Antisocial Personality Disorder vs. Autism: Key Differences
Published by Sagebrush Counseling | Mental Health & Neurodivergent Support
Clearing Up Common Misconceptions
Social interaction difficulties don't always signal the same underlying condition. While both antisocial personality disorder (ASPD) and autism spectrum disorder (ASD) can involve challenges with interpersonal relationships, these conditions are fundamentally different in their origins, motivations, and treatment approaches.
Understanding these distinctions is crucial for accurate diagnosis, appropriate treatment, and reducing harmful misconceptions about neurodivergent individuals. Let's explore what sets these conditions apart and why recognizing these differences matters for both individuals and families seeking support.
What Is Antisocial Personality Disorder?
Antisocial personality disorder is defined by the American Psychiatric Association's Diagnostic and Statistical Manual on Mental Disorders, fourth edition (DSM-IV) as "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood."
Key Characteristics of ASPD:
Intentional disregard for social norms - Individuals with ASPD consciously choose to violate societal rules and laws
Lack of empathy and remorse - They demonstrate little genuine concern for how their actions impact others
Manipulative behavior - They often use charm, deception, or intimidation to achieve personal goals
Persistent pattern from adolescence - ASPD often manipulate others for personal gain, lack empathy, and seldom feel remorse for their actions
Legal and relationship problems - Their behavior frequently leads to arrests, broken relationships, and occupational difficulties
Specific prevalence rates for borderline personality disorder and antisocial personality disorder were estimated at 1.4 percent and 0.6 percent, respectively, making ASPD relatively rare in the general population.
Autism Spectrum Disorder
Autism spectrum disorder (ASD) is a neurological and developmental disorder that affects how people interact with others, communicate, learn, and behave. Unlike personality disorders, autism is a neurodevelopmental condition present from early childhood.
Core Features of Autism:
Social communication challenges - Difficulty with verbal and nonverbal communication, understanding social cues, and maintaining conversations
Sensory processing differences - Over- or under-sensitivity to sounds, lights, textures, tastes, and physical touch
Repetitive behaviors and focused interests - Engaging in repetitive movements, having intense interests, and preferring predictable routines
Early developmental onset - symptoms generally appear in the first two years of life
Spectrum of abilities - Autism is known as a "spectrum" disorder because people with autism have a range of characteristics, needs, strengths, and challenges
Current prevalence data shows that an average of 1 in every 31 (3.2%) 8-year-old children were estimated to have ASD in 2022, making autism significantly more common than antisocial personality disorder.
The Critical Differences: Empathy, Intent, and Understanding
The most important distinction between ASPD and autism lies in empathy and intent:
Empathy Differences:
Autism and Empathy: Autistic people and psychopaths are almost the opposite of each other, as noted by autism researcher Professor Baron-Cohen. Individuals with autism typically have:
Intact affective empathy (emotional responses to others' feelings)
Challenges with cognitive empathy (understanding others' perspectives due to neurological differences)
Genuine care for others, though it may be expressed differently
ASPD and Empathy:
Conscious choice to disregard others' feelings and rights
Lack of both affective and cognitive empathy in meaningful relationships
Self-serving motivations behind most social interactions
Intent and Motivation:
In Autism: When a person with autism fails to understand the point of view of another, it is not due to choices but to a disability. Social difficulties stem from neurological differences, not malicious intent.
In ASPD: People with an antisocial personality disorder resort to deception, intimidation, or violence as they maneuver to gain power and control over other people. Their behavior is calculated and intentional.
Real-World Examples: How These Conditions Look Different in Practice
Understanding these conditions becomes clearer when we see how the same situation might be handled differently by someone with autism versus someone with antisocial personality disorder.
Scenario 1: Group Project at Work
Autistic Individual:
May struggle to understand unspoken group dynamics or indirect communication
Might focus intensely on their assigned portion, missing social cues about collaboration
Could become overwhelmed by conflicting instructions and ask for written clarification
May appear "rude" when directly stating facts or concerns without social pleasantries
Motivation: Genuinely wants to do good work but struggles with social navigation
Response to feedback: Initially confused but willing to adjust approach when given clear, specific guidance
Individual with ASPD:
Quickly identifies group dynamics to determine who has influence or resources
May charm team members to gain allies or shift blame to others
Could take credit for others' work or manipulate deadlines to their advantage
Appears socially skilled but uses this strategically for personal benefit
Motivation: Prioritizes personal advancement over team success
Response to feedback: May become defensive, blame others, or superficially agree while planning retaliation
Scenario 2: Friend Shares Personal Struggles
Autistic Individual:
May offer practical solutions instead of emotional comfort ("Have you tried...?")
