Most people use the word antisocial to refer to people who find it difficult, unpleasant or seemingly unpleasant to relate to . It is basically used as a synonym for a withdrawn and selective person.

However, in psychology the term antisocial is used to designate something completely different, a type of disorder known as antisocial personality disorder that tends to be linked to behaviour that is contrary to social norms and even to the law, ignoring the rights of others in favour of one’s own.

Personality disorders

Throughout our development, we human beings are gradually building our identity. During childhood, adolescence and youth we try and acquire values, beliefs, ideologies or even appearances that allow us to finally find who we are, forming an “I” that we would like to be and shaping a way of seeing, thinking and acting in the world. This continuous and relatively stable pattern of way of being is what we call personality .

However, in many cases the personality that is configured throughout the life cycle is extremely maladaptive, being a very inflexible and continuous element that causes suffering to the person and makes it difficult for him/her to integrate into social, work and personal life.

The study of these maladaptive behaviour patterns, which are now considered personality disorders due to the high level of maladjustment and discomfort they cause in themselves or in the environment, has generated different categories according to the thought, emotion and behaviour patterns of those who suffer from it.

They are generally divided into three large groups or clusters, sharing several common characteristics with each other. Within cluster A there are behavioural patterns considered to be eccentric and the disorders that would form part of it would be paranoid, schizoid and schizotypal disorder.

Cluster C groups personality disorders that include fearful and anxious behaviours such as avoidance, dependence and obsessive-compulsive personality disorder.

Cluster B groups disorders characterized by the presence of drama, emotion and/or instability . Among them are borderline personality disorders, the narcissistic, the histrionic or the one we are dealing with today, the antisocial personality disorder.

Antisocial personality disorder

Antisocial personality disorder is a pattern of behavior characterized by inattention and violation of the rights of others in favor of one’s own , which appears before the age of fifteen. This disregard can manifest itself through various types of behaviour, including criminal behaviour punishable by law.

On a personality level, it can be observed that those who present this disorder usually have a low level of kindness and responsibility , which together make it easier for them to get into disputes with other individuals and with the system.

Generally, these people are ambitious and independent; they are individuals with little tolerance to frustration, little sensitivity to the feelings of others and a very high level of impulsiveness . They act without thinking about the consequences of their actions both for themselves and for others.

As with psychopaths, many of them are extraverted people and have considerable charm and relational ease, but only on a superficial level. They tend to possess narcissistic characteristics, considering their well-being above the rest, and they often use deception and manipulation to achieve their goals.

These people have an unstable lifestyle , because they are too big to make plans for the future and consider the repercussions of their actions. That is why they are generally irresponsible and find it difficult to take on that which implies a commitment, which together with the rest of the characteristics mentioned above, causes people with antisocial personality disorder to present serious problems in adapting to society, having difficulties on a personal, work and social level.

All this causes them to frequently suffer from depressive and tension problems and addictions to different substances or activities. Although this disorder facilitates criminal behaviour, it is necessary to take into account that this does not imply that all criminals are antisocial or that all antisocials are criminals .

Possible causes

As with all personality disorders, establishing the causes of antisocial personality disorder is a complex process that requires consideration of a wide variety of variables, given that personality is an element that is constructed continuously throughout development.

Although their specific causes are not known, a great variety of more or less accepted hypotheses have been established .

1. Biological hypotheses

Studies carried out with twins and adopted individuals show the presence of a certain genetic component, t rmitting some personality characteristics that may cause the disorder to be generated .

The characteristics of this disorder suggest problems of frontal and prefrontal activation, the areas that regulate the inhibition of impulses and govern processes such as planning and forecasting of results.

In people with antisocial personality disorder it has also been found that there is less activation than usual in the amygdala. Bearing in mind that this area of the limbic system governs aversive responses such as fear, an element which leads to the negative evaluation of a situation and therefore allows an impulse to be inhibited, this could lead to the difficulty in curbing behaviour which people with this type of personality display.

2. Psychosocial hypotheses

On a more psychosocial level, it is common for those with antisocial personality disorder to have had a childhood in which they had ineffective parental role models, in conflicting or overly permissive environments.

