1. Introduction

According to Mayo Clinic, antisocial personality disorder (ASPD), sometimes called sociopathy or psychopathy, is a mental health condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. The community has paid close attention to the effects of antisocial personalities [1]. People with ASPD tend to purposely make others angry or upset and manipulate or treat others harshly or with cruel indifference. A sociopath is antisocial and disobeys social norms; sociopaths are classified as having ASPD, which is characterised by a tendency to treat others harshly and feel no guilt, as well as emotional deficiencies. Psychopaths also describe violent or abnormal behaviour that may be the result of a chronic condition that leads to criminal activity or illegal things that are against society's norms [2]. A study published on PMC has shown that ASPD is associated with co-occurring mental health and addictive disorders and medical comorbidity, meaning the simultaneous presence of two or more diseases or medical conditions in a patient [1]. Thus, rates of natural of unnatural death, including suicide, homicide and accidents, are excessive. The vision of this review is to understand the mindset of people with ASPD via analyzing their moral stands and views on ethics to seek better treatments and diagnoses for them and to improve current moral judgements. As the main sources and references for the research, this study consulted a compilation of various studies that examined ASPD and its relationship to morality.

Relevant academic searching engine was used as the main channel for researching information. Ten studies and reviews were selected from various websites with credibility such as NIH (National Library of Medicine). The results of the articles were then compared to figure out some significant similarities and differences that lead to new discoveries or aspects, and these influenced the result of this review. For the discussion of this article, various aspects were considered. The materials and methods of some studies were not only been read and concluded, but were also challenged to reflect on misconceptions of ASPD. There were also some limitations of this review, which would be revealed in the discussion.

2. Moral Judgement and ASPD

Based on various studies, the present study found that there are still a lot of space for improvements in terms of current moral judgements. For example, the study conducted by Bartels shows flaws of the moral judgements of moral dilemmas [3]. The study tested the accuracy of sacrificial dilemmas, where the question of whether to kill a person to prevent others from dying is posed, in the study of moral judgement by inviting participants, meaning have emotional deficits, and measuring antisocial personality traits by using psychopathy and Machiavellianism. The study indicates that the widely adopted use of sacrificial dilemmas in the study of moral judgement fails to distinguish between people who are motivated to endorse utilitarian moral choices due to underlying emotional deficits. Bartels explains that the sacrificial dilemmas are just “math problems” to those people with antisocial personality traits. More focus should be paid to mechanistic studies and more pertinent longitudinal studies. If neurological indicators were considered in addition to behavioural indicators, a more complete picture of the relationship between variables would be obtained. This study gives some clues on how the current moral judgements can be improved.

3. The Role of Gender

A study focusing on gender differences of ASPD with the aspect of moral cognition shows that females and males with ASPD behaves differently. The study has the sample of 88 male and 105 female college students aged 16 to 19 years. It shows that male and female tend to exhibit different behaviors but relationships among the moral cognitive variables and antisocial behavior did not vary by gender. Based on other studies and experts such as a review of pertinent literature led by Rutter, Giller and Hagell concluded various findings on the causal processes involved in the greater involvement of males with ASPD on crime and crime statistics based on youths in late adolescence in United States have reflected a male to female ratio of more than 4:1 for nonviolent crimes and more than 10:1 for violent crimes, the article also displays that male are much more likely to commit crimes than female [4,5]. The result of the study shows that females generally display higher levels of internalizing behaviors, which are negative behaviors that are focused inward including fearfulness, social withdrawal and somatic complaints, than males and males exhibit significantly higher level of externalizing behaviors, which are problem behaviors that are directed toward the external environment including physical aggression, disobeying rules, cheating, stealing and destruction of property, than females. Research projects in the future could go farther in identifying the elements that lead to gender disparities. Furthermore, as the investigation into the gender variations in ASPD symptoms progresses, additional factors may come into play. The inquiry might also look into peer pressure, cultural norms, genetic predispositions, and environmental factors in addition to parental gender stereotypes. Examining these complex factors in more detail would improve the comprehension of the intricate interactions that shape different behavioural patterns in different genders. Through examining the ways in which different factors interact and impact the emergence of ASPD symptoms, researchers can gain a more complex understanding of the complex dynamics underlying gender differences in this disorder.

