Is antisocial personality disorder the same as sociopath

High-Functioning Sociopath or Antisocial Personality Disorder?

People who have been diagnosed with antisocial personality disorder (ASPD) are sometimes called sociopaths. They engage in behaviors that typically harm others for the benefit of themselves.

A “sociopath” has little regard for another person’s emotions, rights, or experiences. They lack remorse for their actions, and they act in ways that show no regard for others, including lying, cheating, and manipulating.

Some people with this condition aren’t very sly about their conduct. Others are quite deceptive.

The people who have an easier time engaging in these dishonest behaviors may be called high-functioning sociopaths. Indeed, someone who’s high functioning often comes off as charming and warm, while hiding behaviors and conduct that’s often anything but.

People with high-functioning ASPD can often do typical ‘everyday’ things like hold down a job and maintain a marriage with kids. However, these otherwise typical behaviors often hide a tendency to manipulate and exploit people and situations for their benefit.

ASPD isn’t common. Between 1 to 4 percent of the population is estimated to have this disorder, with males 3 to 5 times more likely to be diagnosed than females.

But the behaviors of someone with high-functioning ASPD can be all-consuming for people who live with or work around them.

Read on to find out why this condition develops and what treatments are available — whether you’re seeking help for yourself or a loved one.

Some individuals with antisocial personality disorder don’t exhibit polished and polite behaviors as a mask for their manipulations. Some may call these people ‘low-functioning’ sociopaths, though the DSM-5 doesn’t use the terms high or low functioning to describe behaviors associated with ASPD.

People considered ‘low-functioning sociopaths’ may lack the education or interpersonal skills to control and deceive. Instead, they might use threats, coercion, or intimidation to achieve their desired outcome.

Not all high-functioning ASPD symptoms are evident. Many can become more apparent after true intentions or agendas are revealed.

Symptoms and characteristics include:

Superior intelligence. Those who are high functioning are often incredibly smart, with very high IQs which can help them read, manipulate, and control scenarios.
Lack of empathy. People with ASPD don’t comprehend other people’s emotions. Therefore, they don’t appreciate or anticipate the consequences of their actions.
Calculating behaviors. People with this type of sociopathy are driven and determined. A strong self-love (narcissism) and sense of grandiosity may be their catalyst.
Secretive tendencies. High-functioning individuals may keep everything close to the vest. They rarely reveal private information or thoughts unless it’s to manipulate another person.
Charm. Despite generally not enjoying being around people, a high-functioning person displays impeccable social skills.
Sensitivity. People with high-functioning ASPD can be defensive. They may be quick to anger when they perceive they don’t have someone’s approval. That’s because they often feed off admiration from others.
Addictive behaviors. It’s not uncommon for a person with a high-functioning personality disorder to experience addiction. Compulsive behaviors and reactions can lead to issues with gambling, sex, alcohol, and drugs.

Maintaining a relationship with someone who has high-functioning antisocial personality disorder can be difficult, but it is possible. The key may be to care for yourself, rather than pushing them to find help.

These strategies may be useful:

Come to an honest realization

You can’t fix a person with this condition — there is no cure.

But you can arm yourself with the resources you need to properly defend yourself and shepherd them away from scenarios that hurt you.

Don’t make deals

You can’t make agreements or arrangements with someone with high-functioning ASPD.

Only you feel the compulsion to uphold the bargain. They don’t. This could lead to additional harm.

Listen to your gut

Someone with this type of ASPD may be adept at manipulating a person’s emotions in order to achieve their goals. Once the charm wears off, you’re left with the reality.

If you have a gut feeling about them or their motivations, listen to that little voice.

End the relationship

The ultimate way to protect yourself from the potential harm of a person with this type of antisocial behavior is to eliminate them from your life. However, this isn’t always easy.

Get help

If you’ve been hurt by a person with ASPD, you can find help.

Trained mental health professionals can help you understand what you experienced and learn from it. They can then teach you to set protective boundaries to hopefully prevent future abuse.

It’s not clear exactly why some people develop higher functioning ASPD. There’s no known cause.

What is known, however, is that some people are more likely to develop this type of ASPD than others.

factors that may cause high-functioning sociopathy
Sex. Males are more likely to develop ASPD than females.
Genes. A family history of any type of ASPD may increase your risk for it or another type of mental illness.
Conduct disorder. High-functioning ASPD is unlikely to be diagnosed before age 18, but childhood conduct issues may be a sign of a personality disorder like sociopathy.
Trauma. Childhood abuse or neglect increases the risk for this type of disorder.
Unstable childhood. Children raised in environments that are turbulent, even violent, are also at a greater risk.

There’s no single test to diagnose high-functioning ASPD. Mental health professionals often don’t rely on a person’s self-reported symptoms either. That’s because people with this disorder that are high functioning are proficient in lying and covering up their true motives and thoughts.

Instead, mental health experts use a list of persistent negative behaviors to establish high-functioning sociopathy.

