Sociopathy (ASPD) vs. Autism: The Key Differences

Elemy
Updated: February 12, 2022

Sociopathy, also known as antisocial personality disorder (ASPD), is a form of mental illness where a person consistently displays no sense of morals or ethics. People who have ASPD tend to be antagonistic and manipulative, displaying no remorse for their behavior because they are unable to process other people’s emotions and inherent rights.

Because ASPD and autism spectrum disorder (ASD) both involve emotional challenges and limitations, they can often be confused with one another or even misdiagnosed. Get to know the characteristics of ASPD, possible causes, how the condition is diagnosed, and how it differs from ASD.

Characteristics of ASPD

People who have ASPD are good at using their charm or charisma to manipulate others to do their bidding, often for personal gain or pleasure. They may exploit or take advantage of others without any qualms. They have no compulsion about lying, cheating, or stealing because they cannot process how deceptive behavior can have any negative impact on themselves.

Rates of criminal behavior are high among those with ASPD, typically because they have no concept of laws or societal norms applying to them. People with sociopathy callously lie, act impulsively and violently if they don’t get their way, and often abuse drugs or alcohol. Many with ASPD find it prohibitively difficult to function in a job or at school.

Other signs of ASPD include having chronic relationship problems (but never admitting fault in the problems or in the termination of relationships) and a refusal to accept any form of help or treatment (unless they believe they can use the offer of help for their own needs).

It is possible that some signs of ASPD can decrease over time, but sociopathy is usually a lifelong condition.

Possible Causes of ASPD

Experts do not yet know what causes antisocial personality disorder, but many researchers believe it is a combination of the following factors.

Environmental influences. Environmental influences, such as a violent or disruptive home and family life, have been connected to the development of ASPD. Children who grow up in places where there is little to no parental supervision might develop ASPD as a survival mechanism, viewing the rest of the world as a hostile place where the only way to make it is by exploiting others.

Furthermore, children who grow up in situations where they were never rewarded for positive behavior or where antisocial behavior seems to have been rewarded have a greater likelihood of developing sociopathic tendencies as an adult.
Biological or genetic factors. Biological or genetic factors have also been considered. Researchers have noted how ASPD seems to be hereditary, possibly due to a child having grown up in an abusive environment and then passing those genes on to their own offspring.
Brain anatomy. This overlaps with brain anatomy as one of the other suspected causes of sociopathy. People with this disorder have different frontal lobes, which is the region of the brain that moderates judgment and planning. Some research has suggested that changes in the volume of the frontal lobes might make a patient more impulsive, unable to control their inclinations and their behavior.

There is no certainty that people who have these variations in their brain structure will become sociopaths. Rather, neurobiologists suggest that these variations could be the result of traumatic life experiences typically found in people who grow up in abusive or neglectful homes. An altered brain structure might be more a result of this than a cause of ASPD.

Sociopathy vs. Autism: The Key Differences

Because ASPD causes people to show little to no empathy (recognizing and identifying with another’s emotions) toward others, and patients act in ways that are difficult for others to understand, it has been likened to autism.

However, the two are very different conditions and should not be confused with one another. While someone who has autism may also have a form of ASPD (or vice versa), the two conditions are not interchangeable, according to an article by Psychology Today.

Autism occurs early in childhood, and the first signs are developmental delays in how a child communicates and engages with others. Many people who have autism show many individual personality differences, so there is rarely a one-size-fits-all way of diagnosing the disorder. However, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders clarifies that a “persistent impairment in reciprocal communication and social interaction” is the main defining feature that educators, specialists, and caregivers should look for if they suspect a child has autism.

More specifically, a child will show the following signs for there to be enough evidence to positively diagnose autism spectrum disorder (ASD):

Delay and/or difficulty in initiating or responding to social interactions
Difficulty integrating verbal and nonverbal communication into their engagements with others
Difficulty developing, maintaining, and understanding relationships.

Relationships in ASD and ASPD

The difficulty developing, maintaining, and understanding the nature of interpersonal relationships is why some people confuse autism with sociopathy or assume that someone displaying this symptom of autism might be showing signs of sociopathy.

