What's The Relationship Between Antisocial Personality Disorder And Violence?

Antisocial personality disorder (ASPD) is a personality disorder that causes difficulties in relationships and personality difficulties present from childhood or adolescence. This disorder can affect people in numerous ways, particularly affecting their relationships. Given the typical disregard for the rights of others as a symptom of this disorder, individuals may also experience legal problems as a result of aggression and violent crime. Below, explore the relationship between antisocial personality disorder and violence and ways for a person living with the condition or their loved ones to receive support. 

Signs and symptoms of antisocial personality disorder

According to the American Psychiatric Association, antisocial personality disorder affects 0.6% and 3.6% of individuals. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision (DSM-5-TR), lists antisocial personality disorder as a cluster B personality disorder. Cluster B also includes borderline personality disorder, narcissistic personality disorder, and histrionic personality disorder. 

The DSM-5-TR states that individuals must be at least 18 years old and meet at least three of the following criteria to be diagnosed with antisocial personality disorder:

1. Failure to conform to social norms concerning lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest
2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
3. Impulsivity or failure to plan ahead
4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults.
5. Reckless disregard for the safety of self or others
6. Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

Additionally, individuals’ antisocial symptoms must not be caused by a major mental disorder like schizophrenia or bipolar disorder, and they must have had symptoms of conduct disorder prior to the age of 15.

Per the DSM-5, conduct disorder is characterized by a pattern of behavior that disregards the rights of others and violates societal norms. Clinicians divide conduct disorder into four types: 

• Aggression toward other people and animals
• Theft or deceitfulness
• Destruction of property
• Serious violation of social norms

Can ASPD cause violent behavior? 

Individuals living with antisocial personality disorder tend to have a disregard for social norms. They may get involved in altercations, including physical assault, on a regular basis, which may result in physical harm and problems with the police. 

Individuals living with antisocial personality disorder (ASPD) may engage in repetitive acts that warrant arrest, whether they are caught or not. Some may spend time in and out of the criminal justice system for delinquent or criminal behavior. Potentially harmful acts may include speeding and driving while under the influence of alcohol or other substances, which may require substance use (formerly called substance abuse) treatment.

Even those who don’t engage in physically aggressive acts can still do harm, both emotionally and psychologically. One sign of the disorder tends to be manipulating and lying to others. Some individuals may use a fake name with some people to deceive them, and they tend to experience little to no remorse for their behavior. They may also engage in sexual activity without protection with multiple partners.

Causes of antisocial personality disorder

Researchers in the field of biological psychiatry believe that antisocial personality disorder (ASPD) may be caused by a combination of genetic and environmental factors. A person with a first-degree relative with ASPD may be at a higher risk of developing the disorder. Family members of a person with the disorder may also be at a higher risk of substance use disorder or somatic symptom disorder, with the former being more common in men and the latter being more common in women. 

ASPD tends to be more common in men than in women. Still, it may be underdiagnosed in women, possibly as a result of an emphasis on aggression in the criteria for conduct disorder. Environmental risk factors may include neglect, various forms of childhood abuse, and inconsistent parenting—all of which may increase the risk that conduct disorder will develop into ASPD. 

According to the DSM-5-TR, although ASPD is considered chronic, some symptoms, especially criminal behaviors, tend to decrease by the age of 40. Substance use disorder and antisocial behaviors may also decrease with age. 

Treatments for antisocial personality disorder

According to the American Psychiatric Association, there is typically no medication specifically for ASPD, but some individuals may be prescribed medication for co-morbid psychiatric disorders. Talk therapy may be used more often to treat antisocial personality disorder (ASPD). Therapy may be especially beneficial in adolescents with conduct disorder to help prevent the development of antisocial personality disorder.

Some people living with ASPD may not know they have the disorder. They may seek therapy after a friend or loved one recommends treatment as a result of consequences that affect others—not necessarily because of internal distress. Therapeutic approaches that may be used include cognitive-behavioral therapy (CBT), skills training, motivational interviewing, and mentalization-based treatment. 

The evidence for therapy's effectiveness is limited. In some cases, a therapist may focus on reducing interpersonal conflict and improving a person’s psychosocial functioning. In other cases, the treatment plan may involve using the point subtraction aggression paradigm, which measures aggression in response to provocation. 

A therapist may help a person address problems with anger management, which may reduce violent behavior. For those whose condition has affected their livelihood, case management may connect them to sources of income, housing, and mental health services. This resource may be beneficial for individuals who have been in the criminal justice system or acute psychiatric inpatient facilities.

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Finding support 

If you believe that someone you love may have antisocial personality disorder, you may benefit from seeking support. People with ASPD can also seek therapy. Loved ones may have challenges navigating the disconnect between caring deeply for their loved one while also protecting themselves from the potential harm that can come with antisocial personality disorder. 

If you find yourself in this situation, you may benefit from connecting with a licensed therapist who understands antisocial personality disorder and its effects on loved ones. If you don’t have time for traditional in-person therapy at this time, you may benefit from online therapy through a platform like BetterHelp. 

With online therapy, you can connect with a therapist at a time that suits your schedule via audio, video, or live chat. You can also contact your therapist anytime between sessions through in-app messaging, and they will respond when they can. You may find these options useful if you experience concerns about your loved one between sessions.  

In recent years, several peer-reviewed studies have demonstrated the effectiveness of online therapy. Research shows that digital therapy can be effective for stress and anxiety, which may be common among friends and family members of individuals living with antisocial personality disorder, other personality disorders, or other severe mental illnesses.