If a person has at least three of these antisocial behaviors, they’ll likely be diagnosed with the condition:

a disregard for rules, norms, or boundaries
repeatedly lying or deceiving to accomplish personal gain
an inability to act with long-term plans; constantly engaging in impulsive behaviors
lacking remorse for the hurt or pain they’ve caused
failing to maintain responsibilities, such as work or financial commitments
aggressive behavior, especially when challenged or upset
acting recklessly, even when responsible for another’s well-being

There’s currently no cure for high-functioning sociopathy and treatments are limited, too. This may be because most individuals with this type of ASPD won’t seek treatment because they don’t recognize their behaviors as problematic or harmful.

However, if you believe you have high-functioning ASPD or know someone who may, there are some treatments that can help you maintain healthy relationships while working to impede the worst symptoms.

These include:

Psychotherapy: This form of therapy can teach you ways to cope with anger, addictive behaviors, and other symptoms.
Cognitive-behavioral therapy (CBT): This type of therapy may help you discover where your behaviors began. You may work to change harmful thought patterns, too.
Medicine: One study found that men with ASPD who took clozapine showed reduced aggression and violence. However, it’s not currently approved for this purpose. The FDA hasn’t approved any drugs for the treatment of this condition, though some medicines may be used to treat co-occurring conditions, such as anxiety or aggression.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

If you suspect a friend or family member has high-functioning antisocial personality disorder, you may not be able to convince them to seek treatment. Many don’t recognize the harm their condition does to others around them.

What you can do, however, is find help for yourself.

You can learn techniques that will protect you against the possible abuse and manipulation that’s common from people with this type of sociopathy. While not always possible, these measures may help you maintain a loving, stable relationship with them.

If you believe you may be someone with high-functioning ASPD, you can find help, too. Mental health experts can talk with you and your friends or family members to understand the behaviors you exhibit.

You can then discuss possible treatments and ways to properly care for yourself.

High-Functioning Sociopath or Antisocial Personality Disorder?

People who have been diagnosed with antisocial personality disorder (ASPD) are sometimes called sociopaths. They engage in behaviors that typically harm others for the benefit of themselves.

Some people with this condition aren’t very sly about their conduct. Others are quite deceptive.

ASPD isn’t common. Between 1 to 4 percent of the population is estimated to have this disorder, with males 3 to 5 times more likely to be diagnosed than females.

But the behaviors of someone with high-functioning ASPD can be all-consuming for people who live with or work around them.

Read on to find out why this condition develops and what treatments are available — whether you’re seeking help for yourself or a loved one.

Not all high-functioning ASPD symptoms are evident. Many can become more apparent after true intentions or agendas are revealed.

Symptoms and characteristics include:

Superior intelligence. Those who are high functioning are often incredibly smart, with very high IQs which can help them read, manipulate, and control scenarios.
Lack of empathy. People with ASPD don’t comprehend other people’s emotions. Therefore, they don’t appreciate or anticipate the consequences of their actions.
Calculating behaviors. People with this type of sociopathy are driven and determined. A strong self-love (narcissism) and sense of grandiosity may be their catalyst.
Secretive tendencies. High-functioning individuals may keep everything close to the vest. They rarely reveal private information or thoughts unless it’s to manipulate another person.
Charm. Despite generally not enjoying being around people, a high-functioning person displays impeccable social skills.
Sensitivity. People with high-functioning ASPD can be defensive. They may be quick to anger when they perceive they don’t have someone’s approval. That’s because they often feed off admiration from others.
Addictive behaviors. It’s not uncommon for a person with a high-functioning personality disorder to experience addiction. Compulsive behaviors and reactions can lead to issues with gambling, sex, alcohol, and drugs.

These strategies may be useful:

Come to an honest realization

You can’t fix a person with this condition — there is no cure.

But you can arm yourself with the resources you need to properly defend yourself and shepherd them away from scenarios that hurt you.

Don’t make deals

You can’t make agreements or arrangements with someone with high-functioning ASPD.

Only you feel the compulsion to uphold the bargain. They don’t. This could lead to additional harm.

Listen to your gut

Someone with this type of ASPD may be adept at manipulating a person’s emotions in order to achieve their goals. Once the charm wears off, you’re left with the reality.

If you have a gut feeling about them or their motivations, listen to that little voice.

End the relationship

The ultimate way to protect yourself from the potential harm of a person with this type of antisocial behavior is to eliminate them from your life. However, this isn’t always easy.

Get help

If you’ve been hurt by a person with ASPD, you can find help.

Trained mental health professionals can help you understand what you experienced and learn from it. They can then teach you to set protective boundaries to hopefully prevent future abuse.

It’s not clear exactly why some people develop higher functioning ASPD. There’s no known cause.

What is known, however, is that some people are more likely to develop this type of ASPD than others.

factors that may cause high-functioning sociopathy
Sex. Males are more likely to develop ASPD than females.
Genes. A family history of any type of ASPD may increase your risk for it or another type of mental illness.
Conduct disorder. High-functioning ASPD is unlikely to be diagnosed before age 18, but childhood conduct issues may be a sign of a personality disorder like sociopathy.
Trauma. Childhood abuse or neglect increases the risk for this type of disorder.
Unstable childhood. Children raised in environments that are turbulent, even violent, are also at a greater risk.

Instead, mental health experts use a list of persistent negative behaviors to establish high-functioning sociopathy.

