Topic: Lines of Distinction Between Psychopaths and Sociopaths (Compare/Contrast)

Sociopath is a term people use, often arbitrarily, to describe someone who is apparently without conscience, hateful, or
hate-worthy. The term psychopath is used to convey a sociopath who is simply more dangerous, like a mass murderer.
Although sociopath and psychopath are often used interchangeably and may overlap, each has its own clear lines of
distinction. For example, sociopathy is the unofficial term for antisocial personality disorder (APD), while psychopathy is
not an official diagnosis and is not considered an APD.
Differences Between Sociopath vs. Psychopath
Psychopaths are classified as people with little or no conscience but are able to follow social conventions when it suits
their needs. Sociopaths have a limited, albeit weak, ability to feel empathy and remorse. They're also more likely to fly off
the handle and react violently when confronted by the consequences of their actions.
SOCIOPATH PSYCHOPATH
★ Make it clear they do not care how others feels ★ Pretend to care
★ Behave in hot-headed and impulsive ways ★ Display cold-hearted behavior
★ Prone to fits of anger and rage ★ Fail to recognize other people's distress
★ Recognize what they are doing but rationalize their ★ Have relationships that are shallow and fake
behavior ★ Maintain a normal life as a cover for criminal
★ Cannot maintain a regular work and family life activity
★ Can form emotional attachments, but it is difficult ★ Fail to form genuine emotional attachments
★ May love people in their own way
Willem H.J. Martens argues in his infamous article "The Hidden Suffering of the Psychopath" that psychopaths do at
times suffer from emotional pain and loneliness. Most have lead hurt-filled lives and have an inability to trust people, but
like every human being on the planet, they, too, want to be loved and accepted.1
However, their own behavior makes this extremely difficult, if not impossible, and most are aware of this. Some feel
saddened by the actions they are unable to control because they know it isolates them from others even more.
Approach to Violence
While it's common to think of sociopaths and psychopaths as being inherently dangerous, this is more a construct of a TV
drama than a true reflection of the disorder. Violence, while certainly possible, is not an inherent characteristic of either
sociopathy or psychopathy.
With that being said, people with APD will often go to extraordinary lengths to manipulate others, whether it be to charm,
disarm, or frighten them, in order to get what they want. When psychopaths do become violent, as in the case of Jeffrey
Dahmer, they're just as likely to hurt themselves as others.
Martens notes that the more a psychopath feels socially isolated, sad, and alone, the higher his or her risk for violence and
impulsive and/or reckless behavior.
Origins and Development
There are some who say that "sociopaths are made and psychopaths are born," but this characterization may be too far
broad. Although it is true that psychopathy is believed to have genetic components (perhaps caused by the
underdevelopment of the parts of the brain that regulate emotion and impulsiveness), there are clearly other factors that
contribute to the behavioral disorder.
A well-regarded study into psychopathy suggested that psychopaths often have a history of an unstable family life and/or
were raised in poorer neighborhoods prone to violence. Many have had parents who were substance abusers and who
failed to provide parental guidance or attention.2
This typically translates to unstable and failed relationships in adulthood and a fixated sense that you have been "robbed"
of opportunities and advantages afforded to everyone else. Sociopathy also tends to be associated with harmful childhood
experiences, including sexual abuse, physical violence, or parental instability.
Sociopaths have a conscience, albeit a weak one, and will often justify something they know to be wrong. By contrast,
psychopaths will believe that their actions are justified and feel no remorse for any harm done.
This differentiation may suggest that nature plays more of a role in the creation of a psychopath than a sociopath. This is
supported in part by a 2014 review of studies in which as many as a third of people diagnosed with sociopathy essentially
"give up" their antisocial behavior in later life and develop well-adjusted relationships.
Topic: Personality Disorders: Is it Antisocial or Borderline?(Compare/Contrast)

Because they are both personality disorders, antisocial personality disorder (ASPD) shares many of the same traits as
borderline personality disorder (BPD). However, the causes of these conditions and how they manifest can be strikingly
different. Learn more about the differences between antisocial personality disorder and borderline personality disorder so
you can receive proper treatment.

