Antisocial Personality Disorder
Database
* This website does not claim to cover 100% of all information, nor provide 100% accuracy in all domains. Please use our citations for further research and understand that all psychology is subject to change and interpretation
FAQ
Am I a sociopath / psychopath?
This website cannot diagnose you, only a trained psychologist can
But I relate so much to Dexter / Patrick Bateman / Norman Bates / The Joker!
I would hope this is self explanatory, but those are fictional characters - and are written by people who are not psychologists. You cannot diagnose yourself with ASPD by watching movies
Is [insert celebrity or politician here] a sociopath?
As previously stated, diagnosing a person without training and the ability to actually speak to that person directly is impossible. Armchair diagnosis is not a valid diagnosis, and this applies to public figures too
But all sociopaths deserve to be locked up in jail and kept away from society
The belief that someone's mental illness is a justification for imprisoning them without cause is a very slippery slope into fascism. Please recognize that reducing someone to their mental illness is immoral and does not actually benefit society
Can people with ASPD feel love?
Love is a social construct and defined by each individual and their own unique experiences. Yes, people with ASPD are capable of feeling forms of love, but they may be incapable of or struggle with feeling emotional love. Someone with ASPD may feel cognitive love, a form of affection and attachment that is based on things like respect rather than tenderness. Many people with ASPD also have what they call an "exception person", who they feel is an exception to the symtoms of their disorder.
Diagnostic Criteria
DSM-5-TR
Antisocial Personality Disorder
"1. The presence of a pervasive pattern of disregard for and violation of the rights of others. This behavior begins by age 15 and is present in various contexts. Clinical features include ≥3 of the following:2.
- Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
- Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
- Impulsivity or failure to plan.
- Irritability and aggressiveness, often with physical fights or assaults.
- Reckless disregard for the safety of self or others.
- Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.
- Lack of remorse, indifference to or rationalizing having hurt, mistreated, or stolen from another person.3. The individual is at least age 18.4. There is evidence of conduct disorder with onset before age 15.5. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder." [1]
Conduct Disorder
"A. A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated, as manifested by the presence of at least three of the following 15 criteria in the past 12 monthsfrom any of the categories below, with at least one criterion present in the past 6 months:Aggression to People and Animals
1. Often bullies, threatens, or intimidates others.
2. Often initiates physical fights.
3. Has used a weapon that can cause serious physical harm
to others (e.g., a bat, brick, broken bottle, knife, gun).
4. Has been physically cruel to people.
5. Has been physically cruel to animals.
6. Has stolen while confronting a victim (e.g., mugging, purse
snatching, extortion, armed robbery).
7. Has forced someone into sexual activity.Destruction of Property
8. Has deliberately engaged in fire setting with the intention
of causing serious damage.
9. Has deliberately destroyed others’ property (other than by
fire setting).Deceitfulness or Theft
10. Has broken into someone else’s house, building, or car.
11. Often lies to obtain goods or favors or to avoid obligations
(i.e., “cons” others).
12. Has stolen items of nontrivial value without confronting a
victim (e.g., shoplifting, but without breaking and entering;
forgery).Serious Violations of Rules
13. Often stays out at night despite parental prohibitions,
beginning before age 13 years.
14. Has run away from home overnight at least twice while
living in the parental or parental surrogate home, or once
without returning for a lengthy period.
15. Is often truant from school, beginning before age 13 years.B. The disturbance in behavior causes clinically significant
impairment in social, academic, or occupational functioning.C. If the individual is age 18 years or older, criteria are not met
for antisocial personality disorder.Specify whether:
F91.1 Childhood-onset type: Individuals show at least one symptom characteristic of conduct disorder prior to age 10 years.
F91.2 Adolescent-onset type: Individuals show no symptom characteristic of conduct disorder prior to age 10 years.
F91.9 Unspecified onset: Criteria for a diagnosis of conduct disorder are met, but there is not enough information available to determine whether the onset of the first symptom was before or after age 10 years.Specify if:
With limited prosocial emotions: To qualify for this specifier, an individual must have displayed at least two of the following characteristics persistently over at least 12 months and in multiple relationships and settings. These
characteristics reflect the individual’s typical pattern of interpersonal and emotional functioning over this period and not just occasional occurrences in some situations. Thus, to assess the criteria for the specifier, multiple information sources are necessary. In addition to the individual’s selfreport, it is necessary to consider reports by others who have known the individual for extended periods of time (e.g., parents, teachers, co-workers, extended family members, peers)
Lack of remorse or guilt: Does not feel bad or guilty when he or she does something wrong (exclude remorse when expressed only when caught and/or facing punishment). The individual shows a general lack of concern about the negative consequences of his or her actions. For example, the individual is not remorseful after hurting someone or does not care about the consequences of breaking rules.
Callous—lack of empathy: Disregards and is unconcerned about the feelings of others. The individual is described as cold and uncaring. The individual appears more concerned about the effects of his or her actions on himself or herself, rather than their effects on others, even when they result in substantial harm to others.
Unconcerned about performance: Does not show concern about poor/problematic performance at school, at work, or in other important activities. The individual does not put forth the effort necessary to perform well, even when expectations are clear, and typically blames others for his or her poor performance.
Shallow or deficient affect: Does not express feelings or show emotions to others, except in ways that seem shallow, insincere, or superficial (e.g., actions contradict the emotion displayed; can turn emotions “on” or “off” quickly) or when emotional expressions are used for gain (e.g., emotions displayed to manipulate or intimidate others).Specify current severity:
Mild: Few if any conduct problems in excess of those required to make the diagnosis are present, and conduct problems cause relatively minor harm to others (e.g., lying, truancy, staying out after dark without permission, other rule breaking).
