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In the past 3½ decades, I've discussed, read, and studied a significant number of mental health practitioner claims, random anecdotal experiences, and clinical study abstract summaries & reports regarding what is now called Narcissist Personality Disorder (NPD) and how this disorder relates to the psychological condition referred to as a sociopath. When I first looked into how the clinical community faced these two very similar conditions, I found most qualified sources to be mostly consistent in what they indicated.

However, always open to opposing views, I've also read or been informed by others that seem to indicate the earlier claims have all made the same assumptions, and what was considered a common error. The conflicting sources suggested that the earlier sources all conflated the clinical behavior characteristics of the NPD condition with those exhibited by and leading to a diagnosis of a sociopath.

In response to the resulting muddied waters, I found some clarity, at least to myself, in the notion that all Sociopaths are narcissists, but not all narcissists are sociopaths. In other words, when further confused and contradicted, I've always had a tendency to fall back onto those conclusions I arrived at years ago when first settling on a satisfactory understanding of the two.

This understanding concluded that if a subject who was previously diagnosed with NPD was to be clinically diagnosed with the more severe condition of a sociopath, (I assume when formally diagnosed, the vernacular is more sophisticated than what I'm using here) the mental health practitioner making the determination would be required to observe, document, and assess any quantified increases in magnitudes of or changes to exhibited behavioral characteristics common to both the diagnosis of the NPD and the sociopath conditions, as well as any behavioral characteristics associated with either condition but presenting in novel form with the subject.

From what I can remember, a number of these exhibited behaviors were very similar to, if not the same as those used in diagnosing someone with NPD, just at some sorry of elevated measure. Others were similar to those used with NPD, but would exhibit distinct differences if done so by a sociopath. Finally, some of those exhibited behaviors which contribute to the diagnosis of a sociopath seemed completely divorced from and in a few instances conflict with those suggesting a diagnosis of NPD.

Frustratingly, what I have not retained are the specific characteristics or symptoms which triggered the very conversations I remember having. But what I do remember, and do so very clearly, was the lack of intellectual satisfaction I always felt walking away from these discussion related to the unreconciled relationship I always felt these two conditions have to one another, where the parallels in behavior characteristics begin and where they end, or whether or not my fall back conclusion which always seemed to relation static was actually valid, at least from the clinical standpoint.

I know I'm going to be told I can only present one question per post. As such, I'm going to get ahead of that criticism by providing my only question here:

Are there any relationships, similarities, or differences between the specific behavioral characteristics associated with a clinical diagnosis of narcissistic personality disorder (NPD) and those associated with a clinical diagnosis of a sociopath?

That said, the following are not questions to be answered, rather meant to ensure those attempting to provide an answer have been provided a clear understanding of precisely what the single question above is trying to ask.

The following should not be considered additional questions needed to be answered, that would be very anti-stack of me to do. Instead, the following offer additional granularity and detail in the form of drill down questions. These are meant for purposes of guidance in answering the single, not a multiple set of questions noted in bold above.

Basically, I'm restating the same question in a few different ways at a few different levels to ensure the full breadth of the single question is understood and hopefully answered:

1.1 - What are the actual, clinical differences between NPD and the disorder colloquially known as a sociopath?

1.2 - Are the two conditions, NPD and the condition of sociopath, actually considered to be clinically related?

1.3 - Is the relationship really as simplistic as it always just a case of a narcissist exhibiting more acute levels of behavior which is common to both conditions, meet or exceeded a certain behavioral threshold, and thus jumped to the diagnosis of the more severe of the two conditions, and is now a sociopath?

1.4 - If that's the case, what are the specific behavioral characteristics used to make this determination in the clinical setting?

1.5 - What are the predetermined thresholds, how is the associated behavior quantified, and how are those metrics measured?

See, those are simply all small parts of the same question. That's why they are numbered 1.X, to ensure that they are simply detailed parts of the single question in bold.

For the record, this question is being asked to assist me in determining whether specific people I've been exposed to during my life at various times and to various effects to me, were as I suspect, likely diagnosable as sociopaths. All are narcissists, but the lines of delineation are not stated very clearly.

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The Atlas of personality, emotion and behaviour uses a lexical approach that may assist with your question(Mobbs, 2020). The atlas catalogued over 20,000 English language words describing emotion, personality traits and behaviour. The emotions, traits and behaviours used to define each construct are visualised using heat-maps in two dimensions: affiliation and dominance.

The narcissistic and sociopath disorders you refer to are shown with other constructs for comparison:

  • Narcissistic personality disorder (Fig AC)
  • Antisocial personality disorder (Sociopath) (Fig X)
  • Conduct disorder (Fig Q)
  • Dark Triad (Fig H)
  • Criminal behaviour (Fig K)
  • Synonyms of unethical (Fig J)

From a lexical perspective, these constructs are all located in the top-left hand corner of the atlas thus highly related. To specifically answer your question, the similarities of these constructs are that these behaviours are all dominant and disaffiliative. The differences between these constructs is a matter of degree.

The DSM-5 is the clinician's diagnostic manual. The DSM prescribes a number of time and severity based diagnostic criteria to clinically diagnose each specific disorder. The relevant chapters of the DSM are concise and in plain English, so suggest you read the relevant chapters for each specific disorder(American Psychiatric Association, 2013). In addition to the DSM, one would need several years of education and clinical experience to correctly apply the DSM, so would urge caution in attempting diagnosis.

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association.

Mobbs, A. E. D. (2020). An atlas of personality, emotion and behaviour. PloS One, 15(1), e0227877. https://doi.org/10.1371/journal.pone.0227877

Declared interest

I am the author of the atlas paper.

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    $\begingroup$ I have never been shown those heat maps, but I'm fascinated at how they illustrate what is so often a nuanced and ambiguous minute shift in degree of a specific behavior (as you so stated). If this is a novel means of characterizing closely related or similarly presenting disorders which are however two distinctly designated disorders, but often presented challenges for clinicians to differentiate, what a fantastic method. $\endgroup$ – BigNutz Jun 10 at 20:31
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    $\begingroup$ I meant to address one last point from your very much appreciated response. I have watched first hand the severe damage an individual who repeatedly suggests an array of wholly unqualified mental health disorder diagnosis statements in an office setting can have, despite only the most noble if intentions. I can assure you without a doubt in my mind, I will not make the same mistakes after observing the irreparable damage this type of careless delusions of grandeur can inflict on the careers, lives, and mental health of the very individual this person meant to help. Good warning, though. $\endgroup$ – BigNutz Jun 10 at 20:52

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