4. Discussion

4.1. The Accuracy of Experiments in Studies

According to the questionnaire in one prison in Ethiopia in Dessie city, it shows that 320 adult prisoners out of a total number of 1250 prisoners have ASPD while 281 (87.8%) were males [6]. However, among the 1250 prisoners, 1190 are men, which reflects an unequal ratio of male and female prisoners. By investigating on crime rates, it also reflects the group’s moral norms. Moreover, the survey of the experiment is composed of 7 questions only, which cannot precisely measure whether a prisoner have ASPD or not. Comparing with this, another survey or test, MBTI, has 93 questions that are needed to be answered, and this would give a much more exact result with more information about the subject. Also, unlike the questionnaire conducted in the study, which only allows a yes-or-no response option, MBTI has 7 response options, which ranges from “strongly agree” to “neutral” to “strongly disagree”. One thing that needs to be aware of is that MBTI might still be inaccurate despite it already collects an abundant amount of information from the subject. These reflect that the experiment of this study has a nonstandard sampling and rather inaccurate result as there are uncertainties, which might not produce an accurate result.

Moreover, the utilisation of self-rating scales poses difficulties in addressing the problem of inaccuracy, mainly because of the influence of social approval on measurement implementation. That means that future research should pay attention to investigate different approaches, like neurological method or running controlled lab tests. Researchers are able to explore the subtleties of behavioural performance within ASPD groups across a variety of demographics by reorienting the focus towards objective measures and experimental settings. This improvement in methodology may reduce the influence of subjective biases present in self-reporting scales and provide a more accurate and dependable understanding of the differences and similarities in the behavioural manifestations of ASPD. Embracing these innovative approaches could enhance the robustness and validity of findings in the exploration of ASPD and contribute to advancements in diagnostic accuracy and treatment.

Hence, nowadays, the researchers cannot make reckless conclusions such as people with ASPD have a higher possibility than people with BPD (borderline personality disorder) or people with ASPD would be likely to commit crimes. Nevertheless, many studies about ASPD tend to show that people with ASPD have high crime rates.

4.2. ASPD & Utilitarianism

From the study led by Bartels, it shows that people with ASPD have emotional deficits but are clear of social norms [3]. Even though people with antisocial personality traits tended to think of the sacrificial dilemmas as “math problems”, the study notice that the “math problems” they are doing evaluates the options with more people survive. This shows that people with ASPD possibly know how social norms work despite they cannot empathize with others. Thus, it can be seen that fields like psychology and neuroscience are making progress to understand and improve knowledge on ASPD to seek advanced treatments (mainly focusing on therapies) and diagnoses in the future.

4.3. Gender Differences

A study led by Barriga explains the gender differences in ASPD by focusing on moral cognition [7]. Through the study, it proves that males, compared with females, would exhibit elevated levels of antisocial behavior and that males and females show similar moral judgement maturity, but that females would display greater moral self-relevance and less self-serving cognitive distortion. These findings are important as it reflects that females would be easier to be educated of the commonly accepted moral standards than males. It also reflects that males with ASPD would be generally more aggressive than females with ASPD.

4.4. Limitations of the Review

As this review expands based on the references and information from other studies, the author cannot be absolutely sure for some statistics and data of the studies, and this also links back to the accuracy of studies. With no experiment conducted, it is hard to have a clear image of how people with ASPD behaves and acts despite this study can find out this information from other studies and research.

Moreover, ASPD still maintains a lot of mysteries since it is a very new and complicated personality disorder that has not been fully understand, which is one of the biggest difficulties when writing this review. As mentioned in Barriga, Morrison, Liau, and Libbs’s study, Despite the fact that there is a clear gender difference in antisocial behaviour, there is no corresponding difference in moral judgement, which leaves the gender difference in antisocial behaviour susceptible to other explanations [7].

5. Conclusion

Through various studies and findings, this study already see new findings keep trying to challenge the traditional ones. This is the reason why new version of DSM has been updated over time to add and modify the knowledge about psychology and personality disorders. Based on the research, the author have noticed both new discoveries and unchanged traditional understanding about ASPD through associating it with criminology and the study of moral judgements. Through analyzing the gender difference of ASPD, this paper found that males and females behaves differently, which give us important clues on treatment for ASPD. Through looking at the sacrificial moral dilemmas such as the trolley problems, it indicates that some reflections of moral dilemmas can be improved. But undeniably, there are endless debates on moral judgements and certain previous assumptions of ASPD. With the mysteries of ASPD being unveiled, a lot of controversies about this topic might come to an end with answers.