If a person has at least three of these antisocial behaviors, they’ll likely be diagnosed with the condition:

a disregard for rules, norms, or boundaries
repeatedly lying or deceiving to accomplish personal gain
an inability to act with long-term plans; constantly engaging in impulsive behaviors
lacking remorse for the hurt or pain they’ve caused
failing to maintain responsibilities, such as work or financial commitments
aggressive behavior, especially when challenged or upset
acting recklessly, even when responsible for another’s well-being

However, if you believe you have high-functioning ASPD or know someone who may, there are some treatments that can help you maintain healthy relationships while working to impede the worst symptoms.

These include:

Psychotherapy: This form of therapy can teach you ways to cope with anger, addictive behaviors, and other symptoms.
Cognitive-behavioral therapy (CBT): This type of therapy may help you discover where your behaviors began. You may work to change harmful thought patterns, too.
Medicine: One study found that men with ASPD who took clozapine showed reduced aggression and violence. However, it’s not currently approved for this purpose. The FDA hasn’t approved any drugs for the treatment of this condition, though some medicines may be used to treat co-occurring conditions, such as anxiety or aggression.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

What you can do, however, is find help for yourself.

You can then discuss possible treatments and ways to properly care for yourself.

general information, causes, symptoms, treatment

Dissocial personality disorder (sociopathy, unstable psychopathy, antisocial psychopathy) is a mental personality disorder characterized by ignoring social norms and the rights of other people, a tendency to illegal actions.

According to the ICD-10 classification, dissocial personality disorder (F60.2) belongs to the group of specific personality disorders (F60). In accordance with the ICD, specific personality disorders are classified as severe disorders, with marked behavioral abnormalities. They are not a direct consequence of disease or any damage to the brain. The disorder is almost always associated with social breakdown and negatively affects several areas of a person's life. They begin in childhood and adolescence and last for many years. The disorder is detected in 1% of women and 3% of men. Residents of cities, children from large families, people from low-income segments of the population are most susceptible to the emergence of sociopathy.

Researchers claim that patients with antisocial disorder make up to 75% of the contingent of places of detention. But not all sociopaths become criminals - some people commit socially condemned, but not formally punishable actions.

There are two types of people with antisocial personality disorder: passive and active. "Passive" sociopaths do not have internal moral restrictions, but are repelled by the norms of external authorities (religion, legislation). Such behavior protects them from open conflicts with society and allows them to formally meet the requirements of society.

"Active" sociopaths have no internal and external restrictions. If necessary, they can demonstrate to others their responsibility, decency and readiness to abide by the rules of society, but at any opportunity they stop limiting themselves and return to antisocial behavior. "Active" sociopaths often demonstrate criminal behavior, passive - hidden, formally unpunished (lie, manipulation, neglect of duties).

Clinically, sociopathy is manifested by a complete lack of guilt and responsibility for one's actions, an inability to learn from negative experiences. The person is prone to lies and hypocrisy, self-centered, aggressive, lacks empathy and affection. As with other psychotic conditions, the person acts impulsively, but sociopaths are aware that they violate the norms of society, unlike people with psychosis.

People with antisocial disorder commit illegal actions in order to obtain profit or pleasure (fraud, exploitation, etc.), they do not cope well with failures. A person justifies and rationalizes his actions, is indifferent to the negative consequences of his actions for others.

The allocation of this type of personality disorder is conditional. Rather, it is the same type of formation of different constitutional forms of personality. Some of the personalities can be attributed to the circle of schizoid psychopathy (emotionally cold expansive schizoids), others - to emotionally unstable and narcissistic personality disorders.

The main role in the occurrence of antisocial personality disorder is played by heredity and upbringing. With age, some correction of their behavior is possible.

Sociopathies often coexist with other psychiatric illnesses (borderline personality disorder, attention deficit hyperactivity disorder, impulse disorder) and addictions such as substance abuse and alcohol addiction.

Sociopathy is a dynamic personality structure along with masochistic, hysterical and others, which is formed from genetic predisposition and psychogenic factors. Behavior is difficult to treat and correct. Sociopaths are able to be responsible for their actions, they deliberately violate the laws, feeling permissiveness.

Such a person easily endures loneliness, often changes partners, if necessary, create a family, does this in order to better integrate into society. He attracts attention with his charisma and high intelligence.

Uses the norms of society well for his own purposes, rejects traditional patterns of behavior and thinking, does not listen to medical recommendations, easily gives up his comfort (life in an inappropriate place for this, hitchhiking, vagrancy, etc.) Sociopaths do not believe and do not trust anyone .

Causes of disorder

Genetic and psychogenic factors contribute to the development of antisocial personality disorder. The mechanism of development of impulsivity and aggression towards others may be associated with the pathological functioning of the serotonin carrier gene. The hormonal apparatus of a person with sociopathy produces less serotonin, as a result of which he is not able to take the necessary emotions from communication, to experience empathy.

In close male relatives, sociopathy occurs five times more often than in other relatives. In families of patients with antisocial personality disorder, hysterical disorders are often detected. High criminal activity of family members, the presence of relatives suffering from alcoholism and drug addiction, poverty and unfavorable social conditions are also considered as factors contributing to the development of dissocial disorder.

