A schizophrenic sociopath is possible

Antisocial Personality Disorder: What is a Sociopath?

Psychotherapy can be helpful in the case of dissocial disorder, provided that the person concerned voluntarily seeks treatment.
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Sociopathy is a specific form of personality disorder. Affected people show disturbed social behavior: They behave inconsiderately and extremely selfishly, only pursue their own goals, have no sympathy, disregard social norms and cannot submit to rules.

Even in their youth they stand out for their aggressive and anti-social behavior. They often fight each other, disrupt classes at school, are notorious liars, cheat and steal. They often disregard social rules, break laws and become criminals. But sometimes they are also very successful and achieve a high social status, precisely because they put their own interests before those of others and those of the community and often unscrupulously enforce them. Psychiatrists speak of an antisocial or antisocial personality disorder, and the term antisocial or antisocial personality is also found.

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Sociopaths are by no means rare. An estimated one to four percent of the population are affected, men much more often than women. However, it is not certain whether the typical sociopath is actually male or whether antisocial disorders are only expressed in other ways in women and are therefore diagnosed less often. Some experts suspect that typically female anti-social behavior such as gossiping, bullying or being excluded from the group could possibly represent the female expression of an anti-social personality.

The proportion of sociopaths among convicted criminals is particularly high: around 70 percent of prison inmates suffer from antisocial personality disorder.

What is a personality disorder?

A personality disorder is a long-lasting and deeply rooted behavior pattern that is characterized by impaired interpersonal interaction. Personality disorders usually first appear in adolescence or early adulthood. According to the international catalog for the classification of diseases ICD-10, one can distinguish the following forms:

  • paranoid personality,
  • schizoid personality,
  • dissocial personality,
  • emotionally unstable personality,
  • histrionic personality,
  • compulsive personality,
  • fearful-avoidant personality and
  • dependent personality.

In addition to the ICD-10, the US classification of mental illnesses DSM-V is also used in psychiatry. The antisocial personality corresponds to the dissocial personality according to ICD-10 and, like the narcissistic and borderline disorder, it is counted to the group of affective behavioral disorders. According to the DSM-V, an antisocial personality is characterized by irresponsible or illegal behavior and an inability to respect the rights of others. Both classifications are used equally.

Difference Between Sociopathy and Other Personality Disorders

Antisocial personality disorder can occur in isolation as individual disorders, but is also observed together with other mental disorders or physical illnesses. One then speaks of comorbidity. Antisocial behavior is particularly common in connection with addiction disorders such as alcoholism or drug addiction.

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Sometimes there is an overlap between different personality disorders. Antisocial people, for example, often show traits and behaviors similar to those of borderline or narcissistic people. Basically, one can differentiate between the different types as follows:

  • The narcissist, like the dissocial, suffers from a lack of empathy, but shows no pronounced aggressiveness. In addition, the narcissist does not have impulsive or delinquent behavior.

  • People with borderline personality disorder are impulsive and unstable in personal relationships. In contrast to dissocial people, however, they show a tendency to feel guilty and are capable of empathy.

Also within the dissocial personalities different forms and characteristics such as the amoral, the asocial, the sociopathic and the psychopathic personality are differentiated.

What is the difference between sociopath and psychopath?

In the specialist literature, the two terms sociopath and psychopath are not always strictly separated, although a distinction is useful. Psychopathy is the most extreme form of antisocial personality disorder. While the sociopath acts impulsively, the psychopath plans his actions carefully and acts coolly and deliberately. There are the following differences in behavior:

  • Sociopaths have feelings like fear or anger. You feel attacked quickly and then react aggressively. This behavior gets them into trouble and ensures that relationships are mostly superficial and short-lived. Psychopaths, on the other hand, have a good grip on themselves. They also lack compassion, but they are very good at covering up this lack of empathy.

  • Psychopaths are highly functional and usually well integrated into society. They are extremely manipulative and easy to gain the trust of others. Since they can take advantage of others in cold blood and without conscience, they are very dangerous.

In addition, one suspects differences in the development of both clinical pictures. Experts believe that sociopathy is more likely to be triggered by trauma in childhood. The typical sociopath has almost always experienced abuse, violence, or neglect in his childhood. His anti-social behavior often even serves as a survival strategy. Psychopathy, on the other hand, appears to be innate.


In psychopaths, the areas of the brain responsible for impulse control and compassion are not properly developed from birth. The therapeutic options and prognoses are correspondingly different. While antisocial personality disorder can be treated with psychotherapy - an approach that plays a large role in reintegrating offenders into society - there appears to be no cure for a true psychopath. Some experts even believe that treatment may worsen symptoms. Psychopaths accordingly have the highest recidivism rate among offenders.

Causes of Antisocial Personality Disorder

How an anti-social personality develops has not yet been conclusively clarified. Most scientists today assume a combination of genetic and environmental factors:

  • Genetic disposition: The likelihood of antisocial behavior is higher if one or both parents were previously affected by the disorder. A scientific study among twins has also confirmed that there is a genetic predisposition to all personality disorders. Other contributing factors are anxiety disorders, depression, alcoholism, drug addiction and the risk of suicide in the family.

