts already early in life, in childhood or during teenage years, and continues into adulthood. The condition is also known by other terms, some of which were popularized by media, such as psychopathy or sociopathy. 

Dishonesty and manipulation are the key traits of this condition. Because of this, it is important to consider the affected person’s intention and gather information from people who know the person more intimately, or even know about their condition.

Symptoms of Antisocial Personality Disorder

To diagnose the condition, the individual must be at least 18 years old. They must also show symptoms of conduct disorder (a disorder in which a person violates the rights of others and breaks societal rules) before the age of 15.

In adulthood, individuals suffering from antisocial personality disorder often ignore social norms and laws. They may engage in acts such as: 

• Destroying property
• Harassing other people
• Stealing
• Pursuing illegal activities
• Disregarding the rights, wishes, and feelings of others
• Deception
• Manipulation for personal gain
• Lying frequently

Moreover, they may also act on impulse, making decisions without planning or thinking about the possible consequences. This impulsiveness can often lead to unexpected job changes or relationship issues. 

Recklessness is another important trait of antisocial personality disorder. People with the condition often don’t care about their safety or the safety of others and may, for example, drive under the influence of alcohol, engage in risky sexual behaviors, or substance abuse. 

People with antisocial personality disorder often display aggressive traits, frequently getting into physical confrontations or committing violent acts, such as domestic abuse. 

Furthermore, individuals with antisocial personality disorder are also extremely irresponsible. This is often visible in behaviors such as:

• Not showing up for work
• Long periods of unemployment
• Quitting work
• Financial irresponsibility (neglecting child support, not paying debts, etc.)

However, lack of remorse is another crucial trait. They may not care about it, or they may make excuses for, hurting, mistreating, or stealing from others. They often blame the victim, saying it is their fault that something happened to them. These individuals also often try to downplay the harm they caused or show indifference to it, rarely apologizing or trying to make things right. They may hold a mindset that everyone is out for themselves and that one must do whatever it takes to avoid being taken advantage of.

Features that Support a Diagnosis of Antisocial Personality Disorder

People suffering from antisocial personality disorder often struggle to understand or care about the feelings of others. They may appear cold, disrespectful, or dismissive of other people’s emotions or suffering. They may also have an inflated sense of self-importance, viewing normal jobs or daily tasks as being beneath them. Because of this, they can also appear overly confident or arrogant, often trying to impress others with their skills or knowledge. 

They can also be irresponsible as parents, neglecting their children’s basic needs, such as proper nutrition or hygiene, and leaving their children dependent on others for shelter or food when they are absent.

People with antisocial personality disorder may also experience feelings of unease or dissatisfaction, including complaints about feeling tense, unable to handle boredom, or feeling depressed. They often struggle with issues such as: 

• Anxiety
• Depression
• Substance abuse
• Physical health issues with or without a clear medical cause (somatic symptom disorder)
• Gambling addiction

Importantly, they also show traits that are often found in other personality disorders, especially borderline personality disorder, histrionic, and narcissistic personality disorder.

Prevalence of Antisocial Personality Disorder

The 12-month prevalence of antisocial personality disorder ranges from 0.2% to 3.3%. The disorder is more common in populations facing challenging socioeconomic conditions, like poverty, or sociocultural factors, such as migration. 

However, the highest rates are found among the most severe cases of men with alcohol use disorder and in settings such as substance abuse clinics, prisons, or other forensic environments. According to a 2013 article, for instance, 47% of men and 21% of women in prison suffer from antisocial personality disorder. Interestingly, because of this, the article explains that the condition may also have significant costs for the criminal justice and healthcare systems. 

Progression of Antisocial Personality Disorder

Antisocial personality disorder usually follows a long-lasting, chronic course. However, the symptoms may lessen or even show signs of remission (gradual decline) as the individual ages, most often by the age of 40. This remission is most visible in the decline of criminal activities and antisocial behaviors such as substance abuse. However, a diagnosis of the disorder cannot be made before the age of 18.

The Impact of Antisocial Personality Disorder

As mentioned, much of the prison population suffers from antisocial personality disorder. Because of this, antisocial personality disorder is associated with criminal behavior. A paper from 2008 states that individuals diagnosed with antisocial personality disorder are more likely to engage in repeated criminal activities and commit multiple types of crimes, such as theft and violent acts. Crucially, compared to people without the disorder, individuals with antisocial personality disorder were found to practice criminal behavior over a longer period, in some cases even for decades. Since antisocial personality disorder is also linked to substance abuse, the paper explains that individuals with the condition may also often engage in drug-related crimes. 

