Evidence and Limitations of Cognitive-Behavioral Therapy in Antisocial Personality Disorder: A Literature Review

Abstract

Introduction: Antisocial Personality Disorder (ASPD) represents a significant clinical challenge due to its behavioral complexity and the limited therapeutic adherence commonly observed in patients. In this context, Cognitive-Behavioral Therapy (CBT) has been widely applied in the treatment of various personality disorders; however, its specific effectiveness in managing ASPD remains a subject of ongoing debate within the scientific literature. Objective: To examine the impact of Cognitive-Behavioral Therapy in the treatment of Antisocial Personality Disorder, assessing its clinical usefulness and current therapeutic alternatives. Materials and Methods: A documentary review was conducted based on recent academic literature indexed in scientific databases such as PubMed. Studies were selected according to their thematic relevance and recency, with the aim of analyzing available evidence regarding the effectiveness of CBT in ASPD and exploring emerging therapeutic approaches. Results: The review revealed limited literature directly linking CBT with ASPD and the absence of unified conclusions. Nevertheless, the prevailing consensus suggests limited effectiveness of CBT in this population, mainly due to low patient adherence to the therapeutic process. Furthermore, a growing trend toward alternative approaches was identified, including Mentalization-Based Therapy (MBT), Virtual Reality Therapy (VR), and Schema Therapy (ST), supported by technological innovations and integrative models. Conclusion: Current evidence indicates that CBT demonstrates limited effectiveness in the treatment of ASPD, highlighting the need for further research to strengthen its empirical validation or to consolidate alternative therapeutic strategies aimed at optimizing clinical care for this population.