What Triggers the Development of Antisocial Personality Disorder?

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Antisocial personality disorder (ASPD) impacts relationships and affects how people approach recovery from substance use disorder (SUD). Understanding what causes co-occurring disorders like ASPD helps clients and their families know what to expect during treatment and long-term recovery. Often, families are the ones who encourage the need for treatment. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), "Antisocial personality disorder can be difficult to treat. Typically, individuals with this condition don't seek treatment on their own." Pathways Recovery Center educates families and clients about what triggers antisocial personality disorder, treatment options, and how ASPD impacts recovery from SUD. 

What Is Antisocial Personality Disorder?

Antisocial personality disorder is characterized by manipulating, exploitative, and violating behaviors. Often, people with ASPD don't respect personal or social boundaries and rules. Individuals with ASPD use their appearance, skills, and resources to manipulate or intimidate others to achieve their own goals. 

According to the previously mentioned article by the SAMHSA: 

A person with antisocial personality disorder may:

  • Be able to act witty and charming
  • Break the law repeatedly
  • Be good at flattery and manipulating other people's emotions
  • Disregard the safety of self and others
  • Have problems with substance misuse
  • Lie, steal, and fight often
  • Not show guilt or remorse
  • Often be angry or arrogant

Men are more likely to be diagnosed with ASDP. The symptoms are often noticeable in adolescence and young adulthood. Many people with ASDP have a history of harming animals or setting fires as children. The disregard for the pain they cause others makes it difficult to get them to enter treatment willingly. Pathways Recovery Center works with families to facilitate interventions for individuals struggling with SUD and co-occurring ASDP. 

Risk Factors and Causes

The first signs of ASPD begin early in life. Often family and friends notice unusually violent and self-focused behaviors in adolescence. Children with no support system and a lack of stability at home have a higher risk of developing ASPD. However, any child, regardless of socioeconomic status or home environment, has the potential to be diagnosed with the disorder. Researchers have not identified any specific cause of ASDP. 

Some known risk factors include:

  • Genetics
  • Childhood abuse and trauma
  • Diagnosed childhood misconduct or attachment disorders
  • Violent, unstable, toxic, or neglectful home environment during childhood 
  • Family history of ASPD or other mental health disorders 

The symptoms of ASPD significantly increase the risk of developing substance misuse and other risk-taking behaviors. People with ASPD often believe the rules of society and the law don't apply to them, and they manipulate others to achieve their goals. Most people diagnosed with ASPD have experienced trauma and use charm or manipulation to avoid being hurt again. The maladaptive behaviors are often done to protect the person from experiencing betrayal or other emotional pain. Treatment helps clients with co-occurring SUD and ASPD find healthy ways to cope with stressful situations. 

Common Co-Occurring Disorders

People diagnosed with ASPD often have more tense relationships with loved ones, which can contribute to the development of additional co-occurring disorders. According to the journal Psychosis, research has shown "clients with ASPD in addition to co-occurring disorders are a particularly disadvantaged group with greater illness severity, more impaired functioning, and more strained family relationships." The vulnerability of individuals with ASPD makes them especially prone to being diagnosed with multiple conditions. 

Some of the most common co-occurring disorders experienced by individuals with ASPD include: 

  • Schizophrenia
  • Bipolar disorder (BD) 
  • Substance use disorder (SUD)
  • Major depression

Mental health education, counseling, and ongoing outpatient services often provide the best support for individuals with these conditions. According to one research study published in BMC Psychiatry, "Impulsive lifestyle [counseling] … had an impact on substance use in terms of drug use problems and days abstinent for outpatients with substance use disorders and antisocial personality disorder." Family engagement in treatment and recovery often ensures the best outcome. 

How Does Pathways Recovery Center Treat Antisocial Personality Disorder?

Antisocial personality disorder is challenging to treat. In many cases, the client and their family have strained relationships, and the client enters treatment unwillingly. Finding healthy ways to bridge those gaps and repair damaged relationships provides a solid foundation for future changes and healing. Clients and their families frequently experience traumas related to ASPD. Often, all members of the family unit benefit from attending individual and family therapy. Pathways Recovery Center encourages families to actively participate in their loved one's recovery. 

Individuals with ASPD may push the people closest to them away and cause conflict or friction within relationships. Compassion and empathy are exploited, leading to social isolation. Sometimes co-occurring mental health disorders cause more severe symptoms. Studies have shown "[F]amily therapy focuses . . . on the immediate family environment and uses the resources of the family to change the pattern of antisocial [behavior]." 

Family involvement in treatment and the support of peers in group therapy helps clients with ASPD develop pro-social behaviors. Pathways Recovery Center supports families and individuals affected by co-occurring SUD and ASPD by ensuring they have access to the tools and resources they need to heal. 

Researchers still aren't sure what triggers antisocial personality disorder. However, children who experience trauma during childhood have a higher risk of developing ASPD, substance use disorder, and other mental health disorders. The first signs usually appear early on in childhood and young adulthood. Over time, the risk-taking and manipulative behaviors worsen and may lead to relationship issues and criminal behaviors. Pathways Recovery Center uses evidence-based treatments to help people with ASPD and co-occurring SUD. Treatments often involve cognitive-behavioral therapy (CBT) and behavior modification. The dedicated clinicians at Pathways Recovery Center collaborate closely with clients and their loved ones to create a comprehensive and effective treatment plan. To learn more about our programs and services, call us at (888) 771-0966.

Clinically reviewed by 

Moses Nasser
Dr. Moses Nasser, a double board-certified physician in Family Medicine and Addiction Medicine, with expertise in holistic healing, addiction medicine, and psychiatric care, holds an X-waiver to prescribe buprenorphine and has extensive experience in mindfulness-based customer service and medication-assisted treatment.

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