Moderate: The number of conduct problems and the effect on others are intermediate between those specified in “mild” and those in “severe” (e.g., stealing without confronting a victim, vandalism).
Severe: Many conduct problems in excess of those required to make the diagnosis are present, or conduct problems cause considerable harm to others (e.g., forced sex, physical cruelty, use of a weapon, stealing while confronting a victim, breaking and entering)" [2].
ICD-11
The ICD previously included distinct personality disorders, including ASPD, but they were removed and replaced with a diagnostic system that combines severity level with associated traits. I have included the associated trait category that most applies to antisocial personality disorder, although it is a combination of antisocial and narcissistic behaviors.
MILD PERSONALITY DISORDER
"All general diagnostic requirements for Personality Disorder are met. Disturbances affect some areas of personality functioning but not others (e.g., problems with selfdirection in the absence of problems with stability and coherence of identity or selfworth), and may not be apparent in some contexts. There are problems in many interpersonal relationships and/or in performance of expected occupational and social roles, but some relationships are maintained and/or some roles carried out. Specific manifestations of personality disturbances are generally of mild severity.
Mild Personality Disorder is typically not associated with substantial harm to self or others, but may be associated with substantial distress or with impairment in personal, family, social, educational, occupational or other important areas of functioning that is either limited to circumscribed areas (e.g., romantic relationships; employment) or present in more areas but milder" [3].MODERATE PERSONALITY DISORDER
"All general diagnostic requirements for Personality Disorder are met. Disturbances affect multiple areas of personality functioning (e.g., identity or sense of self, ability to form intimate relationships, ability to control impulses and modulate behaviour). However, some areas of personality functioning may be relatively less affected. There are marked problems in most interpersonal relationships and the performance of most expected social and occupational roles are compromised to some degree. Relationships are likely to be characterized by conflict, avoidance, withdrawal, or extreme dependency (e.g., few friendships maintained, persistent conflict in work relationships and consequent occupational problems, romantic relationships characterized by serious disruption or inappropriate submissiveness). Specific manifestations of personality disturbance are generally of moderate severity. Moderate Personality Disorder is sometimes associated with harm to self or others, and is associated with marked impairment in personal, family, social, educational, occupational or other important areas of functioning, although functioning in circumscribed areas may be maintained" [3].SEVERE PERSONALITY DISORDER
"All general diagnostic requirements for Personality Disorder are met. There are severe disturbances in functioning of the self (e.g., sense of self may be so unstable that individuals report not having a sense of who they are or so rigid that they refuse to participate in any but an extremely narrow range of situations; self view may be characterized by self-contempt or be grandiose or highly eccentric). Problems in interpersonal functioning seriously affect virtually all relationships and the ability and willingness to perform expected social and occupational roles is absent or severely compromised. Specific manifestations of personality disturbance are severe and affect most, if not all, areas of personality functioning. Severe Personality Disorder is often associated with harm to self or others, and is associated with severe impairment in all or nearly all areas of life, including personal, family, social, educational, occupational, and other important areas of functioning" [3].
PROMINENT PERSONALITY TRAITS OR PATTERNS
(Only to be combined with a Personality disorder category)Dissociality in personality disorder or personality difficulty
"The core feature of the Dissociality trait domain is disregard for the rights and feelings of others, encompassing both self-centeredness and lack of empathy. Common manifestations of Dissociality, not all of which may be present in a given individual at a given time, include: self-centeredness (e.g., sense of entitlement, expectation of others’ admiration, positive or negative attention-seeking behaviours, concern with one's own needs, desires and comfort and not those of others); and lack of empathy (i.e., indifference to whether one’s actions inconvenience hurt others, which may include being deceptive, manipulative, and exploitative of others, being mean and physically aggressive, callousness in response to others' suffering, and ruthlessness in obtaining one’s goals)" [3].
1. NIH: Antisocial Personality Disorder2. DSM-5-TR3. ICD-11 Classification of Mental and Behavioral Disorders
Millon's Subtypes
"Subclassifying antisocials, psychopaths, and criminals has been a hobby of social scientists for more than a century. Some schemes are based on the types of crimes committed or the severity of the crime, rather than on clusters of trait characteristics. Other schemes are based on methodology-driven approaches, such as cluster analysis. All such schemes fail to recognize the importance of considering other personality characteristics in addition to those of the major pattern. In contrast, the antisocial variants summarized in Figure 5.1 are described as combinations of constructs descended directly from the evolutionary theory (Millon, 1990). Note that other subtypes are possible, and not all antisocials fall neatly into one of the categories" [4].
