Abstract High-functioning antisocial personality traits may manifest in professionally successful individuals whose social competence masks deeper interpersonal and moral deficits. This case series describes two high-achieving Indian professionals (a corporate employee and a nurse) who presented with workplace conflicts and behavioral dysregulation. Despite high cognitive functioning and socially adept presentations, both demonstrated manipulativeness, instrumental interpersonal style, shallow affective empathy, and rationalization of misconduct. Neither met the full The Diagnostic and Statistical Manual of Mental Disorders -Fifth Edition Text Revision criteria for Antisocial Personality Disorder due to the absence of documented childhood conduct disorder which reflects a subclinical but maladaptive variant. Management included cognitive-behavioral and mentalization-based interventions alongside workplace structural modifications, with partial improvement primarily in impulsivity and anger control. These cases highlight diagnostic challenges, the role of family and environmental factors in modulating antisocial traits, and the need for early recognition, targeted psychotherapy, and institutional safeguards in managing this underrecognized subgroup.
Thampuratti et al. (Fri,) studied this question.
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