Symptoms
Both ASPD and BPD are Cluster B personality disorders in the DSM-5. Cluster B disorders are characterized by overly
emotional, dramatic, and unpredictable thinking and behavior. Both conditions are marked by disinhibition, hostility, and
impulsivity.1 ASPD and BDP are also characterized by an increased suicide rate of between 3% and 10%.2

However, the two conditions differ in important ways. While antisocial personality disorder is marked by few emotions
and affects more men than women, borderline personality disorder consists of extreme emotions and affects both men and
women equally.
ASPD BPD
★ Few emotions ★ Intense, volatile emotions
★ Disregard for safety ★ Fear of abandonment
★ Manipulates for money/power/pleasure ★ Idealizes/devalues others
★ Irresponsible ★ Poor self-esteem
★ Lacks remorse ★ Shifting identity
★ More common in men ★ Equally present in men and women
★ A person must be 18+ to be diagnosed with ASPD ★ A person of any age can be diagnosed with BPD
★ Psychotherapy is not effective ★ Psychotherapy can be effective
ASPD Personality Traits
According to the DSM-5, people with ASPD may exhibit the following behavioral characteristics:
★ Antagonism: Antagonism in ASPD is displayed through manipulation, such as using charming behavior to
influence someone. People with ASPD often engage in vengeful behaviors over minor slights and may even resort
to aggression, violence, and cruelty.
★ Disinhibition: Disinhibition in ASPD is characterized by a disregard of social conventions and reckless,
risk-taking behaviors at the expense of others' safety or feelings. It is not uncommon for people with ASPD to
break promises, miss appointments, or drop activities out of boredom or spite.
★ Emotional detachment: People with ASPD exhibit greater egocentric behaviors, making it difficult to establish
balanced and supportive relationships. This emotional detachment can complicate psychotherapy, the practice of
which relies heavily on open interaction.

BPD Personality Traits

People with BPD may have the following personality traits:
★ Negative affectivity: Negative affectivity is characterized by unstable and unpredictable mood changes that are
more dramatic than a situation warrants. This includes intense anxiety over social situations, persistent fear of
rejection, or sudden swings into a deep depression, shame, or guilt. Suicidal thoughts are not uncommon.
★ Disinhibition: People with BPD may engage in impulsive, risky behaviors, often due to frantic efforts to avoid
real or anticipated abandonment or to change intolerable emotional states. These actions are often turned inward,
resulting in self-harm or self-destructiveness. Appointments, promises, and activities will be readily dropped more
out of a sense of hopelessness or anger than out of boredom.
★ Antagonism: People with BPD are easily spurred to anger but are less likely to shut others out. Rather, they will
seek out relationships that can alternate between extremes of idealization and devaluation.

Causes
The exact causes of ASPD and BPD are not clear, but the two conditions share some risk factors in common. The
following are known to increase the risk of a person developing a Cluster B personality disorder:
★ Brain differences: Imaging studies suggest that people with ASPD and BPD have structural differences in areas of
the brain that regulate emotions and impulse control.
★ Family history: Having a family member who has a Cluster B personality disorder increases the risk that a person
will also develop ASPD or BPD.
 ★ Experiences: Stressful and traumatic life events such as attachment problems, neglect, and abuse increase the risk
of developing these conditions.

Some evidence suggests that these conditions are influenced by a combination of genetic and environmental factors.

Diagnosis
Because the two conditions share similarities, it is important to look for the key differences that differentiate them. Both
conditions involve severe problems with self-functioning and interpersonal functioning, but the way these symptoms
manifest is somewhat different between ASPD and BPD.