  • Traumatic childhood experiences: Physical violence, sexual abuse, and other traumatic relationship experiences in childhood increase the risk of developing an antisocial personality disorder.

  • Serotonin deficiency: A deficiency in the neurotransmitter serotonin presumably ensures that sociopaths cannot respond adequately to emotional signals and generally feel less fear. On the one hand, this explains the lack of empathy for the suffering of other people, but also the pronounced tendency towards risky behavior. Some experts assume that people with antisocial personality are generally under-stimulated. That is why they are constantly looking for a "kick" - on the one hand in dangerous sports, but also in criminal activities on the other.

  • Neurophysiological factors: Imaging studies indicate dysfunction in the prefrontal cortex in the brain in antisocial personalities. This is likely to be the trigger for the extreme coldness, especially in the strongest form, psychopathy.

Sign: How to recognize a sociopath

People with antisocial disorder stand out for their socially incompatible behavior. This often shows up in childhood and adolescence.

Possible signs of a dissocial personality can be:

  • Lack of empathy
  • Coldness of feeling
  • pronounced self-centered behavior
  • lack of sense of guilt and responsibility
  • low tolerance for frustration
  • strong impulsiveness
  • Violence
  • Problems in forming long-term relationships
  • high risk tolerance
  • Disregard of social norms and laws

Diagnosis of Antisocial Personality Disorder

To diagnose the personality disorder, both the criteria of the ICD-10 and the DSM-V classification can be used.

According to ICD-10, dissocial personalities must

  • There are peculiarities of character such as egocentricity, a lack of empathy and a lack of conscience and

  • there is a considerable discrepancy between the behavior shown and the social norms. Criminal acts can occur but are not required for diagnosis.

  • Organic causes must have been ruled out for a clear diagnosis.

In addition, at least three of the following criteria must be met:

  1. The person concerned has a lack of empathy and shows coldness towards others.

  2. He (or she) exhibits a clear and persistent irresponsible attitude and repeatedly disregards social norms and obligations.

  3. He is unable to maintain ties or relationships with other people over the long term, although he has no difficulty in establishing relationships.

  4. He has a low tolerance for frustration and often behaves impulsively or aggressively.

  5. The person concerned feels little or no guilt and is unable to learn from negative experience, especially punishment.

  6. He has a tendency to blame others or to use excuses to explain his behavior that has brought him into conflict with society.

The DSM-V is based on similar behavioral patterns, but rather emphasizes the criminal component, which is shown, for example, in violations of the law. In addition, according to this classification, the person concerned must be at least 18 years old so that the disorder can be reliably identified, whereby the conspicuous behavior must have been recognizable at least since the age of 15.

Risks and Complications: How Dangerous Are Sociopaths to Themselves and Others?

People with antisocial disorder tend to lead risky lifestyles, so they are at increased risk of accidents. In addition, they have a relatively high risk of suicide compared to the normal population, especially if they also have other illnesses such as depression or an addiction.

In addition, dealing with sociopaths is often dangerous. It is precisely because they are often charismatic and charming that these people are attractive to others. Dissocial personalities are often found in relationships and partnerships - even if these are mostly short-lived. Experts advise staying as far away as possible from a sociopath once you have recognized him as such. In a relationship, it is advisable to set clear boundaries and protect yourself.

Relatives can try to motivate the person concerned to seek therapy. However, sociopaths themselves are usually not aware of any guilt and see no problem in their behavior. In this respect, they rarely seek out a therapist voluntarily. In most cases, they only start treatment through external pressure, for example because they have committed a criminal offense.

Therapy options and prognosis

Psychotherapy can provide effective help, in which the person affected is supported, among other things, in learning to empathize and to respect the needs and concerns of other people.

Various therapeutic approaches are available to the therapist for the treatment of dissocial personality disorders. First and foremost, these are:

  • Cognitive behavioral therapy with improving behavior control,
  • Strategy training to learn and improve social skills and
  • Classical conditioning with changes in thinking styles that lead to crime.

So far, cognitive behavioral therapy has shown the best results. On the other hand, psychoanalytic and depth psychological approaches seem to be less successful. The prospects are best when the therapist himself is convinced of success and adopts a committed attitude. A strict, distant attitude, on the other hand, is not conducive, nor is a particularly compassionate or friendly, relaxed patient-therapist relationship. In addition, care should be provided beyond the time of therapy, either by the therapist himself or by a probation officer, so that success is maintained in the long term.

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There is currently no drug therapy for antisocial personality disorder. Treatment with psychotropic drugs may be helpful in order to positively influence anger, impulsiveness or a depressed mood. The focus is always on psychotherapy.

Antisocial personality disorder often occurs in conjunction with addictive disorders such as alcoholism or drug addiction. This in particular carries the risk of complications and ensures unfavorable course of the disease. The treatment of accompanying disorders and dependencies is therefore also important for successful therapy.

Overall, the therapeutic prospects of sociopaths are not particularly promising. This is less due to the inability to treat a dissocial personality disorder and more to the lack of motivation on the part of those affected. In general, the following applies: The greater the willingness of the person concerned to cooperate, the better the chances of success of a therapy and the lower the risk of a relapse into antisocial and criminal behavior.

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