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Prognosis[edit]

According to Professor Emily Simonoff of the Institute of Psychiatry, Psychology and Neuroscience many variables are consistently connected to ASPD, such as: childhood hyperactivity and conduct disorder, criminality in adulthood, lower IQ scores and reading problems[1]. The strongest relationship between these variables and ASPD are childhood hyperactivity and conduct disorder. Additionally, children who grow up with a predisposition of ASPD and interact with other delinquent children are likely to later be diagnosed with ASPD[2][3]. Like many disorders, genetics play a role in this disorder but the environment holds an undeniable role in its development.

There may be a high variability of the long-term outlook of antisocial personality disorder. The treatment of this disorder can be successful, but it entails unique difficulties. It is unlikely to see rapid change especially when the condition is severe. As a result of the characteristics of ASPD (e.g., displaying charm in effort of personal gain, manipulation), patients seeking treatment (mandated or otherwise) may appear to be "cured" in order to get out of treatment.[4] Without proper treatment, individuals suffering with ASPD could lead a life that brings about harm to themselves or others. This can be detrimental to their families and careers. ASPD victims suffer from lack of interpersonal skills (e.g., lack of remorse, lack of empathy, lack of emotional-processing skills)[5][6]. As a result of the inability to create and maintain healthy relationships due to the lack of interpersonal skills, individuals with ASPD may find themselves in predicaments such as divorce, unemployment, homelessness and even premature death[7][8]. Comorbidity of other mental illnesses such as Depression or Substance Abuse Disorder is prevalent among ASPD victims.

Epidemiology[edit]

As seen in two North American studies and two European studies, ASPD is most commonly seen in men rather than women, with men being three to five times more likely to be diagnosed with ASPD than women[9][4]. The prevalence of ASPD is even higher in selected populations, like prisons, where there is a preponderance of violent offenders. It has been found that the prevalence of ASPD among prisoners is just under 50%[9]. Similarly, the prevalence of ASPD is higher among patients in alcohol or other drug (AOD) abuse treatment programs than in the general population, suggesting a link between ASPD and AOD abuse and dependence[9][10]. As part of the Epidemiological Catchment Area (ECA) study, men with ASPD were found to be three to five times more likely to abuse alcohol and illicit drugs than those men without ASPD[11]. While ASPD occurs more often in men than women, there was found to be increased severity of this abuse in women with ASPD. In a study conducted with both men and women with ASPD, women were more likely to misuse substances compared to their male counterparts[11][12].

Individuals with ASPD are at an elevated risk for suicide[8]. Some studies suggest this increase in suicidality is in part due to the association between suicide and symptoms or trends within ASPD, such as criminality and substance abuse[13]. Offspring of ASPD victims are also at risk[14]. Some research suggests that negative or traumatic experiences in childhood, perhaps as a result of the choices a parent with ASPD might make, can be a predictor of delinquency later on in the child's life[3]. Additionally, with variability between situations, children of a parent with ASPD may suffer consequences of delinquency if they're raised in an environment in which crime and violence is common[2]. Suicide is a leading cause of death among youth who display antisocial behavior, especially when mixed with delinquency. Incarceration, which could come as a consequence of actions from a victim of ASPD, is a predictor for suicide ideation in youth[15][16].

NStoinski (talk) 20:26, 28 March 2020 (UTC)

Original (03/12/2020):

Prognosis[edit]

According to Professor Emily Simonoff of the Institute of Psychiatry, Psychology and Neuroscience, "childhood hyperactivity and conduct disorder showed equally strong prediction of antisocial personality disorder (ASPD) and criminality in early and mid-adult life. Lower IQ and reading problems were most prominent in their relationships with childhood and adolescent antisocial behaviour."

According to Harvard Medical School, there is a high variability of the long-term outlook of antisocial personality disorder. The treatment of this condition can be successful but it is unlikely to see rapid change especially when the condition is severe.

Epidemiology[edit]

ASPD is seen in 3% to 30% of psychiatric outpatients. The prevalence of the disorder is even higher in selected populations, like prisons, where there is a preponderance of violent offenders. A 2002 literature review of studies on mental disorders in prisoners stated that 47% of male prisoners and 21% of female prisoners had ASPD. Similarly, the prevalence of ASPD is higher among patients in alcohol or other drug (AOD) abuse treatment programs than in the general population,suggesting a link between ASPD and AOD abuse and dependence.