Specifically, people who have ASPD will also struggle to show compassion, care, or concern for others, but the reason behind this is very different compared to someone with autism. Someone with sociopathic tendencies is likely to look at the whole world as a game for them to win, and the people in that game are merely pieces to use and discard at will.

Someone with ASPD will likely be good at reading another person — all the better to identify and exploit their weaknesses through deception, intimidation, manipulation, or outright violence. They can be intentionally, maliciously cruel to get what they want, caring nothing about the people they hurt.

Emotions in Both Conditions

None of that describes a person with autism who may have difficulty reading other people’s emotions, let alone understand that person’s weaknesses. A person with ASPD is, by nature, selfish. A person with autism has a disorder that renders them incapable of fully sharing and expressing an emotional connection with another person in a mutually recognizable way. This is very distinct from the self-centeredness of someone with ASPD, who knows full well what they are doing or saying and does not care.

People with autism can sometimes become frustrated and even aggressive because they cannot understand the behavior or motivations of a person they are engaging with and cannot express their own behavior or motivations to the people around them. Again, this can be erroneously compared to the anger displayed by people with ASPD, which often shows when they don’t get their way, when people challenge them, or when anything happens to dent their self-perceived superiority.

The Psychology Today piece concludes that autism and antisocial personality disorder are “two independent conditions,” and that a person might have the characteristics of one condition but also the features of the other. Autism does not cause sociopathy, and people with ASPD do not have autism by default.

Diagnosing ASPD

When diagnosing antisocial personality disorder, a doctor (typically a professional in mental health treatment) will start with a psychiatric examination, asking the patient questions about their medical history, symptoms, and behavior. Specifically, the doctor will look for the duration, frequency, and severity of the behavior. This is because, like many conditions, ASPD is a spectrum in and of itself. It is possible that a person might have a mild form of ASPD, which is still problematic and needs treatment, but will require a different degree of treatment than someone who has a more severe version.

Regardless of the severity, there are five criteria by which a doctor can return a diagnosis of antisocial personality disorder. These are:

Poor interpersonal functioning. The patient has to base their self-esteem on their personal pleasure, gain, or power; there is no genuine sense of empathy or intimacy with others; their goals disregard any potential negative impact on other people; and there is no internal motivation to abide by any sense of law, social rule, or ethics.
Antagonism and disinhibition. They have no hesitation about being manipulative, deceitful, cruel, or belligerent to anyone, as long as they get their way; they may be exceedingly charming or seductive; they seek revenge for even the most accidental of slights; and they have no sense of personal responsibility or accountability, breaking promises and professional, personal, and social obligations; and they act spontaneously and impulsively, with no remorse for how the behavior impacts others.
Consistency. A doctor will ask if the patient has consistently displayed this behavior across different parts of their life and in different situations. Someone who shows sociopathic behavior only in certain settings might not have ASPD, but another condition with comparable symptoms.
No other explanation. There is no other cultural, social, or psychological reason for the patient to act the way they do. If there was a possibility that their behavior was typical for their mental development in the social or cultural setting they lived in, they would not meet these criteria and it is possible they might not have ASPD. This has to be ruled out for a doctor to return an ASPD diagnosis.
No substance abuse or medical disorder. A patient’s behavior cannot be attributed to the side effects of any controlled substances or health issues, such as head trauma or another mental health disorder.

Treatment & the Future

If there is a diagnosis of ASPD, the next step is treatment. ASPD is notoriously difficult to treat because patients do not feel like there is anything wrong with them or that they need help. Many look down on mental health professionals. Psychotherapy is one option to help people with sociopathy moderate their anger and violent behavior, as well as their use of alcohol or drugs. Medications can also help curb some of the more disruptive or harmful behaviors, but there is no single form of treatment that can fully address ASPD.

Treating antisocial personality disorder is usually a long, slow, frustrating journey that often has many false starts. It is not related to autism, and it is not a form of autism spectrum disorder.