You have probably heard of a “sociopath” or “psychopath”. In popular culture, both words are often used to refer to someone who seems unconcerned with right and wrong, has a tendency to manipulate others, or finds it difficult to understand the feelings of others.
But in the latest version of the official mental health manual, the Diagnostic and Statistical Manual of Mental Disorders, you won’t find either definition. Doctors don’t officially diagnose people as psychopaths or sociopaths. Instead, they use a different term: antisocial personality disorder (ASPD).
Still, some experts use “psychopathy” to describe certain behaviors that may be part of ASPD, and “sociopathy” to mean the same thing as ASPD. In fact, “sociopathy” is the former name for ASPD.
What is Antisocial Personality Disorder?
If you have ASPD, you may act in ways that go against socially acceptable norms. You can break laws and have little or no guilt if you do something wrong. This condition usually develops in childhood, but you can’t get a diagnosis until you’re 18 or older. Doctors diagnose children who have antisocial problems with conduct disorder.
If you have this personality disorder, you may do things like:
- Lying to or misleading others for personal gain
- commit crimes
- Ignoring rules or the safety of others
- Acting impulsively or aggressively
- Act cold to others
- Lying about big and small things
- Having few or no close relationships
- Have trouble holding down a job or doing schoolwork
- Take unnecessary risks
What is Psychopathy?
Psychopathy is not a diagnosis but a set of traits. About 25%-30% of people with ASPD also have psychopathy.
To see if someone has psychopathy, a trained health care provider will conduct a specific test with a list of 20 characteristics. Characteristics often associated with psychopathy include:
- Insincere charm
- Getting bored quickly
- Compulsive lying
- Manipulation of others
- No remorse or guilt
- Little emotional response
- Cruelty without feeling bad about it
- Taking advantage of others
- Behavioral problems that begin in childhood
- Not accepting responsibility
- Many sexual relations
People with psychopathy make up about 1% of the general population, but 15%-25% of people in Dutch prisons. Research shows that people with psychopathy are 15-25 times more likely to break the law and end up in jail than others.
What is the difference between Sociopathy and Psychopathy?
If you have ASPD, or sociopathy, you probably know you’re doing something wrong when you do something wrong. But you may have little empathy for others. That means it can be difficult for you to see things from another person’s perspective or understand how they are feeling. So even though you may know that something you’re doing is harmful or unethical, that’s not enough to stop you from doing it.
On the other hand, some experts believe that people with psychopathy lack empathy or morality. Compared to someone with ASPD who does not have psychopathy, you may feel less respect for others. Others think it’s just much more difficult to predict when your actions will lead to harmful consequences.
Are people with Antisocial Personality Disorder violent?
Anyone can hurt another. The same is true for people with antisocial personality disorder. But just because you have ASPD doesn’t mean you’re violent. But if you have psychopathy, you may be more prone to aggression and violent behavior over the course of your life.
This is shown by research:
About 90% of those released from prison who scored high on traits of psychopathy committed a violent crime within the next 20 years. Only 40% of those who scored low in psychopathy did the same.
People with psychopathy are responsible for the deaths of more than 50% of police officers who die on the job.
Impulsivity and reactivity
If you have ASPD, even if you don’t have psychopathy, you may be more likely to be impulsively aggressive. That means you don’t have much control over your behavior when your emotions are running high. You’re probably not very good at planning for the future either.
But if you have psychopathy, you probably have good control over your thoughts and you tend to plan any aggressive actions. Studies show that you probably have little anxiety. You also probably don’t react as strongly to stress or punishment, which means you have what is called a low reactivity.
What causes it?
It is unclear why some people have antisocial personality disorder or psychopathy. Many things probably play a role, such as:
- The brain. Studies show that people with ASPD may have differences in the brain circuits that control behavior. Research also shows that certain parts of the brain of people with psychopathy are smaller. That includes the areas that govern empathy, moral decision-making, guilt, and shyness.
- Genetics. You are more likely to get this disorder if someone in your family, such as a parent, has it.
- Sex. Antisocial personality disorder and psychopathy can happen to anyone, but seem to be much more common in men. ASPD is three times more common in men than in women. But most research on ASPD has focused on men, and the condition may be underdiagnosed in women.
- Upbringing. Childhood neglect, abuse, or an unstable home life all increase your risk for ASPD.
Brain differences in psychopathy
Research suggests that when you have psychopathy, your brain may exhibit physical differences that make it difficult for you to identify with another person’s distress.
One study compared MRIs of the brains of people with psychopathy to those without psychopathic traits. It found that people with psychopathy had fewer connections between parts of the brain involved in feelings such as guilt or empathy and those responsible for fear and worry.
Other brain imaging research suggests that when you have psychopathy, differences in the way your brain is wired encourage you to value immediate rewards while ignoring the potential consequences.
Treatment for Antisocial Personality Disorder
Antisocial personality disorder is difficult to treat. That’s partly because people who have it often don’t think they need help. But certain symptoms can show up as early as childhood. When that happens, parents can get help for their child, it can improve.
There isn’t enough evidence to know how well any treatment works for adults with ASPD. But if someone with this condition is willing to get help, their doctor may try talk therapy to address anger issues or other mental health issues. Medication can help with behavioral problems such as aggression or depression. But drugs cannot cure antisocial personality disorder or psychopathy.
If you think you have this condition, find a support group or contact a spiritual counselor. Ask your doctor for a referral to someone experienced in treating people with personality disorders.