THE COVETOUS ANTISOCIAL
"The covetous antisocial is a variant resembling a “pure” prototypal pattern. Here, aggrandizement, the desire to possess and dominate, is seen in a distilled form. These individuals feel that life has not given them “their due”; they have been deprived of their rightful amount of love, support, or material reward; and others have received more than their share. Jealous of those who have received the bounty of a good life, they are driven by an envious desire for retribution to take what destiny has refused them. Whether through deceit or destruction, their goal is compensation for the emptiness of life, rationalized by the assertion that they alone can restore the imbalance fated to them. Seething with anger and resentment, their greatest pleasure lies in taking control of the property and possessions of others. Some are overtly criminal. Many possess an enormous drive for revenge, manipulating others like pawns in a power game."Regardless of their success, however, covetous antisocials usually remain insecure about their power and status, never feeling that they’ve been compensated for life’s impoverishments. Ever jealous and envious, pushy and greedy, they may make ostentatious or wasteful displays of materialism and conspicuous consumption such as buying exotic cars, mansions, and elaborate jewelry as a means of exhibiting their power and achievements to others. Most feel a deep sense of emptiness, juxtaposed with vague images of how different life might have been had opportunity blessed them, as it has so many others. Some are simple thieves, while others become manipulative entrepreneurs who exploit people as objects to satisfy their desires. Although they have little compassion for or guilt about the effects of their behavior, they never feel that they have acquired quite enough, never achieve a sense of contentment, and feel unfulfilled regardless of their successes, remaining forever dissatisfied and insatiable" [4].
THE REPUTATION-DEFENDING ANTISOCIAL
"Not all antisocials covet material possessions or power. Those who share traits with the narcissistic personality are motivated by the desire to defend and extend a reputation of bravery and toughness. Antisocial acts are designed to ensure that others notice them and accord them the respect that they deserve. As such, they are perpetually on guard against the possibility of belittlement. Society should know that the reputation-defending antisocial is someone significant, not to be easily dismissed, treated with indifference, taken lightly, or pushed around. Whenever their status or ability is slighted, they may erupt with ferocious intensity, posturing, and threatening until their rivals back down. Some reputation-defending antisocials are loners, some are involved in adolescent gang activities, and still others simply seek to impress peers with aggressive acts of leadership or violence that secure their status as the alpha male, the dominant member of the pack. Being tough and assertive is essentially a defensive act intended to prove their strength and guarantee a reputation of indomitable courage" [4].
THE RISK-TAKING ANTISOCIAL
"Minor risk taking within a controlled environment provides a normal outlet for excitement and sensation seeking; many people love a roller coaster, for example. However, there are individuals for whom risk taking is intended to impress others with a front of courageous indifference to potentially painful consequences. Risk-taking antisocials, who combine antisocial and histrionic traits, wish others to see them as unaffected by what almost anyone else would surely experience as dangerous or frightening. While others shrink in fear, they are unfazed by the possibility of gambling with death or serious injury. Risk is proactively sought as its own reward, a means of feeling stimulated and alive, not a means of material gain. Although their pretense is being dauntless, intrepid, and bold, their hyperactive search for hazardous challenges is seen by normals as foolhardy, if not stupid. In effect, they are thrill seekers infatuated by the opportunity to test their mettle by performing for the attention, applause, and amazement of an audience. Otherwise, they would simply feel trapped by the responsibility and boredom of everyday life. The most important factors making them antisocial is the irresponsibility
of their actions and their failure to consider the consequences for their own life, or the lives of others, as they pursue ever more daring challenges" [4].
THE NOMADIC ANTISOCIAL
"Although the most widely held impression is that antisocials are incorrigible criminals who undermine the values of the surrounding culture, some seek simply to run away from a society in which they feel unwanted, cast aside, or abandoned. Although most antisocials react antagonistically to social rejection, these individuals drift along at the margins of society, scavenging whatever slim resources they come across. The nomadic variant combines antisocial with schizoid and/or avoidant characteristics. Most see themselves as jinxed or doomed and desire only to exist at the edge of a world that would almost certainly reject them. Mired in self-pity, they drop out of society to become gypsy-like roamers, vagabonds, or wanderers. With little regard for their personal safety or comfort, they may drift from one setting to another as homeless persons involved in prostitution and substance abuse.Adopted children who feel uneasy about their place in the world sometimes follow the path of the nomadic antisocial, wandering from place to place in an apparently symbolic search for their true home or natural parents. Their sense of “being no place” signifies alienation from self and others. For this reason, nomadics often appear vaguely disconnected from reality and lack any clear sense of self-identity. Compared to other variants, nomadic antisocials often seem relatively harmless because of their attitude of indifference and disengagement. Some are indeed vacant and fearful, but others are deeply angry and resentful. As a consequence of alcohol or substance abuse, they may act out impulsively, discharging their frustrations in brutal assaults or sexual attacks on those weaker than themselves" [4].
THE MALEVOLENT ANTISOCIAL
"As a blend of the antisocial and paranoid or sadistic personalities, malevolent antisocials are often seen as the least attractive antisocials. Belligerent, rancorous, vicious, malignant, brutal, callous, vengeful, and vindictive, they perform actions charged with a hateful and destructive defiance of conventional social life. Like the paranoid, they anticipate betrayal and punishment. Rather than merely issue verbal threats, however, they seek to secure their boundaries with a cold-blooded ruthlessness that avenges every mistreatment they believe others have inflicted on them in the past. For them, tender emotions are a sign of weakness. They interpret the goodwill and kindness of others as hiding a deceptive ploy for which they must always be on their guard. Where sadistic traits are prominent, they may display a chip-on-the-shoulder attitude and a willingness to confirm their strong self-image by victimizing those too weak to retaliate or those whose terror might prove particularly entertaining. When confronted with displays of strength, malevolents are experts at the art of posturing and enjoy pressuring their opponents until they cower and withdraw. Most make few concessions and instead escalate confrontations as far as necessary, backing down only when clearly outgunned" [4].