The presence of mental illness in close relatives increases the risk of the disorder in children. In this case, the role is played by hereditary predisposition and the adoption of a behavior model from parents (quarrels between family members, violence, divorce of parents), and much also depends on the methods of education (if relatives neglect the child, use violence, are inconsistent in discipline, etc. ).

Sociopathy, like other personality disorders, can be caused by a lack of parental love and care in childhood, which leads to a lack of trust in people. A person with such an experience is emotionally alienated and is able to establish contact with other people only by force. In some cases, family members can unknowingly instill in a person an antisocial behavior model - they give in to a child in order to maintain good relations, in response to his aggressive behavior or stubbornness. Overprotection or neglect can also affect.

People with antisocial disorder find it difficult to accept any point of view other than their own. Studies have shown that people with this disorder are often less anxious than other people. Individuals with antisocial disorder have been found to be less able than controls to solve laboratory tasks, such as finding a way out of a maze, when the key reinforcers are punishments, such as some sort of shock or monetary fine. When the punishments were made more explicit or brought to the subjects' attention to them, learning improved. It is difficult for a person to learn from his mistakes, this may be due to the lack of an element that is key in the learning process.

Scientists have found that subjects with this disease respond to the expectation of stress by low excitation of the brain (slow excitation of the autonomic nervous system, low-frequency EEG waves). Due to low brain arousal, patients may find it difficult to grasp threatening situations, so they have little effect on them. Perhaps that is why anti-social and risky activities attract people, satisfying the need for more excitement.

Symptoms of the disorder

Sociopathy can appear as early as early preschool and adolescence, and symptoms in boys usually become visible as early as early school age. In girls, symptoms appear a little later - during the prepubertal period. The symptoms of the disorder are numerous: the child is selfish, hostile, stubborn, cruel (acts evil with peers, tortures animals, skips classes, runs away from home, spoils property, steals). In dealing with people, he is angry, quick-tempered, fits of rage are possible. Has a very high opinion of himself. A distinctive feature of patients with antisocial personality disorder is early opposition to parents. Due to the lack of attachment to their neighbors and a critical assessment of their actions, they neglect family traditions, moral and legal norms.

A person can deceive, speculate or manipulate other people for his own purposes, using his intellectual abilities for this. In order to get what they want, they are extremely charming, talkative, and endearing. They constantly crave light entertainment and pleasures, an idle lifestyle, try to avoid any work, study, fulfillment of any duties. From adolescence, they are drawn to asocial companies, alcohol, and drugs. They are indifferent to their future, live in the present. Weak-willed and cowardly - they try to run away from any difficulties and troubles.

Patients with antisocial personality disorder may rationalize their actions by blaming those they offended that they themselves are to blame or that they deserve such treatment. They do not feel remorse and repentance, they are always sure that they are right, at any cost they do what they consider the best for themselves at the expense of other people. They are guided not only by selfish interests, but also by the desire to annoy and offend others. Any penalty from them is regarded as a manifestation of injustice.

In adulthood, a person with a similar disorder most often looks adequate and socially adapted. There are no problems in communication - thanks to the charm and ability to win over others, they often make a good impression with superficial contacts. Sociopaths have a special attraction, and people who need to be nurtured and guided like to be around such a “strong” person. It reassures them and gives them confidence. A person with a sociopathy is often sexually attractive, which he takes advantage of. Sexual life is a source of pleasure. Such a person is not able to love, empathize, sympathize, but can imitate love. you will never suspect that he does not feel anything for you.

A person with a dissocial disorder is a desperate debater who always wins, and if they try to catch him, he will dodge to the end, but will not admit to being wrong or lying and most likely will go on the counterattack. When trying to argue the accusations and his wrongness, the sociopath will respond with accusations that they want to denigrate his honor. You should not compete with such a person, in any situation it is important for him to always win, and he uses any means for this.

As a result of their impulsiveness, patients do not plan in advance, are socially and financially irresponsible - carelessly handle money, often move, change their place of residence and work, relationships. They may not pay bills, loans, alimony. Very often, sociopaths end up in prison, for many people with this disorder, the criminality of behavior begins to decrease after 40 years. Abuse alcohol and psychoactive substances. In a state of intoxication, conflict and aggressiveness increase.

Antisocial personality disorder persists throughout life, treatment is ineffective, but it helps to slightly correct behavior. Some patients create social groups isolated from society, become leaders of sects or criminal gangs. With age, many patients develop concomitant affective and somatic disorders, alcoholism, and drug addiction.

Diagnosis of disorder

The disorder is diagnosed on the basis of a conversation with a person and the collection of an anamnesis of life. To assess the degree of neglect of duties and neglect of established rules, social conditions and cultural norms of a particular region are taken into account.

Antisocial personality disorder is diagnosed in the presence of general manifestations of the disorder and specific symptoms:

the disorder is initiated at an early age (up to 15 years), there are no alternating periods of exacerbation and recovery;
constant deliberate violation of social norms, laws, disregard for the rights and feelings of people;
a person easily loses his temper, is angry, prone to violence;
there is no sense of guilt and responsibility for their actions;
a tendency to constant lies, fraud and manipulation;
condemnation of other people's actions, justification and rationalization of their own;
there is no planning, impulsiveness of actions, irresponsibility.

