The essential feature of antisocial personality 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. This pattern has also been referred to as psychopathy, sociopathy, or dyssocial personality disorder. Because deceit and manipulation are central features of an- tisocial personality disorder, it may be especially helpful to integrate information acquired from systematic clinical assessment with information collected from collateral sources.
For this diagnosis to be given, the individual must be at least age 18 years (Criterion B) and must have had a history of some symptoms of conduct disorder before age 15 years (Criterion C). Conduct disorder involves a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are vio- lated. The specific behaviors characteristic of conduct disorder fall into one of four cate- gories: aggression to people and animals, destruction of property, deceitfulness or theft, or serious violation of rules.
The pattern of antisocial behavior continues into adulthood. Individuals with antiso- cial personality disorder fail to conform to social norms with respect to lawful behavior (Criterion A1). They may repeatedly perform acts that are grounds for arrest (whether they are arrested or not), such as destroying property, harassing others, stealing, or pur- suing illegal occupations. Persons with this disorder disregard the wishes, rights, or feel- ings of others. They are frequently deceitful and manipulative in order to gain personal profit or pleasure (e.g., to obtain money, sex, or power) (Criterion A2). They may repeat- edly lie, use an alias, con others, or malinger. A pattern of impulsivity may be manifested by a failure to plan ahead (Criterion A3). Decisions are made on the spur of the moment, without forethought and without consideration for the consequences to self or others; this may lead to sudden changes of jobs, residences, or relationships. Individuals with antiso- cial personality disorder tend to be irritable and aggressive and may repeatedly get into physical fights or commit acts of physical assault (including spouse beating or child beat- ing) (Criterion A4). (Aggressive acts that are required to defend oneself or someone else are not considered to be evidence for this item.) These individuals also display a reckless disregard for the safety of themselves or others (Criterion A5). This may be evidenced in their driving behavior (i.e., recurrent speeding, driving while intoxicated, multiple acci- dents). They may engage in sexual behavior or substance use that has a high risk for harm- ful consequences. They may neglect or fail to care for a child in a way that puts the child in danger.
Individuals with antisocial personality disorder also tend to be consistently and ex- tremely irresponsible (Criterion A6). Irresponsible work behavior may be indicated by sig- nificant periods of unemployment despite available job opportunities, or by abandonment of several jobs without a realistic plan for getting another job. There may also be a pattern of repeated absences from work that are not explained by illness either in themselves or in their family. Financial irresponsibility is indicated by acts such as defaulting on debts, fail- ing to provide child support, or failing to support other dependents on a regular basis. In- dividuals with antisocial personality disorder show little remorse for the consequences of their acts (Criterion A7). They may be indifferent to, or provide a superficial rationaliza- tion for, having hurt, mistreated, or stolen from someone (e.g., ”life’s unfair,” "losers de- serve to lose”). These individuals may blame the victims for being foolish, helpless, or deserving their fate (e.g., "he had it coming anyway”); they may minimize the harmful consequences of their actions; or they may simply indicate complete indifference. They generally fail to compensate or make amends for their behavior. They may believe that everyone is out to "help number one” and that one should stop at nothing to avoid being pushed around.