Antisocial Personality Disorder

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, text revision (DSM-5-TR), a person
with antisocial personality disorder must be at least 18 years old and have severe problems functioning in these two
specific areas:
★ Self-functioning: ASPD is broadly defined as behaviors in which people think only of themselves and/or focus on
personal goals and gratification without taking into account what is culturally acceptable or ethical. By definition,
people with ASPD gain a sense of self-esteem from pursuing pleasure, power, or getting what they want.
★ Interpersonal functioning: People with ASPD cannot display concern or empathy for other people's feelings or
needs. They have difficulty forming any true sense of intimacy and instead use power to exert dominance in a
relationship.

Borderline Personality Disorder

To be diagnosed with borderline personality disorder, a person must have severe problems functioning in both of these
areas:
★ Self-functioning: People with BPD typically struggle with identity and are prone to feelings of emptiness,
self-loathing, and worthlessness. Because of this, they have difficulty establishing goals or pursuing long-term
interests, often undermining themselves at every turn.
★ Interpersonal functioning: Feelings of low self-esteem typically manifest in hypersensitivity to anything
construed as criticism or rejection. People with BPD tend to lash out irrationally at even minor slights (like
interruptions in conversation). Unable to see beyond their own feelings, people with BPD tend to lack empathy
and find themselves in unstable relationships prone to conflict.

People with borderline personality disorder may display symptoms similar to ASPD. However, with ASPD, manipulation
occurs as a way to get what a person wants (such as power or money), whereas with BPD, it occurs as a way to gain
nurturance from others.

Treatment
Certain forms of cognitive-behavioral therapy (CBT), such as dialectical behavior therapy (DBT) and mentalization-based
therapy (MBT), have been extremely effective in treating BPD.
By contrast, ASPD is notoriously difficult to treat with psychotherapy. People with the condition rarely seek treatment
independently and may only come into contact with treatment due to arrest and incarceration. Some evidence suggests that
long-term therapy with CBT may help people gain insight and improve their behavior.
Medications such as antidepressants, antipsychotics, anxiolytics, and mood stabilizers can also help manage symptoms
associated with BPD or ASPD, such as depression, aggression, or co-occurring disorders.
Prevention
There is no way to prevent antisocial personality disorder or borderline personality disorder. If you know that you have a
family history of BPD, watching for signs and getting an early diagnosis and treatment may help improve outcomes.
ASPD is sometimes preceded by conduct disorder during childhood. Getting an accurate diagnosis and appropriate
treatment of conduct disorder during childhood may help minimize the risk of developing ASPD during adulthood.
Summary
Antisocial personality disorder and borderline personality disorder are both Cluster B personality disorders that share
several symptoms in common. However, there are important differences that distinguish between the two conditions. Both
conditions are thought to be caused by factors such as brain differences, genetics, and adverse experiences. BPD may
respond to psychotherapy and medication, but ASPD is very difficult to treat with psychotherapy.
Topic: What Is Impulsivity? (Descriptive)

Impulsivity, or impulsive behavior, is broadly defined as actions without foresight that are poorly conceived, prematurely
expressed, unnecessarily risky, and inappropriate to the situation. Impulsivity is associated with undesirable, rather than
desirable, outcomes.

Impulsivity is a characteristic of a number of mental health conditions, including borderline personality disorder (BPD),
bipolar disorder, and attention deficit hyperactivity disorder (ADHD).

People who experience impulsivity may make hasty decisions, get into arguments, and engage in risky behaviors. In
addition to undermining relationships and a person's overall sense of well-being, impulsive behaviors can also lead to
financial and legal harm if left unchecked.

Fortunately, there are treatments that can help bring impulsivity under control, including psychotherapy, mindfulness
training, and pharmaceutical drugs.

Characteristics of Impulsivity
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), impulsive behaviors are a hallmark of
BPD and other conditions. How it presents may vary depending on a person's specific diagnosis and the severity of their
condition.

People who are impulsive are commonly described as:

★ Hot-headed
★ Rash
★ Unpredictable
★ Unstable

This instability often causes people to struggle with feelings of inadequacy that manifest with unstable emotions, unstable
behaviors, and unstable relationships. In BPD, for example, people may be quick to lash out at anything considered a
slight and will often fail to recognize how those emotions are unreasonable or excessive.