The disorder can be differentially diagnosed with the following diseases:

Narcissistic Personality Disorder . The person is not capable of empathy, tends to exploit others for their own purposes, but is not aggressive. Patients with narcissistic disorder have difficulty managing their self-esteem, it is important for them to hear praise and belong to special groups of people. To maintain their sense of superiority, they devalue other people and their achievements. They overestimate their abilities and exaggerate their achievements. Patients with antisocial personality disorder exploit others for material gain, while those with narcissistic personality disorder exploit others to maintain their self-esteem.

Borderline Personality Disorder . BPD patients are prone to manipulative behavior, the goal of manipulation is to gain attention and support, not material gain. Patients experience intense fear or anger when they feel ignored or rejected, afraid of being abandoned, left alone. Often and abruptly change the point of view, there is a phase of idealization and devaluation. They empathize only if they are sure that this person will come to their aid at any moment and will not leave them alone. After the end of the outburst of anger, he feels guilt and shame, convinces himself how much he himself is a bad person.

Conduct disorders . Destructive patterns of behavior, in violation of norms and laws, occur before the age of 15 and stop with adulthood. In about a third of cases, they persist, the symptoms consistent with antisocial personality disorder. The disorders are characterized by persistent uncommunicative, aggressive, defiant patterns of behavior. Diagnosis is based on behavior patterns, including excessive conflict, deceit, cruelty to other people and animals, damage to property, etc. The presence of such pronounced signs is sufficient for diagnosis, but specific actions are evaluated only in conjunction with other factors.

Psychopathy . A disease with pronounced antisocial behavior, with complete preservation of thinking. Sociopathy is a milder form of psychopathy. With a normal existence in society, but a complete disregard for the rules and laws, we are talking about sociopathy. Psychopaths also know how to manipulate others, do not form attachments, other people are needed only to achieve their goals and entertainment. But if the psychopath is inclined to build and implement his plans in cold blood, then the sociopath acts spontaneously, often commits risky acts.

Substance dependence . Impulsivity and irresponsibility can be the result of substance use. The analysis is based on the patient's history. Dependence can accompany a dissocial disorder, or be an independent disease.

Heboid schizophrenia . The presence of pronounced emotional changes and early onset emotional dullness is often a sign of slowly developing schizophrenia with heboid manifestations or chronic mania. The leading place in the manifestations of the heboid state in schizophrenia in adolescence is occupied by psychopathological disorders that contribute to a strong distortion and exaggeration of the typical manifestations of puberty (the desire to assert oneself, a tendency to oppose, contradict others). Under the influence of the disorder, the usual manifestations become psychopathological, total negativism and opposition to others and discipline develop.

Dissociative Identity Disorder . A type of dissociative (conversion) disorder. It is characterized by the presence of two or more alternating personalities (alter-personality, ego-state or identity). Dissociative identity disorder is accompanied by an involuntary escape from reality, derealization, depersonalization. Inability to recall events from daily life, certain personal information, traumatic events, or severe stress. The cause of conversion disorder is almost always a trauma in childhood or adulthood. As a result of an identity disorder, a person finds himself in one or more personalities at the same time or in turn. At such moments, a person disconnects from himself and stops feeling his own body, may not see himself from the outside. Personalities within a person can have different ages, genders, nationalities, mental abilities, temperaments, and have completely different behaviors and habits.

Emotionally unstable personality disorder . Such people are prone to impulsive actions, are not afraid of consequences, are unpredictable, conflict and capricious. They tend to have emotional outbursts and are unable to control their temper tantrums. There are two types of disorder: impulsive type (emotional instability and lack of emotional control) and borderline type (characterized by a disorder of self-perception, goals and aspirations, a constant feeling of emptiness, tension and instability of interpersonal relationships, self-destructive behavior, suicidal attempts are possible).

Treatment of antisocial disorder in Alter

Individuals with antisocial disorder almost never seek psychiatric help. But many sociopaths feel the inner emptiness that is formed due to the lack of attachments and harmonious relationships with others, and they want to correct this.

Treatment of antisocial disorder is carried out with the help of a course of individual psychotherapy, sometimes methods of cognitive behavioral therapy and situational management. It is not easy for a specialist to find contact with such people, but the doctors of the Alter Mental Health Center are able to find an approach to each patient.

Treatment at Alter for patients with antisocial personality disorder is selected individually, depending on the overall clinical picture. Individual psychotherapy helps to achieve a strong positive effect, harmonizing the life of the patient and his loved ones, and is also aimed at correcting the model of thinking and behavior, impulse control. Pharmacotherapy is prescribed if sociopathy has comorbid mental disorders to relieve symptoms.

Patients with severe impulsivity, aggressiveness, and affective lability benefit from treatment with cognitive-behavioral therapy and medications.

It is possible to undergo treatment in Moscow for dissocial personality disorder at the Clinic of Dr. Shmilovich "Re-Alt" at the address Moscow, Vsevolozhsky per., 2/2.

