Diseases & Conditions

Antisocial Personality Disorder

Overview, Causes, & Risk Factors

Personality is a distinct set of traits, behaviors, beliefs, and patterns. People who have a personality disorder have a hard time dealing with other people. Those who have antisocial personality disorder (APD) ignore normal rules of social behavior and are impulsive and reckless. This means they often have aggressive and violent relationships. They show no respect for others and do not feel remorse for their actions. Early signs include lying, stealing, fighting, and missing school. People who have APD are at high risk for substance abuse, especially alcohol. This is true because alcohol and drugs can help relieve the tension, irritability, and boredom they feel. These problems continue into adulthood. Diagnosis is made after the age of 18.

What is going on in the body?

Experts are not sure what is going on in the body that may be related to this condition. Further study is needed.

What are the causes and risks of the condition?

Experts do not know the specific causes of APD. The disorder occurs much more often in people who have a parent with APD. So, experts think that biological and genetic factors play a key role. APD is four times more common in men than in women.

Experts also believe that frequent exposure to criminal behavior and substance abuse contributes to the development of APD. Children raised in a chaotic, neglectful, harsh, and abusive home are also at higher risk.

Symptoms & Signs

What are the signs and symptoms of the condition?

Persons who have APD act in cold and insensitive ways. At times, they can seem charming but are often cunning and insincere. They tend to view relationships only in terms of what they can gain from them.

People with APD may think that it is reasonable to manipulate or deceive others to get what they want. As a result, these persons tend to have a general lack of regard for rules, laws, and customs. They assume that these rules and laws do not apply to them. This causes frequent problems at work or with the law.

General symptoms include:

  • disregard for safety and responsibility
  • impulsiveness
  • irritability, aggressiveness, and/or violent behavior
  • lack of conscience or remorse for consequences of behavior
  • lack of empathy
  • lack of honesty

  • Diagnosis & Tests

    How is the condition diagnosed?

    A healthcare provider makes the diagnosis based on the symptoms and behaviors of the person. A doctor may also use psychological testing to diagnose APD.

    Prevention & Expectations

    What can be done to prevent the condition?

    Because experts are not sure what causes APD, it is not known if there is anything that can be done to prevent the condition.

    What are the long-term effects of the condition?

    People who have APD usually have long-term problems in relationships with others. A repeated pattern of job and legal problems is often seen.

    What are the risks to others?

    Because people who have APD are often violent and do not respect others, anyone who comes into contact with them is potentially at risk. Care should be taken to maintain a safe distance.

    Treatment & Monitoring

    What are the treatments for the condition?

    Psychotherapy is the primary treatment for this disorder. Medicines may also help reduce specific symptoms such as mood swings and anger. But medicines are used only to help with psychotherapy.

    People who have APD rarely seek treatment. Instead, family members or employers often pressure them into treatment. Treatment may even be ordered by the court. Because the person who has APD does not understand his or her problem, effective treatment is very hard. But behavioral approaches can help the person make a connection between feelings and actions. Many who have this disorder have not made emotional connection in a relationship. So, it is critical that they form a therapeutic relationship with the healthcare provider.

    What are the side effects of the treatments?

    Medicine side effects depend on the drug prescribed. Drugs that cause psychological and physical addiction should be used with care.

    What happens after treatment for the condition?

    Many people with APD can improve with proper care. Often, medicine is given for a long time. With therapy, people with APD may better recognize the effects of their behaviors on others. And it may help them live healthier, more fulfilling lives.

    How is the condition monitored?

    The person should keep track of symptoms and report any that are new or worsening to the healthcare provider. He or she may need to adjust the medicine so that it works better or so there are fewer side effects.


    Author:Ann Reyes, Ph.D.
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:12/17/01
    Reviewer:Lisa Sterling, PharmD
    Date Reviewed:12/17/01