Antisocial Personality Disorder (ASPD)

The majority of criminals easily meet criteria for antisocial personality disorder. Antisocial Personality Disorder (ASPD) is the most common psychiatric disorder among people who have been incarcerated. A systematic cross-national review found that ASPD is present in about 47% of people currently incarcerated (Fazel and Danesh 2002). In some studies, the prevalence is greater still, reaching as high as 78% (Rotter et al. 2002).

In contrast, only about 10% of incarcerated people suffer from major depression, which is among the most common disorders in non-incarcerated populations (Merikangas et al. 2010).

Furthermore, while almost half of currently incarcerated people are estimated to suffer from ASPD, the disorder is far less common in the general population, where lifetime prevalence rates range from 3% to 5% (Goldstein, et al. 2017).

DSM-5 Criteria 

The presence of a pervasive pattern of disregard for and violation of the rights of others. This behavior begins by age 15 and is present in various contexts. Clinical features include 3 or more of the following:

  1. Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
  2. Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
  3. Impulsivity or failure to plan.
  4. Irritability and aggressiveness, often with physical fights or assaults.
  5. Reckless disregard for the safety of self or others.
  6. Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.
  7. Lack of remorse, indifference to or rationalizing having hurt, mistreated, or stolen from another person.

The individual is at least age 18.

There is evidence of conduct disorder with onset before age 15.

The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder. 

Adults who do not have evidence of conduct disorder in childhood and adolescence but otherwise meet the diagnostic criteria for ASPD can be diagnosed with adult antisocial behavior. While adult antisocial behavior is not a formal DSM-5  diagnosis. There are codes and these codes are used to identify factors influencing a patient’s mental health status or contact with mental health services. The brain is developing and that means a personality is developing till the age of 18 and it’s the reason for not diagnosing underage people.

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