A sociopath: who is it, signs, differences from a psychopath

Charming scoundrels, tireless careerists, and sometimes predators in human form. We tell you who sociopaths are, how you can recognize them and how to communicate with them

Contents:

Sociopath, sociophobe and psychopath: the difference
How to recognize
Are sociopaths really smart and charming
How to treat
How to communicate
Can a sociopath fall in love
More to read

Who is a sociopath

A sociopath is a person with an antisocial (or antisocial) personality disorder. A sociopath ignores generally accepted norms of morality and behavior in society. For his own benefit, he lies and manipulates other people, giving the impression of being calculating, selfish and aggressive.

The word "sociopathy" comes from two words: the Latin socium - "society" and the ancient Greek pathos - "disease", that is, it means a violation in social relations, an inability to obey the rules of society [1].

The DSM-5 Mental Health Manual does not use the word sociopath. According to the handbook, a person with antisocial disorder might be called a sociopath or a psychopath, but these terms are not used to make a diagnosis. Doctors in Russia and abroad do not diagnose people with sociopathy, but with antisocial personality disorder [2].

History of the term

Doctors have noticed a long time ago cold selfish rationality in some patients, which often develops into aggressive behavior [3]. One of the first physicians to describe such people was the French physician Philippe Pinel, who in 1806 called their condition "madness without delirium" (maniaque sans délire), and his student, psychiatrist Jean-Etienne Dominique Esquirol (Jean Etienne Dominique Esquirol) - rational madness.

Another popular name, common in the USA and England in the 19th century, is moral insanity, that is, the inability to follow generally accepted moral standards. The term "psychopathy" was first used to describe such people in the late 19th century by the German psychiatrist Julius Ludwig August Koch.

In the 1930s, psychiatrists coined a new definition, sociopath, because the term "psychopathy" could easily be confused with psychosis, a bout of inappropriate behavior. In addition, the prefix "socio" reflected the widespread belief at the time that sociopaths were people whose behavior was influenced by the social environment, and not, for example, genetics.

The term “sociopath” was much more popular in the West than in Soviet and Russian psychiatry. In the West, many researchers have used sociopathy and psychopathy interchangeably. But at 19In 1980, the third edition of the DSM handbook added the term "antisocial personality disorder" and it has been used as an official diagnosis ever since.

Culture has always had images of people with sociopathic traits. Cain is sometimes called the first sociopath, who, according to the Old Testament, killed his brother Abel. One of the most famous female sociopaths of ancient Greek mythology is Medea (on the left is Eugene Delacroix’s painting “Medea”, 1838), a princess and sorceress who killed her children to avenge her husband for treason. Another “literary” sociopath is King Shahriyar from “A Thousand and One Nights” (on the right is Anton Pieck’s painting “Scheherazade Tells Tales to Shahriyar”, 1943), who executed his wives after their wedding night. (Photo: mirovoeiskusstvo.ru, artnet.com)

At the end of the 20th century, the term “sociopath” was popularized by American culture: in many films and TV shows, the main characters go beyond social rules and norms. They do not always cause the approval of the viewer, but almost always - a burning interest.

Sociopathic villain, 15-year-old Alex deLarge in the film adaptation of Anthony Burgess's A Clockwork Orange, who commits crimes, ends up in jail, participates in an experiment to "cure" aggression, but in the end never becomes "normal" . A positive image of a sociopath is Sherlock from the BBC series. (Photo: www.fansshare.com, www.walesonline.co.uk)

According to neuroscientist James Fallon, who specializes in the study of psychopaths, Sherlock Holmes is a sociopath (or psychopath) who lacks empathy: he imitates emotions without actually experiencing them [4].

At the same time, Sherlock is very charismatic and in the series often demonstrates that he cares about other people's feelings. James Fallon, who is also a sociopath, explains that such empathy is not characteristic of them. This is probably an invention of the writers to make the main character more attractive to the audience. Real sociopaths are nasty people, Fallon points out.

Sociopath, sociophobe and psychopath: the difference

Sherlock's phrase in the British BBC series of the same name "I'm not a psychopath, but a high-functioning sociopath" plays on the difference between a psychopath and a sociopath. But when making a medical diagnosis, there is no difference between sociopathy and psychopathy. The DSM-5 Handbook of Mental Disorders makes no distinction between the two—it defines both psychopaths and sociopaths as people with antisocial personality disorder.

However, some psychologists separate psychopaths and sociopaths from each other. Psychologist Robert D. Hare, who invented a special test for psychopathy (PCL-R), believes that sociopaths have a concept of morality, although it may differ from the generally accepted one [5]. Sociopaths have little empathy for others, but they understand the difference between good and evil. For psychopaths, there is no morality or empathy at all.

Some neurobiological studies indicate that sociopaths and psychopaths may have different brain structures [6]. Some areas of the brain in psychopaths are simply not developed. In sociopaths, these areas are normal and, despite antisocial behavior, they have the rudiments of morality. The behavior of sociopaths in comparison with psychopaths can also be explained by social reasons - for example, the influence of the environment, and not an abnormal structure of the brain.

