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In the interest of clinical accuracy...
Narcissists, antisocials and sociopaths all share a lack of empathy, interpersonal exploitation, and severe self-absorption as part of their presentation. My experience in watching forensic psychiatrists at work is that when a narcissist crosses the line and commits any act that might possibly be identified as unlawful (whether law enforcement takes action or not), such as theft, extortion, physical threats, physical violence, robbery, fatal physical acts...you catch my drift, eh? The narcissistic personality disorder diagnosis goes out the window in favor of antisocial personality disorder. If you look at the diagnostic criteria for the latter, there's a number of criteria specific to violations of the law, whether felony or misdemeanor level.
Sociopathy is not a DSM diagnostic category. It may not ever have been. It's used in discussion, evaluation and diagnostic formulation to mostly to identify the severity of somebody who's probably diagnosed with antisocial personality disorder. In descriptive sections of an assessment, terminology such as "sociopathic behavior" or "sociopathic presentations" will be used to clarify and emphasize pathology and behavior...but it's not a diagnostic category. In simple terms...really bad antisocials are sociopathic. At least that how I see it.
Last edited by Ike Bana; 07-18-2015 at 10:39 AM.
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