Diagnosis of Antisocial Personality Disorder
The diagnosis of antisocial personality disorder is complex and requires a careful, consistent approach supported by thorough psychological assessment. Clinicians use criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to make the diagnosis.
Key Diagnostic Criteria (DSM-5):
- Pervasive disregard for the rights of others since age 15
- At least three of the following:
- Repeatedly breaking the law
- Deceitfulness (lying, aliases, conning)
- Impulsivity or failure to plan
- Irritability and aggressiveness
- Reckless disregard for safety
- Consistent irresponsibility
- Lack of remorse
Additional Conditions:
- Individual must be at least 18 years old
- Must show signs of conduct disorder before age 15
- Symptoms not better explained by another mental disorder (e.g. schizophrenia or bipolar)
Assessment Methods:
- Clinical interview with a psychologist or psychiatrist
- Review of legal, medical, and behavioural history
- Reports from family members, teachers, or law enforcement
- Use of structured diagnostic tools like the PCL-R (Psychopathy Checklist – Revised)
Differential Diagnosis:
ASPD is sometimes confused with other mental health conditions that share similar behavioral traits, such as borderline personality disorder or narcissistic personality disorder:
- Borderline Personality Disorder
- Narcissistic Personality Disorder
- Substance Use Disorders
- Bipolar Disorder during manic phases
Diagnosis of Antisocial Personality Disorder
In South Africa, professionals often identify ASPD in forensic settings or psychiatric hospitals. However, many individuals remain undiagnosed, especially if they avoid contact with mental health professionals.
Let’s now explore the treatment and management strategies for ASPD.
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Cognitive behavioral therapy Cape Town
Antisocial Personality Disorder