4. Personality Disorders in Modern Life by Theodore Millon
Psychopathic and Antisocial-only
"Both subtypes of individuals are known to act on impulse, display aggression, and engage in antisocial behaviors. One distinguishing aspect of the behavior of the 'psychopathic' subtype is the presence of traits that reflect superficial interpersonal connections and blunted affect that impede their ability to form and maintain, meaningful, long-term relationships. On the one hand, the 'psychopathic' individual draws you in with charm and manipulation, but also engages in hostile, impulsive and irresponsible behavior with an uncanny selfish drive. On the other hand, the 'antisocial-only' individual engages in hostile, impulsive, and irresponsible behavior with a tinge of reactivity and brute force. Thus, despite many similarities in the actions of these individuals, a growing body of research suggests that relatively distinct socio-affective processes characterize these subtypes of individuals (11–14, 37–41)" [5].
THE PSYCHOPATHIC SUBTYPE
"The first subtype, which we term the 'psychopathic' subtype, are individuals infamous for their prolific antisocial behavior and their ability to be interpersonally manipulative and charming. They engage in elaborate cons, callously assault others, impulsively look for adventures, and chronically commit antisocial acts in order to obtain their goals (e.g., money, power, thrills). Psychopathic individuals commit two to three times more violent and non-violent crimes than non-psychopathic individuals, recidivate at a much higher rate, and are responsible for a disproportionate share of the estimated annual costs associated with crime in the United States (10). In his seminal writings, Cleckley states that the individual with psychopathy 'cannot be depended upon to show the ordinary responsiveness to special consideration or kindness or trust. No matter how well he is treated… he shows no consistent reaction of appreciation except superficial and transparent protestations. Such gestures are exhibited most frequently when he feels they will facilitate some personal aim' [(15), p. 354]. The individual with psychopathy, therefore, uses their ability to connect interpersonally and emotionally at a surface level in order to arrange their relationships and social transactions in ways that will benefit them, usually at the expense of others" [5].Some also argue that the psychopathy subtype can be broken down further into primary and secondary subtypes. To read more on this, click here.
THE ANTISOCIAL-ONLY SUBTYPE
"The second subtype, the 'antisocial-only' subtype, is defined by their chronic impulsive, irresponsible, reactively aggressive, and antisocial behavior. Unlike, the 'psychopathic' subtype, these individuals are not characterized by grandiose charm and a callous, lack of empathy. Rather, individuals in this subtype are typically assessed using diagnostic criteria that reflect various antisocial acts only. Adults in this subtype can be identified diagnostically by assessing for antisocial personality disorder (ASPD) using the criteria put forth by the DSM-5. ASPD is related to repeated social norm violations, impulsivity, irresponsibility, and aggression that began in childhood to persist into adulthood (34). In order to receive a diagnosis of ASPD, individuals must meet criteria for CD prior to the age of 16 (which can be diagnosed retrospectively). In the DSM-5, youth with CD are characterized by a pattern of behaviors that violate the rights of others or societal norms in several ways (e.g., aggression to people or animals, destruction of property, theft, rule violations, etc.). In terms of prevalence, estimates suggest that between 50 and 66% of male prisoners meet criteria for ASPD (35, 36). Finally, some researchers, particularly using young samples, examine cumulative scores of conduct problems that cut across rule-breaking and aggressive behavior" [5].
5. Cognitive Empathy in Subtypes of Antisocial Individuals
Primary and Secondary Psychopathy
"The distinction between primary and secondary psychopathy was first proposed in the 1940s (1). The former, also referred to as idiopathic or constitutional psychopathy, was historically considered the 'true,' 'pure,' or essential type of psychopathy, also equated with a low anxiety psychopathic type (2), and later referred to as primary psychopathy. In contrast, secondary psychopathy, sometimes referred to as neurotic, symptomatic, or reactive, was thought to result from or be secondary to other psychiatric conditions, leading to terms such as 'neurotic sociopath' (3) and later termed 'secondary psychopathy.'"The antisocial behavior often found in secondary psychopathy is similar to that of primary psychopathy, but is considered secondary to what was previously termed neurotic conflicts (1, 4). Contemporary conceptualizations of psychopathy maintain a two-component framework, such as the two-factor model (5, 6), where Factor I includes traits or personality characteristics such as superficial charm, lack of remorse, callousness, and egocentricity, and Factor II includes antisocial behaviors such as criminal behavior and poor behavioral control." [6].
"Although both factors are associated with antisocial behaviors, hostility and reduced empathy, primary psychopathic traits predominantly reflect interpersonaland affective difficulties and characteristics such as grandiosity, manipulative behaviors,superficial charm, a lack of remorse or guilt, and emotional detachment (Karpman,1941). Secondary psychopathic traits instead refer to antisocial and lifestyle features, often portrayed by individuals who are irresponsible, impulsive, incapable of long-term planning and display erratic, aggressive behaviors (Karpman, 1941)" [7].
