Roles Of Adverse Childhood Experiences And Early Maladaptive Schemas In Antisocial Personality Disorder: A Systematic...

Antisocial personality disorder (ASPD) is characterized by a pattern of negligence towards social norms, illicit and aggressive conduct, and lack of remorse. Adverse Childhood Experiences (ACEs) and subsequent development of Early Maladaptive Schemas (EMS) play a significant role in psychopathology vulnerability, including personality disorders. However, the evidence on the link between cognitive and environmental vulnerability in ASPD specifically is still limited. The aim of the present review is to analyze and discuss the available literature exploring the role of specific ACEs and EMSs in the development of ASPD and investigate the possible mediating role of cognitive variables between environmental factors and ASPD.

A systematic analysis was conducted of records published from January 1st, 2002 to March 18th, 2025 on APAJournals, MEDLINE, Google Scholar, PubMed, using keywords pertaining to three concepts: "antisocial personality disorder", "early maladaptive schema/schema mode", "adverse childhood experiences".

A total of 7719 records were screened, while 229 records were analyzed against our eligibility criteria, resulting in the inclusion of 26 records. The studies emphasize the contribution of physical abuse, and Disconnection/Rejection and Impaired limits domains in the etiology of ASPD. Regarding the mediation between ACEs and ASPD, various studies focused on dysfunctional schema-modes, finding that Child, Over-compensatory, and Healthy Adult modes play a role in ASPD, highlighting the relevance of maladaptive coping and rapid emotional fluctuation in the disorder.

The results enhance our understanding of the contribution of ACEs and EMS in the development of ASPD; however, evidence of a link between cognitive and environmental variables in the development of the disorder is scarce and heterogeneous. Going forward, studies should particularly investigate environmental and cognitive vulnerability to promote a greater understanding of ASPD functioning and tailor clinical interventions based on specific hyper-invested goals and the learned maladaptive coping strategies to pursue them.