Antisocial Personality Disorder

Diagnosis of Antisocial Personality Disorder

Diagnosing antisocial personality disorder (ASPD) can be challenging because people with the condition often do not believe they need help. They may seek medical attention only for related issues such as:

• Depression or anxiety

• Anger outbursts

• Substance use problems (alcohol or drugs)

Key factors in diagnosis

• Mental health evaluation: Includes discussing thoughts, feelings, behavior patterns, relationships, and family history.

• Symptom assessment: Observing patterns of disregard for rules, lack of empathy, and difficulty forming healthy relationships.

• Personal and medical history: Helps rule out other conditions.

Additional input

• With permission, family and friends may provide important observations about behavior.

• ASPD is usually not diagnosed before age 18, though some symptoms may appear in childhood or early adolescence.

Early identification may improve long-term outcomes.

Treatment of Antisocial Personality Disorder

While treatment can be challenging, some people benefit from a long-term, structured approach with mental health professionals experienced in ASPD. Treatment depends on:

• Individual situation

• Severity of symptoms

• Willingness to participate in therapy

Talk therapy (psychotherapy)

• Focuses on anger management, violence prevention, and substance use treatment.

• May address co-occurring mental health conditions such as depression or anxiety.

• Effectiveness is limited if the individual denies their behaviors contribute to problems.

Medications

• No medications are specifically approved by the FDA for ASPD.

• Doctors may prescribe medications for related conditions, including:

  • Anxiety or depression

  • Aggression or irritability