What is Antisocial Personality Disorder in Children and Teens?

Antisocial Personality Disorder (ASPD) is a mental health condition defined by a disregard for the rights or feelings of others, impulsivity, and a pattern of manipulative or harmful behavior. 

Teens with antisocial personality disorder can be charming yet deceitful. They use their likability and social skills to convince others that their actions or words are genuine when inevitably they may not be. Unfortunately, a teen with ASPD typically has little interest in pleasing anyone other than themselves.

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) outlines the diagnostic criteria for mental disorders, including ASPD. Current versions of the DSM consider antisocial personality disorder as a combination of two traits common among those with ASPD: psychopathy and sociopathy. 

Psychopathy and ASPD

Psychopathy is not an official diagnosis, but describes behavioral traits that include harmful actions towards others.

A person with these psychopathic traits typically feels little or no emotions. They often mimic empathy to manipulate others, yet they don’t experience it themselves. 

Oftentimes, a person with this trait is charming and charismatic. However, their manipulative behaviors and hurtful actions as well as lack of empathy make it hard for them to form healthy, intimate relationships. They are prone to violence, criminal actions, and aggression.

Typically, psychopathy is caused by structural problems in the brain. Thus, a person might be born with this condition. 

Sociopathy and ASPD

Sociopathy often co-occurs with environmental causes such as childhood trauma and abuse.

Because sociopathy develops in response to traumatic experiences, people with this trait are more capable of relating to others. However, they also exhibit similar manipulative behaviors as people with psychopathy. They struggle with emotional regulation and impulse control as well.

In addition, they are often haphazard, easily agitated, and more impulsive than someone who meets the criteria for psychopathy. 

Regardless, sociopathy and psychopathy aren’t diagnoses. But these traits can occur in people with personality disorders, especially ASPD.

Antisocial Personality Disorder (Defined by the DSM)

According to the American Psychiatric Association (APA), the DSM (Diagnostic and Statistical Manual of Mental Disorders) states that a person “must show a continuing pattern of disregard for and violation of the rights of others, occurring since age 15” AND have 3 or more of the following traits:

• Failing to conform to social norms and laws (for example, breaking the law or not following the rules)
• Deceitfulness (i.e., lying or manipulating others for their own benefit or pleasure)
• Difficulty with impulse control and an inability to plan ahead
• Irritability, easily agitated, or aggressive behaviors (often getting into arguments or fights)
• Disregard for the safety of other people (for instance, driving recklessly with others in the car)
• Irresponsible behavior (not paying bills or rent, failure to maintain employment—generally this doesn’t apply to teens since they are still gaining these skills)
• Lack of remorse (being indifferent to the people they mistreat or harm)

It’s important to remember that these traits and behaviors must represent a pattern. That is why ASPD isn’t diagnosed officially in teens. The person must display these traits for years before getting a diagnosis.

In addition, some of the traits of ASPD could be caused by other issues. For example, impulse control and reckless behavior can be symptoms of attention-deficit/hyperactivity disorder (ADHD). Teens with a history of trauma or childhood abuse can also be more prone to irritability and agitation.

Still, it’s helpful to look out for these early signs of antisocial personality disorder in teens and children.

What Are the Early Signs and Symptoms of ASPD in Children and Teens?

Although it cannot be diagnosed until adulthood, children and teens might display early signs of antisocial personality disorder. 

Understanding these warning signs and antisocial personality disorder symptoms can help parents, caregivers, and educators begin interventions quickly. The earlier a teen gets help, the less likely they are to develop ASPD in adulthood. 

Persistent Disregard for Rules and Authority

This can be challenging to understand, as many teens rebel against authority to some degree or another. Oftentimes, this can be normal and expected as teens develop their identity and personality. In other words, teens need to challenge what is expected of them in order to develop their identity.

However, persistent disregard for rules and authority differs from normal teenage rebellion. This is more about patterns and consistent problematic behaviors than a few isolated incidents.