Similarly, another article published in Social Psychiatry and Psychiatric Epidemiology emphasizes the serious consequences of antisocial personality disorder. As with the previous paper, this article also states that individuals with antisocial personality disorder are more likely to engage in criminal behavior such as theft, violence, or substance abuse. The article associates antisocial personality disorder with detrimental life outcomes such as unemployment, homelessness, and even a higher possibility of unnatural death, including violent accidents or incidents. 

Risk Factors for Antisocial Personality Disorder

Genetic factors play a vital role in antisocial personality disorder. The condition is more common among close biological relatives of those with the disorder than in the general population.

Adoption studies show that both genetic and environmental factors contribute to the risk of developing antisocial personality disorder. Both biological and adopted children of parents with the disorder have a higher risk of developing it. While adopted children tend to resemble their biological parents more, the adoptive family environment also influences the risk of developing personality disorders and related mental health issues.

However, many studies emphasize that many of the risk factors associated with antisocial personality disorder begin in childhood. A study from 2001 that explores these childhood risk factors includes:

• Attention deficit hyperactivity disorder (ADHD) (characterized by hyperactivity, impulsivity, and attention problems)
• Impulsivity
• Aggression
• Difficult temperaments
• Academic problems 

The study also emphasizes family environment, such as family conflict, neglect, or exposure to violence, as significant risk factors for the development of antisocial personality disorder. Additionally, children who are excluded by their social group may turn to antisocial groups. 

Culture and Antisocial Personality Disorder

Antisocial personality disorder is often linked to lower socioeconomic status and urban environments. However, it is important to mention that the diagnosis of the disorder is difficult to apply in environments where survival strategies are necessary because of difficult circumstances. Because of this, when the condition is being diagnosed, it is important to consider the individual’s social and economic circumstances.

A paper from 1997, for example, highlights the important role of socioeconomic factors in the development of antisocial personality disorder. The article explains that people suffering from antisocial personality disorder often grow up in communities with low socioeconomic status. They often experience poverty and inadequate access to education and resources. This and other negative social experiences contribute to the individual learning antisocial behaviors. 

Gender and Antisocial Personality Disorder

Antisocial personality disorder is more often diagnosed in men than in women. According to a 2008 article, men diagnosed with antisocial personality disorder often commit more violent crimes, while women with antisocial personality disorder are more likely to engage in nonviolent actions such as manipulation, self-harm, or property crimes. Women with antisocial personality disorder are also more likely to be diagnosed with other mental health conditions, such as anxiety, depression, and substance abuse. Women are also more likely to get divorced or face unemployment issues. The article states that, although fewer women are diagnosed with antisocial personality disorder, they tend to have experienced more severe challenges in life, such as childhood abuse. 

Guide for Living Near or with Someone with Antisocial Personality Disorder 

If you live with or near someone with Antisocial Personality Disorder, here are essential tips:

1. Set clear boundaries: Individuals with Antisocial Personality Disorder may disregard others’ limits. Communicate your boundaries and enforce them consistently to protect your emotional well-being.
2. Do not engage in power struggles: People with Antisocial Personality Disorder may try to manipulate or control situations. Avoid confrontations or attempts to “win” arguments. Stay calm and assertive without being drawn into conflicts.
3. Maintain emotional distance: It’s important to avoid getting emotionally entangled. People with Antisocial Personality Disorder often lack empathy and may exploit their emotions. Keep interactions neutral and non-reactive when possible.
4. Focus on self-care: Living around someone with Antisocial Personality Disorder can be emotionally exhausting. Prioritize your own mental and physical health by engaging in self-care practices, and seeking support from friends, family, or professionals, like Sintelly.
5. Avoid enabling harmful behavior: Do not ignore or excuse harmful actions, even if it seems easier. Hold the individual accountable for their behavior, but recognize that you cannot change them.
6. Educate yourself: The Sintelly app can help you protect your mental health by offering a chatbot to talk through your concerns and thought patterns. Through Cognitive Behavioral Therapy (CBT) exercises, you can learn coping mechanisms that help you manage stress and maintain emotional balance when dealing with difficult situations.

Remember, it is not your responsibility to fix or change someone with Antisocial Personality Disorder. Focus on protecting your well-being while maintaining a safe distance.

