In society, “sociopath” refers to a person with antisocial personality disorder (ASPD). Some people use the term “high functioning sociopath” to describe a person who can mask symptoms of their ASPD well.

Antisocial personality disorder (ASPD) is one of ten types of personality disorders.

Dramatic, erratic, unpredictable, and emotional behavior characterize people’s interactions with others across all cluster B personality disorders, such as ASPD.

This article explores what ASPD is and how high and low functioning symptoms present differently. It also goes over how to treat ASPD.

The term “sociopath” was once used to describe people with antisocial personality disorder. However, this term is no longer typically used in clinical settings due, in part, to derogatory connotations associated with the term.

High functioning sociopathy is also not a clinical term. It is language that may be socially used to describe a person with antisocial personality disorder, yet appears to have impeccable social skills or has a well-developed ability to fit in.

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ASPD is a deeply ingrained dysfunction of thought processes that center upon social irresponsibility. Often, people with ASPD display exploitative, deviant, or criminal behavior without feeling remorse. Disregard for, and the violation of, the boundaries or rights of others are other typical features of this disorder.

People with ASPD may exhibit symptoms, such as:

  • refusing to conform to the law
  • difficulty holding down a job or place in school
  • lying or manipulating for personal gain
  • disregarding social norms
  • incapable of forming consistent, stable relationships

Learn more about ASPD.

People may sometimes refer to those with an ASPD diagnosis as sociopaths. Sociopathic behaviors typically involve a person being unconcerned with the emotional safety of themselves or others, and a disinterest in following societal norms.

ASPD is rare. According to a 2015 study, an estimated 1–4% of the general population may have ASPD. However, the exact cause is unknown.

Although people may use the terms high and low functioning sociopath, these are not clinical terms, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR) does not differentiate between subtypes of ASPD.

Low functioning ASPD

Some individuals with ASPD take little care, or have little aptitude, to hide their behaviors and attitudes. Societally, this may be referred to as “low functioning” ASPD. Individuals may have difficulty maintaining relationships and employment due to ASPD symptoms and behaviors.

High functioning ASPD

Others can be quite skilled at deceiving or manipulating others. People may call those who are more adept at practicing deception and manipulation in social interactions to facilitate their own ends “high functioning sociopaths.” People with high functioning ASPD may come across as pleasant, warm, and charming.

Not all symptoms of high functioning ASPD are obvious. However, some may become more obvious over time.

Symptoms and characteristics of ASPD include:

  • the ability to act witty and charming
  • the ability to flatter people and manipulate other people’s emotions
  • failing to conform to laws and social norms
  • having a disregard for the safety of themselves and others
  • lying, stealing, and fighting often
  • not showing remorse or guilt
  • frequently showing arrogance or anger
  • having issues with substance misuse

To diagnose ASPD, a person may have a documented history of conduct disorder.

A doctor can only diagnose ASPD if someone is 18 years or older and demonstrates three or more of the following behaviors:

  • repeated lawbreaking
  • frequent deceitfulness
  • spontaneous, impulsive behavior
  • difficulty maintaining plans
  • irritability and aggression
  • disregard for safety
  • being irresponsible
  • showing no remorse for their actions

To diagnose ASPD, these signs must be part of a person’s regular pattern of behavior and not part of a schizophrenic or manic episode.

Treatment for ASPD depends on the individual. For some, ASPD is a lifelong condition and can be very difficult to manage. Others may be able to manage their condition with therapies, medications, or both. The most effective treatment plan for someone will take into account their individual circumstances, age, behavioral or criminal history, and whether they are living with a substance use disorder (SUD) or alcohol use disorder (AUD).

Treatments for ASPD include:

  • Cognitive behavioral therapy (CBT) can sometimes help treat ASPD. CBT is a type of psychotherapy that focuses on helping people deal with unwanted or unhelpful thought patterns by changing their beliefs about how they think.
  • Mentalization-based therapy (MBT) is another subtype of psychotherapy that more people are using to treat cluster B personality disorders.

Democratic therapeutic communities (DTC)

Research suggests that community-led programs may be an effective treatment for those living with ASPD. However, more research is needed on the exact effectiveness.

Democratic therapeutic communities (DTC) are a type of social therapy. The goal is to address an individual’s risk of offending, alongside their emotional and psychological needs.

DTC centers around large and small therapy groups, with a focus on community issues. Self-motivation is a key criterion for a person to gain a place on a DTC scheme. The individual seeking treatment should be willing to contribute to community projects by working together and is subject to participating in democratic processes.

Antisocial personality disorder is a condition whose signs include a lack of compassion and empathy for others, deceitfulness, manipulativeness, and impulsiveness.

There is no cure for ASPD, but a person living with the condition may help manage symptoms through psychotherapies or democratic therapeutic communities. A mental health professional can help create the most effective treatment plan based on individual needs.