Which is a differential diagnosis for Antisocial Personality Disorder?

• A. Schizophrenia
• B. Narcissistic Personality Disorder
• C. Histrionic Personality Disorder
• D. Substance Use Disorders

Answer: (D)

The situation tests identifying conditions that can mimic an antisocial pattern. Substance Use Disorder is a key differential because chronic use can drive deceit, impulsivity, and risk-taking that resemble antisocial traits. The differentiation hinges on the course: antisocial personality disorder requires a pervasive pattern of disregard for rights and conduct problems beginning before age 15 and persisting across contexts. If the problematic behaviors occur mainly during intoxication, withdrawal, or while craving drugs, then a substance-related etiology is more likely. If the antisocial pattern remains evident even when not under the influence, that supports antisocial personality disorder.