Causes of Antisocial Personality Disorder
The causes of antisocial personality disorder are multifaceted, and may involve a combination of genetic and environmental factors.
It is commonly thought that individuals with this disorder may exhibit social isolation or discomfort around others.
ASPD is a mental health disorder that can have a negative impact on an individual’s life and those around them.
The disorder is not related to discomfort or preference for solitude. The causes of ASPD are not fully understood, and the most effective treatments are not known.
Symptoms and key traits of antisocial personality disorder (ASPD)
Individuals with antisocial personality disorder (ASPD) typically display a repeated pattern of deceitful, exploitative, or manipulative behavior towards others.
They often lack remorse or guilt for their actions and may violate the rights and personal space of others, leading to an increased risk of engaging in criminal activities.
ASPD symptoms can vary from one individual to another, and may consist of:
- Using manipulative tactics to gain power over others
- Being charming, witty, or arrogant
- Demonstrating patterns of irritability, anger, or aggression
- Experiencing legal or financial difficulties, or having issues at work
- Showing disregard for personal safety or the safety of others
- Engaging in violent or aggressive behavior
- Being devoid of empathy, guilt, or remorse for their actions
- Blaming others for their behaviors or downplaying the impact of their actions.
Diagnosis
ASPD is considered a rare mental health condition, with an estimated prevalence of 1–4% in the general population. Men are more likely to receive a diagnosis of ASPD, with a 3 to 5 times higher likelihood than women.
It’s important to note that ASPD is typically diagnosed in individuals who are 18 years of age or older.
To receive a diagnosis of ASPD, an individual must meet certain criteria, such as having a previous diagnosis of conduct disorder before the age of 15 and exhibiting at least three symptoms of ASPD since that age. It’s important to note that these symptoms must occur independently of any coexisting mental health episodes or disorders.
Cluster B personality disorders
Antisocial personality disorder is categorized as a cluster B personality disorder in the DSM-5. Other disorders in this cluster include borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder.
The exact cause of ASPD is not fully understood, and there is debate among researchers and medical professionals about whether it is a distinct diagnosis or significantly overlaps with psychopathy, which some believe may be a more severe subtype of ASPD.
Researchers have proposed several theories about what may contribute to the development of ASPD, including genetic factors and environmental influences.
However, the exact cause of ASPD remains unclear and is likely to be a complex interplay between various factors.
Genetic risk factors
A study conducted in 2019 suggests that genetic factors may contribute to 38-69% of ASPD diagnoses.
A study conducted in 2013 indicates that the genes responsible for ASPD may affect other bodily systems, such as:
- Dopamine system: regulates mood, motivation, and reward
- Serotonin system: responsible for impulse control, sleep, and regulating feelings and behavior
- Epinephrine/norepinephrine system: controls nervous system activity, such as the fight or flight response
Environmental factors
Environmental factors can also contribute to the development of ASPD, according to a 2021 published research.
The research indicates that various environmental risk factors associated with experiences during pregnancy and early childhood could be linked to the development of ASPD.
- Risk factors related to pregnancy and infancy: Factors that increase the risk of developing ASPD and are associated with pregnancy and infancy include: substance use or smoking during pregnancy, maternal stress and anxiety during pregnancy, delivery complications, malnutrition during infancy, and exposure to heavy metals.
- Childhood trauma: abusive or neglectful parent-child relationships, verbal or physical abuse, inconsistent or controlling discipline.
- Social risk factors: The risk of developing ASPD may also be associated with certain social factors such as growing up in an underprivileged community, being exposed to peer groups that engage in anti-social behavior, and experiencing social violence.
Related conditions
ASPD can often co-occur with substance use disorders, mood disorders such as depression, and behavioral addictions like gambling.
Addressing these related conditions along with antisocial behavior may increase the effectiveness of treatment plans for ASPD.
Treatment for ASPD
Antisocial personality disorder can be treated, but the most effective treatments are still uncertain, according to a review conducted in 2020.
ASPD treatment can be challenging due to the nature of the disorder. Individuals with ASPD may not acknowledge their need for intervention or believe that they are experiencing behavioral difficulties.
It may take time and multiple attempts to find an effective treatment strategy. Collaborating with a doctor and therapist can provide guidance and support in this process.
A 2015 study found that early intervention for ASPD can be more effective. The study showed that 59% of participants who received early treatment displayed ASPD-related symptoms at age 25, compared to 69% of participants who did not receive early intervention.
According to researchers, early intervention could potentially reduce ASPD behaviors in young individuals who are at risk. However, such treatment programs are believed to be more effective if they involve the individual’s family and social circle.
Therapy
After a diagnosis of ASPD, therapy is frequently the initial form of treatment:
- Cognitive behavioral therapy (CBT): Cognitive behavioral therapy (CBT), which aims to modify negative thoughts and behaviors, is considered the most effective form of therapy for treating ASPD.
- The Incredible Years Program: The Incredible Years Program is a therapeutic intervention that aims to prevent and treat behavior problems that may lead to the development of ASPD. It focuses on building positive relationships between children and their caregivers.
- Multisystemic Therapy (MST): Multisystemic Therapy (MST) is a type of group therapy program that is specifically designed to address serious antisocial behaviors, including criminal or illegal behavior, in adolescents aged between 12 and 17. The program involves working with families and addressing factors such as family dynamics, peer relationships, and school or community involvement to prevent and treat ASPD.
- Functional Family Therapy (FFT): A type of family-based therapy called Functional Family Therapy (FFT) is used for at-risk youth between the ages of 11 and 18. The aim of FFT is to reduce harm and increase protective factors within the family.
Medications
Based on current evidence, medications are not considered an effective treatment for ASPD. Rather, they are more commonly prescribed to address co-occurring conditions that may be present alongside ASPD.
Antipsychotics, antidepressants, and mood stabilizers are often prescribed to treat aggression in people with ASPD, but they are primarily used to treat underlying conditions co-occurring with ASPD.
Some examples of medications used include risperidone (antipsychotic), quetiapine (antipsychotic), sertraline (antidepressant), fluoxetine (antidepressant), and carbamazepine (mood stabilizer).
What’s next
ASPD behaviors can have detrimental effects on both the individual and those around them. However, early intervention and proper treatment can lead to positive outcomes.
Genetic and environmental factors may both contribute to the development of ASPD, according to research.
To prevent the full development of ASPD symptoms, identifying at-risk young individuals is an important initial step.
Early intervention that addresses environmental factors could help decrease the chances of individuals with ASPD engaging in harmful behaviors towards themselves and others.
If you’re seeking help but don’t know where to begin, there are resources available to guide you.
7 sources
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nlm.nih.gov/books/NBK546673/ - Gibbon S, et al. (2020). Psychological treatments for people with antisocial personality disorder.
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apa.org/record/2003-02091-011 - Tuvblad C, et al. (2013). Genetic and environmental influences on antisocial behavior.
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