COMORBID: What is Antisocial Personality Disorder?

December 12, 2022

5 mins

Never Alone Recovery


Popular entertainment would have you fear psychopaths, but what's the truth about antisocial personality disorder? As part of our new COMORBID series, let's take a closer look.


Our COMORBID series takes a deeper look at some of the misunderstood psychological disorders that occur (or develop) in those suffering from addiction.

For this first installment, we're looking at antisocial personality disorder.

Of all mental health conditions, sociopathy is arguably the most stigmatized. To give you a more nuanced picture than the wild depictions in TV and film, we’re going to take a look at the reality of sociopathy. Or as it is known officially, antisocial personality disorder.

What Does it Mean to be a Sociopath?

Being a sociopath means that a person has chronic difficulty engaging appropriately with social norms. This leads to a number of characteristics that are common in people with sociopathy, including:

  • Not understanding the difference between right and wrong.
  • Not respecting the feelings and emotions of others.
  • Frequently lying or deceiving others.
  • Acting callously.
  • Having difficulty recognizing or understanding emotions.
  • Engaging in manipulative behaviors.
  • Being arrogant or impulsive.
  • Violating the rights of others through dishonest actions.
  • Taking unnecessary risks.
  • Having trouble realizing the negative aspects and/or consequences of his or her behavior.

A person with antisocial personality disorder may not realize that what he or she is doing is wrong, or else they don’t care. According to psychologist Robert Hare, creator of the Psychopathy Checklist used to diagnose psychopathy, those who exhibit sociopathy have both a conscience and a sense of morality. However, that morality does not match social norms. 

Despite being a common colloquial term, ‘sociopath’ isn’t used in clinical diagnosis. Rather, people who exhibit these behaviors are simply individuals with antisocial personality disorder. 

Antisocial personality disorder is a cluster B personality disorder, which means it disrupts the emotions and is characterized by extreme and often irrational behaviors. Someone with antisocial personality disorder may repeat harmful actions that could  lead to arrest or criminal prosecution. Even then, there’s often a lack of remorse for these actions.

The DSM-5, which is what mental health professionals use to diagnose various mental health conditions, defines antisocial personality disorder as a consistent disregard for rules, social norms, and the rights of others. The DSM also points to difficulty controlling impulses and managing responsibilities, little to no guilt or remorse, and a tendency to justify negative actions. 

A person with antisocial personality disorder may have other co-occurring conditions that may or may not be related. These can include anxiety disorders, depressive disorders, substance use disorders, gambling disorders, and virtually any other form of impulse control disorder. It’s also possible for someone with antisocial personality disorder to also meet the diagnostic criteria for other cluster B personality disorders. 

Not all people with antisocial personality disorder act on their emotions.

The thing to remember is that not all people with antisocial personality disorder act on their emotions. Just as not everyone who violates the rights of others has a mental health condition. Antisocial personality disorder tends to remind us of famous criminals afflicted with this disorder, like Ted Bundy, but the reality is that only about one percent of people have it.

Treatment for antisocial personality disorder can vary. Since there are no medications that directly treat it, psychotherapy is the go-to form of treatment for antisocial personality disorder. However, the patient must recognize his or her issue for therapy to work. If he or she doesn’t recognize the behavior as wrong, someone with antisocial personality disorder may have trouble recognizing that help is needed.

What makes a Sociopath vs Psychopath?

The terms psychopath and sociopath are often used interchangeably, which could be why both terms are extremely stigmatized. However, neither term is a medical term or actual diagnosis. Rather, they’re used to describe more specific types of behaviors exhibited by people with antisocial personality disorder.

With this in mind, let’s go over what researchers consider to be the differences between sociopath and psychopath. 

Psychopaths are calculated, sociopaths are impulsive.

While deceit and manipulation are associated with both personality types, they ultimately manifest in different ways. 

Sociopathy differs from psychopathy in that sociopaths tend to be more erratic and impulsive. Meanwhile, a psychopathy diagnosis focuses on what a person is thinking rather than how he or she is behaving. Someone with psychopathy can be cunning and manipulative or engage in pathological lying without guilt. There’s a callousness and lack of empathy.

Psychopaths are less predisposed to violence.

According to the DSM-5, psychopathy is a lack of anxiety or fear as well as a dominant, bold style of interaction that can mask harmful behaviors. 

There are two main categories of psychopath: successful and unsuccessful. Those who fall into the successful category are able to achieve their goals through nonviolent means. Their executive functioning is better, and they are able to achieve societal success. Often in the corporate world, they will get to this point by degrading employees, blaming others, or relying on deceptiveness. 

An unsuccessful psychopath is one who not only rejects but outright breaks social norms, from relatively harmless offenses up to murder. Even so, psychopaths are often far more calculated and controlled than sociopaths. 

Psychopathy is interpersonal, sociopathy is behavioral.

Psychopathy focuses on interpersonal and affective aspects of behavior while sociopathy is more based in behavior. A person with sociopathy can be described as quick to anger while a psychopath disregards the rights and feelings of others, engages in more controlled and manipulative behavior, has no shame, and is unable to form emotional relationships. 

Finally, sociopathy is considered an environmental construct rather than a genetic one. By comparison, psychopathy appears to be linked to biology. 

How is Antisocial Personality Disorder Treated?

Although antisocial personality disorder is a lifelong affliction, that doesn’t mean it cannot be treated. 

With counseling and therapy being the best forms of treatment for antisocial personality disorder, many patients are coached regarding the management of behaviors, emotions, distress, anxiety, and even depression. Any oc-occurring issues are examined in order to maximize the individual’s ability to live a healthy, stable, and productive life.

Group-based sessions can be helpful as well. In a group setting, patients can work on their impulsivity, aggression, and antisocial behaviors.

When appropriate, mood stabilizers may be prescribed as part of a patient’s overall treatment plan. 

Stay Strong With Never Alone Recovery

Antisocial personality disorder is a complex and more nuanced condition than is often portrayed in the media. And it isn’t the only mental illness to receive such treatment. Plenty of people are experiencing mental health issues they don’t understand because of these misunderstandings and misconceptions. 

At Never Alone Recovery, we recognize that not everyone's needs are the same. If you or someone you love would never from dual-diagnosis addiction treatment for individuals suffering from antisocial personality disorder, contact us today. Our intake coordinators can work with you or your loved one to find the right path to recovery.

Call our toll-free number today to see which of our resources could help you.

COMORBID, comorbid disorders

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