According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, ASPD is characterized by a pervasive disregard for and violation of other people's rights and involves at least three of the following behaviors: repeated criminal acts, deceitfulness, impulsiveness, repeated fights or assaults, disregard for the safety of others, irresponsibility, and lack of remorse. Epidemiologic studies and laboratory research have consistently linked alcohol use with aggression; however, not every person under the influence of alcohol manifests increased aggression. Recent research has suggested that people with ASPD may be more prone to alcohol-related aggression than people without ASPD. People with ASPD are more likely to meet the criteria for alcohol abuse or dependence and are more susceptible to alcohol's aggression-related effects. Researchers have developed several theories to explain the cause of alcohol-related aggression; these theories focus on expectancies, brain function, and brain chemistry. It is unlikely, however, that any one factor sufficiently explains the association between alcohol consumption and increased aggression. It is still unclear as to whether the association of alcohol-related aggression with ASPD results from some key feature of ASPD itself or from the difficulties that many people with ASPD have in controlling aggressive or impulsive behaviors. Also, researchers have not identified the neurological and biochemical factors that underlie alcohol-related aggression. When these issues have been clarified, researchers may be able to develop effective treatment approaches for decreasing alcohol-related aggression. 2 figures and 34 references