Antisocial Personality Disorder (ASP)
Antisocial Personality Disorder (ASP)
Individuals with ASP repetitively disregard the rules and laws of society and rarely experience remorse for their actions.
Epidemiology
Antisocial personality disorder is present in 3% of men and 1 % of women. About half have been arrested; about half of those in prison have ASP.
Etiology
ASP is more common among first-degree relatives of those diagnosed with ASP. In families of an individual with ASP, men show higher rates of ASP and substance abuse, whereas women have higher rates of somatization disorder. A harsh, violent, and criminal environment also predisposes people to this disorder.
Clinical Manifestations
History and Mental Status Examination
Individuals with ASP display either a flagrant or well-concealed disregard for the rules and laws of society.
They are exploitative, lie frequently, endanger others, are impulsive and aggressive, and rarely experience remorse for the harm they cause others. Alcoholism is a frequently associated finding in this population.
Many individuals with ASP are indicted or jailed for their actions. Their lifetime suicide rate is 5%.
Differential Diagnosis
Bipolar disorder and substance abuse disorder can prompt antisocial behaviors during the acute illness that remit when the disorder is controlled. The antisocial behavior of individuals with ASP conversely: is not state dependent. ”
Revision date: July 8, 2011
Last revised: by Andrew G. Epstein, M.D.