It is common for them to have parents who are hostile, abusive or mistreating. Thus, with these types of models they may end up assuming that exercising their will is above other considerations , which they will replicate in adulthood.

Cases have also been found at the opposite end: with absent or overly permissive parents, children end up learning that they can always do their own thing, and that they react in a vengeful way to the cessation or threat of cessation.

Another element to take into account is that antisocial personality disorder may be preceded by another type of behavioural disorder in childhood: dissocial disorder . Although it does not occur in all cases, having had a dissociative disorder in childhood multiplies the risk that as an adult the individual will end up developing antisocial disorder.

Some authors consider that the basic problem is the slowing down of cognitive development, which prevents them from being little able to put themselves in the role of other people and see the world from perspectives different from their own.

Treatments applied

The treatment of personality disorders in general is complicated , since they are configurations that include behaviours and ways of seeing and acting that have been acquired and reinforced throughout life. In addition, people often consider this to be their way of being, so they are not likely to want to change it unless they perceive it as causing them excessive distress.

In the case of antisocial personality disorder, the treatments usually have one more complication, and that is that the treatment is usually imposed either by those close to you or by the courts after committing a crime. Thus, the subject in question is usually not cooperative when seeing it as an external imposition, not generally accepting the need for treatment.

In therapy, the management of these cases requires that the patient is asked not only what is intended to be achieved and how to do it, but especially to make him/her aware of the need for change and the advantages and disadvantages that this would have in his/her life.

As far as possible, the therapist must be able to make himself or herself be seen as someone respectable and close who does not seek to impose his or her authority, avoiding possible resistance from the patient and facilitating the establishment of a good therapeutic relationship.

Going through psychotherapy

It is common to apply cognitive therapy (specifically dialectically oriented brief cognitive therapy, based on Linehan’s dialectical therapy), in which training sessions are used in which skills of awareness, interpersonal effectiveness, emotional regulation and frustration tolerance are addressed.

The aim is first of all to arouse interest in the long-term consequences of the treatment and to make people understand how their own behaviour affects others, and then to try to increase interest in the well-being of others.

Other useful elements include having the patient tell his or her life story, as this can greatly help the patient to observe events that have happened to him or her in a different way and to reflect on his or her life. The work on the capacity for empathy, although complicated for this type of patient, can be increased through exercises such as role reversal .

Psychoeducation of the subject’s immediate environment is also helpful, in order to help establish limits on behaviour and to have a greater capacity to cope with the situation.

Pharmacological treatments?

At the pharmacological level there is no specific treatment for antisocial personality disorder . This is due, among other things, to the fact that the behavioural patterns associated with this condition are so entrenched in the person’s daily life that an approach based on the reductionism of acting on certain brain circuits only encompasses the full extent of this phenomenon. After all, part of the disorder is also in the way the person establishes relationships with others, and these relationships reinforce this type of maladaptive behaviour because of their expectations.

However, it may help to give substances that keep the mood stable, such as some antidepressants (SSRIs are often used). Of course, this doesn’t solve the whole problem, but it can be a supplement.

However, it should be borne in mind that this type of disorder is often associated with the consumption of psychoactive substances, and it is not uncommon for addictions to appear.

Bibliographic references:

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Fifth edition. DSM-V. Masson, Barcelona.
  • Davidson, K.M. & Tyrer, P. (1996). Cognitive therapy for antisocial and borderline personality disorders. Single case study series. British Journal of Clinical Psychology, 35 (3), 413-429.
  • Quiroga, E. & Errasti, J. (2001). Effective psychological treatments for personality disorders. Psicothema, Vol. 13, no. 3, pp. 393-406. University of Almería and University of Oviedo.
  • Santos, J.L. ; García, L.I. ; Calderón, M.A. ; Sanz, L.J.; de los Ríos, P.; Izquierdo, S.; Román, P.; Hernangómez, L.; Navas, E.; Ladrón, A and Álvarez-Cienfuegos, L. (2012). Clinical Psychology. Manual CEDE de Preparación PIR, 02. CEDE. Madrid.