How to Spot Antisocial Personality Disorder

How to Spot Antisocial Personality Disorder

Like other personality disorders, an antisocial personality disorder is characterized by a chronic, ongoing pattern of behavior that adversely affects functioning and can lead to other mental and emotional challenges. People with an antisocial personality disorder often struggle to conform to or adhere to expectations of society and don’t typically follow or play by “the rules.” If they do, it is likely because some type of punishment has been held over their actions. Despite the negative behaviors associated with an antisocial personality disorder, a teen with this condition can also be charming and deceitful. They use their unique ability to act and be “what they need to be” at the moment to convince others of their genuine nature. Unfortunately, those with antisocial personality disorder have little interest in anything other than themselves. 

What is Antisocial Personality Disorder?

Modern diagnostic criteria provided in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) consider antisocial personality disorder to include two related yet not identical conditions. The first is a psychopath. This is someone whose hurtful actions and behaviors towards others tend to reflect calculation, manipulation, and cunning. They also tend to feel little or no emotion and mimic (as opposed to truly experience) empathy for others but can be deceptively charming and exude charisma. However, they are incapable of forming intimate and lasting relationships with others. This is a severe form of antisocial personality disorder.

In contrast, sociopaths are more capable of forming attachments with others but still have little concern for social rules. Sociopaths are often more impulsive, haphazard, and easily agitated when compared to those with psychopathy. An antisocial personality disorder is more common in men and is believed to affect up to five percent of the population.

Diagnosing Antisocial Personality Disorder in Teens

The Diagnostic and Statistical Manual for Mental Disorders requires specific criteria to be met before a diagnosis of antisocial personality disorder is possible. For teens under the age of 18, some of the diagnostic criteria are a limiting factor in diagnosing this specific personality disorder. However, some of the critical criteria require the presence of particular symptoms beginning at or before age 15. For example, the first criteria state one must have a “pervasive pattern of disregard for and violation of the rights of others, since age 15 years, as indicated by three (or more) of the following.” The list includes seven characteristics, including deceitfulness, failure to conform to social norms, reckless disregard for the safety of others, and lack of remorse, among others.  The second criteria state the individual must be at least age 18. So, while it is required that your teen display specific elements of diagnostic criteria beginning before age 15, a clinical diagnosis cannot be made until the age of 18.

What are the Symptoms of Antisocial Personality Disorder?

A teen with an antisocial personality disorder will display various symptoms depending on the severity of their condition. The most common indicators of antisocial personality disorder include dishonesty, irritability, and aggressive behavior, utter disregard for the safety and emotions of others, and the inability to show remorse. In some cases, someone with an antisocial personality disorder will find themselves in frequent legal trouble due to their inability to control their actions with or towards others. You may also notice your teen participating in new or worsening drug or alcohol abuse. One of the most significant challenges parents face with an antisocial personality disorder is that it isn’t always obvious. A teen (or adult) with this condition is capable of acting witty and charming. They are skilled in flattery and can creatively and successfully manipulate the emotions of others.

For this reason, people and parents may not always realize there is an underlying problem. Peers, co-workers, and teachers are generally led to believe the individual is kind, compassionate, and empathetic. However, on the inside, their greatest and only concern is for themselves. They are unlikely to and often incapable of caring for or about the thoughts, feelings, and emotions of others. For this reason, teens with antisocial personality disorder are unlikely to develop lasting relationships with peers or significant others. They will often be perceived as “players” by potential love interests and loners by potential peers.

What are the Potential Causes and Risk Factors?

As with many personality disorder diagnoses, the specific cause of antisocial personality disorder is unknown. Several elements could be considered contributing factors, including genetics and biology. Environmental factors, including child abuse, parental abandonment, and antisocial or alcoholic parents, are considered contributing risk factors. Also, brain defects or traumatic brain injuries during the developmental years may play a role. Because many with antisocial personality disorder have struggles with the legal system, the prison population consists of a high percentage of individuals with varying severity levels of antisocial personality disorder. Research shows as many as forty-seven percent of male and twenty-one percent of female inmates have the condition.