In psychological terms, impulsive behaviors are inherently inappropriate either in terms of scale or potential risk. In some
cases, people are less likely to take into account potential consequences and will often turn to self-harm behaviors (like
binge eating or excessive drinking) as a means to cope.

However, impulsive behaviors are not, in and of themselves, a diagnosis. It is only when the behavior is pervasive,
detrimental, and interferes with a person's ability to function normally that mental health diagnoses such as BPD or
bipolar disorder may be considered.

I mpulsivity should not be confused with a compulsion, in which a person recognizes the behavior is abnormal but cannot
stop it. With impulsivity, the person will act out without inherently recognizing that the behavior is abnormal.

Identifying Impulsivity
Impulsivity is not a separate condition, but it is often a symptom of a mental health condition. No single test can confirm
whether impulsive behavior is the result of BPD, bipolar disorder, or some other condition. A doctor will perform a
psychological exam to determine whether the symptoms are consistent with the criteria outlined in the DSM-5.

During a psychological evaluation, a doctor will ask questions about the symptoms a person is experiencing, including
questions about the severity, nature, and duration of the symptoms. In some cases, they may ask other people who have
contact with the individual, such as family members, for information about symptoms and behavior.

In addition to a psychological assessment, a doctor may also conduct a physical exam and order blood work. This can help
rule out medical conditions that might be contributing to or causing the symptoms.

Risk Factors for Impulsivity

There are a number of different factors that are associated with an increased risk for impulsive behavior. Some of these
include:
★ Age: Younger people are more prone to engaging in impulsive behaviors than older people.
★ Sex: Boys and men tend to be affected by impulsivity more frequently.
★ Family history: A family history of mental illness or impulsive behavior can lead to an increased risk.
★ Trauma: Exposure to trauma, violence, abuse, and neglect may increase a person's risk for impulsivity.
★ Substance use: Using drugs and alcohol can contribute to impulsive behavior.

Causes of Impulsivity
The exact causes of impulsivity are not fully understood, but it is believed that both environmental factors and genetic
factors may play a role.

Psychological Factors
Impulsivity may sometimes stem from traumatic experiences, particularly those that occur in early childhood.A child's
upbringing, including their caregiver's parenting styles, can also impact the development of self-regulation skills. Kids
who do not learn to regulate their behavior effectively may experience greater impulsivity as a result.

Environmental factors can also make more people with mental health conditions such as BPD and bipolar disorder
effectively manage symptoms of impulsivity.

Genetic Factors
In some conditions, impulsivity might be influenced by genetic factors. Genetic mutations that impact the production of
serotonin and dopamine, the neurotransmitters associated with mood and cognition, can contribute to increased
impulsivity. Some research has also shown that genetic errors may increase heritable impulsivity.

Other conditions linked to impulsivity, including bipolar disorder and ADHD, are believed to share underlying genetic
factors. These genetic influences likely impact the shared symptoms such as impulsivity.

It is this combination of environmental, genetic, and physiological factors that likely creates the perfect storm for the
development of many mental health conditions that are associated with impulsivity.

Conditions Linked to Impulsivity

Impulsive behaviors can occur in a number of different mental health conditions:
★ Physical causes of impulsivity, including acquired brain injury or a neurodegenerative disease like Alzheimer's
disease or Huntington's disease.
★ Bipolar mania, often in tandem with grandiosity and a flight of ideas (During an acute manic episode, a person
will often act impulsivity with little thought of the consequence. Spending sprees and hypersexual behaviors are
two common examples of impulsivity related to bipolar disorder).6
★ Attention-deficit hyperactivity disorder (ADHD), known as hyperactive-impulsive ADHD, spurred by the
child's inability to keep still or control inappropriate behavior (It is this lack of control, combined with a
constantly shifting focus of interest, that spurs impulsivity.)7
★ Substance use disorders, although the impulsiveness is typically exhibited under the influence of drugs, when
craving drugs, or when actively seeking drugs.8
★ Antisocial personality disorder (ASPD), closely aligned with BPD but differs in that there is a pervasive and
persistent disregard for morals, social norms, and the rights and feelings of others
★ Impulse control disorders: These include conditions such as intermittent explosive disorder, kleptomania,
pyromania, and trichotillomania, which can result in risky behaviors that may harm the self or others.

