No, autism spectrum disorder (ASD) and antisocial personality disorder (ASPD) are two distinct conditions, as noted in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR).

However, people sometimes conflate ASD and ASPD because there may be some overlap concerning social interaction, awareness, and behaviors.

ASD refers to a range of neurodevelopmental conditions characterized by differences in communication and social interaction behaviors.

ASPD is a personality disorder in which a person engages in behaviors for self-gain that affect others, often without remorse, guilt, or sympathy. These actions may be seen as violent, callous, calculated, or intentional.

ASD and ASPD can both cause social dissonance and negatively impact the well-being of others.

According to a 2024 review, both conditions are characterized by dysfunctions in empathy. However, there are key distinctions between their empathetic dysfunctions and behavioral intent, or lack thereof.

Empathy refers to your ability to recognize and understand another person’s feelings and respond to them in a compassionate and appropriate manner. In other words, “putting yourself in someone else’s shoes.”

There are two aspects of empathy:

  • cognitive, which refers to your ability to recognise emotions, thoughts, and feelings
  • affective, which refers to your ability to share or engage in those emotions

According to the review authors, autistic people may have difficulty with cognitive empathy, but not affective empathy. Initiating, responding to, or maintaining a conversation, as well as recognizing emotions, may be difficult.

But, while this may affect others, the individual isn’t trying to do so intentionally.

On the other hand, people with ASPD tend to be better at cognitive empathy, but not affective empathy. As a result, they may behave in a manipulative manner, yet feel no remorse for the impact on others.

Yes, it’s possible to have a diagnosis of ASD and ASPD, as both are classified as separate mental disorders in the DSM-5-TR.

That said, researchers suggest that it may be difficult to diagnose both conditions separately because there aren’t many specific guidelines on diagnosing people who exhibit behaviors of both ASD and ASPD.

If you think you or a child has ASD or ASPD, consider speaking with a healthcare professional, such as a primary care doctor, pediatrician, or mental health specialist. They can evaluate your symptoms and perform several diagnostic tests to help develop an appropriate treatment plan.

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Your healthcare team may comprise several people who can provide support.

Sometimes, a medical specialist will be required to help diagnose, manage, or treat a healthcare condition.

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