* Author note: Here ASPD is referred to as APD, but the abbreviations are synonynous
6. Psychopathy: what are fearless people afraid of?7. Primary and Secondary Psychopathic Traits: Investigating the Role of Attachment and Experiences of Shame8. Psychopathy: A Review for the Pharmacist
Possible Causes
As there is a large amount of very conflicting research, I have attempted to include information from multiple sources, although the explanations and data provided may be only a small bite of the many theories and studies of ASPD. If you would like to read about the disorder from a single source, I highly recommend Theodore Millon's Personality Disorders in Modern Life, as he provides a lengthy explanation of the disorder and utilizes helpful charts and diagrams. I have not used his work as my sole source, as it does not have the most recent of information. Regardless, he is considered a great perspective on personality disorders, as he is largely unbiased and prioritizes science over morality."Current research and consensus suggests that the development of antisocial personality disorder is likely influenced by a combination of genetic and environmental factorsWhile the exact causes are still not fully understood, researchers have identified a few contributing factors:Genetic predisposition: Studies suggest that there is a genetic component to ASPD, so people who have a family history of the disorder may be at a higher risk of developing it themselvesChildhood trauma and other environmental factors:Traumatic childhood experiences, such as abuse, neglect, or witnessing violence, can contribute to the development of ASPD. Wider environmental factors, such as growing up in a chaotic or unstable environment, or lacking positive role models or social support, can also increase the risk of developing ASPDBrain abnormalities: Some research points to brain abnormalities, impairments, or injuries to certain parts of the brain as potential contributors to ASPD" [9]The following explanations are incomplete examples of the many perspectives and studies on the causes of ASPD, and we recommend further research to gain a more full understanding of what current research suggests
GENETICS
"Overall, estimates of the heritability of antisocial behavior (a component of both ASPD and psychopathy) have been equivocal, with one study reporting little and others reporting high (71%) heritability. This heterogeneity in heritability estimates may reflect sample characteristics [e.g., age, gender, nature of the sample (community v clinical) etc.] and methodological inconsistencies (e.g., assessor proficiency, assessment tool, etc.). Recent reviews and meta-analyses have shown evidence of strong genetic effects on antisocial behavior and shared and individual-specific environmental influences. Importantly, Rhee and Waldman's 2002 meta-analysis reported both additive and non-additive genetic contributions to antisocial behavior (32% and 9% respectively), along with 16% of the variance explained by shared environment and the remaining 43% explained by individual-specific environmental influences. Since the publication of that meta-analysis, other studies have yielded heritability estimates in a similar range - 38% genetic contribution to the variance in antisocial behavior."There are very few studies of the heritability of ASP disorder. One of the few studies was conducted by Fu and colleagues using the male-only Vietnam Era Twin Registry sample. They observed that 69% and 31% of the variance in ASPD was attributed to genetic and individual-specific environmental influences respectively, with no evidence for shared environmental influence. These findings are largely consistent with earlier research indicating a moderate correlation between proband and relative ASPD status (r = .43 +/− .05) suggesting familial aggregation of ASPD . However, family studies do not enable disentangling genetic influences from shared environmental influences."Investigations into the genetic and environmental contributions underlying psychopathy have relied on self-reports of psychopathic traits as opposed to diagnosis, and have suggested that psychopathic traits have substantial genetic influences. Rhee and Waldman included studies investigating psychopathic traits as an independent construct. Results from the best fitting model indicated that 49% of the variance in self-reported psychopathy was attributable to additive genetic effects and 51% to individual-specific environmental effects with scant evidence for shared environmental influences. More recent genetic investigations have corroborated these findings, in both adult and adolescent populations."Overall, results of these studies reveal that both psychopathic personality traits and ASPD are influenced by additive genetic factors and non-shared environmental factors with no significant contribution of shared environment. These findings differ from those indicating considerable shared environmental contributions to antisocial behavior. One proposed limitation to this body of research is that many heritability studies of psychopathy only assessed the antisocial deviance factor and did not include the affective-interpersonal traits that are central to the psychopathy construct. Inclusion of the affective-interpersonal factor of psychopathy may alter the behavioral genetic findings by revealing shared environment as a significant contributor to psychopathy and distinguishing the heritability of ASPD and psychopathy. Future research is needed to address this possibility" [10].
ENVIRONMENT
"Although there is substantial genetic liability for ASPD, environmental sources also play a role in its developmental course, and the current study focuses on two of these environmental sources: adverse childhood experiences and childhood psychopathology. Adverse childhood experiences, which encompass various forms of abuse, neglect, and impoverishment during childhood are prime examples of the negative socialization experiences that engender antisocial traits and behaviors. Similarly, childhood psychopathology, such as Attention-Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), and CD frequently serve as stepping stones toward a lifespan of recurrent antisocial behavior as seen in ASPD" [11]."A variety of studies have examined the associations between adverse childhood experiences and ASPD and produced varying results. Using prospective longitudinal data, Fergusson, Boden, and Horwood examined the association between childhood sexual abuse, childhood physical abuse, and ASPD and found that the prevalence of ASPD at ages 18–21 and 21–25 was two to four times greater among those that had been sexually abused compared to those who had not. Similarly, those who experienced regular physical abuse or severe physical abuse had ASPD at a prevalence that was two to seven times higher than those who were not physically abused. In multivariate models, sexual abuse predicting ASPD; however, physical abuse did not in the fully adjusted model. Douglas et al. studied three adverse childhood experiences, witnessing or experiencing a violent crime, sexual abuse, and physical abuse among a sample of subjects dependent on alcohol, cocaine, or opioids and found adverse childhood experiences increased the odds of ASPD by 1.47 increased odds" [11].