How impulsivity presents varies depending on the condition. With borderline personality disorder, a person will have
extreme emotions that they find hard to control. With antisocial personality disorder, there will be a marked lack of
emotions.

Examples of Impulsivity
Impulsivity may be experessed in a variety of ways depending on the underlying cause. Every individual and situation is
different. Some common examples of impulsivity include:
 ★ Abruptly changing or canceling plans ★ Jumping to conclusions
★ An inability to remain still ★ Meaningless or risky sex
★ Binge eating or drinking ★ Over-apologizing
★ Clearing out belongings to "start anew" ★ Oversharing of emotions
★ Constantly "turning over a new leaf" ★ Overspending
★ Destroying property ★ Physical violence
★ Escalating confrontations ★ Quitting a job suddenly
★ Frequent emotional outbursts ★ Self-harm
★ Inability to receive criticism without affront ★ Self-mutilation
★ Joining and quitting a lot of groups ★ Threatening to harm one's self or others

Treatment for Impulsivity

While impulsive behaviors can be severe and pervasive, they can often be successfully managed with treatment. Many
treatments for mental health conditions have components that specifically target impulsivity.

Psychotherapy
Dialectical behavior therapy (DBT) focuses on building skills that reduce your impulsive behaviors and increase your
ability to think and reflect before acting. By using coping mechanisms to handle intense emotions, a person with BPD is
better equipped to face situations without confrontation.

Mindfulness, a skill taught in DBT, encourages you to stay in the moment, which can help you to remain more aware of
your actions so you take the time to consider consequences. Practicing this technique can help you to take the time needed
to reflect on your options, empowering you to make more rational decisions about how to respond to events around you.
Mindfulness meditation is a modality often used to support the training.

Medication
Medications like selective serotonin reuptake inhibitors (SSRIs) sometimes combined with a low dose of an antipsychotic
may also help. This is especially true if your behavior is extreme and poses a risk to your safety or those around you.9

There are a number of drugs that specifically treat impulsivity, including:

★ Atypical antipsychotics: Abilify (aripiprazole) is seen to reduce interpersonal problems and impulsivity.
★ Mood stabilizers: Lamictal (lamotrigine) may help reduce impulsivity and anger, while Topamax (topiramate)
may ameliorate impulsivity, anger, and anxiety.

Medications are most effective when used in conjunction with psychotherapy with a therapist who specializes in treating
impulsive behavior.

Coping With Instability

In addition to complying with your treatment plan and seeing a therapist, there are steps you can take to better cope with
impulsivity. Often, the first step is to identify the impulsive behaviors that you’d like to change. Next, you can try one of
these strategies when you notice an urge to engage in one of those behaviors:

★ Conduct a chain analysis, which allows you to identify the impulsive behavior, what happened prior to the
behavior, evaluate your thoughts and feelings, and consider the consequences.
★ Join a support group. If you lack resources like supportive friends and a family, joining a support group can be
helpful in managing your impulsive behaviors. It will also allow you to talk to others about what has (and hasn't)
worked for them as far as coping with impulsive behaviors.
★ Replace impulsive behaviors with healthy ones. While impulsivity may cause a short-term positive effect (for
example, taking away anxiety or fear), there are healthy ways to cope, including going for a walk, journaling,
talking to a trusting friend, or meeting with a support group.
★ Practice deep breathing. Deep breathing is one way to help manage stress, which can help you regulate your
mood and reduce impulsive behavior. Focusing on your breathing can also help distract you as you move past the
urge to act impulsively.