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Antisocial personality disorder signs and symptoms may include:
•Disregard for right and wrong
•Persistent lying or deceit to exploit others
•Using charm or wit to manipulate others for personal gain or for sheer personal pleasure
•Intense egocentrism, sense of superiority and exhibitionism
•Recurring difficulties with the law
•Repeatedly violating the rights of others by the use of intimidation, dishonesty and misrepresentation
•Child abuse or neglect
•Hostility, significant irritability, agitation, impulsiveness, aggression or violence
•Lack of empathy for others and lack of remorse about harming others
•Unnecessary risk-taking or dangerous behaviors
•Poor or abusive relationships
•Irresponsible work behavior
•Failure to learn from the negative consequences of behavior

Antisocial personality disorder symptoms may begin in childhood and are fully evident for most people during their 20s and 30s. In children, cruelty to animals, bullying behavior, impulsivity or explosions of anger, social isolation, and poor school performance may be, in some cases, early signs of the disorder.

Although considered a lifelong disorder, some symptoms — particularly destructive and criminal behavior and the use of alcohol or drugs — may decrease over time, but it’s not clear whether this decrease is a result of aging or an increased awareness of the consequences of antisocial behavior.

Antisocial personality disorder is a type of chronic mental condition in which a person’s ways of thinking, perceiving situations and relating to others are dysfunctional — and destructive. People with antisocial personality disorder typically have no regard for right and wrong and often disregard the rights, wishes and feelings of others.

Those with antisocial personality disorder tend to antagonize, manipulate or treat others either harshly or with callous indifference. They may often violate the law, landing in frequent trouble, yet they show no guilt or remorse. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. These characteristics typically make people with antisocial personality disorder unable to fulfill responsibilities related to family, work or school.

Having a personality disorder makes it hard to engage in behavior and activities that may help you feel better. Ask your doctor or therapist how to improve your coping skills and get the support you need.

If your loved one has a personality disorder

If you have a loved one with a personality disorder, work with his or her mental health provider to find out how you can most effectively offer support and encouragement.

You may also benefit from talking with a mental health provider about any distress you experience. A mental health provider can also help you develop boundaries and self-care strategies so that you’re able to enjoy and succeed in your own life.

The treatment that’s best for you depends on your particular personality disorder, its severity and your life situation. Often, a team approach is appropriate to make sure all of your psychiatric, medical and social needs are met. Because personality disorders are long-standing, treatment may require months or years.

Your treatment team may include your:
•Primary doctor
•Psychiatrist
•Psychotherapist
•Pharmacist
•Family members
•Social workers

If you have mild symptoms that are well controlled, you may need treatment from only your primary doctor, a psychiatrist or a therapist. If possible, find medical and mental health providers with experience in treating personality disorders.

Depending on your needs and type of personality disorder, treatment may include:
•Psychotherapy
•Medications
•Hospitalization

Psychotherapy

Psychotherapy, also called talk therapy, is the main way to treat personality disorders. During psychotherapy, you learn about your condition and talk about your mood, feelings, thoughts and behaviors with a mental health provider. Using the insight and knowledge you gain, you can learn healthy ways to manage your symptoms and reduce behaviors that interfere with your functioning and relationships.

Psychotherapy may be provided in individual sessions, in group therapy, or in sessions that include family or even friends. There are several types of psychotherapy — your mental health provider can determine which one is best for you, depending on your needs.

Medications

There are no medications specifically approved by the Food and Drug Administration (FDA) to treat personality disorders. However, several types of psychiatric medications may help with various personality disorder symptoms.
•Antidepressants. Antidepressants may be useful if you have a depressed mood, anger, impulsivity, irritability or hopelessness, which may be associated with personality disorders.
•Mood stabilizers. As their name suggests, mood stabilizers can help even out mood swings or reduce irritability, impulsivity and aggression.
•Antipsychotic medications. Also called neuroleptics, these may be helpful if your symptoms include losing touch with reality (psychosis) or in some cases if you have anxiety or anger problems.
•Anti-anxiety medications. These may help if you have anxiety, agitation or insomnia. But in some cases, they can increase impulsive behavior, so they’re avoided in some personality disorders.

Hospitalization and residential treatment programs

In some cases, a personality disorder may be so severe that you require psychiatric hospitalization. This is generally recommended only when you aren’t able to care for yourself properly or when you’re in immediate danger of harming yourself or someone else. After you become stable in the hospital, your doctor may recommend a day hospital program, residential program or outpatient treatment option.

If your doctor suspects you have a personality disorder, exams and tests may include:
•Physical exam. The doctor may do a physical exam and ask in-depth questions about your health. In some cases, your symptoms may be linked to an underlying physical health problem.
•Lab tests. For example, your doctor may order blood tests, such as a complete blood count (CBC) or a thyroid test, to determine if a physical health problem may be causing some of your symptoms. Your doctor may also order a screening test for alcohol and drugs.
•Psychological evaluation. This includes a discussion about your thoughts, feelings and behavior and may include a questionnaire to help pinpoint a diagnosis.

Sometimes it can be difficult to determine the type of personality disorder, as some personality disorders share similar symptoms. But it’s worth the time and effort to get an accurate diagnosis so that you get appropriate treatment.

Diagnostic criteria

The symptoms and clinical features for each personality disorder are detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This book is used by mental health providers to diagnose mental disorders and by insurance companies to reimburse for treatment.

To be diagnosed with a particular personality disorder, you must meet DSM criteria. Each personality disorder has its own set of diagnostic criteria. However, generally the diagnosis of a personality disorder includes long-term marked deviation from cultural expectations that leads to significant distress or impairment in at least two of these areas:
•The way you perceive and interpret yourself, other people and events
•The appropriateness of your emotional responses
•How well you function when dealing with other people and in relationships
•Whether you can control your impulses