In younger children and teens, setting fires and participating in or solely committing animal cruelty are often seen during the early development stages of antisocial personality disorder.  Children and adolescents who have been diagnosed with conduct disorder are more likely to develop an antisocial personality disorder. Conduct disorder is similar to antisocial personality disorder but is diagnosed at a younger age. Of those children with conduct disorder, an estimated twenty-five percent of girls and forty percent of boys will meet the diagnostic criteria for antisocial personality disorder. Also, boys will generally exhibit symptoms earlier than girls. Conduct disorder is a significant risk factor in the development of antisocial personality disorder. Research indicates that children who do not develop conduct disorder and progress to age fifteen without antisocial behaviors will not develop an antisocial personality disorder. A small percentage of adults diagnosed with an antisocial personality disorder never met the criteria for conduct disorder or received treatment in a program like Beachside to address symptoms of a personality disorder as adolescents or teens.

Treating Antisocial Personality Disorder

An antisocial personality disorder is one of the most challenging to treat. Teens (or adults) with this diagnosis are unlikely to seek treatment on their own. In some cases, they are only likely to begin attending mental health treatment programs such as that here at Beachside as part of a court order. The primary course of treatment for an antisocial personality disorder is psychotherapy. This is a form of individual counseling that focuses on one’s thoughts and behavioral patterns. The most common form of psychotherapy used in the treatment for personality disorders is cognitive-behavioral therapy or CBT. During a therapy session, a therapist will encourage your teen to examine their thoughts and actions to determine what events and situations may be at the root of their challenges. Once they have developed an understanding of what may contribute to harmful and unhealthy behaviors, they can develop and practice healthier and safer thoughts and behaviors.

In some cases, group and family therapy may also be helpful for your teen. Family therapy can help encourage understanding among family members of teens who struggle with an antisocial personality disorder. Because family plays a crucial role in ongoing healing and recovery, it is necessary to understand the signs and symptoms associated with the illness and triggers that could contribute to worsening symptoms or relapse. If group therapy is used as part of a treatment program, it is most beneficial when it is tailored to meet the specific needs of group members with an antisocial personality disorder. A teen with this illness may be more comfortable and open discussing their feelings and emotions with a group of like-minded individuals who share similar problems and challenges.

Currently, there is not an approved medication used to treat the symptoms of antisocial personality disorder. However, in specific circumstances, medications may be used to help stabilize mood swings or treat some of the more overwhelming and distressing symptoms of the illness, including violent aggression and impulsivity. Also, suppose antisocial personality disorder co-occurs with another mental health disorder such as depression, anxiety, or post-traumatic stress disorder. In that case, medications may help alleviate the co-occurring disorder symptoms, making treatment for both conditions more effective.

An antisocial personality disorder is a life-long condition; however, helping your teen seek treatment can provide the opportunity for reduced symptoms. As teens age, there remains the possibility of mostly remitted symptoms as they reach adulthood. Although they will always remain at risk for relapse or new and worsening mental health concerns should they encounter triggers, they cannot manage adequately. For antisocial personality disorder and other personality disorders, the most effective treatments are those explicitly designed around the treatment needs and goals of your teen and family. Each person who seeks help for their mental health is unique, and therefore, the treatment plans and programs used to help them achieve recovery should be equally so. At Beachside, our caring and compassionate staff will offer a treatment program for your teen based on evidence-based, comprehensive therapies designed to treat the whole person. We understand holistic treatments, those that address the mind, body, and spirit, are the most successful. The path to recovery from antisocial personality disorder is not easy. Still, with commitment and the strong support staff at Beachside, your teen can start their journey towards healthier, happier relationships with peers and loved ones. If you are concerned your teen may be struggling with antisocial personality disorder symptoms, don’t wait another day. Reach out to the team at Beachside today. Let our admissions team answer any questions you may have about how Beachside can help your teen today.


American Psychiatric Association. Antisocial personality disorder. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Arlington, VA: American Psychiatric Publishing. 2013https://www.webmd.com/mental-health/antisocial-personality-disorder-overview#1