Someone with antisocial personality disorder (ASPD) may be less likely to experience remorse and empathy, and more prone to negative emotions, like anger and sadness. But there are exceptions.
A lack of consideration for others is one of the hallmarks of antisocial personality disorder, sometimes referred to as sociopathy. Sociopathy is often related to a higher chance of criminality and deceitfulness and may sometimes be related to low empathy and lack of remorse.
The ability to experience empathy may be challenged in some people with antisocial personalities, although it is still possible to receive the diagnosis and still feel empathy.
What is empathy?
Empathy is a cognitive and emotional skill that allows someone to see the world from another person’s perspective.
Empathy helps you relate to those around you and is what can help guide pro-social responses and reactions.
While different models of empathy exist, many experts agree on two primary forms of empathy:
- Cognitive empathy is the ability to recognize and understand someone’s feelings and experiences and imagine yourself in those scenarios.
- Emotional empathy is experiencing shared emotions with someone or feeling emotions as though the experience is your own.
Yes, impaired ability to develop and experience empathy is a symptom of antisocial personality disorder, although not the only one.
Also, not everyone with an antisocial personality lacks empathy, as long as they meet other criteria on the list.
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision, (DSM-5-TR) establishes four criteria for diagnosing antisocial personality:
- A persistent pattern of behaviors that demonstrate a disregard for the needs and rights of other people in three or more of these ways:
- repeated behaviors that violate the law and are grounds for arrest
- pathological lying or any type of deceitfulness
- low or no impulse control and inability to plan ahead
- physical aggressiveness in the form of assault or fist fights
- disinterest in other people’s safety or their own
- irresponsible behaviors that lead to job loss or financial trouble
- lack of remorse or guilt for hurting others in any way
- being at least age 18
- concrete evidence of challenging behavior before age 15
- antisocial behavior isn’t due to injury, schizophrenia, or bipolar disorder
The DSM-5-TR also discusses antisocial personality disorder under the Alternative DSM-5 Model for Personality Disorders section providing additional information for the diagnosis that focuses on impairments in personality and possible pathological traits.
The alternative proposed criteria for diagnosing antisocial personality are:
- moderate or significant impairment in at least two of four areas:
- having six or more of these pathological personality traits:
- risk taking
For example, someone with antisocial personality disorder may be able to experience cognitive empathy, but experience impairments in intimacy and identity. This could lead them to act in manipulative, hostile, and deceitful ways. These symptoms may also cause them to show no consideration or regard for others.
“Those with ASPD have difficulty being empathetic with others as part of their personality makeup,” explains Dr. Sandra Wartski, a psychologist in Raleigh, North Carolina. “They may be able to acknowledge others’ feelings (such as recognizing that the other person is sad or frustrated) but don’t necessarily feel activated or concerned about this.”
What is a dark empath?
Dark empaths are people who use cognitive empathy skills to maneuver those around them for personal benefit, without thought or concern for their well-being.
While ASPD is an official mental health condition, a dark empath is not.
While sociopathy and psychopathy are often interchangeable, they aren’t the same. Both terms are related to antisocial personality disorder.
Dr. Harold Hong, a board certified psychiatrist from Raleigh, North Carolina, explains the main difference between sociopathy and psychopathy is the presence of conscience, your inner sense of morality.
“Psychopaths do not have a conscience,” he says. “They can easily lie, manipulate, and hurt others because they do not feel empathy or guilt. Sociopaths, on the other hand, may still have a little conscience but will engage in harmful behaviors anyway.”
This means that a sociopath may be more likely to experience remorse than a psychopath.
Psychopathy can be a specifier for antisocial personality under the Alternative DSM-5 Model for Personality Disorders.
Someone with a diagnosis of ASPD with psychopathic features may experience less empathy than someone with an antisocial personality without any psychopathic features.
Made vs. born
Wartski says, “One of the easiest distinctions I have learned is that psychopaths are born, and sociopaths are developed during their formative years.”
While there appear to be hereditary and genetic reinforcements that may contribute to the development of antisocial personality, adverse childhood experiences, abuse, and environmental factors
ASPD with psychopathic features
Empathy and remorse in sociopaths vs. psychopaths
Remorse implies that you feel deep regret for something you’ve done that was morally wrong or harmful.
Remorse can be considered a part of emotional empathy because it’s a response demonstrating you understand and care for how your behaviors have impacted others.
While sociopaths may be more likely to experience some level of empathy, when they don’t, they will often lack remorse as well. Psychopaths, on the other hand, consistently show a lack of empathy and remorse.
Yes, people living with antisocial personality disorder experience feelings and emotions.
“These [emotions] may include anger, anxiety, depression, and even fear,” says Hong.
Anger was the study’s most prevalent emotion across all narrative descriptions, including narratives describing love.
“People with ASPD can likely experience a wide range of emotions, but their emotions are generally going to be related to their own experiences (such as excitement with feeling power or control) and less about reflecting on others’ experiences,” points out Wartski.
Positive vs. negative emotions
Positive emotions are those viewed as enjoyable or rewarding. They include:
Negative emotions are those that are unpleasant or cause distress, such as:
ASPD is considered a lifelong mental health condition, but treatment like behavioral therapy can help manage symptoms. ASPD with psychopathic features may be more difficult to treat.
“In some cases, patients may also need to be hospitalized if they pose a danger to themselves or others,” says Hong. “No FDA-approved medications for ASPD exist.”
Current pharmacological interventions address some of the symptoms of ASPD, explains Hong, For example, antipsychotics for aggressive behavior and anticonvulsants for impulsivity.
Wartski adds that a willingness to enter into treatment can be a limitation for someone living with ASPD.
“Because narcissism is a significant factor for most with ASPD, they don’t see themselves as having any problems, and so there is nothing, from their perspective, to change or treat,” she says.
Antisocial personality disorder is a lifelong mental health condition that involves long-standing patterns of disregard for the feelings or rights of others. Sometimes, the condition is referred to as sociopathy.
While some people living with ASPD may have low empathy, they can still experience it in some forms, even if they only use it to control or manipulate those around them.
Treatment can help manage some symptoms, but recognizing they need help can be challenging for people with antisocial personality.