Examples of this antisocial behavior include the following:

• Skipping school or “playing hooky” repeatedly
• Frequently defying curfew or sneaking out without permission
• Resisting discipline at home or in school
• Purposefully disrespectful to authority figures, like educators, conduct officers, and police

Lack of Empathy or Remorse

Lack of empathy or remorse are significant indicators of a teen developing ASPD as an adult. While children and teens are often self-centered by nature, they should develop empathy as they get older. Children develop a skill called theory of mind (ToM) that is critical to developing empathy.

According to npj Mental Health Research, “ToM is often described as the ability to attribute mental states to oneself and others.” 

In other words, theory of mind is the ability to understand that other people have their own thoughts, beliefs, emotions, and intentions. Children often have a self-centered perspective on the world—believing that their thoughts and feelings are the same as everyone else’s. As children develop ToM, they understand that other people can feel pain, joy, and sadness.

This is why children begin feeling guilt or remorse for behaviors that harm others. They realize that other people are also capable of feeling hurt as they themselves can be hurt. 

But without these developmental skills, children might intentionally inflict harm on others or not feel sorry if they do. In severe cases, adolescents may act cruelly toward animals or small children.

Deceitfulness and Manipulation

Deceitfulness and manipulation might be similar to testing limits and boundaries, as teens often do. Oftentimes, teens try to see what they can get away with or how they can avoid taking responsibility for their actions. For example, they might feign being sick to avoid going to school.

However, when deceit and manipulation become habitual, this can be problematic. It can be a warning sign of antisocial personality disorder or other behavioral health symptoms. Teens who never acknowledge responsibility for their own mistakes usually blame others—therefore, they never feel like they are in the wrong.

Increased Risk-Taking Behaviors

Again, there is a fine line between teens testing boundaries and risk-taking behaviors. Sometimes, teens cave in to peer pressure and engage in reckless activities. Examples include substance abuse, vandalism, or driving too fast.

However, these behaviors can be dangerous and lead to long-term consequences. In teens with early signs of ASPD, they engage in thrill-seeking behaviors at the expense of personal or public safety, like setting fires to other people’s property. 

For example, a teen might drive recklessly with others in the car, making them feel unsafe and afraid—but continue to do so anyway. They might even laugh about it or dismiss the concerns of others.

What Are the Risk Factors and Causes of Antisocial Personality Disorder?

Antisocial personality disorder causes can include biological, genetic, and environmental risk factors. Childhood trauma is also a potential risk factor and cause of ASPD.

Biological and Genetic Risk Factors of ASPD

• Family History: A family history of ASPD or other other personality disorders can increase the risk of a teen developing ASPD. In addition, any mental or behavioral health disorder, such as substance abuse, depression, or bipolar disorder, can increase the risk of a child developing ASPD or another behavioral health disorder.
• Brain Structure: According to Restorative Neurology and Neuroscience, neuroimaging of people with traits of psychopathy (common among those with ASPD) could be caused by abnormalities in the structure of a person’ brain.

Environmental Risk Factors of ASPD

• Unstable Home Life: Children and teens growing up in homes with instability, abuse, neglect, or inconsistent discipline are more likely to develop ASPD or other behavioral disorders. Oftentimes, home environments like this co-occur with parents or caregivers who have substance use or mental health disorders.
• Peer Influence: A child’s peer group and friends have a significant impact on their behaviors. Children and teens associating with peers who encourage antisocial behaviors are more likely to engage in these types of behaviors.

Childhood Trauma and ASPD

Childhood trauma is a risk factor for developing ASPD and other mental or behavioral health disorders. These experiences are also called Adverse Childhood Experiences (ACEs), which are linked to behavioral, psychological, emotional, and medical challenges in adulthood.

Examples of childhood trauma that could be an underlying cause of ASPD include the following:

• Physical, verbal, or sexual abuse
• Violence and assault
• Witnessing violent acts (especially in the home)
• Family members who attempt or die by suicide
• Parent or caregiver with untreated addiction or mental illness

What Is the Difference Between Conduct Disorder Vs. Antisocial Personality Disorder?

The main difference between conduct disorder and antisocial personality disorder is the age of diagnosis.

Conduct disorder is diagnosed in childhood or early adolescence. These behaviors develop over time and the child appears to have little empathy or concern for other people. Overall, it doesn’t look much different from ASPD in terms of behaviors and characteristics.

