The Sociopath

In medical terms, a sociopath (or psychopath) is a person who has antisocial personality disorder, or ASPD for short. Those with ASPD, if you can identify them, should be avoided at all costs.

First of all, a personality disorder is a person’s style of coping with the environment that is enduring and maladaptive. We all have a particular style, however, most have a style which helps them get through life “intact.”

The person with ASPD is the one who is out there visiting sweet little old ladies and taking all their money from them. These people (usually men) often show up offering to sell them a garden patio, or a sunroom, or some such wonderful thing, costing an “amazingly low $10,000!” Of course, the price is high because you know you get what you pay for. It’s this kind of line that reels them in. The catch is that the poor little old lady has to come up with the cash up front. Guess what? She’s out 10 grand and never gets the promised construction.

What makes this character tick? They place no value on relationships. For some reason, these guys have little or no conscience (nearly complete or complete lack of remorse). All they care about is gratifying their own needs, with no regard to consequences borne by others who happen to get in their way.

People with ASPD come in all shapes, sizes, and modus operandi. They are master con artists, the most charming of ladies’ men, and the serial murderers. Some are seemingly “less evil” than others, but they all share the common characteristic of insisting on gratification of all their perceived needs, no matter the cost. What varies between individuals is the perceived need, and has much to do with the environment in which they grew up. The disorder begins in adolescence, in fact criteria for diagnosis includes onset by age 15.

In the adolescent, harbingers of conduct disorder and later, ASPD, include repeated criminal activity, lying, conning, physical aggression, reckless disregard for safety of self or others, and irresponsibility.

ASPD has a prevalence of 3% in men and 1% in women, and is thought to be genetically predisposed. This is backed up not only by research, but also by the fact that there are multiple disorders known to be genetic that tend to be co-morbid with ASPD. These include anxiety disorders, substance abuse, somatization disorder, and pathological gambling.

In addition, observations of people with ASPD reveal a relative disinhibition of behaviors, which may be mediated by serotonergic imbalance in a *part of the brain known to have bearing on emotions. Imaging studies suggest structural and functional anomalies in the CNS, specifically in the prefrontal lobes, and less autonomic activity. Studies do show a low level of arousal, poor fear conditioning, and decision-making deficits.

So, how do you know when you come face-to-face with one of these fellas? It can be difficult, but basically, you go by your gut. Remember when you’ve had the feeling that so-and-so seems way friendlier than usual? Then you ask yourself, “I wonder what he wants?” That’s one red flag. Another red flag is the guy who thinks he is “God’s gift” to women, and is ultra-charming. He’s the one you catch with someone else, and then he says something like “what’s the big deal? It’s all your fault anyway.” Big red flag there. The person with ASPD is a gifted liar as well. They can look you right in the face and speak utter nonsense and you will wonder if they are telling you the truth. Another big red flag.

References:

1. 1) A. Raine, T. Lencz, S. Bihrle, et al: Reduced prefrontal gray atter volume and reduced autonomic activity in antisocial personality disorder. Arch Gen Psychiatry 2000 Feb; 57(2): 119-27; discussion 128-9
2. 2) RJ Kavoussi, EF Coccaro: Divalproex sodium for impulsive aggressive behavior in patients with personality disorder. J Clin Psychiatry 1998 Dec; 59(12): 676-80

*septohippocampus (if anyone cares)