Sociopathy: Causes, signs, and treatments

Reviewed by Brooks W. Baer LCPC, CMHP

What is sociopathy? 

“Sociopathy” is another word for antisocial personality disorder (ASPD), a personality disorder involving a lack of remorse and a disregard for other people’s rights and feelings. 

People diagnosed with ASPD tend to act impulsively, struggle with anger management, and lack empathy. These qualities together can lead them to cross the line into criminal behavior. 

What causes sociopathy? 

Experts believe environmental factors like childhood trauma, abuse, neglect, or impoverishment are major influences in sociopathy: Instead of being born with these traits, people learn sociopathic behaviors to cope with unstable or chaotic living environments. Genetic factors may also play a role. 

Common risk factors for sociopathy include: 

  • Genetics: If a family member has ASPD, you’re at greater risk for developing it. 
  • Biochemistry: Mental health disorders like ASPD may come from a lack or suppression of certain brain chemicals. 
  • Environmental factors: Growing up in an unpredictable, unstable, or abusive household may increase your risk. 
  • Trauma: Unaddressed or untreated trauma can increase your risk. 
  • Childhood mental illnesses: Mental illnesses that are usually diagnosed during childhood—like oppositional defiant disorder (ODD), ADHD, or conduct disorder—may increase your risk of ASPD. 

Symptoms of sociopathy 

You may hear the term “sociopath” in TV shows or movies that portray criminals. But most people with ASPD are not criminal masterminds—instead they react impulsively, hardly thinking through the consequences of their actions for themselves or others. 

People with ASPD often lack: 

  • Conscience: People with ASPD frequently manipulate and exploit others for personal gain. They typically don’t follow an internal moral compass. 
  • Honesty: People with ASPD will lie for convenience or strategic purposes. 
  • Empathy: Most people with ASPD don’t consider the feelings of others, and they’re indifferent when they have hurt or mistreated someone else. 
  • Responsibility: People with ASPD often neglect things like financial debts, job duties, legal requirements, and relationship or parenting obligations. 
  • Remorse: When faced with the consequences of their behavior, people with ASPD rarely feel or express remorse. Instead, they often rationalize their actions and blame others. 
  • Regard for others: People with ASPD don’t care very much about other people’s well-being. They may take risks that jeopardize their own safety and others’. 
  • Self-control: People with ASPD react impulsively and don’t consider the consequences. They’re often verbally and physically aggressive. 

Examples of sociopathic behavior 

  • Stealing 
  • Lying or gaslighting 
  • Abusing animals or people 
  • Assuming fake identities when convenient 
  • Taking action without planning first 
  • Destroying property 

What’s the difference between sociopathy and psychopathy? 

Sociopathy and psychopathy overlap in some ways, but they’re two distinct conditions. 

Some experts think that psychopathic tendencies have a genetic cause—and that people with psychopathic traits have physiological differences in parts of the brain related to emotion and impulse control. People with psychopathy lack remorse and tend to be more callous and unemotional, qualities that can make them more effective at being manipulative, charming, and calculating. Unlike people with sociopathy, they tend to plan their behavior carefully. Psychopathy is also much less common, occurring in less than 1% of the US population. 

Sociopathy, meanwhile, is largely thought of as something you develop in response to a harmful living environment, especially in childhood (though genetics play some role as well). People with ASPD can be manipulative and can lack remorse, but they don’t have the superficial charm and charisma of psychopathy. In addition, they tend to be more impulsive and hot-headed—behaviors that tend to make them less effective. “The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5), estimates that 0.2 to 3.3% of the US population meets the diagnostic criteria for ASPD. 

Does my child have ASPD? 

Childhood personalities are works in progress, so their features change frequently. Qualities like morality, honesty, empathy, responsibility, and remorse aren’t instinctual—they have to be learned as a child develops. A child who lacks those qualities doesn’t have ASPD. They’re simply still developing. 

Children can’t be diagnosed with antisocial personality disorder until they’re 18. But children may be diagnosed with other mental health conditions, such as ODD or conduct disorder, before then. Speak with your child’s doctor or therapist if you’re concerned about sociopathic behaviors. 

Treatment options for sociopathy 

If you or a loved one have symptoms like the ones listed above, help is available. Common treatments include: 

  • Cognitive behavioral therapy (CBT): This form of talk therapy can help you change negative patterns of thinking and behaving that interfere with functioning. 
  • Antipsychotic drugs: Although there aren’t approved medications for the treatment of antisocial personality disorder, antipsychotic drugs can decrease symptoms of impulsivity and aggression. 
  • Mood stabilizers: Similar to antipsychotic medications, mood stabilizers don’t treat the underlying ASPD itself but can help manage symptoms of impulsive aggression. 

Barriers and access to treatment 

It can be challenging for people with ASPD to receive and benefit from help; if they aren’t motivated to change their behavior, they won’t believe they need treatment. 

Treatment isn’t always effective for sociopathy, but it does help some people. Success is more likely when people have milder forms of the condition, or when they have the internal motivation to change. 

Some people with ASPD seek therapy for other mental illnesses, such as anxiety or depression, and end up receiving treatment for sociopathy, too. Others must be compelled to get treatment, either through a family member’s ultimatum or through a legal obligation like a court order. 

If you or a loved one feel ready to start treatment, browse our directory of therapists.