Cognitive Behavioral Therapy (CBT) for Antisocial Personality Disorder

It is important to mention that many studies emphasize that the treatment of antisocial personality disorder is challenging. An article from 2014 explains that antisocial personality disorder is difficult to treat because it involves impulsivity, deceit, and disregard for others. The study states that some treatment methods, such as cognitive behavioral therapy (CBT) and modified therapeutic communities (MTC), show promising results but do not always result in significant differences between treated and untreated individuals. The success of treatment is mostly observed in reduced criminal activity. However, although these treatment methods appear promising, the treatment needs to fit the needs and behaviors of the individual. 

However, many studies also support the efficacy of CBT. A 2009 study, for example, explores CBT treatment for men suffering from antisocial personality disorder, especially focusing on aggressive behavior. The study compared two groups, one receiving standard treatment and the other CBT. The group that received CBT showed more promising results, decreasing physical and verbal aggression over time. Individuals treated with CBT also showed improvements in social functioning, reduced harmful alcohol use, and improved positive interactions and relationships with other people.

Furthermore, another study from 2017 examines the efficacy of CBT in treating antisocial personality disorder. It states that CBT is often emphasized to reduce problematic behaviors such as impulsivity, aggression, and substance abuse. This is achieved through the teaching of healthy coping strategies.

However, although many studies suggest CBT as an effective treatment for antisocial personality disorder, it is important to mention that much of the research suggests (as in the 2017 study) that more studies need to be carried out to strengthen the evidence. It is also challenging that many individuals with antisocial personality disorder are reluctant to seek help or lack the determination and responsibility for CBT, making the treatment more difficult. 

How the Sintelly App Can Help 

Antisocial Personality Disorder presents a unique set of challenges when it comes to treatment, including impulsivity, deceit, and a disregard for others. 

CBT is often recommended for Antisocial Personality Disorder to help individuals learn healthier ways to cope with their impulses and reduce aggressive behaviors. The Sintelly app provides interactive CBT exercises that guide users through self-reflection and help them identify and challenge negative thought patterns. For example, users can engage in activities that focus on understanding the consequences of their actions, teaching them how to slow down impulsive reactions and consider more socially appropriate responses. Over time, these exercises can help reduce harmful behaviors like physical or verbal aggression.

Many individuals with Antisocial Personality Disorder struggle with forming positive relationships and tend to engage in manipulative or harmful social interactions. The Sintelly app includes exercises that help users develop better social functioning by teaching them how to recognize and challenge thoughts that contribute to antisocial behavior. For example, CBT exercises may ask users to identify situations where they acted impulsively or manipulatively and reflect on how different behaviors could lead to better outcomes in their relationships. This practice helps users slowly build more constructive and empathetic ways to interact with others, fostering healthier relationships over time.

One of the main challenges in treating Antisocial Personality Disorder is that many individuals lack the motivation or sense of responsibility to seek help. The Sintelly app helps address this by providing users with progress-tracking features that visually show their behavioral improvements over time. By logging daily activities, thoughts, and emotions, users can monitor their progress, which serves as a motivating factor to continue with treatment. The app’s personalized insights and structured approach help individuals take more responsibility for their treatment process.

Many individuals with Antisocial Personality Disorder struggle with emotional dysregulation, leading to heightened aggression or impulsivity. The app’s mindfulness and relaxation techniques offer tools for managing emotions in the moment. Through guided breathing exercises, body scans, and meditation practices, users can learn to calm themselves before reacting impulsively. This approach can reduce emotional outbursts and contribute to more controlled, thoughtful responses in difficult situations.

Treatment for ASPD must be tailored to the unique needs and behaviors of the individual, and the Sintelly app allows for a personalized approach. The app’s AI-driven therapy chatbot adapts its responses and exercises based on the user’s progress, ensuring that the treatment aligns with the user’s specific challenges. This personalized feedback loop helps ensure that the treatment is effective and targeted toward the individual’s areas of concern.

As individuals with Antisocial Personality Disorder are often reluctant to seek help, the accessibility of the Sintelly app can help bridge this gap. Offering a discreet, self-guided tool allows individuals to engage with therapeutic exercises at their own pace without the need for a clinical setting. This flexibility can help those who may be hesitant or unwilling to participate in traditional therapy, providing them with a non-confrontational way to start addressing their behaviors.