table of contents
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Terms like sociopath get thrown around. You’ll hear them applied to people as wide-ranging as history’s most notable serial killers to today’s Fortune 500 CEOs––and maybe even your friend’s loathsome boss.
But what is a sociopath, actually? Here we break down symptoms, personality traits, and more.
What is a sociopath?
The term sociopath is sometimes used to describe a person with antisocial personality disorder (ASPD).
Personality disorders are a group of conditions that affect a person’s personality, thinking, and behavior. There is a wide range of personality disorders but ASPD is part of cluster B personality disorders, which are characterized by unpredictable or overly dramatic behavior or thinking (Fisher, 2020).
Around 4% of the general population has ASPD, with men being up to five times more likely than women to display these traits (Trull, 2010; Fisher, 2020).
People with ASPD don’t feel remorse, lack empathy, and have no regard for the feelings of others. They are apt to exploit and manipulate others for personal gain and experience no remorse in doing so.
Due to their disregard for the rights of others, they are unable to form and maintain healthy relationships and have trouble abiding by the law or holding down a job.
Another telltale sign of antisocial personality disorder is a failure to learn from negative experiences or punishment, so they may continue engaging in criminal behavior despite the potential consequences (Black-a, 2019).
Borderline personality disorder (BPD): testing, types, and traits
While the signs of ASPD may begin in childhood or adolescence, the condition cannot be diagnosed in a person under the age of 18. Before age 18, a person with these sorts of symptoms can be diagnosed with conduct disorder.
One study found that among youth with substance abuse disorders and conduct disorder, 61% had progressed to a diagnosis of ASPD in adulthood (Myers, 1998). The condition is a lifelong disorder, although symptoms may become milder later in life (Fisher, 2020).
Sociopath vs. psychopath: what’s the difference?
The two terms are often used interchangeably, even among healthcare professionals. Both sociopaths and psychopaths have ASPD, but some researchers argue that psychopaths have a more severe form of ASPD than sociopaths do, with a greater tendency for violence.
One general distinction between sociopaths and psychopaths is that while sociopaths have no regard for other people’s emotions, psychopaths often pretend to care. Sociopaths typically exist on the fringe of society and display odd behavior while psychopaths can be charming and engaging when they choose to.
What are the signs of a sociopath?
The hallmark symptoms of antisocial personality disorder are persistent patterns of socially irresponsible, exploitative, and remorseless behavior. Symptoms of ASPD may include (Fisher, 2020):
- A lack of empathy and concern for others
- A lack of remorse, and failure to adjust their actions in the future to avoid hurting others
- Disregard for the rules or the law, even when facing punishment
- History of criminal behavior
- Ignoring responsibilities at work, school, and to friends and family
- Impulsivity and tendency to engage in risky behavior
- Inability to form stable, healthy relationships
- Narcissism and a sense of superiority to others
- Tendency for irritability and aggression that may lead to violence
- Using their charisma and intelligence to manipulate or deceive others for personal gain or pleasure
What causes ASPD?
Researchers don’t know for sure what causes antisocial personality disorder, but they believe it may have both genetic and environmental factors.
Childhood abuse and neglect may increase the risk of becoming a sociopath. In addition to family dynamics, negative experiences at school, work, and marriage can all exacerbate sociopathy.
Additional risk factors for receiving a diagnosis of ASPD include a history of substance abuse, less education, and lower IQ levels (Black-a, 2019; Fisher, 2020).
PTSD: understanding post-traumatic stress disorder
Sociopath diagnosis and testing
When testing for ASPD, a healthcare provider will begin by reviewing the person’s history and asking questions about their behavior and feelings towards others.
The official diagnostic criteria for ASPD, per the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), states that a person must consistently demonstrate at least three of the following behaviors since age 15 (Fisher, 2020):
- Consistently ignoring social norms and breaking the rules or the law
- Repeatedly lying, deceiving, or conning others for personal pleasure or profit
- Impulsivity, inability to plan, or acting without considering the consequences
- Tendency towards aggressiveness, often leading to physical fights or assaults
- Recklessness and disregard for their own safety and that of others
- Irresponsibility and lack of followthrough on personal and professional obligations
- Lack of remorse or regard for hurting others
Additionally, the person’s antisocial symptoms must not otherwise be explained by a diagnosis of schizophrenia or bipolar disorder (Fisher, 2020).
Psychotherapy: everything you need to know
Treatment for antisocial personality disorder
Antisocial personality disorder is not curable, but symptoms can be managed with long-term psychotherapy, including cognitive behavioral therapy.
Medication is not recommended as a long-term treatment for ASPD but may be prescribed to manage specific symptoms or other mental health conditions (Black-b, 2020).
For example, impulsivity can be treated with anticonvulsants, while aggressive behavior can be managed with antipsychotics, selective serotonin reuptake inhibitors, and mood stabilizers (Fisher, 2020). Clozapine has been shown to be particularly effective in reducing violence, anger, and impulsivity among those on the psychopathic spectrum of ASPD (Brown, 2014).
It can be challenging to maintain a relationship with a person who has ASPD. While it’s unlikely that you can change their behavior, working with a therapist or mental health professional can help you learn how to set boundaries and protect yourself emotionally while supporting the person you care about.
- Black, D. W-a. (2019). Antisocial personality disorder: Epidemiology, clinical manifestations, course and diagnosis. In A. Skodol & M. Friedman Eds.). Retrieved June 22, 2021, from: https://www.uptodate.com/contents/antisocial-personality-disorder-epidemiology-clinical-manifestations-course-and-diagnosis.
- Black, D. W-b. (2020). Treatment of antisocial personality disorder In A. Skodol & M. Friedman Eds.). Retrieved June 22, 2021, from: https://www.uptodate.com/contents/treatment-of-antisocial-personality-disorder.
- Brown, D., Larkin, F., Sengupta, S., Romero-Ureclay, J. L., Ross, C. C., Gupta, N., Vinestock, M., & Das, M. (2014). Clozapine: an effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectrums, 19(5), 391–402. doi: 10.1017/S1092852914000157. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24698103/.
- Coid, J., & Ullrich, S. (2010). Antisocial personality disorder is on a continuum with psychopathy. Comprehensive Psychiatry, 51(4), 426–433. doi: 10.1016/j.comppsych.2009.09.006. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20579518/.
- Fisher, K. A., & Hany, M. (2020). Antisocial personality disorder. In StatPearls. StatPearls Publishing. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31536279/.
- Myers, M. G., Stewart, D. G., & Brown, S. A. (1998). Progression from conduct disorder to antisocial personality disorder following treatment for adolescent substance abuse. American Journal of Psychiatry, 155(4), 479–485. https://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.155.4.479
- Trull, T. J., Jahng, S., Tomko, R. L., Wood, P. K., & Sher, K. J. (2010). Revised NESARC personality disorder diagnoses: gender, prevalence, and comorbidity with substance dependence disorders. Journal of Personality Disorders, 24(4), 412–426. doi: 10.1521/pedi.2010.24.4.412. Retrieved from https://pubmed.ncbi.nlm.nih.gov/20695803/.
Yael Cooperman is a physician and works as a Senior Manager, Medical Content & Education at Ro.