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Health A-Z

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Harvard Medical School

Treatment

Many psychotherapy techniques have been proposed for treating antisocial personality disorder. Unfortunately, research does not indicate that any of the current treatments is particularly helpful for treating the personality disorder itself. As a result, the choice of treatment can be guided by a person's specific circumstances. In younger people, family or group psychotherapy may help to change destructive patterns of behavior, teach new vocational and relationship skills, and reinforce a person's social support. Psychotherapy also may help a person with this disorder learn to be more sensitive to the feelings of others and encourage new, socially acceptable and productive ways of thinking about one's goals and aims. Cognitive therapy attempts to change sociopathic ways of thinking. Behavior therapy uses reward and punishment to promote good behavior.

In some cases, symptoms can be treated with medication, although again there is no specific medication that is considered best for all people with this disorder. Selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac) and sertraline (Zoloft), may decrease aggressiveness and irritability. These drugs are useful if either anxiety or depression are present, or if the person is using substances to self-medicate for anxiety or low mood.

There are many questions about how helpful any of these interventions can be in an illness where, by definition, people who are affected do not recognize that they have a problem. Treatment is more likely to be successful if it is started earlier in life, but it is difficult to change long-entrenched patterns of thinking and behavior. Also, the longer a person lives with this personality style, the less he or she may be interested in taking responsibility for change. For some people, the tendency toward aggression and irritability decreases with age, but some personality characteristics may persist.

Often the only thing that can protect victims of antisocial behavior is the criminal justice system. In rare instances, corrections systems (jails and prisons) provide opportunities for treatment or rehabilitation, but often these environments, with their abundance of antisocial individuals, only promote antisocial behavior.

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From Health A-Z, Harvard Health Publications. Copyright 2007 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.

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