ASPD, Definitions, and Inflicted Insight

I know I did a post on Anti-Social Personality Disorder but I just wanted to clear up a couple of things. I recently heard a "statistic" that "1 in 25 people are sociopaths". Now, let's remember that sociopathy is considered a subdivision of ASPD and 3% of men and 1% of women are diagnosed with the disorder. The world is roughly 50/50, so the total probability is actually 2% (1.5% + 0.5%). That makes it 1 in 50.

But moving on from that, there is a reason I brough this up - these same "statistic" was mentioned in the context where the author was saying that 1 in 25 people are completely without empathy. Not only that, they credit the World Health Organization (ICD) for this. But wait! Let's take another look at the diagnosis criteria...

(quoted from my prior post, which contains the links)

Under the DSM-IV

A) There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three or more of the following:

1. failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest;
2. deception, as indicated by repeatedly lying, use of aliases, or conning others for personal profit or pleasure;
3. impulsiveness or failure to plan ahead;
4. irritability and aggressiveness, as indicated by repeated physical fights or assaults;
5. reckless disregard for safety of self or others;
6. consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations;
7. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another;

B) The individual is at least age 18 years.

C) There is evidence of conduct disorder with onset before age 16 years.

D) The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode. 

Under ICD-10 (where it is classified under the similar Dissocial Personality Disorder)

It is characterized by at least 3 of the following:

1. Callous unconcern for the feelings of others
2. Gross and persistent attitude of irresponsibility and disregard for social norms, rules, and obligations.
3. Incapacity to maintain enduring relationships, though having no difficulty in establishing them
4. Very low tolerance to frustration and a low threshold for discharge of aggression, including violence.
5. Incapacity to experience guilt or to profit from experience, particularly punishment.
6. Markedly prone to blame others or to offer plausible rationalizations for the behavior that has brought the person into conflict with society

Why am I bringing this up again? Because for each person who references the World Health Organization to say that sociopaths (sufferers of antisocial personality disorder) lack empathy, they seem to forget the simple phrases "at least 3" and "three or more". Only one symptom in the DSMV and two in the ICD-10 roughly correspond to lack of empathy. This means that it's possible for the not to have lack of empathy has a symptom. Now, of course I don't know the probability and relationships between each symptom but the point is that it is possible! But hey, congratulations world - you're just stereotyped another group of people based one aspect that subdivision of them have.


Furthermore, I would like to draw attention to some symptoms these being:

1. lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another;
2. Markedly prone to blame others or to offer plausible rationalizations for the behavior that has brought the person into conflict with society

 While if you take many of the symptoms aside they can appear to be somewhat normal behaviour, I wanted to draw special attention to this. Now, very few people will try to hurt a person for the sake of hurting a person - most will rationalize it with things like "they deserved it", "it wasn't that bad", or "it was for the better". How many times is this actually true and not just people trying to feel less guilty. Again, look at the wording - specifically in point one: "lack of remorse or ..."

A sufferer of ASPD can feel remorse, but just rationalize a misdeed - like "sane" people do. So... is this behaviour sane? Even blaming others - "If my boss hadn't fired me...", if this, if that. These are possible symptoms of what people like to call sociopathy.

But the ones that reach the media are dramatic and extremely negative - portraying the worst of a group of people who, quite frankly, are mostly normal. However, as a friend pointed out, there may be another reason why the least glamorous symptoms are the ones that are emphasized, and next to no attention towards the more commonplace ones.

Nobody wants to draw attention to their own potentially sociopathic behaviour. This is an especially good point when combined with the idea of "inflicted insight" - the idea of exposing the less savoury or comfortable facets of a person's own psyche and forcing them to confront them. I've mentioned the Milgram Experiment before, where participants pretty much blindly followed orders to electrocute another person - many of those same participants (84%) thanked the people running the experiment for showing them that side of them and helping them realize that they needed to question their own actions more, and 15% were neutral.

And yet inflicted insight is veiwed as a bad thing. Could this be why people ignore the more mundane symptoms? Because people don't want to know that they aren't so different from the sociopaths they so revile?

In order to solve a problem, it actually needs to be acknowledged first.