WHAT IS ANTISOCIAL PERSONALITY DISORDER?
Antisocial Personality Disorder (ASPD) is one of the most challenging forms of personality disorders, not only for those who live with it, but particularly for close family and friends too.
Typically, those with ASPD will be impulsive, reckless and pay little regard for how their behaviour affects other people. They tend to be manipulative (even with people they care for), short-tempered, easily frustrated and often violent as a result. It can range from small bouts of bad behaviour to breaking the law repeatedly and often committing some pretty serious crimes.
Criminal behaviour is one of the key features of ASPD. Many of those with the condition (diagnosed or not) go on to break the law which often leads to prison sentences. It is estimated that 60-70% of people in prison have ASPD (or another personality disorder). Men with antisocial personality disorder are also 3-5 times more likely to misuse illegal drugs and alcohol. As a result, they are also more likely to die sooner, either from this misuse or often because their behaviour is overtly reckless.
ASPD is one of the most difficult conditions to treat, but it is possible. Cognitive Behavioural Therapy or Mentalisation-based Therapy have been proved to be useful in treating ASPD, although part of the condition means those with it would be unwilling to seek treatment and less likely to attend sessions if they were arranged.
Antisocial Behaviour Disorder isn't a condition that is easily attributed. It can only be diagnosed in an adult when they have met at least three of the criteria below. These include:
Breaking the law repeatedly.
Lack of remorse.
Disregard for the safety of themselves or others.
Consistently irresponsible and deceitful.
Impulsive behaviour or being incapable of planning ahead.
Irritable and aggressive.
It is worth noting that these signs must form part of a person's 'normal' personality and NOT be part of a schizophrenic or manic episode.
If someone meets at least three of the above, they also must have had a history of disorderly behaviour that occurred before they were 15 years old (e.g. truancy, substance abuse, theft, etc.) to be diagnosed with ASPD. They will also need to have had a very detailed psychological assessment. If you were late returning a library book once, you probably aren't the type of person we're talking about.
Those with antisocial personality disorder used to be referred to as being a psychopath or a sociopath (but not in a 'horror movie' type way). In the UK at least, this terminology is no longer used as part of the Mental Health Act.
WHAT CAUSES ANTISOCIAL PERSONALITY DISORDER?
Whilst many mental illness aren't gender-specific, ASPD does tend to affect more men than women. Why some people are affected and others aren't is, as is often the case, open to interpretation.
Whilst it's only diagnosed in adults, it tends to manifest itself in their late teens, 20s and 30s and many of the more intense or extreme symptoms gradually decrease as they get into their 40s and 50s.
Many (but not all) people diagnosed with ASPD have a history of childhood problems. They may have grown up under difficult family circumstances including parents who were constantly at conflict, perhaps they were taken into care or lived in a home where substance or alcohol abuse were common.
There is no 'one size fits all' approach and many people who lived under similar circumstances do not develop ASPD or any other conditions.
If you live with ASPD, there may be some organisations on our Where To Turn pages that can help you. If not, and you know of one, please let us know and we'll look into it.
Also, if you'd like to share your experiences of living with ASPD with our community so they can better understand how it feels, please take a look at our 'Men Tell' section.