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Due to new discoveries and more insight into ASPD, more cases of the mental illness are able to be uncovered. Both psychologists and psychiatrists now have the ability to distinguish it from other mental illnesses such as schizophrenia and bi-polar disorder. The answer is now able to be found in the past, beginning in the childhood of the patient in question. .
Symptoms of ASPD usually occur prior to the age of fifteen but cannot be diagnosed until the age of eighteen (Goldberg). This is due to the fact that the nervous system is still immature and that can be the reasoning for these signs and symptoms. The symptoms begin in an almost unnoticeable way. Granted, all children go through a phase of awkwardness to adjust to new people as well as surroundings; in a child with ASPD it will appear slightly more severe. The child will pull away from any type of social interactions such as recess, group activities, and even family gatherings. Another symptom that arises during childhood is lack of remorse. If a relative dies, or the family pet, there is no sadness that follows. Not far behind comes the killing of small animals; the throwing of rocks to birds flying in the sky, a magnify glass to an ant hill, and the suffocation of cats and dogs just to see their pain and suffering. As they grow older they become more aggressive and irritable, leading to more impulsive actions such as picking fights with a weaker individual. Due to these signs becoming more apparent the patient or a family member of the patient will seek out help. .
When help is sought out the clinician will run a few tests to rule out anything else that can be causing these signs and symptoms. They will begin with a physical exam, following with blood work and lab tests, ending with a psychological evaluation. The physical exam will rule out any internal organ issues causing fatigue and sluggishness. The blood work is to find any imbalance of hormones such as serotonin which is what some call a "mood balancer".