Chances are good that you know or have at least met someone with antisocial personality disorder, aka a sociopath. According to some estimates, up to 4% of the population (mostly men) have the disorder, making it more common even than bipolar disorder.
Although there’s no official diagnosis of a “high-functioning sociopath,” it’s a term that could apply to most people with antisocial personality disorder, because they often don’t have any trouble getting by. Their behavior tends to hurt others more than themselves, which is why so few actually seek or receive treatment.
“Most are out there leaving a trail of broken hearts and pain,” Stephen Salzbrenner, MD, assistant professor of psychiatry at the University of Nebraska College of Medicine in Omaha, tells Health.
In order to get an official diagnosis of antisocial personality disorder (ASPD), a person needs to have at least three of seven traits outlined in the Diagnostic and Statistical Manual of Mental Disorders, the official diagnostic “bible” of the psychiatric community. That means ASPD exists on a spectrum, with some people exhibiting more severe behavior than others.
The general rule is that people with ASPD have no regard for other human beings and will go to great lengths—often using other people, breaking the law, and becoming violent—to get what they want. The behavior can be egregious (rape or murder), or it may stop at lying and cheating.
Now a little bit of reassuring news: You’re not likely to be married to or the business partner of a true sociopath, says Dr. Salzbrenner. In fact, someone diagnosed with ASPD “probably wouldn’t even be in a relationship,” he says. “The only relationship they would be in is where there’s some kind of material gain or sexual gain. They will shack up with somebody if there’s something to gain, but as soon as they lose that they’re off.”
If you have the misfortune of crossing paths with a high-functioning sociopath, though, you could be in trouble. Certainly, you’ve heard the stereotype of the charmer who talks a woman into signing over her inheritance or life-insurance policy. It may seem unlikely that you would do this for someone you don’t know well, but, says Dr. Salzbrenner, sociopaths are “phenomenal at making you feel like you’ve known them forever.”
Similarly, people with ASPD don’t tend to stick with jobs for long. “They’re probably temp workers,” says Dr. Salzbrenner. Someone who stays with a job for a long time may have antisocial traits but likely doesn’t meet all the criteria for a diagnosis, he adds.
Other traits of someone with ASPD also get in the way of living stable lives, starting with irresponsibility. This might manifest as not showing up to work on time or not even looking for work when they’re unemployed, as well as not paying bills, debts, or child support.
In general, sociopaths are rule breakers. Even more, they’re law breakers, and many have spent time in correctional facilities. “These people, left to their own devices, wouldn’t follow any rules unless it served their own self-interest,” says Dr. Salzbrenner.
High-functioning sociopaths often lie—about something as significant as their identity or as seemingly trivial as where they spent the afternoon. It’s a “pattern of calculated lying,” says Dr. Salzbrenner. They also tend to exaggerate to make themselves look better and to deflect blame onto others.
While the lies may be calculated, sociopaths also tend to be impulsive, not calculating long-term consequences. “They really don’t have a very identifiable picture of what lies down the road if they do something wrong but are [instead] very responsive to immediate reward,” says Dr. Salzbrenner. “Having an affair is nothing to them, or stealing something is nothing.” And because sociopaths are so charming and witty, they may not actually get caught, or they may avoid facing punishment if they are caught.
Perhaps not surprisingly, high-functioning sociopaths are also reckless, perhaps speeding or driving while drunk or high. In fact, people with ASPD are more likely than the average person to have substance abuse issues. They are also easily provoked and can get aggressive, even sometimes picking fights—and they don’t show remorse for any pain or damage they may have caused.