Might share their own similar experiences to show understanding
Could appear uncomfortable with emotional displays due to sensory overwhelm
May not know the "right" thing to say but genuinely cares about their friend's wellbeing
Motivation: Wants to help but may not express empathy in expected ways
Follow-up: Checks in later with concrete offers of support
Individual with ASPD:
Says the "right" words but lacks genuine emotional investment
May mentally catalog this vulnerability for potential future manipulation
Could use the information to appear trustworthy while pursuing hidden agendas
Might become impatient if the friend's problems don't benefit them somehow
Motivation: Maintains relationships for what others can provide
Follow-up: Support disappears when inconvenient or no longer useful
Scenario 3: Accidentally Breaking Someone's Belonging
Autistic Individual:
Immediately feels distress about causing harm, even if accidental
May struggle to find the right words to apologize but clearly feels remorse
Offers to replace or fix the item, sometimes going overboard to make amends
Might avoid the person temporarily due to anxiety about the social interaction
Emotional response: Genuine guilt and concern for the other person
Learning: Takes extra precautions to prevent similar accidents
Individual with ASPD:
Shows surface-level concern but primarily worried about consequences to themselves
May blame external factors or the other person ("Why did you leave it there?")
Offers minimal restitution and becomes irritated if pressed for more
Moves on quickly, showing little lasting concern about the impact
Emotional response: Annoyance at inconvenience, minimal genuine remorse
Learning: Focuses on avoiding getting caught rather than preventing harm
Scenario 4: Being Corrected on a Mistake
Autistic Individual:
May initially feel defensive due to rejection sensitive dysphoria
Processes the correction literally and wants to understand exactly what went wrong
Might ask detailed follow-up questions to prevent future mistakes
Could become upset about the social dynamics but accepts the factual correction
Internal experience: "I want to do this right" mixed with social anxiety
Outcome: Adjusts behavior based on new understanding
Individual with ASPD:
Views correction as a challenge to their authority or image
May respond with charm ("You're absolutely right") while planning how to discredit the corrector
Shows no genuine interest in improving, only in managing perception
Could retaliate later through subtle sabotage or public embarrassment
Internal experience: "How dare they question me" and strategic planning
Outcome: Focuses on revenge or image management rather than improvement
Misconceptions and Harmful Stereotypes
Common Myths About Autism:
Myth: Autistic individuals lack empathy
Reality: They have strong emotional empathy but may struggle to express it conventionally
Myth: Social difficulties indicate antisocial tendencies
Reality: Equating the social interaction deficits in autism with an antisocial personality disorder is inaccurate and it may be harmful, adding to the stigma experienced by those with neurodevelopmental conditions
Understanding Aggression:
When aggression occurs in autism, it's typically due to:
Frustration from communication barriers
Sensory overload or environmental stressors
Difficulty understanding social situations
Self-regulation challenges
A person with autism may become frustrated, then aggressive because he does not understand the behavior of another person. This is very different from the frustrated antisocial person who simmers with anger whenever others disagree with him, fail to do what he wants, or do not affirm his inflated view of himself.
Neurodivergence and Mental Health: Making the Distinction
Autism as Neurodivergence:
Autism is widely recognized as a form of neurodivergence - a natural variation in human brain development. The neurodiversity movement emphasizes that:
Autistic individuals have unique strengths and perspectives
Differences should be accommodated, not "cured"
Society benefits from neurological diversity
ASPD and the Neurodiversity Debate:
While some argue that ASPD represents neurodivergence, this remains controversial because:
ASPD involves harmful behavior toward others
ASPD is marked by a disregard for social norms and the rights of others
The condition often requires intervention to prevent harm
For more insights on neurodivergent experiences, explore our other posts on [supporting neurodivergent individuals] and [understanding sensory processing differences].
Diagnosis and Professional Assessment
Getting an Accurate Diagnosis:
For Autism:
Comprehensive developmental history assessment
Observation of communication and social interaction patterns
Standardized autism diagnostic tools (ADOS, ADI-R)
Diagnosing ASD in adults is often more difficult than diagnosing ASD in children
For ASPD:
Clinical interviews and behavioral assessment
Review of childhood conduct disorder history
Assessment of current interpersonal relationships
Legal and occupational history evaluation
Important Note: Misdiagnosis can occur, particularly in women and marginalized populations. If you're seeking assessment, work with professionals experienced in neurodevelopmental conditions and personality disorders.
