The Antisocial Personality

Antisocial personality disorder (ASP) is a personality disorder officially recognized by the American Psychiatric Association and often associated with substance abuse and criminal behavior. The key features of the disorder are outlined in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, commonly known as the DSM-IV. The essential feature of this disorder is “a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood” (American Psychiatric Association 1994: 645). Common signs of childhood development of ASP are lying, stealing, fighting, resisting authority, and cruelty to animals. Aggressive sexual behavior, excessive drinking, and drug abuse are common in adolescence. Adult manifestations include illegal behavior, deceitfulness, recklessness, violence, substance abuse, job troubles, and marital difficulties. A diagnosis of ASP is not made unless the individual is at least 18 years old.

One of the earliest and most extensive clinical descriptions of the antisocial personality was Hervey Cleckley's psychopath syndrome, described in his classic book The Mask of Sanity. Cleckley's indicators of ASP are somewhat different from those in the DSM-IV, as he placed more emphasis on underlying personality traits, such as lack of remorse, guilt, or empathy, and total self-centeredness. Cleckley often described antisocials as having an inner emptiness. He suggested that people with ASP lack inhibitions about committing antisocial acts, do not fear impending punishments, often act without regret or shame, are unable to learn from experience, and are impulsive and aggressive. Davison and Neale (1990: 260) further describe the antisocial personality as “disruptive individuals whose deep-seated ethical and moral maladjustments frequently bring them into serious conflict with their associates and with society.” In short, these people are poorly socialized and seem to lack a conscience, although they can be quite charming if it serves their immediate purpose.

Research shows that individuals diagnosed with ASP often abuse alcohol and drugs and often commit crimes. Approximately 90 percent of persons diagnosed with ASP are substance abusers. Furthermore, antisocial substance abusers commit more crimes as well as more serious crimes. The treatment of ASP is a major issue; although much attention has been paid to developing effective treatments for ASP, there is relatively little scientific evaluation of these programs, and most treatment decisions are made on the basis of case studies, anecdotes, and opinion reported in the professional literature.