Antisocial Personality Disorder: How Is It Diagnosed & Treated?

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Personality disorders are mental health diagnoses that typically significantly impact and even impair individuals and their relationships. Antisocial Personality Disorder (APD) involves individuals who might not appear initially that they have difficulties in their life or in relationships. In some cases, people with APD might seem very charming and personable at first. However, those relationships can quickly turn toxic and end abruptly due to certain symptoms. Individuals who have APD disregard, ignore, and even violate the rights of others. They have no empathy for others and low to non-existent moral conscience. These symptoms make it difficult for people with APD to have long-lasting, healthy relationships. Individuals with APD also can exhibit aggressive and impulsive behaviors that can lead to legal issues including criminal activity. The term sociopath is often a familiar descriptor used for someone who has APD. These individuals have a history of issues and symptoms that present themselves in childhood. Conduct Disorder is a diagnosis that shares similar characteristics with APD but is a diagnosis that is only given to children. Children who have been diagnosed with Conduct Disorder may then be diagnosed with APD upon reaching adulthood.

In order to be diagnosed with any personality disorder, a person must fulfill very specific criteria over a period of time. At least 3 of the following criteria have to be present for an individual 18 years or older:

  • Repeated violations of the law
  • Chronic deception
  • Impulsivity and lack of planning
  • Irritability and aggressiveness
  • Little regard for their safety or the safety of others
  • Irresponsibility
  • Lack of repentance for wrongdoing

These signs also cannot be explained by another disorder or developmental issues. It also has to create significant impairment in daily living including their relationships. Evidence of conduct disorder similar to the symptoms listed can be traced back to their life before the age of 15. When 3 more of the criteria are present, someone can be diagnosed with Antisocial Personality Disorder.

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Treatment of APD is often very difficult and considered possibly one of the most difficult personality disorders to treat. One of the biggest issues is that someone with APD will typically have a difficult time seeing or admitting they even need help. The unfortunate reality is that many with APD end up in the justice system due to breaking the law. Without being pushed or, in some instances, court mandated, these individuals will not likely seek treatment on their own. Some medications are used to treat symptoms of APD like antidepressants or mood stabilizers for aggression or impulsivity. The most helpful form of treatment is consistent therapy. The focus of treatment is on a person’s ability to avoid past mistakes. Creating structure and logical rules for individuals to follow can help them avoid issues that “get them into trouble.” Therapy can point out the benefits of positive behavior and the negatives of antisocial behavior. Treatment can also be effective with the participation of family or other support networks. While it is difficult to treat Antisocial Personality Disorder, it is possible to manage symptoms that may help individuals function better in society.

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Michelle Overman is a Licensed Marriage & Family Therapist working as a counselor for students, faculty, and staff at Abilene Christian University in Abilene, Texas. She works with athletes, bridging the gap between athletics and mental health at ACU. She is becoming a Certified Mental Performance Consultant in sports psychology.  Michelle ran her own private practice in Austin, Texas where she worked with a diverse population, including couples and families. Michelle earned a Master’s in Marriage & Family Therapy and has been working in the field for 6 years.