NEUROBIOLOGY
Of all the possible influencing factors in the development of ASPD, neurobiology-based theories appear to be ones with the least evidence. We have included examples of evidence that has been found, although there are also many studies that appear to disprove theories about brain abnormalities playing a significant role."Abnormalities have...been found in the symmetry of the hippocampi in unsuccessful psychopaths. Raine et al. (2004) found that unsuccessful psychopaths have an exaggerated asymmetry in the anterior hippocampus (right bigger than left), when compared to the healthy control group. An interesting point raised by Raine et al. (2004) is that an exaggerated asymmetry between right/left hippocampi is normally present in the fetus and becomes less exaggerated during the normal development of the child; thus, this normal development could be blocked or hindered as the child develops a personality disorder. Broken homes and uncaring families have long been implicated in the environmental conditions surrounding critical developmental periods in children with conduct disorder (CD) (Farrington, 2005). A traumatic upbringing could also be implicated in the deficits found in all of the aforementioned brain regions. Apart from being involved in the threat circuitry, the hippocampus is also implicated in spatial memory. If unsuccessful psychopaths suffer from poor memory, it could contribute to their inability to make good cognitive judgments. Memory deficits and poor social conditioning no doubt lead to poor integration."There appears to be a dynamic neural system (that is no doubt contingent upon input from other regions) between the frontal cortex and the limbic regions. Deficits in the frontal cortex (particularly the orbito frontal region), deficits in the amygdala, and deficits in the tract that joins the two, seem to be implicated in personality disorders or syndromes that involve aggression and social integration. The damage to these regions no doubt has behavioral implications for other regions that communicate with them via efferent/afferent tracts, such as the threat system involving the amygdala, hippocampus, and PAG, and higher order executive functions involving the frontal cortices. At the moment there are limited studies on these second-order implications outside of this immediate neural region" [12].
9. Born or made? Understanding antisocial personality disorder10. Epidemiology, Comorbidity, and Behavioral Genetics of Antisocial Personality Disorder and Psychopathy11. The etiology of antisocial personality disorder: The differential roles of adverse childhood experiences and childhood psychopathology12. The neurobiology of antisocial personality disorder: The quest for rehabilitation and treatment
Comorbidity
What the DSM-5-TR says
"Individuals with antisocial personality disorder may also experience dysphoria, including complaints of tension, inability to tolerate boredom, and depressed mood. They may have associated anxiety disorders, mood disorders, substance use disorders, somatic symptom disorder, and gambling disorder. Individuals with antisocial personality disorder also often have personality features that meet criteria for other personality disorders, particularly borderline, histrionic, and narcissistic personality disorders. The likelihood of developing antisocial personality disorder in adult life is increased if the individual experienced childhood onset of conduct disorder (before age 10 years) and accompanying attention-deficit/hyperactivity disorder" [2].
There may be conflicting statistics depending on the recency, location, and quality of each source of data. We encourge that you do your own research to find other studies that may have different results.
NPD
About 25% people with ASPD have narcissistic personality disorder [13]
BPD
About 6% to 27% of people with ASPD have BPD
In clinical and forensic settings the comorbidity are up to 57% [14]
ADHD
Up to 44% of adults with ADHD may also have ASPD [15]
Anxiety Disorder
Nearly 55% of people with ASPD have an anxiety disorder [16]
Substance Use
As much as 90% of people with ASPD abuse drugs or alcohol [17]
2. DSM-5-TR13. Differentiating Narcissistic and Antisocial Personality Disorders14. A psychometric investigation of gender differences and common processes across Borderline and Antisocial Personality Disorders15. Psychopathic traits in adult ADHD patients16. Lifetime comorbidity of antisocial personality disorder and anxiety disorders among adults in the community17. Links Between Substance Abuse and Antisocial Personality Disorder (ASPD)
Societal Usage of "Sociopath" and "Psychopath"
The origins of antisociality and psychopathy
The Mask of Sanity by Hervey M. Cleckley, M.D. (1941)
"The antisocial personality has been known since at least the ancient Greeks. In the 1800s, the origins of antisocial behavior were associated with the philosophical debate between free will and determinism. Given such a context, the physicians of the 1800s naturally wondered whether antisocial persons could understand the consequences of their own actions. Philippe Pinel (1801, 1806) referred to a form of madness known as la folie raisonnante, a tendency toward impulsive and self-damaging acts in the presence of unimpaired intelligence and full awareness of actions. Pinel’s observation was
intended to be descriptive, not value-laden. The idea that psychopathology could occur in the absence of mental confusion then spread throughout Europe but was still hotly debated."Other physicians regarded antisocial individuals as being defective in character and, therefore, worthy of moral condemnation. The term moral insanity, first used by Prichard (1835), crystallized this notion. Prichard held that despite understanding the choices before them, their conduct was swayed by overwhelming compulsions. He also broadened the syndrome to include diverse emotional and mental conditions, all of which shared a common inability to guide themselves according to an inner sense of rightness, goodness, and responsibility. Though unscientific, the idea of moral insanity still has a certain appeal, if only because the normal person often has no way of identifying with the more pathological actions of antisocials and psychopaths. Dahmer and Mudgett, discussed briefly at the beginning of this chapter, provide two examples. Toni is certainly less extreme, though we still wonder why she cannot understand the consequences her actions will have on her life."Subsequent writers suggested parallels between anatomical defects and defects of character, though in a way that would be considered amusing today. For example, some believed that a specific cerebral center controlled morality (Maudsley, 1874). Just as some individuals are colorblind, some were regarded as morally blind. Other writers held that antisocials were born delinquents possessing common physical features, such as a large, projecting lower jaw, outstretched ears, sloping forehead, left-handedness, robust physique, precocious sexual development, insensitivity to pain, and muscular agility (Lombroso, 1887). Stone (1993) suggests that society needs the comfort of believing that criminals somehow look different to reassure ourselves that we are protected from true psychopaths, who cloak themselves with the trite and ordinary."Toward the end of the nineteenth century, psychiatry began to turn away from moral classification and toward observational research. Koch (1891) proposed that the term moral insanity be replaced by psychopathic inferiority, explicitly casting the syndrome as an “inferiority of brain constitution” (p. 54). Though his intentions were the same as those of Pinel—to classify scientifically rather than morally—the choice of words was poor. “Inferiority” was eventually dropped in later usage, after the term traveled to the United States. The term psychopathic, literally meaning “psychological pathology,” endured for the first three decades of the twentieth century, referring to a broad range of conditions far beyond our contemporary antisocial personality. Cleckley’s 1941 work [as pictured above] crystallized the construct of psychopathy in its modern form, thus launching a research tradition that has flourished ever since" [4].As of now, ASPD is considered the umbrella term for both sociopathy and psychopathy in the DSM-5-TR, although psychopathy can still be given as a separate diagnosis, just not an officially coded one. The primary diagnostic tool for psychopathy is the Hare Psychopathy Checklist-Revised (PCL-R). Below is the list of statements given to patients who are being assessed for psychopathy. With the highest score possible being 40, typically a score of 30 or more is indicative of psychopathy. A common criticism of the PCL-R is that it does not specify what falls under each category, particularly the statements involving marital relationships. Many psychologists have suggested that including "frequent marital relationships" makes it harder to assess younger patients, while others argue that "marital relationships" can be considered an umbrella for romantic relationships that did not lead to marriage.
