DSM 5 Sociopath Diagnostic Definitions And Symptoms

Updated September 04, 2018

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The DSM 5, (the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition), provides mental health care professionals a set of common criteria used for diagnosing mental health disorders. This manual has changed a few times, it 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 heal care professionals still debate the criteria for sociopathy/psychopathy; some contend that these two disorders are distinct disorders, other agree that they both reference the same disorder, some disagree with the new grouping under APD, others believe it is the best option. Regardless of how these professionals view the statistics and diagnostic criteria for sociopath, the DSM 5 remains the definitive go to for diagnosing this disorder.

Criteria And Features Of Personality Disorder

The DSM itself lists APD/sociopath under the heading of Personality disorders. The main features of a personality disorder are impairments and deficits in the understanding and functioning of self and interpersonal behaviors, and the addition of pathological personality traits. Once the criteria for a personality disorder is met, the disorder is further evaluated to refine the personality disorder diagnosis further. First the criteria for personality disorder, then the criteria for APD/sociopath must be met for a solid diagnosis.

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

  1. A pervasive pattern of behavior/inner experience that deviates from the social norms and expectations of the individuals culture
    1. Interpersonal functioning
    2. Cognition
    3. Impulse control
    4. Affect/affectivity
  2. The pervasive pattern of behavior/inner experience remains unchanged across a range of both personal and social situations
  3. Important areas of life are disrupted by these pervasive patterns of behavior, clinical distress, deficit or impairment is noted in occupational and social situations
  4. The pervasive pattern of disruptive behavior/inner experience can be noted back to adolescence and/or early adulthood.
  5. The pervasive pattern is not connected to or a symptom of any other mental disorder.
  6. The pattern is not the result of a physical problem such as a head injury, the pattern is not a side effect of medication or substance abuse.

The following are features of personality disorder:

  1. Severe deficits or impairments in empathy, intimacy, or other interpersonal interactions, and in personal identity, self-direction, or other self-functioning behaviors.
  2. One or more pathological personality traits or facets
  3. The impairments in personality and personality trait expression are stable over time and across situations.
  4. These impairments to personality and personality trait expression are not due to developmental stage or socio-cultural environment.
  5. The impairments to personality and personality trait expression are the result of medication, substance abuse or physical problem such as head trauma.

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Once the criteria and features of a personality disorder are met, the diagnostic evaluation moves on to 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, some can be treated using proven therapy methods.

How The DSM 5 Is Used To Diagnose A Sociopath

The DSM 5 is used to diagnose a sociopath by a psychologist/psychiatrist or other licensed mental health care professional. The criteria for the proper diagnosis of a sociopath is found in the criteria for antisocial personality disorder. The diagnostic criteria include symptoms, length of time the symptoms are present, the persistence of the symptoms, and the severity of the symptoms. All this information helps licensed mental health professionals make a well-informed diagnosis.

Antisocial personality disorders have the same generalized symptoms, it is the expertise of the psychologist/psychiatrist that decides the accuracy of the diagnosis. It is important to research any licensed mental health care professional you plan to work with; for yourself or someone you love. The more qualified the professional, the more accurate the diagnosis. Training, residency, schooling, 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

Sociopath DSM 5 is found under the heading of antisocial personality disorder. 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 antisocial personality disorder, and this term is also a diagnosis. Today, sociopath does not have a separate entry in the DSM 5, but the term sociopath is still recognized as a diagnosis by many mental health care professionals. Regardless, a sociopath would fall under APD and treated as such.

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

  1. Persistent patterns of disregard and violation of the rights of others, present since the age of 15 and consisting of at least three of the following resulting in hurting, mistreating, and/or stealing from someone:
  2. Disrespect and failure to conform to lawful behavior resulting in repeated arrests.
  3. Persistent deceitfulness, using aliases, and lying to con others for personal gain.
  4. Impulsive and unable to plan.
  5. Easily irritated, aggressive and prone to repeated physical altercations and assaults.
  6. Reckless, disregarding the safety of others and one's self.
  7. Persistently irresponsible, inability to maintain consistent work behavior and/or honor financial obligations.
  8. Indifferent rationalization without remorse.

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Criteria for impairment of personality and personality traits:

  1. Severe impairment/deficits in personality functioning both identity and self-direction
    1. Identity impairment - self-esteem is tied to personal gain, power, and pleasure, and marked ego-centric behaviors
    2. Self-direction impairment - absence of social conformity to the law or other culturally accepted norms, and, goal setting is based on personal gain and gratification.
  2. Severe impairments/deficits in interpersonal function both empathy and intimacy
    1. Lack of empathy- no concern for the feelings, wants, and needs of others, no remorse after harming others.
    2. Lack of intimacy - inability to maintain a mutual intimate relationship, relationships are used for personal gain, deceitfulness, coercion, dominance, and intimidation are used to control others.
  3. Person is at least 18 years of age or older
  4. Conduct disorder is noted before the age of 15
  5. Antisocial behavior is not related to schizophrenia or manic episodes.
  6. Impairment of personality and trait expression is stable across situations and over time.
  7. Impairment of personality and trait expression is not related to developmental stage or socio-cultural environment.
  8. Impairment of personality and trait expression is not due to medicine, substance abuse, or head trauma.
  9. Person is at least 18 years of age or older.

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Persistent pathological personality traits:

  1. Antagonism
    1. Manipulative - frequent use of deceit, subterfuge, charm, seduction, and ingratiation to achieve personal goals.
    2. Deceit - lies and fraudulent representation of self, embellishment and lying when relating events.
    3. Callous - cold, uncaring, and indifferent to the feelings of others, lack of remorse for the hurt they cause to others, aggressive and sadistic.
    4. Hostile - aggressive and angry at perceived slights and insults, vengeful and mean.
  2. Disinhibition
    1. Irresponsible - failure to honor obligations, lack of respect for promises made and agreements.
    2. Impulsive - acts on momentary stimulus, no planning, inability to plan.
    3. Risk Behavior - denies personal danger, engages in dangerous activity to one's self and others, engages in risk behaviors to stave off boredom.

Sociopath DSM 5 Treatment

Treatments such as medication, therapy, psychotherapy, cognitive therapy, or counseling do not have much of an affect 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 normal brains show. This information may one day lead to treatments for the sociopath, but right now there is not much that can be offered.

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One of the only treatments noted to have at least minimal affect 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 limited 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 something worth engaging in.

This reward system is like behavior modification therapy, but there is a 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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