Antisocial personality disorder (ASPD), sometimes referred to as sociopathy, is a mental health condition classified under cluster B personality disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). People with ASPD often show a persistent disregard for others' feelings, tend to manipulate or exploit others, and usually lack remorse for their actions.

This condition affects up to 3% of adults in the U.S. and is more commonly diagnosed in individuals assigned male at birth.

Personality Traits

People with ASPD may initially seem charismatic, charming, and confident. They can use flattery to influence or manipulate others. However, they often present as arrogant, overly self-assured, and dismissive of others’ perspectives or feelings.

Impact on Relationships

A lack of empathy is a core symptom of ASPD. Individuals with this disorder often disregard moral boundaries and may lie, manipulate, or even abuse people close to them. After causing harm, they usually do not express guilt or regret, which makes it difficult for them to maintain healthy or lasting relationships.

Risk-Taking and Impulsive Behavior

Impulsivity is another common trait. People with ASPD often act without considering the consequences, which can lead to aggressive or reckless behaviors. They may appear frequently irritated or angry and have a higher risk of engaging in violent or dangerous actions.

Some individuals with ASPD also seem unaffected by fear or fail to recognize fear in others, which may increase their potential to cause harm to themselves or others.

Legal and Behavioral Issues

Due to their disregard for rules and societal norms, people with ASPD often face legal issues. Their impulsive and reckless behavior can lead to repeated encounters with law enforcement or incarceration. Additionally, substance abuse is common among individuals with ASPD, and may result in further legal violations, such as driving under the influence.

Early Symptoms in Childhood

Although ASPD cannot officially be diagnosed until adulthood, warning signs may appear during childhood or adolescence. These early indicators may include:

  • Aggressive or violent behavior

  • Frequent lying or cheating

  • Trouble with authority figures

  • Repeated school disciplinary issues

  • Cruelty toward animals

  • Fire-setting behavior

  • A lack of remorse for wrongdoing

Supporting a Loved One With ASPD

Living with or caring for someone with ASPD can be emotionally draining and, at times, unsafe. If you have a family member or partner with this condition, it’s essential to protect your own well-being. Seeking guidance from a therapist or support group can help you cope and develop strategies for healthy boundaries.

When To Seek Professional Help

It’s important to reach out to a healthcare provider if you or someone close to you shows signs of ASPD. A doctor can refer you to a mental health specialist for a full evaluation. A diagnosis of ASPD may be made in adults over the age of 18 who exhibit at least three of the following behaviors:

  • Persistent lying or deceit

  • Repeatedly breaking the law

  • Impulsivity or poor planning

  • Aggressive or irritable behavior

  • Chronic irresponsibility

  • Disregard for safety of self or others

  • Lack of guilt or remorse

Not everyone with ASPD is aware of their condition, and some may deny the need for treatment. However, regular therapy sessions can be beneficial if the individual is open to getting help. Therapy can help reduce harmful behaviors and improve functioning.

If you or someone you care about is experiencing thoughts of self-harm or suicide, immediate support is available. Call or text 988 or visit resources like 988lifeline.org or SpeakingOfSuicide.com/resources.

Questions To Ask a Mental Health Provider

When you seek help, consider asking these questions to better understand your diagnosis and treatment options:

  • Why do I have difficulty feeling empathy?

  • What type of personality disorder might I have?

  • Will I need therapy, medication, or both?

  • Is recovery or improvement possible with treatment?

  • Can I manage this disorder without professional help?

A Quick Review

Antisocial personality disorder is a serious condition that impacts emotional and behavioral regulation. Common symptoms include lying, impulsive actions, disregard for others’ feelings, and engaging in risky or unlawful behavior.

Because people with ASPD may not recognize their symptoms, diagnosis often occurs after concern is raised by others. If you're experiencing these signs or someone close to you is concerned about your behavior, seeking help from a therapist can lead to better understanding, management, and an improved quality of life.