Societal usage
When mystery, crime, and horror media began to gain traction in the early 1900s, the concept of a fictional sociopath/psychopath became popularized and reinterpreted through the lens of entertainment rather than psychology. In order to create a realistic and disturbing villain, the usage of this character archetype became a common practice to get the audience really scared by the fact that the villain could be a real person. Although "psycho" was originally used as an abbreviation for "psychologist/psychology" in the 1920s, it later became slang for "psychopath/psychopathic" [18]. One of the earliest examples is the 1959 book Psycho, which tells the story of a psychopathic serial killer with "multiple personalities". The popularity of this book and its film adaptation is largely responsible for the terms becoming more widely used. After Psycho was American Psycho, a 1991 book (and later movie) that depicted the psychopath archetype as well-dressed, handsome, and charming. The shift from depicting psychopaths as introverted or strange to depicting them as having superficial charm and style is part of what has led to the modern reinterpretations of this fictional archetype and society's perception of psychopathy/sociopathy.Although many people still view psychopaths as terrifying and dangerous, there are many who have so greatly enjoyed seeing this character archetype that they have felt an unhealthy and unrealistic kinship to it. Many men in particular - primarily those who feel ostracized from society or who are bigoted and misogynistic - have developed an identification with psychopathic characters such as Norman Bates (Psycho), Patrick Bateman (American Psycho), the Joker (DC Comics), and Dexter Morgan (Dexter). The identification with the fictional psychopath archetype is not inherently wrong, but it has led to many individuals believing they are psychopathic despite not having been diagnosed with ASPD or otherwise. A reason why fiction is so deeply loved by most people is that it allows us to put ourselves in the shoes of characters who are living different lives than us. If the audience is able to put themselves in the shoes of a villainous character, it simply means that the author has done their job well. Many people who feel lonely or powerless may wish that they had the power and aggressiveness of a "psychopath", but that does not mean that they are one. Those who identify with psychopathic characters are more likely to simply be lovers of crime fiction, rather than meeting the criteria for actual ASPD and/or psychopathy.
The Modern ASPD Community
With the invention of the internet and the modern demonization of sociopathy/psychopathy came the development of the ASPD community, a subgroup of the online mental health community that consists of people who have or suspect they have antisocial personality disorder. This community largely strives to combat stigma and create safe spaces for people with ASPD to process their struggles without shame.The modern online mental health community has a significant tie to the online LGBTQ+ community, as well as other smaller communities such as the alterhuman/otherkin/therian/etc, genderqueer, and aromantic/asexual communities. In the LGBTQ+ community, the creation of flags to represent identities or orientations has spread to other online communities, the mental health and disabiled communities included. Below are the examples of the flags and symbols chosen to represent people with ASPD. The symbol depicted is an upside down scale, meant to represent the opposite of social and legal morals and justice.
ASPD awareness flag
Design by npdsafe on Tumblr
ASPD flag with symbol
Design by aspdsolac on Tumblr
ASPD symbol
Design by gashmasc on Tumblr
This online ASPD community has also greated a large collection of other ASPD-related identities, flags, and terms, some also intersecting with queerness and alterhumanity.
