Antisocial Personality Disorder: Understand, Recognise and Support Change

Antisocial Personality Disorder (ASPD) is a complex and often misunderstood mental health condition. It is characterised by a long-standing pattern of disregard for others, violation of societal rules, and a lack of empathy or remorse.

People with ASPD may engage in manipulative, deceitful, or criminal behaviour, but behind these behaviours can be a deep history of trauma, neglect, or early behavioural issues. While treatment is challenging, it is not impossible, especially when approached with professional insight, firm boundaries, and long-term therapeutic goals.

What is Antisocial Personality Disorder?
ASPD is a diagnosable personality disorder listed in the DSM-5-TR. It is typically diagnosed in adulthood but requires evidence of Conduct Disorder before age 15. The condition often includes:

• Disregard for others’ rights and feelings
• Repeated lying, deceit, or manipulation
• Impulsivity and failure to plan ahead
• Irritability and aggressive behaviour
• Lack of remorse after harming others
• Consistent irresponsibility (e.g., financial, work-related)
• Criminal behaviour or arrests

In Australia, ASPD is more commonly recognised in forensic and correctional settings, but it is also seen in general mental health and community care settings.

What Causes ASPD?
ASPD arises from a mix of genetic, neurological, psychological, and environmental factors. Contributing risk factors include:

• Childhood trauma or abuse
• Neglect or unstable caregiving environments
• Early behavioural problems (e.g., aggression, cruelty to animals, truancy)
• Family history of personality disorders or substance use
• Brain differences in areas related to impulse control and empathy

Recognising the Signs of ASPD
ASPD symptoms may present as:

• Frequent conflict with authority figures
• Chronic rule-breaking or deceit
• Poor impulse control
• Exploiting or harming others without guilt
• Disregard for safety (self or others)
• Superficial charm or charisma masking manipulative behaviour
• Lack of long-term, stable relationships

Myths about ASPD
Myth: People with ASPD are “evil” or “monsters.”
Truth: ASPD is a mental health condition with behavioural and emotional roots—often tied to early trauma. While some behaviours are harmful, effective management is possible with the right support.

Myth: There’s no point in treating ASPD.
Truth: While ASPD can be resistant to change, structured treatment focused on behaviour, accountability, and therapeutic engagement can reduce harmful behaviours and improve functioning.

Why Seeking Help Matters
Left untreated, ASPD can lead to repeated legal issues, substance abuse, interpersonal violence, or homelessness. But intervention can:

• Improve emotional regulation
• Reduce criminal or risk-taking behaviour
• Support the development of healthier relationships
• Address co-occurring mental health issues like depression, anxiety, or addiction

How MeHelp Psychology Can Assist You
Our team of psychologists is trained in managing complex behavioural patterns with empathy, firm boundaries, and evidence-based practice. While ASPD requires a nuanced, long-term approach, we offer:

• Schema Therapy: To address deep-rooted patterns of behaviour and early maladaptive schemas
• Cognitive Behavioural Therapy (CBT): To challenge distorted thinking and encourage prosocial behaviour
• Dialectical Behaviour Therapy (DBT) Skills: For emotion regulation, distress tolerance, and interpersonal effectiveness
• Motivational Interviewing: To build insight and support engagement in treatment
• Co-occurring Treatment: For substance use or trauma-related difficulties

Real-Life Example
Ben, 28, had a history of conflict with the law and difficulty maintaining employment. Initially reluctant to engage, he was referred for therapy after a community corrections order. Through structured sessions focusing on accountability, self-awareness, and skill-building, Ben reduced his risk-taking behaviour, improved his relationship with his family, and started a vocational course.

Practical Steps for Managing ASPD Traits

• Consistency and Structure: Routine and firm boundaries support behavioural stability.
• Therapeutic Alliance: Building trust with a therapist takes time but is foundational to progress.
• Accountability Over Blame: Therapy focuses on responsibility, not punishment.
• Avoid Substance Abuse: Drugs and alcohol often worsen impulsivity and aggressive behaviour.
• Seek Support: Involvement of family or community services can help stabilise life circumstances.

Frequently Asked Questions (FAQs)
Can someone with ASPD get better?
Yes, although the process is often slow. Improvements can be made in emotional regulation, impulse control, and relationships, especially with consistent support and commitment.

Is online therapy appropriate for ASPD?
In most cases, yes. Online sessions work best with a structured plan and clear boundaries.

Do people with ASPD want help?
Not always initially. But many seek support after recognising consequences of their behaviour or when linked to legal or relationship challenges.

Is a GP referral needed?
Not for private sessions. But for Medicare rebates, a Mental Health Care Plan is required. We can guide you through the process.

Take the First Step
ASPD is a serious condition, but with structured care and the right clinical approach, real progress is possible. MeHelp Psychology offers compassionate, firm, and effective support for individuals managing ASPD traits or diagnoses.

Book your first session today and begin your path toward behavioural change and emotional stability.