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Understanding Antisocial Personality Disorder

When talking about addiction, it is impossible to leave personalities out of the conversation. Antisocial personality disorder (ASPD) is not a condition exclusive of substance abusers, but many struggle with it. A condition characterized by a lack of empathy and regard for others can very much sum up how many with substance use disorders treat others around them. Let’s take a closer look at this condition and how it relates to addiction.   

What is Antisocial Personality Disorder?

Those with antisocial personality disorder struggle with a mental health condition that causes patterns of manipulation around others. ASPD can start in childhood or early adolescence and continues well into adulthood. The condition causes people to struggle with an innate predisposition to disregard the law, violate others’ rights, and manipulate others. 

It’s common for people with ASPD to engage in violent or aggressive behavior and participate in criminal activity. Many of these characteristics are very familiar to those with substance use disorders. One study in Alcohol Research and Health found that more than 3% of men and 1% of women have ASPD. The condition is overall more common among men than women.


Like many other mental health disorders, there isn’t a single cause attributed to ASPD. Genetics and environmental factors may play a role, much like in the onset of addiction. Overall, men who experienced abuse or neglect as a child grew up with parents with ASPD, or those who grew up with alcoholic parents have an increased risk of developing the disorder. Research also suggests a person with an antisocial personality disorder has differences in the frontal lobe, the area of the brain responsible for planning and judgment. 

Recognizing the Symptoms

In children, recognizing the symptoms of antisocial personality disorder can be a bit more challenging. However, they might display symptoms like a tendency to be cruel to animals and set fires illegally. At its core, people struggling with this condition cannot consider other people’s feelings, thoughts, and motivations, leading to a harmful disregard for others. People with antisocial personality disorder:

  • Act out impulsively and fail to consider the consequences
  • Difficulty feeling empathy for others
  • Struggle with legal problems due to failure to conform to social norms
  • Difficulty with authority
  • Display cruelty to animals
  • Engage in risky behaviors like fire setting
  • Display aggressiveness and irritability that leads to physical assault
  • Have poor or abusive relationships
  • Are likely no neglect or abuse their children
  • Compulsively lie and deceive others for personal gain

Overall, someone with ASPD might be regarded as having no conscience or feel remorse for their harmful actions. As teenagers and adults, they’re more likely to engage in risk-taking behaviors and criminal acts. It’s also common for them to struggle with substance abuse and other addictive behavioral patterns. 


Although ASPD symptoms start early in childhood years, the condition is often not diagnosed until later in life. In fact, the disease cannot be officially diagnosed before the age of 18. Unfortunately, kids that display symptoms are diagnosed with conduct disorder instead. The same happens for those in their teenage years. Even still, someone needs to show the symptoms of the disease before the age of 15. To be diagnosed with ASPD, people need to show at least one of these seven symptoms:

  • Disregard for the safety of themselves and others
  • Failure to obey laws and a long-term pattern of breaking the law
  • Impulsive behavior
  • Aggression
  • Lack of remorse for actions
  • Lying or manipulating others for profit or amusement
  • A pattern of reckless behavior

In addition to these symptoms, the DSM diagnostic criteria also emphasize that the person must be at least 18 years old and not display antisocial behavior due to bipolar disorder or schizophrenia. According to the DSM-V, 0.2% to 3.3% of U.S. adults have an antisocial personality disorder.

Treatment for Antisocial Personality Disorder

ASPD is very challenging to treat for several reasons. First, people with this condition rarely seek treatment on their own. Even after an altercation with the legal system, they’re not likely to feel remorse for their actions. However, for those who seek treatment, various approaches could help manage the condition. 


Cognitive-behavioral therapy (CBT) can help those looking to change maladaptive behaviors. Long-term treatment paired with group and family therapy can be highly successful. The mentalization-based treatment has also shown promise in treating ASPD. 


In most cases, those struggling with ASPD will start a medication regimen. Usually, a combination of anti-anxiety medications, antidepressants, mood stabilizers, and antipsychotics. Still, the type of medication someone takes will depend on the symptoms they display and their biggest struggles. 

Looking for Help

Unfortunately, those with an antisocial personality disorder often don’t seek treatment. This condition often leads to incarceration, injury, or even death due to harmful actions. It usually affects their ability to work and maintain relationships. Thus many of them struggle to live a normal life. 

Research suggests that those with a strong social support system and family ties have the best outlook. If you have a loved one or someone you know who has ASPD, you may find it helpful to speak with a mental health professional. At Lighthouse Recovery Institute, our therapists can help you learn coping skills to set healthy boundaries to protect yourself from harm. It might also help you find the best way possible for your loved ones to start seeking the help they need to manage their condition. 

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