Antisocial Personality Disorder (ASPD)

Antisocial personality disorder (ASPD, 反社會人格) is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) of the American Psychiatric Association (2013) as “a pervasive pattern of disregard for and violation of the rights of others.” It is characterised by irresponsibility, exploitation of others for self-interest without remorse, and authority defiance. Patients typically begin to exhibit antisocial behavior in adolescence, including breaking the law, infringing upon others’ rights, acting impulsively and recklessly, and making repeated mistakes without repentance. These behaviors, if it persists to adulthood, will  eventually constitute antisocial personality disorder. 

ASPD Causes  

The cause of antisocial personality is still uncertain, but it is estimated to be predisposed by genetic and environmental factors such as: 

• Genetics: Some studies have shown MAOA variant gene is strongly related to impulsive and aggressive behavior; of interest are Chromosomes 6p21.2 and 6p21.32 which have been previously linked to psychiatric disorders including schizophrenia and bipolar affective disorder 
• Sex: Antisocial personality disorder affects more men than women  
• Traumatic childhood experiences, such as being an abused or neglected child  
• Growing up in a challenging family environment, such as parents involved in alcohol or substance abuse, domestic violence or excessively harsh treatment of their children 

ASPD Symptoms  

• Exploitative, manipulative and violative of the rights of others 
• Good at lying 
• Lack of empathy for the suffering of others and little regret or self-blame 
• Irresponsible and disregards social norms 
• Rarely nervous  
• Unreliable, dishonest, insincere 
• Does not easily feel remorse or shame 

• Lack of judgment and failure to learn from experience 
• Unresponsive in general interpersonal relationships 
• Confused sex life 
• Difficulty implementing any life plan 
• Unable to maintain a lasting and meaningful relationship 

Adults with antisocial personality disorder typically exhibit conduct disorder symptoms by age 15, including severe, persistent behaviors such as: 

• Violence against people or animals 
• Destroy property 
• Fraud, theft 
• Serious violation 

ASPD Diagnosis 

• Conduct a psychological assessment of the patient's thoughts, feelings, relationships, behavioral patterns, and family history 
• Diagnosis can only be made if a previous diagnosis of conduct disorder (DC) has been made by age 15 or older 
• Assessment based on indicators are listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) published by the American Psychiatric Association (Link 1) 

ASPD treatments 

• Psychotherapy 

A psychologist discusses with patients including anger and violence management, alcohol or drug abuse treatment and other mental health conditions. 

• Drug 

There are no drugs specifically approved to treat antisocial personality disorder; doctors may prescribe medications for conditions related to antisocial personality disorder, such as anxiety, depression, or aggression. 

ASPD preventive methods 

There is no sure way to prevent the development of an antisocial personality, but characteristics of  antisocial behavior generally begins in childhood. Therefore, if parents, teachers and pediatricians can detect it early, they can intervene and improve the symptoms. The following self-care techniques can also reduce symptoms: 

• Seek community support: Joining self-help or support groups can allow patients to share experiences and learn improvement strategies. 
• Maintain a healthy lifestyle: A balanced diet, regular exercise and good sleep habits can help patients improve their overall mental health. 
• Avoid drugs and alcohol: Drugs and alcohol may exacerbate symptoms of antisocial personality disorder and lead to additional personal and social problems. 

OT&P Medical Advice 

Antisocial personality is a complex and difficult-to-treat disorder, but it is not impossible to manage. Treating antisocial personality disorder takes time and patience. Symptoms can be effectively improved through professional mental health services and the help of patients' relatives and friends. If you or someone you know, - has a child who may be exhibiting early signs of antisocial personality disorder, please seek help from a psychiatrist to find the best treatment options for the patient.