Antisocial Personality

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Antisocial personality disorder (APD) is a condition in which people disregard the rights of others and violate those rights by acting in aggressive, irritating, and even criminal ways. APD begins in childhood and early adolescence. People with APD engage in bullying, vandalism, violence, and lying, and they do not feel guilt or regret for their actions. Two-thirds of those diagnosed with APD are male.

The causes of APD are not known, but low levels of serotonin, a brain chemical, may be one factor. Problems with the functioning of dopamine, another brain chemical, may also play a role. APD patients often have antisocial relatives, with substance abuse, divorce, and child abuse common in the family.

A large percentage of alcohol and drug abusers suffer from APD. For some, the abuse of alcohol or drugs causes the antisocial behaviors. For other abusers, substance abuse is just one expression of a wide range of antisocial behaviors.

A child who exhibits antisocial behavior problems is at greater risk for alcoholism later in life. Alcoholism in people with APD is usually more severe and of longer duration than in people without APD. The onset of symptoms of alcoholism in those with APD usually occurs earlier, at age 20, compared to nearly age 30 for those without APD. APD alcoholics do not respond as well to treatment, relapsing much earlier than alcoholics without APD. While males with APD have a shortened life expectancy, the disorder tends to get better with age or at least to stabilize.

Research reports suggest that alcoholism complicated by APD is more heritable than non-APD alcoholism. In a Swedish adoption study, for adopted sons whose biological fathers had APD and alcoholism, the risk of alcoholism was nine times that of adopted sons whose biological fathers did not have APD.

Females with APD frequently develop eating disorders as well as substance abuse disorders. Most of these patients have bulimia nervosa rather than anorexia nervosa. Treatment of an eating disorder generally takes longer in women with APD than in those without it.

AIDS presents other dangers for substance abusers with APD. Males with APD have a high rate of risky behaviors related to HIV infection. These behaviors include using intravenous (injected) drugs, sharing needles, having sex with multiple partners, and engaging in anal sex.

Most patients diagnosed with APD improve over time with treatment. The most beneficial forms of therapy for APD appear to be group and family therapies rather than individual psychotherapy or medications.

Addictive Personality; Alcohol: Psychological Consequences of Chronic Abuse; Childhood Behavior and Later Drug Use; Conduct Disorder; Risk Factors for Substance Abuse.

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