The lack of remorse, tendency to manipulate, and limited empathy associated with antisocial personality disorder (ASPD) may lead to behaviors that could jeopardize the safety of others. But this isn’t always the case.

Antisocial personality disorder is the formal mental health diagnosis for what’s commonly referred to as “sociopathy.” People living with the condition are often labeled “sociopaths.”

ASPD is a cluster B personality disorder characterized by dramatic, impulsive, and erratic behaviors.

Lack of remorse and emotional empathy may be symptoms of an antisocial personality. These symptoms may allow for harmful behaviors and distressing outcomes — for others and the person living with the condition.

The clinical features of sociopathy are typically associated with a higher potential for dangerous behaviors and criminality. It doesn’t mean every person with ASPD is dangerous or engages in destructive behavior.

Sociopaths: “The most dangerous criminal type”

Entertainment media and true crime spotlights have painted a grim picture of antisocial personality disorder.

Fictional antagonists and most-wanted criminals are readily labeled “sociopaths.” This misconception has contributed to a sense of stigma and stereotype about what it means to live with an antisocial personality.

According to Dr. David Tzall, a psychologist from Brooklyn, New York, ASPD exists on a spectrum and not everyone should be labeled “dangerous.”

“It is best to think of personality disorders on spectrums rather than [as] binary,” he says. “We all have ASPD traits, but some of us have them more than others.”

A 2020 study investigating the prevalence of antisocial personality among formerly incarcerated adults suggests the numbers are much lower than once thought — as low as 3%, compared to earlier rates estimated at around 21%.

“Sometimes, we have these [sociopathic] traits and we can use them for appropriate and helpful endeavors rather than hurtful nefarious deeds,” adds Tzall.

Was this helpful?

Sometimes, people with sociopathy are labeled as dangerous because they may tend to engage in abusive behaviors. The link between antisocial personality and psychological abuse is two-fold, though.

Studies indicate that childhood trauma or abuse heightens the risk of developing ASPD later in life,” Dr. Harold Hong, a board certified psychiatrist from Raleigh, North Carolina, explains.

Psychological abuse during childhood, also called emotional abuse, may include:

  • constant criticism
  • rejection
  • threats
  • withholding affection
  • lack of guidance or support

Sociopathy may also have genetic and hereditary contributing factors. However, the combination of inherent and environmental factors appears to heavily influence the development of the condition.

ASPD and adult psychological abuse

While psychological abuse as a child may increase the chances of developing sociopathy, those living with ASPD as adults may also be more likely to engage in emotional abuse.

“People with ASPD may be more likely to engage in psychological abuse since they often lack empathy and may not understand the impact their words and actions have on others,” Hong says. “Since they often relate to the world in a very self-centered way, they may employ abusive tactics to control or manipulate their partners.”

Hong notes that some tactics people with ASPD may engage in include:

  • manipulation
  • humiliation
  • isolation
  • gaslighting
  • guilt-tripping
  • insults
  • criticism

Formal symptoms of antisocial personality disorder

Antisocial personality disorder appears in two places on the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).

The classic diagnostic criteria of the DSM-5-TR define ASPD as a long-term pattern of disregard for others and a violation of others’ rights, present since age 15, and indicated by three or more of the following:

  • repeated acts of criminality that demonstrate a lack of conformity with social norms and lawful behaviors
  • deceitfulness, primarily for personal gain or pleasure
  • impulsivity
  • aggressiveness and irritability displayed through physical altercations or assaults
  • disregard for personal safety or safety of others
  • patterns of irresponsibility
  • lack of remorse

A diagnosis can only be given if the person is at least 18 years of age, has evidence of conduct disorder before age 15, and behaviors are not seen exclusively during episodes of schizophrenia or bipolar disorder.

The Alternative DSM-5 Model for Personality Disorders is included in section III of the DSM-5-TR and offers an accepted, flexible approach to diagnosing personality disorders.

In this model, antisocial personality is assessed as a moderate or great impairment in personality function, noted in two or more of the following areas:

  • identity (self-esteem is gained through personal power or pleasure)
  • self-direction (goal setting comes from personal gratification and nonconformity with lawful or ethical behavior)
  • empathy (a lack of concern for needs, feelings, or suffering of others)
  • intimacy (inability to create mutually intimate relationships; the use of exploitation as a primary means of interacting with others)

Six or more of the following personality traits must also be identified:

  • manipulativeness
  • deceitfulness
  • callousness
  • impulsivity
  • risk-taking
  • hostility
  • irresponsibility

ASPD may also manifest “with psychopathic features.” This indicates higher levels of detachment, lower chance of empathy, and emotional stability.

Was this helpful?

Talking about low empathy and remorse doesn’t necessarily mean these are absent in someone with sociopathy.

Tzall explains that, because ASPD can be modeled on a spectrum, these can be present at some level.

Types of empathy

Different models of empathy exist, but many experts agree on two basic principles:

Emotional empathy: The ability to feel someone’s emotions as if they were your own.

Cognitive empathy: The ability to understand and recognize emotions.

If you live with ASPD, you may be able to experience cognitive empathy more than emotional empathy.

Was this helpful?

“People with ASPD certainly can have remorse,” says Tzall. “When we talk about a real lack of remorse, it is more about those who are considered psychopaths.”

The term “psychopath” is the nonmedical word often used to describe antisocial personality with psychopathic features. This subtype of ASPD affects approximately 1.2% of the population.

“[Psychopaths] are typically disregardful and callous toward others, which puts them at high risk for crossing social boundaries and breaking the law,” Hong says.

Lack of remorse: Sociopaths vs. narcissists

Hong notes it can be challenging to distinguish between narcissistic personality and sociopathy. Both conditions are grouped under “cluster B” and may have overlapping traits.

“Both are characterized by a lack of empathy, selfishness, and a disregard for the rights of others,” he explains.

According to the DSM-5-TR, one of the primary differences between antisocial personality and narcissistic personality disorder (NPD) is that NPD does not typically involve a high chance of aggression or impulsivity.

If you’re living with NPD, you may have a higher need for admiration and praise. This isn’t the case in ASPD.

“People with NPD may be more likely to engage in grandiose behavior and have an inflated sense of self-importance, while those with ASPD may be more likely to act out in criminal or abusive ways,” states Hong. “I’d like to stress, however, that not all people with either disorder will engage in abusive or criminal behavior.”

Was this helpful?

While living with ASPD may make someone more prone to unlawful actions or ones that violate the rights of others, it’s estimated only a small percentage of convicted criminals live with sociopathy.

Violence is also not exclusive to ASPD. A 2019 study notes paranoid schizophrenia is most often linked to violent behaviors.

Living with ASPD, or any mental health condition, doesn’t mean someone will become a criminal or hurt others. ASPD can exist on a spectrum and may never lead to dangerous behaviors.