  1. ^ Simonoff, E., Elander, J., Holmshaw, J., Pickles, A., Murray, R., & Rutter, M. (2004). Predictors of antisocial personality: Continuities from childhood to adult life. British Journal of Psychiatry, 184(2), 118–127. https://doi.org/10.1192/bjp.184.2.118
  2. ^ a b Azeredo, A., Moreira, D., Figueiredo, P. et al. Delinquent Behavior: Systematic Review of Genetic and Environmental Risk Factors. Clin Child Fam Psychol Rev 22, 502–526 (2019). https://doi.org/10.1007/s10567-019-00298-w
  3. ^ a b Baglivio, M. T., Wolff, K. T., Piquero, A. R., & Epps, N. (2015). The relationship between adverse childhood experiences (Ace) and juvenile offending trajectories in a juvenile offender sample. Journal of Criminal Justice, 43(3), 229–241. https://doi.org/10.1016/j.jcrimjus.2015.04.012
  4. ^ a b Fisher KA, Hany M. Antisocial Personality Disorder. [Updated 2019 Nov 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546673/
  5. ^ Mann, F. D., Briley, D. A., Tucker-Drob, E. M., & Harden, K. P. (2015). A behavioral genetic analysis of callous-unemotional traits and Big Five personality in adolescence. Journal of Abnormal Psychology, 124(4), 982–993. https://doi.org/10.1037/abn0000099
  6. ^ Habel, U., Kühn, E., Salloum, J. B., Devos, H., & Schneider, F. (2002). Emotional processing in psychopathic personality: Emotion and Psychopathy. Aggressive Behavior, 28(5), 394–400. https://doi.org/10.1002/ab.80015
  7. ^ Mueser, K. T., Crocker, A. G., Frisman, L. B., Drake, R. E., Covell, N. H., & Essock, S. M. (2005). Conduct disorder and antisocial personality disorder in persons with severe psychiatric and substance use disorders. Schizophrenia Bulletin, 32(4), 626–636. https://doi.org/10.1093/schbul/sbj068
  8. ^ a b Krasnova, A., Eaton, W. W., & Samuels, J. F. (2019). Antisocial personality and risks of cause-specific mortality: Results from the Epidemiologic Catchment Area study with 27 years of follow-up. Social Psychiatry and Psychiatric Epidemiology, 54(5), 617–625. https://doi.org/10.1007/s00127-018-1628-5
  9. ^ a b c National Collaborating Centre for Mental Health (UK). Antisocial Personality Disorder: Treatment, Management and Prevention. Leicester (UK): British Psychological Society; 2010. (NICE Clinical Guidelines, No. 77.) 2, ANTISOCIAL PERSONALITY DISORDER.
  10. ^ Mueser, K. T., Crocker, A. G., Frisman, L. B., Drake, R. E., Covell, N. H., & Essock, S. M. (2006). Conduct disorder and antisocial personality disorder in persons with severe psychiatric and substance use disorders. Schizophrenia bulletin, 32(4), 626–636. https://doi.org/10.1093/schbul/sbj068
  11. ^ a b Robins LN, Tipp J, Przybeck T.  Antisocial personality, Psychiatric Disorders in America.Robins LN, Regier DA, editors. New York: Free Press; 1991. pp. 258–290.
  12. ^ Compton WM, Conway KP, Stinson FS, et al. Prevalence, correlates and comorbidity of DSM-IV antisocial personality syndromes and alcohol and specific drug use disorders in the United States: results from the National Epidemiological Survey on alcohol and related conditions. Journal of Clinical Psychiatry. 2005;66:677–685.
  13. ^ Verona, E., Patrick, C. J., & Joiner, T. E. (2001). Psychopathy, antisocial personality, and suicide risk. Journal of Abnormal Psychology, 110(3), 462–470. https://doi.org/10.1037/0021-843X.110.3.462
  14. ^ Mok, P. L. H., Pedersen, C. B., Springate, D., Astrup, A., Kapur, N., Antonsen, S., Mors, O., & Webb, R. T. (2016). Parental psychiatric disease and risks of attempted suicide and violent criminal offending in offspring: A population-based cohort study. JAMA Psychiatry, 73(10), 1015. https://doi.org/10.1001/jamapsychiatry.2016.1728
  15. ^ Mok, P. L. H., Pedersen, C. B., Springate, D., Astrup, A., Kapur, N., Antonsen, S., Mors, O., & Webb, R. T. (2016). Parental psychiatric disease and risks of attempted suicide and violent criminal offending in offspring: A population-based cohort study. JAMA Psychiatry, 73(10), 1015. https://doi.org/10.1001/jamapsychiatry.2016.1728
  16. ^ Abram, K. M., Choe, J. Y., Washburn, J. J., Teplin, L. A., King, D. C., & Dulcan, M. K. (2008). Suicidal ideation and behaviors among youths in juvenile detention. Journal of the American Academy of Child & Adolescent Psychiatry, 47(3), 291–300. https://doi.org/10.1097/CHI.0b013e318160b3ce
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