Treatment and Support Approaches
Support for Autism:
Behavioral therapies focused on building communication and social skills
Sensory accommodations to manage environmental challenges
Social skills training in structured, supportive environments
Family education and support to understand neurodivergent communication styles
Occupational therapy for daily living skills and sensory integration
Treatment for ASPD:
Psychotherapy (primarily cognitive-behavioral approaches)
Dialectical behavior therapy for emotional regulation
Group therapy for interpersonal skills development
Substance abuse treatment when co-occurring
Crisis intervention for safety concerns
While the disorder is often thought untreatable, this conclusion is premature because of the lack of relevant treatment research. However, treatment success often depends on the individual's willingness to engage genuinely in the process.
Supporting Families and Individuals
For Families of Autistic Individuals:
Learn about sensory processing and communication differences
Create predictable, accommodating environments
Connect with autism-informed therapists and support groups
Advocate for appropriate educational and workplace accommodations
For Families Affected by ASPD:
Prioritize safety and boundary-setting
Seek therapy to process trauma and develop coping strategies
Consider family therapy with experienced professionals
Connect with support groups for families affected by personality disorders
Remember, having clear understanding of these conditions helps reduce stigma and ensures individuals receive appropriate support tailored to their specific needs.
Frequently Asked Questions
Can someone have both autism and antisocial personality disorder?
Yes, it's theoretically possible for an individual to have both conditions simultaneously, just as someone could have autism and depression. A person could have a broken wrist and the flu—one has nothing to do with the other. And so it is that a person may have characteristics of autism but also have features of a personality disorder. One does not "cause" the other. However, this would require careful differential diagnosis by qualified professionals.
Are autistic individuals more likely to develop personality disorders?
Borderline Personality Disorder co-occurs with ADHD and Autism at higher rates (than seen in the non-ADHD & Autistic population). In fact, the prevalence rate of nearly all Personality Disorders is higher among people with ADHD and Autism. This may be due to increased vulnerability to trauma and the challenges of navigating a neurotypical world without proper support.
How can I tell the difference between autism-related social difficulties and antisocial behavior?
Look at the underlying motivation and emotional response. Autistic individuals typically show genuine care for others but may struggle to express it appropriately. Those with ASPD show calculated disregard for others' wellbeing and rarely demonstrate authentic remorse for harmful actions.
Can antisocial personality disorder be treated?
While challenging to treat, ASPD is not untreatable. Success depends largely on the individual's genuine commitment to change and participation in long-term therapy. No medication is currently approved to treat ASPD, nor are any routinely used, making psychotherapy the primary treatment approach.
Is it harmful to compare autism to personality disorders?
Yes, comparing autism to antisocial personality disorder can be harmful because it perpetuates negative stereotypes about neurodivergent individuals. Autism is a neurological difference, not a character flaw or choice, and autistic individuals deserve understanding and accommodation, not stigmatization.
How early can these conditions be identified?
Although autism can be diagnosed at any age, it is described as a "developmental disorder" because symptoms generally appear in the first two years of life. ASPD, however, cannot be diagnosed until age 18, though patterns of conduct disorder in childhood may be precursors.
Taking the Next Step: Get Professional Support
Understanding the differences between antisocial personality disorder and autism is just the beginning. Whether you're seeking diagnosis, treatment, or support for yourself or a loved one, professional guidance is essential.
Ready to explore neurodivergent-informed therapy? Our team at Sagebrush Counseling specializes in autism assessments, neurodivergent support, and family therapy approaches that honor individual differences while building essential life skills.
How We Can Help:
✓ Autism counseling for adults (referrals for children/teens can be given, send a message if you need these)
✓ Neurodivergent-affirming therapy approaches
✓ Family counseling and education
✓ Social skills development in supportive environments
✓ Trauma-informed care for complex presentations
Contact Sagebrush Counseling today to schedule a consultation and take the first step toward better understanding and support. Every individual deserves care that recognizes their unique neurology and lived experience.
References and Resources:
National Institute of Mental Health - Antisocial Personality Disorder Statistics
National Institute of Mental Health - Autism Spectrum Disorder
Centers for Disease Control and Prevention - Data and Statistics on Autism
National Institute of Environmental Health Sciences - Autism Research
This article is for educational purposes only and does not constitute medical or psychological advice. Always consult qualified healthcare professionals for diagnosis and treatment recommendations.
