An Innovative Treatment’s Potential for Antisocial Personality Disorder

By: Wakui Waiganjo

How does one solve an issue society collectively knows little about? By making sure everyone learns a little more about it. 

Aggression, recklessness, irritability, dishonesty, chronic irresponsibility, and a lack of remorse. When we hear these traits we think of the worst of society, the small segment of the population who make life difficult for everyone else.

​However, these traits as defined by Fonagy (2025) are the signs of a mental health issue called Antisocial Personality Disorder which affects between 1-3% of the population, millions of people.

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Defining the Issue:
Antisocial Personality Disorder is one of the most understudied mental illnesses, a significant problem. Fonagy (2025) explains that people with Antisocial Personality Disorder comprise up to fifty percent of the criminal population and that this has disastrous societal effects. For example, about 16.7 billion pounds in the United Kingdom are lost annually from a lack of productivity, healthcare, and critical justice as a result of people with this disorder. 

The Backstory: 
I became interested in this topic after a memoir titled Sociopath piqued my curiosity. The author explains how she has felt different from a very young age in terms of her emotional strength and her journey on the path to self understanding. The book is among the most memorable I have ever read, and when choosing a research topic last fall, it was not difficult for me to decide I wanted to study a topic related to sociopaths, which is an informal term for antisocial personality disorder.  

As looked into the issue of crime among this population, I wondered what the United States was doing in terms of treatment options and whether improvement of therapy in correctional services could lower the recidivism rate, which is the percentage of people who go back to prison after their initial sentence, a rate higher among this population than on average. The finding was that there are several implemented treatments, particularly one named cognitive behavioral therapy which focuses on identifying negative thought patterns, yet they all had mediocre proof of effectiveness or even contradictory studies. For example, treatment that focuses on making inmates feel guilt for their actions towards a victim often leads to no constructive growth and shame, but is still implemented in some localities. 

What’s Already Out There:
Based on studies published, a treatment called mentalization based therapy appears to have the most potential. As the focal point, the treatment allows inmates to understand the variety in people’s thoughts. According to Warner (2022), Burghardt (2023), de Wit-de Visser (2025), and O’Leary (2022), this leads to improvements in personal relationships as inadequately understanding other’s intentions, beliefs, and emotions is what leads to poor social functioning. The treatment also addresses attachment trauma, a core cause of Antisocial Personality Disorder for inmates, as according to Flaaten (2024), 60.8% of the individuals with Antisocial Personality Disorder compared to 37.4% of the healthy control group have experienced at least one type of traumatic event.

Lastly, there are the benefits that come from the treatment taking place in a group setting which according to Bateman (2022) allows for real time practice and feedback from peers rather than untrusted authority figures as well as generally improved life outcomes. This is seen as in one study by Fonagy (2025), at 12 months, participants showed a significant reduction in violent behavior and there were significant improvements in intimate partner violence negotiation skills at 18 months. 

This can be contrasted with other prominent treatments, like the aforementioned widely utilized Cognitive Behavioral Therapy, in which according to Contrera-Bustamente (2026), improvements in excessive alcohol consumption, positive attitudes, and social functioning after six months were found to be statistically insignificant when compared to conventional treatment. 

Mentalization based therapy was developed in 1990s Europe whilst others originated largely in the mid 20th century, but they all suffer from a lack of information and studies. Although integral when determining the ideal therapy selection for those with Antisocial Personality Disorder, many studies were hindered by a multitude of factors such as a lack of participants, inability to compare based on crime type, and inability to account for demographics like income or sex. For an issue that, if addressed, could have significant positive effects for society to be so egregiously understudied is intolerable. 

My Findings: 
In order to contribute to existing information and find further correlation between implementation of mentalization based therapy for inmates with Antisocial Personality  Disorder and reduced recidivism, I interviewed seven mental health professionals on the specific traits of the disorder and the mechanisms of therapies that address them. Five of 7 of the clinicians interviewed stated that mentalization based therapy is potentially the most effective treatment for Antisocial Personality Disorder because of its specific process of understanding the mind of others and oneself, particularly in comparison to cognitive behavioral therapy, dialectical behavioral therapy, and token based therapy. 

The findings aligned with the earlier literature review but there were multiple limitations in my own study as well: a pool of only seven experts for example, or the fact that an interviewee had a work emergency and had to leave early, preventing me from being able to ask several questions. 

What You Can Do:
The potential of mentalization based therapy, and even other treatments, is not something that can continue to be ignored due to the potential of its implementation in the reduction of the societal problem of recidivism. Through this article, I hoped to not only share awareness on this issue but to encourage the studying of what is ignored, which may seem unglamorous at first but is so important to society under the surface. 
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