Angel ASPD: someone with ASPD who identifies as an angel
Coined by masobutch on Tumblr
ASPD Bunny: someone who has ASPD and a connection to bunnies
Coined by muldyke on Tumblr
ASPD 4 ASPD: someone with ASPD who prefers to or only dates others with ASPD
Design by woodbyne on Tumblr
4. Personality Disorders in Modern Life by Theodore Millon18. Origin and history of psycho
Terminology
ANTISOCIAL PERSONALITY DISORDER: Also referred to as ASPD, a psychiatric disorder in the DSM-5-TR characterized by "a pervasive pattern of disregard for and violation of the rights of others" [1].CONDUCT DISORDER: Also referred to as CD, a psychiatric disorder in the DSM-5-TR characterized by "a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms
or rules are violated" [2]. Evidence of this disorder must be present by age 15 to qualify for a diagnosis of ASPDADULT ANTISOCIAL BEHAVIOR: Also referred to as AAB, a psychiatric syndrome not in the DSM, in which one meets all criteria for ASPD, but there is no evidence of conduct disorder by age 15ASPD TRAITS: When a person has or is diagnosed with traits of ASPD, rather than the full disorderANTISOCIAL: A spectrum of traits involving legal and social rule-breaking exibited by those with and without ASPDASOCIAL: A preference for being alone for one or more reasons. NOT related to ASPDSOCIOPATH: An outdated term for antisocial traits included under the ASPD diagnostic umbrellaPSYCHOPATH: Another term included under the ASPD diagnostic umbrella that can be applied to certain individuals who qualify for psychopathy. Not a diagnosis, but a term for a presentation or collection of traits that may be applied to some people, primarily criminals, who are believed to have developed ASPD due to genetics rather than environment
AFFECTIVE/EMOTIONAL EMPATHY: The experience of being able to feel someone else's emotions. People with ASPD have a deficit in or lack of thisCOGNITIVE EMPATHY: The experience of being able to identify and understand someone else's emotions. Many people with ASPD have cognitive empathy, while others have a deficit in or lack of this tooCOMPASSION: The act of supporting someone else's emotions through words and/or actions. Compassion is a choice that anyone can make, regardless of their empathy or lack thereof
PERSON TYPES: A label given based on the type of attachment that a person with a personality disorder has to another person. Based on the more commonly used "favorite person" for those with BPDEXCEPTION PERSON: Someone whom a person with ASPD considers to be an exception to their antisocial traits, or someone they consider better than other people (abbreviated as EP or EXP)SOCIAL PERSON: Someone whom a person with ASPD feels the most comfort and enjoyment from socializing with (abbreviated as SOP or SOC)PARTNER IN CRIME: Someone whom a person with ASPD sees as a partner to do fun or reckless behaviors with (abbreviated as PIC)
1. NIH: Antisocial Personality Disorder2. DSM-5-TR
About the Website Creator
Who are we?
We are an adult system titled The Void System, but you may refer to us as Void. Our pronouns are void/it/he. Kindly do not refer to us as they/them, as those are not our pronouns. Our primary gender identity is agender and we are on the aroace spectrum.
Why did we make this database?
We have Antisocial Personality Disorder / traits and wanted to create a collection of information that people can easily access to learn more about the disorder without being overwhelmed by the massive amounts of misinformation and uninformed stigma online.We have heard from many other people with ASPD that researching this disorder is both difficult and upsetting, as internet searches often lead to information being published by communities of people who know nothing about what sociopathy/psychopathy is, and people who pretend to have ASPD to imitate fictional characters or appear "edgy", rather than trained psychologists and people who have the disorder.
What other disorders do we have?
We have been diagnosed with many disorders by different psychologists, but we will list the primary ones that we believe are relevant to understanding us.- Antisocial Personality Disorder *
- Narcissistic Personality Disorder
- Dissociative Identity Disorder
- Autism Spectrum Disorder
- (Complex) Post Traumatic Stress Disorder
- Psychotic Disorder / Symptoms of Psychosis* We have been diagnosed with ASPD traits due to our psychologist believing it would be negative to give us both NPD and ASPD diagnoses officially, but it is generally agreed upon that we have ASPD
How can you see more from us?
Our Tumblr is @narc-rantsPLEASE...- DO NOT ask us for therapeutic advice. We cannot legally offer you paid sessions and we are not interested in being a sounding board for your trauma- DO NOT ask us to identify if someone you know has ASPD. Only a trained and certified psychologist who has met the person themself is qualified to diagnose them- DO NOT bother sending us weird messages about how evil we are or how we need god. We are an atheistic Satanist and your threats and preaching is actually just a source of amusement for us. We suggest you save your breath for someone who cares
Our Informal Research Study
Our aim
To informally collect data on Narcissistic Personality Disorder and analyze patterns in the results. We do not make any claims that the data we collect will be accurate or that our data pool will be free of factors that may sway our results in ways that would not occur in a formal settingWE DO NOT ENCOURAGE THE USE OF OUR FINDINGS TO SUPPORT YOUR OWN STUDY, AS WE CANNOT GUARANTEE THE ACCURACY OF OUR RESULTS OR THE HONESTY OF OUR PARTICIPANTS
Hypotheses
We hypothesize that our results will support the following claims:The majority of our participants with NPD will...
- have experienced caregiver abuse
- identify as being on the aromantic spectrum
- identify as being on the asexual spectrum
- have been abused more than having inflicted it
- be against or conflicted by the concept of recovering from their disorderOf our participants with NPD who identify as alterhuman/otherkin/therian/etc, the majority will...
- identify with or as a diety, demon, or other spiritual beingOur participants with NPD who are also diagnosed with ASPD or ASPD traits will...
- have a higher rate of physical and sexual abuse of humans than those without
- have a higher rate of animal abuse than those without
The study
Our study is being conducted using a survey with a list of 25 questions, given to two groups of anonymous participantsSurvey one is for our sample group, those with professionally diagnosed NPDSurvey two is for our control group, those without NPD, NPD traits, or suspicion that they have itBoth surveys are identical, with the exception of necessary changes that do not impact the results
The surveys
If you would like to view the surveys or participate in the study, it is still ongoing and we are still accepting new participants to grow our sample sizeSURVEY ONE - only take this survey if you have been professionally diagnosed with NPDSURVEY TWO - only take this survey if you do not have NPD, NPD traits, or suspicion that you have it
Current findings
In question 18 of survey one, 60 participants were asked to choose one or multiple responses to the following question:
In my childhood, I was abused by my caregivers in one or multiple ways
