Just a Bad Attitude, or a Personality Disorder?
Traits and Tendencies of Antisocial Personality Disorder
Many people wonder about behaviors like stealing, quick temper, or hurting others — done by people who show no sign of remorse, sometimes lie, and disregard the knowledge or feelings of the people around them, much like what we often see reported in the news. Most people view these individuals simply as having a “bad character,” but some of them actually show traits or tendencies consistent with a condition known in English as Antisocial Personality Disorder.
First, let’s understand the word “personality” — something everyone has. Personality refers to a person’s thoughts, perceptions, and behavior, shaped by many factors including genetics, upbringing, culture, and life experience, which together influence how a person responds and interacts with others or with different situations.
The term “personality disorder,” meanwhile, refers to a pattern of thoughts, feelings, and behavior that is inflexible and poorly adapted, often deeply ingrained and causing problems — such as difficulty forming relationships with others, an inability to adapt to changing situations, or clearly abnormal deviations in behavior — all while the person feels no concern about their own inappropriate behavior. They often refuse psychological help and don’t accept that they have a problem at all, unlike people with depression or anxiety disorders. Because of this, people with personality disorders often never enter treatment.
Antisocial personality disorder can only be diagnosed once a patient turns 18. Physicians assess this based on observation, behavioral history, and information from the patient’s history and from family or people close to them. A physician may diagnose antisocial personality disorder if the patient shows a documented pattern of delinquent, gang-like behavior before age 15. This behavior may stem from genetics, upbringing, and brain function, along with external factors. Under DSM-5 criteria, the noticeable abnormal history or behavior of antisocial personality disorder typically appears in childhood, with at least 3 symptoms present before age 15.
Causes of Antisocial Personality Disorder (ASPD)
• Abnormalities in brain function and neurotransmitters • Having a family member with antisocial personality disorder • Inappropriate upbringing in childhood, such as abuse, physical harm, neglect, or family violence • An unsuitable environment, such as at school or among peers
What Symptoms Fall Under Antisocial Personality Disorder (ASPD)
People with antisocial personality traits can show a wide range of behaviors depending on the severity of the condition. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), published by the American Psychiatric Association, sets out diagnostic criteria for antisocial personality disorder. ASPD is a mental health condition characterized by a widespread pattern of disregarding and violating the rights of others. Common symptoms of ASPD may include:
• Disregard for the law — a history of repeated law-breaking, such as theft, vandalism, and other crimes
• Impulsivity — a common symptom of ASPD, which can show up in many ways, including risky behavior, substance use, and impulsive aggression, along with a lack of restraint or forethought
• Deceitfulness — repeated lying, manipulation, and deceiving others to achieve their own goals or personal gain, often through pretense and deliberate deception to get what they want
• Lack of empathy — difficulty recognizing or caring about the feelings and needs of others, and a lack of conscience or sense of right and wrong
• Irritability and aggression — aggressive and violent behavior, mood swings, quick temper, and aggressive behavior toward the people around them
• Recklessness — engaging in dangerous or careless behavior without regard for the consequences, such as driving under the influence or having unprotected sex
• Irresponsibility — a history of failing to meet obligations, such as work or financial commitments
People with antisocial traits also commonly struggle with alcohol and drug use, or have other co-occurring psychiatric conditions such as depression or anxiety disorders, self-harming or harmful behavior toward others, and other behaviors that raise the risk of premature death due to increasing violence.
However, in patients who already have a substance use or alcohol problem, behavior may appear similar to antisocial personality disorder — but if they are able to stop using substances permanently, their personality, temperament, mood, and thinking often improve. In such cases, the patient may not actually have a personality disorder at all outside the period when they were using substances.
Treatment with Psychotherapy
Psychotherapy is a treatment approach aimed at addressing psychological problems or disorders, and includes a range of methods — such as cognitive behavioral therapy (CBT), which uses conversation to help patients understand their problems and move toward changing their thoughts and behavior; mentalization-based therapy, which helps patients recognize and understand their own mental states and those of others; anger and emotion management; and treatment for co-occurring alcohol or substance use.
Medication Treatment
Currently, no medication has been approved specifically to treat antisocial personality disorder. However, physicians may prescribe medication to help treat related conditions — such as antidepressants, anti-anxiety medications, or newer antipsychotic medications to help manage impulsivity and aggression. In some cases, a physician may recommend admission to a psychiatric hospital for closer monitoring.
If you suspect a family member or someone close to you shows signs of antisocial personality disorder, gently encourage them to see a psychiatrist for proper treatment and medication, using words that show understanding and concern, so they’re willing to undergo diagnosis and receive correct treatment. This can also help prevent the impact of their behavior on others, and help you and your family learn how to cope and protect yourselves — especially when the person shows severe aggressive behavior. At DAY ONE, a private drug treatment center, our holistic treatment approach restores health across body, mind, and social life, using a range of treatment methods.
For more information, contact us at
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