Sociophobia and sociopathy are similar-sounding terms, but refer to completely different mental disorders. A sociophobe is a person who is uncomfortable being in society, he experiences anxiety when communicating with people. A sociophobe suffers not from antisocial, but from social anxiety disorder.

How to recognize a sociopath

Some doctors classify sociopaths into types. For example, the American psychologist and psychiatrist Eric Berne in his book "Introduction to Psychiatry and Psychoanalysis for the Uninitiated" divides them into two types:

Latent sociopath. According to Bern, he behaves normally in society, without causing problems to anyone. Such a person is not guided by moral considerations, but obey some kind of authority or doctrine (for example, an authoritarian religion or sect). An example of a latent sociopath is a lawyer without ethical principles. Confident in the guilt of his client, he, nevertheless, will try by all means to save him from prison. Such a sociopath operates within the framework of his own invented rules, not paying attention to public morality.
Active sociopath. He is also able to put on a mask of integrity if it suits him. But, unlike the first type, outside the reach of laws and justice, he does not restrain himself and does whatever he wants. Active sociopaths can be called some cold-blooded serial killers or, for example, successful scammers.

Not all scientists share this point of view [7]. Eric Berne also acknowledges that there are many kinds of sociopathic behavior, and one sociopath may be different from another. However, he notes common features common to people with this diagnosis:

Desire to get what you want at any cost. They say about such people that they go over their heads. They are not stopped by any remorse, nor intelligence prompts like "if I do this, it will fly into me." A sociopath always does what he wants, regardless of the consequences. Eric Berne notes the impulsive behavior of sociopaths: unlike a person who behaves badly because he challenges society or, for example, takes revenge on someone, a sociopath simply takes and does what he wants without hesitation.
Lack of empathy and compassion. The emotional palette of sociopaths is limited. They do not feel sympathy for others and are not able to experience deep sincere emotions of joy, happiness, admiration. Although, in order to achieve their goals, they can imitate them - for example, demonstrate feelings with words and facial expressions. Scientists agree that sociopaths are capable of experiencing negative emotions - anger, frustration and rage [8]. But it is possible that such seizures are different from those that ordinary people are susceptible to. A sociopath who wrote under the pseudonym M. Thomas the book Confessions of a Sociopath. Live without looking into the eyes, ”says that her anger cools instantly, giving way to cold calculation.
"Evil inclinations" manifested from childhood. Sociopathic tendencies can often be noticed already in childhood: expulsion from school for bad deeds, theft, constant getting into trouble. This creates the impression that this behavior cannot be influenced - the sociopath repeats it over and over again with other people and in a different environment.

These signs of antisocial disorder described by Berne and several others are listed in the DSM-5. There are eight criteria in total, and sometimes it is enough to make a diagnosis if the patient has three or four of these signs [9].

Some studies have revealed unusual differences between sociopaths and other people: for example, people with psychopathic traits prefer the bitter taste of food to everything else, they are not inclined to “infect” yawns from others and make little eye contact with the interlocutor [10], [11], [12 ].

There is evidence that sociopaths of all musical genres like rap the most [13]. Therefore, Hannibal Lecter, enjoying classical music, seems like another cinematic fiction. Mads Mikkelsen as Hannibal Lecter in Hannibal (Photo: Youtube)

Psychologist Sergei Pustovoitov warns against thoughtlessly labeling loved ones. If you decide to look for a sociopath in your environment, then most likely you will not find one, but you will find those who are familiar with sociopathic character traits - accentuations. This may be a lack of expressed sympathy, a tendency to lie and manipulation, as well as the predominance of personal interests over public ones. But none of these signs in itself is not decisive. The diagnosis of "sociopathy", or rather, "antisocial personality disorder", can only be made by a psychiatrist or psychotherapist.

Are sociopaths really smart and charming?

Sociopaths don't have to be intellectuals. Among them there are both people with high intelligence and low, explains clinical psychologist Alexei Mosin. The latter tend to be impulsive and prone to outbursts of aggression, unable to restrain themselves and therefore prone to criminal criminal behavior. Such sociopaths can often be found in prisons and other correctional institutions.

Sociopaths with high intelligence adapt much better in society. But this does not prevent them from neglecting the rights of other people, breaking boundaries or even laws. If they commit an unseemly act, this is usually a covert manipulation, intrigue, a "multi-move" combination, but not direct aggression.

Dr. House is another likely sociopath, teetering on the edge between inadequacy and genius. (Photo: www. tvn.cl)

According to Alexei Mosin, Dr. House from the popular series is a model of a person with a personality disorder: antisocial, but useful. His environment is ready to tolerate his behavior, as he is literally irreplaceable. Society gives House the so-called "idiosyncratic credit", that is, it forgives him for oddities, because his activities benefit others. Perhaps this attitude of society is one of the secrets of the charm of sociopaths.

Psychologist Sergey Pustovoitov explains that people with other mental disorders most often fall under the charm of sociopaths - for example, with a dependent disorder or the "victim" syndrome. For people with a healthy mind, a sociopath will be perceived as an unscrupulous, greedy voluptuary, and they will not buy his smile.

