A sociopath is a term used to describe someone who has antisocial personality disorder (ASPD). People with ASPD can’t understand others’ feelings. They’ll often break rules or make impulsive decisions without feeling guilty for the harm they cause.
People with ASPD may also use “mind games” to control friends, family members, co-workers, and even strangers. They may also be perceived as charismatic or charming.
ASPD is part of a category of personality disorders characterized by persistent negative behaviors.
The new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) says that someone with ASPD consistently shows a lack of regard for others’ feelings or violations of people’s rights. People with ASPD may not realize that they have these behaviors. They may live their entire lives without a diagnosis.
To receive a diagnosis of ASPD, someone must be older than 18. Their behaviors must show a pattern of at least three of the following seven traits:
- Doesn’t respect social norms or laws. They consistently break laws or overstep social boundaries.
- Lies, deceives others, uses false identities or nicknames, and uses others for personal gain.
- Doesn’t make any long-term plans. They also often behave without thinking of consequences.
- Shows aggressive or aggravated behavior. They consistently get into fights or physically harm others.
- Doesn’t consider their own safety or the safety of others.
- Doesn't follow up on personal or professional responsibilities. This can include repeatedly being late to work or not paying bills on time.
- Doesn’t feel guilt or remorse for having harmed or mistreated others.
Other possible symptoms of ASPD can include:
- being “cold” by not showing emotions or investment in the lives of others
- using humor, intelligence, or charisma to manipulate others
- having a sense of superiority and strong, unwavering opinions
- not learning from mistakes
- not being able to keep positive friendships and relationships
- attempting to control others by intimidating or threatening them
- getting into frequent legal trouble or performing criminal acts
- taking risks at the expense of themselves or others
- threatening suicide without ever acting on these threats
- becoming addicted to drugs, alcohol, or other substances
Other ways to diagnose ASPD include:
- evaluating the person’s feelings, thoughts, behavioral patterns, and personal relationships
- talking to people close to the person about their behaviors
- evaluating a person’s medical history for other conditions
ASPD can be diagnosed in someone as young as 15 years old if they show symptoms of a conduct disorder. These symptoms include:
- breaking rules without regard for the consequences
- needlessly destroying things that belong to themselves or others
- lying or constantly deceiving others
- being aggressive toward others or animals
There’s no clinical difference between a sociopath and a psychopath. These terms are both used to refer to people with ASPD. They’re often used interchangeably.
Some have attempted to distinguish the two by the severity of their symptoms. A sociopath may be someone who only makes minor transgressions that don’t cause serious harm or distress. But a psychopath may be described as someone who’s physically violent or put others in danger. However, when one considers the DSM-5 diagnostic criteria, all of these symptoms can be found in the ASPD category.
Exhibiting frequently selfish behavior is in and of itself not sufficient to diagnose someone as a sociopath. An ASPD diagnosis is only given when symptoms happen for an extended period and don’t change because of punishment or lifestyle changes. Someone who’s selfish may show these behaviors for a short while, but feel bad about them or change their behavior over time or because of punishment.
Generally, people with personality disorders such as ASPD don’t think they have a problem. Talk to your doctor if you think you have ASPD. Your doctor may refer you to a mental health practitioner for diagnosis and treatment.
ASPD often requires long-term treatment and follow-up. Treatment may not be successful if the person isn’t willing to seek treatment or cooperate with treatments.
Possible treatments for ASPD include:
Psychotherapy consists of talking with a therapist or counselor about thoughts and feelings that can exacerbate ASPD behaviors. It may also include management therapy for anger, violent behavior, and addiction to drugs or alcohol.
Cognitive behavioral therapy (CBT)
CBT helps you think more carefully about your actions and responses to people and situations. CBT won’t cure ASPD, but it can help develop positive, less harmful behaviors. CBT can also help you accept that you have the disorder and encourage you to be proactive in addressing your behaviors.
There’s no specific medication for the treatment of ASPD. You may receive medications for associated mental disorders, though, like anxiety, depression, and aggressive behavior. The medication clozapine (Clozaril) has shown some promise as a treatment for men with ASPD.
If someone in your life with ASPD is causing you harm, removing that person from your life may be the healthiest way to cope with their behavior.
In many cases, you may not feel comfortable leaving a family member, close friend, or spouse with ASPD. Marriage counseling or couples therapy can help you develop a positive relationship with someone who has ASPD.
To help maintain a relationship with someone who has ASPD:
- Acknowledge that they may not be able to fully understand your emotions.
- Explain to the person how their behavior affects others and causes harm.
- Make your boundaries explicitly clear to them.
- Offer specific consequences for harmful behaviors.
ASPD can’t be cured. But it can be treated with therapies that focus on limiting destructive behaviors by replacing them with constructive behaviors.
If you have ASPD, remember that you can still have stable and loving relationships with others. Accepting that you have ASPD and acknowledging the consequences of your actions can help you manage your behaviors and keep your relationships strong.