Personality disorders, like ASPD, take time to develop because a person’s personality is a pattern of behaviors, beliefs, thoughts, and feelings. On the other hand, a conduct disorder is a behavioral issue that can respond to interventions. Still, if these behaviors continue they can become embedded into a teen’s personality—leading to ASPD.

Symptoms include of conduct disorder include the following:

• Aggression
• Property destruction
• Deceitfulness
• Serious rule violations
• Bullying
• Physical violence
• Threats
• Sexual assault
• Vandalizing or setting fires to destroy property
• Breaking into homes or businesses
• Running away from home
• Promiscuity and risky sexual behaviors
• Easily frustrated
• Difficulty making and keeping friendships

It’s critical for parents, caregivers, and teachers to intervene with these antisocial behavioral issues present in conduct disorders. Otherwise, there could be several negative long-term consequences.

What Are the Long-Term Consequences of Untreated Antisocial Behavior?

Untreated antisocial behaviors can lead to several harmful long-term consequences—even if a child isn’t diagnosed with conduct disorder.

Antisocial behaviors involve risk taking and other dangerous behaviors that may escalate. In addition, some of these behaviors have long-lasting consequences, like unwanted pregnancy, bodily injury, or a criminal record. Furthermore, a person’s support system might abandon them due to their behaviors, leaving the person more vulnerable to co-occurring conditions, like addiction or mental health disorders.

Long-term consequences of untreated antisocial personality disorder traits include the following:

• Developing a substance use disorder (SUD)
• Arrest and criminal record
• Incarceration
• Health and medical issues (resulting from recklessness and substance abuse)
• Mental illness, like anxiety and depression
• Increased risk of suicidality and self-harm
• Trouble maintaining employment or stable housing
• Difficulty forming or maintaining healthy relationships

Can ASPD Be Prevented or Managed With Early Intervention?

Early signs of antisocial personality disorder can lead to early interventions, which can help to prevent a teen from developing the disorder in adulthood.

However, the longer these early warning signs are ignored, the more likely it is that the child will have ASPD as an adult. In addition, early intervention can reduce the severity of symptoms currently displayed. This can also promote healthy, pro-social behaviors.

Early intervention can also reduce the risk of developing comorbidities, such as co-occurring substance abuse and mental health disorders. These comorbid conditions can make long-term treatment much more complicated.

Overall, it is best for parents to get their child into treatment right away. Early intervention significantly reduces the risk of worsening conditions. 

Not only that, but once a teen reaches adulthood, parents won’t have the ability to get their adult child into treatment without a court order or legal interventions.

Parents of troubled children might assume it’s “just a phase,” or “they just need ‘tough love.’” But for conduct disorders and early signs of ASPD, “tough love” strategies simply don’t work because the teen won’t feel remorse or guilt about their behaviors. When children and teens are below the age of 18, it is much easier for parents to get them into treatment than after they reach adulthood.

Lastly, the antisocial behaviors of ASPD and conduct disorder often prevent the individual from seeking treatment on their own. They might view mental health professionals as another authority figure to defy. This is another reason why it’s critical to get treatment for teens as quickly as possible.

What Is the Treatment for Antisocial Personality Disorder in Teens?

Treatment for teen antisocial personality disorder includes behavior therapies and a robust support system involving parents, family, peers, and educators.

Behavioral therapy is one of the most common and effective treatments for teen ASPD. This will help teens recognize harmful thought patterns and improve their behaviors. 

There are many different types of behavioral therapies, including:

• Cognitive-Behavioral Therapy (CBT): Cognitive-behavioral therapy is among the most common types of behavioral therapies to treat mental and behavioral health disorders. During CBT, teens work with a therapist to identify—and challenge—problematic thoughts and beliefs.
• Dialectical Behavior Therapy (DBT): Dialectical behavior therapy is a type of CBT that specializes in treating symptoms of borderline personality disorder (BPD). Some of these symptoms are similar to ASPD. DBT focuses on building skills in four areas, (1) mindfulness, (2) emotion regulation, (3) interpersonal effectiveness, and (4) distress tolerance.

In addition, treatment professionals can address co-occurring disorders, such as substance abuse or mental health disorders. Treating early symptoms of ASPD alongside co-occurring disorders improves the outcomes for all conditions. These treatments may include psychiatric medications, holistic approaches, and therapy.

