Antisocial Personality Disorder

Antisocial personality disorder (APD) is an ongoing pattern of behavior in an adult that involves disregard for social rules and serious violation of the rights of others through aggressive, dishonest, reckless, and irresponsible acts.

What Is Antisocial Personality Disorder?

Antisocial personality disorder (APD) is one of the ten different types of personality disorders ^* that are currently classified by mental health experts. Like other personality disorders, APD refers to a personality style that consists of troubled ways of thinking, feeling, and behaving, and it is diagnosed only in adults (but the personality style and the problematic behavior it causes must have been present since adolescence). Of all the personality disorders, APD has been the focus of the most research and attention, perhaps because people with APD often cause harm to others and have a negative effect on society.

Adults with APD engage in aggressiveness or physical assaults, cheating, lying, or other behaviors for which they can get arrested. They are often impulsive ^* and reckless and disregard their own safety or the safety of others. People with APD tend to be poor planners, and they may ignore financial responsibilities like paying rent or other bills. They often have poor work records and many engage in impulsive criminal behavior or spousal abuse. To be diagnosed with APD, a person must have had symptoms of conduct disorder ^* since the age of 15, thus demonstrating a long-standing pattern of antisocial behaviors ^* .

APD was first described in the 1800s as a "defect of moral character" and as "moral insanity." The terms psychopath and sociopath have also been used to describe what is now called antisocial personality disorder. Those with APD seem to lack a conscience and fail to learn from consequences or punishment alone. They may fail to show remorse and may lack sympathy for those they have hurt. People with APD may experience most emotions at a shallow level.

What Causes Antisocial Personality Disorder?

Antisocial behavior tends to run in families. Researchers have tried to determine how much of this tendency is due to genetics and biology and how much is learned behavior. Some studies have identified certain brain problems and learning defects in people with APD. For example, researchers have found that areas of the brain that are involved in thinking ahead and in considering the consequences of one's actions may be different in people with APD. This finding lends evidence to the theory that an inherited brain problem may contribute to the poor planning and impulsivity that are characteristic of people with APD.

Other studies have found differences in the brains of people with APD that may contribute to disordered learning and attention. One series of experiments demonstrated that people with antisocial personalities did not experience normal anxiety before being given a shock and that they did not learn to avoid the shock like other subjects in the experiment did. This may explain why people with APD do not seem to learn from negative consequences or punishment.

Research that separates genetic from environmental factors (for example, studies of identical twins raised in different homes) has shown that genetic factors explain about half of antisocial behavior. Family environment or upbringing plays an important role as well. Experts currently believe that a combination of genetic inheritance and environmental factors lead to most cases of APD. In other words, some people seem to have a biological tendency to develop APD and the family environment will determine whether or not that tendency is fulfilled. People without the biological tendency for APD, regardless of the family environment in which they are raised, are not likely to develop APD as an adult (although they may have conduct disorder as a youth).

How Is Antisocial Personality Disorder Treated?

Treatment of APD presents a challenge because those with APD are unlikely to consider themselves as having a problem and are therefore unlikely to seek help. Without motivation to change one's own behavior, it is unlikely that any meaningful change will take place. Because people with APD tend to violate the rights of others, they often encounter the criminal justice system. Though they may be imprisoned, punishment alone usually fails to teach someone with APD to behave differently. Still, APD is a serious social problem. Some early interventions may help prevent APD from developing in those at risk, such as youth with severe conduct disorders and those who are juvenile offenders.