DSM 5 Sociopath Diagnostic Definitions And Symptoms

By Nadia Khan

Updated August 15, 2019

Reviewer Lindi Herrin, LPC

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The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), provides mental health care professionals a set of common criteria used for diagnosing mental health disorders. This manual is updated periodically when new advances and understandings in psychology become apparent. The DSM- 5 has gone through a few changes and one of those changes is the diagnostic title for sociopath. Sociopath and psychopath are now blanketed under the title Antisocial Personality disorder or APD for short.

Although sociopath is not a category of its own, it is understood to be explained and addressed under the new title of APD. Psychologists and other mental health care professionals debate the criteria for sociopathy and psychopathy. Some contend that these two terms are distinct and others argue that they both reference the same disorder. The DSM- 5 remains the primary source in the United States for diagnostics.

Criteria And Features Of Personality Disorder

The DSM- 5 includes APD under the heading of Personality disorders. Impairments in personality both self and interpersonal, are present as well as pathological traits. Symptoms tend to begin in adolescence or early adulthood and continue over many years. Personality disorders contribute to conflicts with others, diffuse relationships or lack of relationships, as well as a significant interference in social situations. Once the criteria for a personality disorder is met, the symptoms are further evaluated to determine the criteria for a specific personality disorder. Personality disorders are organized in three clusters labeled A, B, and C. APD is under Cluster B which includes disorders that are characterized by erratic or dramatic behavior and engagement in extremely impulsive, theatrical, illegal and promiscuous behaviors.

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The following is the criteria for personality disorder, the first step in diagnosing APD using the DSM- 5:

  1. Significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning.
  2. One or more pathological personality traits
  3. The impairments in personality are stable across time and consistent in situations
  4. The personality impairments are not better understood as a normative part of a developmental stage or social environment
  5. Substance use or a medical condition is not the only cause

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Once the criteria are met, the diagnostic evaluation moves on to determine the specific personality disorders. There are many different types of personality disorder listed in the DSM-5, only a trained mental health care professional can properly diagnose and treat personality disorders. Not all personality disorders require medication as some can be treated using evidence based therapies.

How The DSM 5 Is Used To Diagnose A Sociopath

The DSM-5 is used by a psychologist, psychiatrist or other licensed mental health care professional. The diagnostic criteria includes specific symptoms as well as duration and severity. All of this information helps licensed mental health professionals make a well-informed diagnosis.

Personality disorders have the same generalized symptoms. It is the expertise of the psychologist or psychiatrist that decides the accuracy of the diagnosis. It is important to research any licensed mental health care professional to determine who has experience working with personality disorders. Clinical training, licensure and patient reviews are all good ways to research and choose a licensed psychiatrist, psychologist, therapist, or counselor.

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DSM Sociopath Criteria And Features

A licensed professional will use the criteria for antisocial personality disorder to help diagnose a sociopath. There are several disorders that fall under the term of personality disorder, such as antisocial personality disorder. Currently, sociopath does not have a separate entry in the DSM-5.

The following criteria is listed in the DSM 5 for antisocial personality disorder:

  1. Significant impairments in personality functioning manifests by:
  2. Impairments in personality functioning manifest by
    1. Identity: Ego-centrism; self esteem derived from personal gain, power, or pleasure
    2. Self-direction: Goal-setting based on personal gratification; absence of prosocial internal standards associated with failure to conform to lawful or culturally normative ethical behavior.
  1. Impairments in interpersonal functioning (a or b)
    1. Empathy: Lack of concern for feelings, needs, or suffering of others; lack of remorse after hurting or mistreating another.
    2. Intimacy: Incapable for mutually intimate relationships, as exploitation is a primary means of relating to others, including by deceit and coercion; use of dominance or intimidation to control others.
  1. Pathological personality traits in the following domains:
  2. Antagonism, characterized by
    1. Manipulativeness: Frequent use of subterfuge to influence, or control others; use of seduction, charm, glibness, or ingratiation to achieve one's ends.
    2. Deceitfulness: Dishonesty and fraudulence; misrepresentations of self; embellishment or fabrication when relating events
    3. Callousness; Lack of concern for feelings or problems of others; lack of guilt or remorse about the negative or harmful effects of one's own actions on others; aggression; sadism.
    4. Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; mean, nasty, or vengeful.
  3. Disinhibition, characterized by;
    1. Irresponsibility; Disregard for-and failure to honor-financial and other obligations or commitments; lack of respect for-and lack of follow through on-agreements and promises.
    2. Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans.
    3. Risk-taking: Engagement in dangerous, risky, and potentially self-damaging activities, unnecessarily and without regard for consequences; boredom proneness and thoughtless initiation of activities to counter boredom; lack of concern for one's limitations and denial of the reality of personal danger.
  4. The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
  5. The impairments in personality functions and the individual's personality trait expressions are not better understood as normative for the individual's developmental stage or sociocultural environment.
  6. The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (drug abuse, medication) or a general medical condition (head injury, trauma)
  7. The individual is at least 18 years of age.

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Sociopath DSM 5 Treatment

Treatments such as medication, psychotherapy, cognitive therapy, or counseling do not have much of an effect on sociopath behavior. There is no cure for this mental disorder, and most individuals who suffer from this disorder do not seek help. Some research into sociopathic behavior has been done using scientific methods and EEG machines. These EEG machines show the electrical impulses in the brain and when sociopaths are shown emotional images, they do not have the same electrical impulse as normal brains.

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One of the only treatments noted to have some impact on the behavior of the sociopath is reward therapy. Reward therapy rewards the individual when they engage in behaviors that in line with social norms. This reward therapy has had some success with those who are incarcerated, and many correctional facilities are trying this out. Reward therapy works on the basis that sociopaths respond to instant gratification of their wants, and this instant gratification makes certain behaviors beneficial to them. This system only works if the individual believes that the behavior and reward are worthy of attention.

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This reward system is similar to behavior modification therapy with one major difference. Behavior modification works on the idea that eventually, through the modification of behaviors, the individual will no longer engage in the unwanted behavior. However, the reward system does not claim to modify behavior, only control it for the moment, not the long haul.

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