It is also vital for parents, caregivers, educators, and others involved in the teen’s life to create a strong support system. This system can include other close family members, coaches, medical professionals, and mental health staff as well.

How Can Parents, Caregivers, and Teachers Help Teens With ASPD? 

Building a strong support system to help teens with ASPD traits is critical to early intervention and treatment.

Trying to help a troubled teen with signs of ASPD can be challenging. Parents can burn themselves out managing their child on their own. By involving other adults and professionals in the teen’s life, parents have the support they need to help their child. 

The following are additional effective strategies for parents and caregivers of teens with conduct disorder or signs of ASPD:

• Setting Clear Rules and Consequences: Most teens test boundaries, however, teens with ASPD will push and overstep boundaries often. It’s important to establish clear and consistent boundaries. Additionally, consequences for breaking rules must be both logical, clearly established ahead of time, consistent, and not overly punitive.
• Positive Reinforcement and Skill Building: Oftentimes, parents and caregivers focus on the problematic behaviors of teens. However, they must also help their child build prosocial skills by reinforcing positive behaviors. For instance, make sure to say things like “I’m proud of you” or “That was a good choice,” when teens display prosocial behaviors like honesty, empathy, helpfulness, and cooperation.
• Collaborating with Schools and Educators: Parents and caregivers of troubled teens should inform school staff about their child’s behaviors. That way, teens get consistency in both the school and home setting. Teachers and school officials can also provide valuable resources for parents and troubled students.
• Seeking Behavioral Health Support: A therapist or psychiatrist can help parents understand their child’s problematic behaviors. They can also teach the teen about managing their maladaptive behaviors and treat underlying causes as well as co-occurring conditions.

Resources for Parents and Families

Additional resources for parents, caregivers, and families of teens with ASPD include the following:

• Family Therapy & Counseling: Family therapy programs can help families understand their loved one with ASPD. This can also help individual family members learn to cope with the stress of living with someone who struggles.
• Support Groups & Community Programs: Support groups and community programs connect families with resources to benefit their loved one. In addition, support groups can help family members learn how to support their loved one and how to manage their own stressors.
• Residential Treatment Programs (RTCs): Residential treatment programs or inpatient facilities can help troubled teens learn coping skills without the influence of outside stressors. These programs provide a homelike setting that is conducive to healing and recovery.
• Outpatient Programming: Outpatient programs range from high to low levels of care based on the amount of time the person spends in treatment. For example, a partial hospitalization program (PHP) involves attending a program for about 6-8 hours per day. On the other hand, an intensive outpatient program (IOP) has a more flexible schedule to accommodate for school and other obligations.
• Therapeutic Education Programs: At Beachside Teen Treatment Center, we offer therapeutic education to teens in our long-term programs. That way, they don’t fall behind in their academic studies. During this program, we also teach prosocial skills and coping mechanisms for emotional health issues.

When to Seek Help (Warning Signs You Should NOT Ignore)

Lastly, it’s important to seek help for children and teens displaying early signs of antisocial personality disorder. While these signs don’t necessarily mean the child has ASPD, these are still problematic behaviors that cannot be ignored.

Below is a list of warning signs parents and caregivers should not ignore:

• Escalating aggression or threats
• Repeated suspensions or expulsions
• Decline in empathy or personal responsibility
• Acts of violence toward younger siblings, family pets, or animals
• Verbal abuse toward family members
• Repeated lying and being being dishonest
• Having a sense of superiority over others
• Being extremely opinionated and inflexible
• Reckless behaviors, including substance abuse and risk-taking

Start Early Intervention for Antisocial Personality Disorder in Teens Today

Parents who have children or teens with early signs of ASPD may feel like there is no hope for their child. Oftentimes, parents and caregivers become burnt out trying to manage their child’s problematic behaviors on their own. But, with professional treatment and a strong support system, teens can learn healthy, prosocial behaviors to reduce the risk of developing antisocial personality disorder.

Beachside Teen Treatment Center in Malibu, California, is here for you and your child. Contact us today at (888)254-0916 or visit our admissions page to get your child the help they deserve.