Overview

Antisocial personality disorder, sometimes called sociopathy, is a mental 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 antagonize, manipulate or treat others harshly or with callous indifference. They show no guilt or remorse for their behavior.

Individuals 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. Because of these characteristics, people with this disorder typically can't fulfill responsibilities related to family, work or school.

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Symptoms

Antisocial personality disorder signs and symptoms may include:

• Disregard for right and wrong
• Persistent lying or deceit to exploit others
• Being callous, cynical and disrespectful of others
• Using charm or wit to manipulate others for personal gain or personal pleasure
• Arrogance, a sense of superiority and being extremely opinionated
• Recurring problems with the law, including criminal behavior
• Repeatedly violating the rights of others through intimidation and dishonesty
• Impulsiveness or failure to plan ahead
• Hostility, significant irritability, agitation, aggression or violence
• Lack of empathy for others and lack of remorse about harming others
• Unnecessary risk-taking or dangerous behavior with no regard for the safety of self or others
• Poor or abusive relationships
• Failure to consider the negative consequences of behavior or learn from them
• Being consistently irresponsible and repeatedly failing to fulfill work or financial obligations

Adults with antisocial personality disorder typically show symptoms of conduct disorder before the age of 15. Signs and symptoms of conduct disorder include serious, persistent behavior problems, such as:

• Aggression toward people and animals
• Destruction of property
• Deceitfulness
• Theft
• Serious violation of rules

Although antisocial personality disorder is considered lifelong, in some people, certain symptoms — particularly destructive and criminal behavior — may decrease over time. But it's not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.

When to see a doctor

People with antisocial personality disorder are likely to seek help only at the urging of loved ones. If you suspect a friend or family member may have the disorder, you might gently suggest that the person seek medical attention, starting with a primary care physician or mental health professional.

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Causes

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, shaped through an interaction of inherited tendencies and environmental factors.

The exact cause of antisocial personality disorder isn't known, but:

• Genes may make you vulnerable to developing antisocial personality disorder — and life situations may trigger its development
• Changes in the way the brain functions may have resulted during brain development

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Diagnosis

People with antisocial personality disorder are unlikely to believe they need help. However, they may seek help from their health care provider because of other symptoms such as depression, anxiety or angry outbursts or for treatment of substance abuse.

People with antisocial personality disorder may not provide an accurate account of signs and symptoms. A key factor in diagnosis is how the affected person relates to others. With permission, family and friends may be able to provide helpful information.

After a medical evaluation to help rule out other medical conditions, the health care provider may make a referral to a mental health professional for further evaluation.

Diagnosis of antisocial personality disorder is typically based on:

• A psychological evaluation that explores thoughts, feelings, relationships, behavior patterns and family history
• Personal and medical history
• Symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Though typically antisocial personality disorder isn't diagnosed before age 18, some signs and symptoms may occur in childhood or the early teen years. Usually there is evidence of conduct disorder symptoms before age 15.

Identifying antisocial personality disorder early may help improve long-term outcomes.

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Complications

Complications, consequences and problems of antisocial personality disorder may include, for example:

• Spouse abuse or child abuse or neglect
• Alcohol or substance abuse
• Being in jail or prison
• Homicidal or suicidal behaviors
• Having other mental health disorders such as depression or anxiety
• Low social and economic status, and homelessness
• Gang participation
• Premature death, usually as a result of violence

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Prevention

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 spot 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.

Early, effective and appropriate discipline, lessons in behavior modification, social and problem-solving skills, parent training, family therapy, and psychotherapy may help reduce the chance that at-risk children go on to become adults with antisocial personality disorder.

Coping and support

Skills for family members

People with antisocial personality disorder often act out and make other people miserable — with no feeling of remorse. If you have a loved one with antisocial personality disorder, it's critical that you also get help for yourself.

A mental health professional 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. They can also recommend strategies for coping.

Seek a mental health professional who has training and experience in managing antisocial personality disorder. Ask your loved one's treatment team for a referral. They may also be able to recommend support groups for families and friends affected by antisocial personality disorder.

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Risk factors

Certain factors seem to increase the risk of developing antisocial personality disorder, such as:

• Diagnosis of childhood conduct disorder
• Family history of antisocial personality disorder or other personality disorders or mental illness
• Being subjected to abuse or neglect during childhood
• Unstable, violent or chaotic family life during childhood

Men are at greater risk of having antisocial personality disorder than women are.

Source: http://www.mayoclinic.com