Are You Dealing with a Sociopath? Here’s How To Tell…

When you think of the word sociopath, you might feel fearful and unsettled. While the word itself is oftentimes hard to describe, the facts show that a sociopath is someone who is antisocial with no conscience or moral standards. They ignore reality and live an uncaring, selfish life. Sociopaths have characteristics defined through interpersonal, behavioral, affective, and antisocial categories. However, many don’t know what a sociopath truly is. For instance, do you know the difference between a psychopath and a sociopath? Is Antisocial Personality Disorder really how sociopaths are diagnosed? We’ll start from the beginning.

What is a Sociopath?

The Diagnostic and Statistical Manual’s (DSM) authority guidelines for Antisocial Personality Disorder can sometimes undermine and underscore how to recognize a sociopath. The DSM-5 works on paper, but people are rarely only a list of bullet points defined by distinct categories. James Fallon, author of The Psychopath Inside, recognizes this. He broke down the definition of a sociopath into four, more descriptive and unique categories:

  • Interpersonal: in interactions with other people, a sociopath is likely to be superficial and incapable of deep, meaningful relationships and connections. They easily can put on the charm and/or act attached and caring, but it is a complete façade. By definition, a sociopath is antisocial. They are known to be pathological liars and use deception to get what they want, but friendships and partnerships are meaningless.
  • Affective: when thinking about a sociopath’s emotions and feelings, a sociopath is one who lacks all empathy. They cannot view things from another’s perspective or care about how someone else might be feeling. Think: no conscience or remorse.
  • Behavioral: there is nothing predictable about a sociopath’s behavior. They are impulsive and unreliable, cannot set goals, or understand/accept responsibility for their actions.
  • Antisocial: this is the fundamental concept that defines a sociopath. A sociopath is alone in the world, apart from society and any interpersonal relation. The rules of society mean nothing. Consequently, this means they often have juvenile delinquency and criminal records.

Sociopath Traits

While a psychopath’s behavior can be traced neurologically, a sociopath has normal neurological functioning. In some cases however, the behavior and resulting mental illness can be traced to a lesioned brain region. Many of the symptoms are induced through socio-cultural factors within the environment, meaning this behavior is nurtured. Their behavior is conniving and deceitful, even though they could come across as quite charming. They use this charm to manipulate and pathologically lie. It’s not that they “lack morals” per se, but instead, their moral compass is just abnormal. This trait does have the potential to be traced to a neurological component.

Certain emotions and behaviors are easily identifiable. Sociopaths always seem nervous, somewhat agitated, and are quite volatile, leading fits of anger and emotional outbursts. Because of this, they are uneducated and oftentimes cannot hold a job. They might be able to form a type of attachment with someone, but they don’t understand the society or its rules. Also, any crime committed by a sociopath will almost never be premeditated or planned – they are completely impulsive in nature.

The Brain of a Sociopath

Sociopaths do not have any visible neurological defects or abnormalities relating to etiology. It could be possible, however for a sociopath to have a lesioned brain region. Both psychopathy and sociopathy usually involve impaired cognitive functioning, but different parts of the brain are affected. Psychopaths don’t feel fear or have any sense of right and wrong. Sociopaths do.

Neurologically, a sociopath could be completely “all there” with perfect functioning. However, the moral compass is off-kilter. On the contrary, psychopathy is seen as a merging of genetic and chemical imbalances. Neurologically, they lack what is required to develop morals and a sense of ethics. Just with those facts, begin to think about just how different the two terms are.

At this point, there are no neurological studies that tie moral beliefs to antisocial behavior (a huge factor in sociopathy). There are research studies that show how the brain’s empathy circuit is affected, outlining neurological correlates for how certain attitudinal or behavioral moral outcomes could be fostered.

Sociopaths vs. Psychopaths: What’s the difference?

In today’s worlds of psychology and medicine, the labels sociopath and psychopath are often used interchangeably. However, when the DSM-5 is studied, experts in the field will tell you there are pronounced distinctions between the two. When you hear mental health jargon, often outdated, words are thrown around for effect and lack of effect – not for their validity. With sociopathy, it is either congenital or acquired. Psychopathy is a convergence of genetic and chemical imbalances. This is an illustration of nature (psychopathy, genetics) versus nurture (sociopathy, environment). With where the DSM is today, terms such as psychopath are meticulously defined. Professionals in the field are becoming more aware of not using the terms psychopath and sociopath interchangeably. You cannot disagree with the contrasting neurological frameworks between the two, especially while trying to study behavioral characteristics and treatment options. Incarcerating someone and rehabilitating someone are two very different things.

What characteristics do they share? At the start, they are both defined in the DSM-5 under Antisocial Personality Disorders. They both have a general disregard for laws and social norms, the rights of others, failure to feel remorse, guilt, or empathy, and a tendency to display violent behavior.

Antisocial Personality Disorder

Per the Diagnostic and Statistical Manual (DSM-5), the essential features that a personality disorder exudes are impairments of personality functioning and the presence of pathological personality traits. To be diagnosed with Antisocial Personality Disorder, the following broad scope of criteria must be met:

Significant impairments in personality functioning manifest by:

  • Impairments in self-functioning manifest by identity (i.e. ego-centrism) OR self-direction (i.e. failure to conform to legal, ethical behavior)  AND
  • Impairments in interpersonal functioning manifest by lack of empathy and intimacy.


Pathological personality traits in the following domains:

  • Antagonism characterized by manipulativeness, deceitfulness, callousness, and hostility.
  • Disinhibition characterized by irresponsibility, impulsivity, and risk taking.

The afore-mentioned impairments in functioning should be relatively consistent/stable across time and situations. These impairments cannot be related to a developmental stage or socio-cultural environment. Lastly, these impairments cannot be attributed to a medicine or illegal substance or general medical condition. The individual must be 18 years of age to receive this diagnosis. Up until the age of 18, a child could be diagnosed with conduct disorder.

Notably, recognize that the DSM-5’s diagnostic term for sociopathy is “Antisocial Personality Disorder.” This is why you see doctors using this prognosis. With DSM-5 as the authority of mental health, they go by what is operationalized.

Antisocial Personality Disorder Treatment

Because of the nature of those with Antisocial Personality Disorder, they rarely seek, want, or realize they need treatment. According to the National Institute of Mental Health, it is one of the most difficult personality disorders to treat successfully. The one reason you might find someone in treatment is due to a court order.

At the core of treatment is cognitive behavioral therapy (CBT). While not a proven cure, CBT will help manage the harsh symptoms of Antisocial Personality Disorder, such as understanding and rewarding appropriate behaviors and having consequences for negative behaviors. If there are any comorbidities, medication will often be prescribed. If a patient is highly irritable or volatile, it might be helpful. However, no specific psychotropic drug for Antisocial Personality Disorder exists – which might be a good thing in the context of abuse.

Naturally, many types of therapy could be somewhat helpful: psychotherapy, talk therapy, and group therapy to name a few. CBT is known as the gold standard, as it focuses on behavior modification techniques. It will also hone in on distorted thought patterns that lead to a sociopath’s impulsive or inappropriate behavior.

What is important is awareness. Being mindful of these symptoms and standard characteristics of a sociopath need to be known. If you experience a brain injury or are in an accident and begin to experience similar kinds of emotions or reactions, a consultation with your doctor should be the first priority. Finding a cognitive behavioral therapist is oftentimes a great idea whenever dealing with maladaptive thoughts and behaviors, which have the power to enter anyone’s life.


author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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