How sociopathy is diagnosed and treated

Psychologist Sergei Pustovoitov says that sociopaths do not seek psychiatric or psychotherapeutic help on their own. Their first encounter with a doctor occurs when, for example, they commit an offense and are required to undergo a medical examination. According to 2002 data, 47% of convicted men in 12 Western countries had antisocial personality disorder [14]. Sociopathy is also detected in offenders under the age of 18. Such juvenile sociopaths are the same "difficult children" from the children's room of the police. After the diagnosis is made, doctors and psychologists work with them, treatment is prescribed - these can be medications and psychotherapy.

Clinical psychologist Alexei Mosin confirms that people with antisocial disorder rarely go to the doctor themselves. One of the signs of sociopathy is the denial of such a disorder, and sociopaths will not voluntarily come into therapy.

Antisocial disorder is most often diagnosed in people from low-income or large families, says Yulia Levchenko, psychiatrist and psychotherapist at the Federal Research and Clinical Center of the Federal Medical and Biological Agency of Russia. At the same time, concomitant diseases or injuries are often detected in them - physical or moral violence in a close environment, craniocerebral disorders and neuralgia, mental retardation or schizophrenia, alcoholism and drug addiction. In all these and other cases, the diagnosis of "antisocial personality disorder" can only be made by a qualified specialist - a psychotherapist or psychiatrist. He will focus, among other things, on the signs indicated in the DSM-5 mental disorders directory.

Despite the fact that it is difficult for sociopaths to adapt in society, they are rarely recognized as incompetent and receive a disability, notes Yulia Levchenko. Patients with schizophrenia, severe psychosis, and clinical depression are much more likely to receive disability.

Neuropsychologist Alexei Leontiev explains that in Russia a sociopath with a confirmed diagnosis does not receive any benefits or concessions. Such people are restricted in their rights to carry weapons and obtain a driver's license. They will not be hired to work in government agencies - they use special tests (SMIL) to identify possible mental disorders [15]. And when committing a crime, a sociopath will face more severe punishment than if he was undiagnosed. The court proceeds from the fact that a sociopath, having broken the law once, is likely to break it the next time.

How to communicate with a sociopath

Gelana Shirikinova, a medical psychologist at the Medscan clinic, advises when communicating with a sociopath:

speak harshly and firmly, the arguments in the conversation should be categorical and not subject to objection;
keep your composure: no need to cry, fight and fall into hysterics, as this "feeds" the sociopath, making him stronger;
do not succumb to provocative behavior: blackmail, suicide threats and other manipulations;
do not give the sociopath any indulgences: if a prohibition is established for a sociopath, then in case of violation, punishment must necessarily follow.

If it is possible not to communicate with a sociopath at all, it is better not to communicate, says neuropsychologist Alexei Leontiev. If it turns out that a loved one is a sociopath, then you should distance yourself from him as much as possible. A sociopath will in any case do what he wants, in any situation he will manipulate others - in a soft or overwhelming manner. People around a sociopath, in an attempt to change his personality, run the risk of encountering aggression or even violence, and, by submitting to a sociopath, derail their lives.

Aleksey Mosin shares a similar opinion. Relatives of a sociopath live in constant anxiety and fear, because one of the consequences of sociopathy is great difficulty in adapting to society, not only for the person with the diagnosis, but also for the people around him. Simply put, it is extremely difficult for people around a sociopath to lead a normal life. They often need professional help. This is where mindfulness, interpersonal effectiveness, emotion regulation, and stress management training can help. They are recommended by psychologists as part of dialectical-behavioral psychotherapy, a special method of treating "difficult" patients with mental disorders. Such trainings will also be useful for those close to a sociopath, Alexey Mosin believes.

A sociopath does not experience empathy to the extent that other people do. And therefore, emphasizes Alexei Leontiev, one can become an authority for him only with the help of physical or mental suppression. In his opinion, the only way to cope with a sociopath is to be a psychopath, a cold-blooded manipulator of the overwhelming type.

Can a sociopath fall in love? Scientists suggest that the ability of a sociopath to love depends on how developed his antisocial disorder is [16]. People who score high on the Hare Psychopathy Scale (PCL-R) are more likely to avoid any attachment. If they enter into a relationship, it is not because they fell in love, but because the relationship brings some benefit to them.

A sociopath's relationship with another may not be based on attachment and psychological intimacy, but, for example, on a shared view of the world. A good example is the union of Bonnie and Clyde, in which both are trying to get as much as possible from other people. Perhaps now one of them, or both of them, would be diagnosed with antisocial disorder. Pictured is a frame from the movie "Bonnie and Clyde", 1967 (Photo: www.sheknows.com)

Researchers have studied the impact of a sociopath on his partner and on their relationship in general [17]. They tested 140 couples aged 18 to 35 on a psychopathy scale. In addition, each of the partners was separately asked about the strength of his attachment: how high is their fear of being abandoned and the desire to avoid emotional contact. The researchers followed the couples for a year and re-surveyed a year later. It turned out that men with pronounced sociopathic traits showed an inability to get close to their partner. In addition, a woman paired with a sociopath over time became more detached, disappointed in the relationship. And men in relationships with a sociopathic woman became emotionally unstable, anxious and dependent.

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