DSM 5 Sociopath Diagnostic Definitions And Symptoms

By Nadia Khan

Updated November 09, 2019

Reviewer Lindi Herrin, LPC

The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), provides mental health care professionals with 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 several changes, and one of those changes is the diagnostic title for a sociopath. The terms 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 explained and addressed under the new title of APD. The criteria for sociopathy and psychopathy has long been under debate by psychologists and other mental health care professionals. While some contend that these two terms are distinct and should have a category of their own, others argue that they both reference the same disorder. The DSM- 5 remains the primary source in the United States for diagnostics.

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Criteria and Features of Personality Disorder

The DSM- 5 includes APD under the heading of Personality Disorders. Impairments in both self and interpersonal personalities are present as well as pathological traits. Symptoms tend to begin in adolescence or early adulthood and continue over many years. Some symptoms someone with Antisocial Personality Disorder may exhibit are:

  • Being very charming or witty in order to manipulate someone or get what they want.
  • Exudes a sense of superiority or arrogance.
  • Impulsive and prone to taking risks or engaging in dangerous behavior with little regard to how it may affect others.
  • Lack of empathy or feelings towards others or a situation.
  • May display hostile, aggressive behavior, or become violent.
  • Being dishonest or lying to people.
  • No regard or care for what is right or wrong.
  • Being irresponsible.
  • Inability to maintain healthy relationships.
  • Lack of regard for rules or societal norms.

When someone is consistently exhibiting these symptoms, and there is cause for concern, you may wonder what's going on and seek medical help. After an initial conversation and a physical evaluation, the doctor may refer the patient to a mental health professional who will look at the following things in order to render a diagnosis of APD.

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

Once APD has been diagnosed, the diagnostic evaluation moves on to determine the specific personality disorders. There are many different types of personality disorders listed in the DSM-5. Therefore, only a mental health professional who specializes in personality disorders can properly diagnose the illness and provide a treatment plan. Keep in mind that not all personality disorders require medication, and some can be treated using evidence-based therapies.

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How the DSM 5 Is Used to Diagnose a Sociopath

Personality disorders are organized in three clusters labeled A, B, and C. APD falls under Cluster B, which includes disorders characterized by erratic or dramatic behavior and engagement in extremely impulsive, theatrical, illegal, and promiscuous behaviors. Personality disorders typically have the same generalized symptoms. The diagnostic criterion includes specific symptoms as well as the duration and severity of the symptoms, so it's important to be truthful and honest about all symptoms as the information provided is used to render a diagnosis.

The expertise of the psychologist or psychiatrist also plays a significant role in the accuracy of the diagnosis. As such, it is important to research licensed mental health care professionals and look at a few of them to determine the best choice. It's best to go with someone who has extensive experience working with personality disorders. A diagnosis of a sociopath can be devastating for the family and the individual, so you want to make sure no mistakes are being made. Clinical training, licensure, and patient reviews are all good ways to research and choose a licensed psychiatrist, psychologist, therapist, or counselor.

What Are the DSM-5 Criteria and Features for Sociopath?

A medical professional will use the criteria for Antisocial Personality Disorder to help diagnose a sociopath. Currently, "Sociopath" does not have a separate entry in the DSM-5 and falls under the umbrella of Antisocial Personality Disorder. The following criteria are listed in the DSM 5 for a diagnosis of Antisocial Personality Disorder:

Significant Impairments in Personality Functioning

Impairments in personality functioning can be identified by several factors.

  • Identity: Ego-centrism; self-esteem derived from personal gain, power, or pleasure.
  • Self-direction: Goal-setting based on personal gratification. In other words, having little-to-no regard for social standards, such as obeying the lawful or reasonable ethical behavior.

Impairments in interpersonal functioning can include the following:

  • Empathy: Lack of concern for feelings, needs, or suffering of others. Lack of remorse after hurting or mistreating another.
  • Intimacy: Incapable of mutually intimate relationships, as exploitation is a primary means of relating to others. This is normally recognized by deceitful behavior or intimidation to control others.

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Pathological Personality Traits in the Following Domains

Antagonism can be characterized by the following.

  • Manipulation: Frequent use of subterfuge to influence or control others; use of seduction, charm, glibness, or ingratiation to achieve one's ends.
  • Deceitfulness: Dishonesty and fraudulence; misrepresentations of self; in other words, stretching the truth when relating events.
  • 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.
  • Hostility: Persistent or frequent angry feelings; anger or irritability in response to minor slights and insults; inconsiderate, spiteful, or vengeful.

Lack of Inhibition can be characterized by the following.

  • 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.
  • Impulsivity: Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of possible outcomes; difficulty establishing and following through with plans.
  • 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 the personal danger.

The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations. 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 socio-cultural environment.

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). The individual must be at least 18 years of age to be taken into serious consideration for the condition.

Sociopath DSM 5 Treatment

Treatments such as medication, psychotherapy, cognitive therapy, or counseling do not have much of an effect on sociopath behavior, nor is there a cure for the mental disorder. Unfortunately, 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 when sociopaths are shown emotional images, and they do not have the same electrical impulse as normal brains, therefore indicating their brain functions differently than the average man or woman.

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 are 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 the instant gratification of their wants, and this instant gratification makes certain behaviors beneficial to them. This system only works if the individual believes 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 unwanted behavior. However, the reward system does not claim to modify behavior. It simply controls it for the time being.

BetterHelp Can Help You

Knowing there is no cure for the disorder and knowing that the treatments, which are available are not particularly helpful, can be disheartening. But nonetheless, therapy and counseling are still recommended for the individual with the diagnosis as well as their families and loved ones. It is not an easy task interacting with, living with, or being in a relationship with someone who is a sociopath. It can take an immense toll on the mental well being of everyone.

Therefore, therapy is strongly recommended. If you are experiencing something like this or having a difficult time coping with a sociopath, consider seeking help for yourself. If seeing someone in person is not an option for you or if it makes you feel uncomfortable, you can still get plenty of help and support through online counseling. BetterHelp has an army of therapists who can answer your questions and give you the support and help you need in a trying time. Read below for some reviews of BetterHelp counselors.

Counselor Reviews

"Dr. Anstadt is helping me figure out how to live a quality life. His wisdom and knowledge are helping me navigate my negative thoughts and dig out where they are coming from, which is what I need. I can't recommend him enough."

"Kristen helps me to see my life and myself from a different perspective. I tell her about my experiences, and she is able to hone into another side of the story that I couldn't get working things out on my own. And I had tried for a very long time. As someone particularly skeptical of counseling in general, it has been refreshing to speak and work with someone who genuinely recognizes that I am seeking help but reluctant to take it. Her patience and consistent inquiry have been the greatest asset for me, and I appreciate my time with her."

Conclusion

While being labeled a sociopath implies negative connotations, it does not have to be a negative thing. Some of the most successful people in this world are sociopaths. It's all a matter of deciding what kind of person you want to be in life and channeling your potentially negative symptoms into a positive outcome.

There is nothing wrong with being ambitious and confident in your abilities. If you are reading this article, you're already one step ahead of others because it means you care about how your actions affect those around you. If you are looking for some help on how to manage your symptoms or how to be a better person, get some professional guidance, lean on your support system and lead a life that makes everyone proud!


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