---
title: "Antisocial personality disorder"
chunk: 7/9
source: "https://en.wikipedia.org/wiki/Antisocial_personality_disorder"
category: "reference"
tags: "science, encyclopedia"
date_saved: "2026-05-05T15:21:37.098549+00:00"
instance: "kb-cron"
---

== Prognosis ==
Boys are almost twice as likely to meet all of the diagnostic criteria for ASPD than girls and they will often start showing symptoms of the disorder much earlier in life. Children who do not show symptoms of the disease through age 15 will almost never develop ASPD later in life. If adults exhibit milder symptoms of ASPD, it is likely that they never met the criteria for the disorder in their childhood and were consequently never diagnosed. Overall, symptoms of ASPD tend to peak in late teens and early twenties but can often reduce or improve through age 40.
Symptoms of antisocial personality disorder (ASPD) often peaks in early adulthood, with individuals in their twenties and thirties displaying increased impulsivity, aggression, and other antisocial behaviors. Research has identified several factors that may contribute to the onset and persistence of ASPD symptoms during this period, including poor family functioning, reduced empathic concern, and elevated motor impulsivity. For instance, a study of 443 emerging adults found that low parental behavioral control and high impulsivity were significant predictors of antisocial personality problems.
As individuals with ASPD age, behavioral symptoms frequently diminish—a phenomenon sometimes referred to as "antisocial burnout." This decline is especially evident in impulsive and aggressive behaviors. However, core traits such as manipulativeness and emotional detachment may persist into later life. While these residual traits may not result in overt criminal activity, they can continue to negatively affect interpersonal relationships and social functioning.
In older adulthood, the apparent decline in ASPD prevalence may be influenced by diagnostic limitations. Standard diagnostic criteria may fail to capture age-specific manifestations of the disorder, potentially leading to underdiagnosis or misclassification. Additionally, neurodegenerative conditions such as frontotemporal dementia can mimic or exacerbate antisocial behaviors in older individuals, complicating accurate assessment and treatment planning.
ASPD is ultimately a lifelong disorder that has chronic consequences, though some of these can be moderated over time. 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. In fact, past studies revealed that remission rates were small, with 27-31% of patients with ASPD seeing an improvement "with the most violent and dangerous features remitting". 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. According to definitions found in the DSM-5, people with ASPD can be deceitful and intimidating in their relationships. When they are caught doing something wrong, they often appear to be unaffected and unemotional about the consequences. Over time, continual behavior that lacks empathy and concern may lead to someone with ASPD taking advantage of the kindness of others, including their therapist.
Without proper treatment, individuals with ASPD could lead a life that brings about harm to themselves or others. This can be detrimental to their families and careers. Those with ASPD lack interpersonal skills (e.g., lack of remorse, lack of empathy, lack of emotional-processing skills). 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 by suicide. They also see higher rates of committed crime, reaching peaks in their late teens and often committing higher-severity crimes in their younger ages of diagnoses. Comorbidity of other mental illnesses such as depression or substance use disorder is prevalent among patients with ASPD. People with ASPD are also more likely to commit homicides and other crimes. Those who are imprisoned longer often see higher rates of improvement with symptoms of ASPD than others who have been imprisoned for a shorter amount of time.
According to one study, aggressive tendencies show in about 72% of all male patients diagnosed with ASPD. About 29% of the men studied with ASPD also showed a prevalence of premeditated aggression. Based on the evidence in the study, the researchers concluded that aggression in patients with ASPD is mostly impulsive, though there are some long-term evidences of pre-meditated aggressions. It often occurs that those with higher psychopathic traits will exhibit the pre-meditated aggressions to those around them. Over the course of a patient's life with ASPD, he or she can exhibit this aggressive behavior and harm those close to him or her.
Because a patient with severe ASPD may not quickly respond to the administered therapies, Harvard Medical School notes that time and resources may be better spent treating victims who have been affected by someone with severe ASPD, such as their family. In fact, a patient with ASPD may only accept treatment when ordered by a court, which will make their course of treatment difficult and severe. Because of the challenges in treatment, the patient's family and close friends must take an active role in decisions about therapies that are offered to the patient. Ultimately, there must be a group effort to address the long-term effects of the disorder.