If you know someone who lies all the time and is incredibly impulsive, they may have ASPD

• Antisocial personality disorder is a condition that causes aggression or violence.
• Many people with the disorder frequently violate rules and may end up in trouble with the law.
• It can be caused by genetic factors, brain-damaging incidents, or childhood trauma.

Antisocial personality disorder (ASPD) is a mental health condition that causes behavior like lying, acting recklessly, and violence.

ASPD is relatively rare — between 1%-4% of Americans are affected — but it can be dangerous. Experts are still struggling to find the best way to treat those with ASPD and protect the people around them.

Here are some of the common signs of ASPD and why it's so difficult to treat.

What is antisocial personality disorder?

"Antisocial personality disorder usually manifests as a violation of boundaries, rules, and laws," says Elizabeth Jeglic, PhD, a professor of psychology at John Jay College.

The first signs of ASPD usually show up in childhood or adolescence — you might see behaviors like "rule breaking, aggressive behavior, lying, truancy, running away from home, and theft," Jeglic says.

This bad behavior continues through adulthood and the person may end up in prison or somehow involved in the criminal justice system, says Jeglic.

According to the Diagnostic and Statistical Manual of Mental Disorders, some of the common symptoms of ASPD include:

• Repeatedly breaking the law
• Lying, conning, or manipulating other people
• Acting impulsively
• Irritability and aggressiveness that leads to fighting
• Disregarding one's own safety or the safety of others
• Acting irresponsibly

Along with this list, there are two key signs that someone actually has ASPD rather than just acting antisocial, says David Reiss, MD, a psychiatrist in private practice.

1. The person "experiences no regret, remorse or guilt about their actions, with no sense of any accountability."
2. "The person has no empathy, concern, or care about their victims."

The causes of antisocial personality disorder

There are several different factors that can make someone more likely to develop antisocial personality disorder, including:

• Genetic factors
• Brain damaging incidents including:
• Being exposed to alcohol while in the womb
• Being exposed to lead during childhood
• Suffering a traumatic brain injury
• Certain early childhood experiences, including:
• Abuse and neglect
• Exposure to violence
• Having a parent with a substance abuse disorder

Diagnosis and treatment

ASPD is diagnosed through a clinical interview with a mental health professional. The provider will also look at any documented history of the disorder, which often includes criminal record review, Jeglic says.

You can only be diagnosed with antisocial personality disorder if you're over 18 — if you're younger, similar symptoms might be diagnosed as conduct disorder or oppositional defiant disorder, Jeglic says.

Antisocial personality disorder is extremely difficult to treat because people with the disorder often don't believe they need help.

A therapist may offer Cognitive Behavioral Therapy (CBT) to help people with ASPD "learn more effective ways to cope with their emotions, challenge their angry, hostile thoughts, and learn prosocial strategies to obtain their goals," Jeglic says.

"Those with high levels of anger, aggression and/or depression may also benefit from psychotropic medication," Jeglic says. However, there's still very little research on which medications help treat ASPD and the US Food and Drug Administration (FDA) hasn't approved any specific drug for the condition.

If someone with ASPD doesn't feel any empathy or guilt at all, the only option may be to try to reduce harm through therapy, Reiss says. This means "striving to teach the person with ASPD that it is actually in their best interest to act more responsibly and as if they have empathy," says Reiss.

"That is certainly not a cure, but it may decrease the damage done to others by the person with ASD," Reiss says.

Insider's takeaway

Antisocial personality disorder is a serious mental health condition that is difficult to treat. However, not all people with ASPD are a danger to themselves or the people around them.

If you think you may be struggling with symptoms of ASPD, reach out to a doctor or mental health provider for support.

If you think someone you know may have ASPD, "the only appropriate reaction is to stay away from the person and maintain as little contact and interaction with the person as is practically possible," Reiss says.