Flossing Without Flossing?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Flossing Without Flossing?
You almost certainly brush your teeth. You might use mouthwash. A lot of people floss for three weeks at a time, often in January.
There are a lot of options for oral hygiene; variations of the above, and many alternatives too. This is a big topic, so rather than try to squeeze it all in one, this will be a several-part series.
The first part was: Toothpastes & Mouthwashes: Which Help And Which Harm?
How important is flossing?
Interdental cleaning is indeed pretty important, even though it may not have the heart health benefits that have been widely advertised:
However! The health of our gums is very important in and of itself, especially as we get older:
Flossing Is Associated with Improved Oral Health in Older Adults
But! It helps to avoid periodontal (e.g. gum) disease, not dental caries:
Flossing for the management of periodontal diseases and dental caries in adults
And! Most certainly it can help avoid a stack of other diseases:
Interdental Cleaning Is Associated with Decreased Oral Disease Prevalence
…so in short, if you’d like to have happy healthy teeth and gums, flossing is an important adjunct, and/but not a one-stop panacea.
Is it better to floss before or after brushing?
As you prefer. A team of scientists led by Dr. Claudia Silva studied this, and found that there was “no statistical difference between brush-floss and floss-brush”:
Flossing is tedious. How do we floss without flossing?
This is (mostly) about water-flossing! Which does for old-style floss what sonic toothbrushes to for old-style manual toothbrushes.
If you’re unfamiliar, it means using a device that basically power-washes your teeth, but with a very narrow high-pressure jet of water.
Do they work? Yes:
As for how it stacks up against traditional flossing, Liang et al. found:
❝In our previous single-outcome analysis, we concluded that interdental brushes and water jet devices rank highest for reducing gingival inflammation while toothpick and flossing rank last.
In this multioutcome Bayesian network meta-analysis with equal weight on gingival inflammation and bleeding-on-probing, the surface under the cumulative ranking curve was 0.87 for water jet devices and 0.85 for interdental brushes.
Water jet devices and interdental brushes remained the two best devices across different sets of weightings for the gingival inflammation and bleeding-on-probing. ❞
~ Journal of Evidence-Based Dental Practice
You may be wondering how safe it is if you have had dental work done, and, it appears to be quite safe, for example:
BDJ | Water-jet flossing: effect on composites
Want to try water-flossing?
Here are some examples on Amazon:
- Waterpik Complete Care 9.0 ← example of a top-end water-flossing device
- Philips Sonicare Power Flosser 3000 ← top-tier not-Waterpik-brand device
- INSMART Cordless Water Dental Flosser ← very low price and still average 4.5 star reviews, so in our opinion, a fine first choice
Bonus: if you haven’t tried interdental brushes, here’s an example for that
Enjoy!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Recommended
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
How To Improve Your Heart Rate Variability
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
How’s your heart rate variability?
The hallmarks of a good, strong cardiovascular system include a medium-to-low resting heart rate (for adults: under 60 beats per minute is good; under 50 is typical of athletes), and healthy blood pressure (for adults: under 120/80, while still above 90/60, is generally considered good).
Less talked-about is heart rate variability, but it’s important too…
What is heart rate variability?
Heart rate variability is a measure of how quickly and easily your heart responds to changes in demands placed upon it. For example:
- If you’re at rest and then start running your fastest (be it for leisure or survival or anything in between), your heart rate should be able to jump from its resting rate to about 180% of that as quickly as possible
- When you stop, your heart rate should be able to shift gears back to your resting rate as quickly as possible
The same goes, to a commensurately lesser extent, to changes in activity between low and moderate, or between moderate and high.
- When your heart can change gears quickly, that’s called a high heart rate variability
- When your heart is sluggish to get going and then takes a while to return to normal after exertion, that’s called a low heart rate variability.
The rate of change (i.e., the variability) is measured in microseconds per beat, and the actual numbers will vary depending on a lot of factors, but for everyone, higher is better than lower.
Aside from quick response to crises, why does it matter?
If heart rate variability is low, it means the sympathetic nervous system is dominating the parasympathetic nervous system, which means, in lay terms, your fight-or-flight response is overriding your ability to relax.
See for example: Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature
This has a lot of knock-on effects for both physical and mental health! Your heart and brain will take the worst of this damage, so it’s good to improve things for them impossible.
This Saturday’s Life Hacks: how to improve your HRV!
Firstly, the Usual Five Things™:
- A good diet (that avoids processed foods)
- Good exercise (that includes daily physical activity—more often is more important than more intense!)
- Good sleep (7–9 hours of good quality sleep per night)
- Reduce or eliminate alcohol consumption (this is dose-dependent; any reduction is an improvement)
- Don’t smoke (just don’t)
Additional regular habits that help a lot:
- Breathing exercises, mindfulness, meditation
- Therapy, especially CBT and DBT
- Stress-avoidance strategies, for example:
- Get (and maintain) your finances in good order
- Get (and maintain) your relationship(s) in good order
- Get (and maintain) your working* life in good order
*Whatever this means to you. If you’re perhaps retired, or otherwise a home-maker, or even a student, the things you “need to do” on a daily basis are your working life, for these purposes.
In terms of simple, quick-fix, physical tweaks to focus on if you’re already broadly leading a good life, two great ones are:
- Exercise: get moving! Walk to the store even if you buy nothing but a snack or drink to enjoy while walking back. If you drove, make more trips with the shopping bags rather than fewer. If you like to watch TV, consider an exercise bike or treadmill to use while watching. If you have a partner, double-up and make it a thing you do together! Take the stairs instead of the elevator. Take the scenic route when walking someplace. Go to the bathroom that’s further away. Every little helps!
- Breathe: even just a couple of times a day, practice mindful breathing. Start with even just a minute a day, to get the habit going. What breathing exercise you do isn’t so important as that you do it. Notice your breathing; count how long each breath takes. Don’t worry about “doing it right”—you’re doing great, just observe, just notice, just slowly count. We promise that regular practice of this will have you feeling amazing
Share This Post
-
I Contain Multitudes – by Ed Yong
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
A little while back we reviewed a book (Planet of Viruses) about the role of viruses in our lives, beyond the obvious. Today’s book gives the same treatment to microbes in general—mostly bacteria.
We all know about pathogens, and we all know about gut microbiota and that some (hopefully the majority) there are good for our health. This book covers those things too, but also much more.
Pulitzer Prize-winning science writer Ed Yong takes a big picture view (albeit, of some very small things) and looks at the many ways microbes keep us alive, directly or indirectly. From the microbes that convert certain proteins in breast milk into a form that babies can digest (yes, this means we produce nutrients in breast milk that have been evolved solely to feed that bacterium), to those without which agriculture would simply not work, we’re brought to realize how much our continued existence is contingent on our trillions of tiny friends.
The style throughout is easy-reading pop-science, very accessible. There’s also plenty in terms of practical take-away value, when it comes to adjusting our modern lives to better optimize the benefits we get from microbes—inside and out.
Bottom line: if you’d like to learn about the role of microbes in our life beyond “these ones are pathogens” and “these ones help our digestion”, this is the book for you.
Click here to check out I Contain Multitudes, and learn more about yours and those around you!
Share This Post
-
Carbonated Water: For Weight Loss, Satiety, Or Just Gas?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
There are two main mechanisms of action by which sparkling water is considered to help satiety and/or weight loss; they are:
- It “fills us up” such that we feel fuller sooner, and thus eat less, and thus (all other things being equal) perhaps lose weight
- The carbon dioxide is absorbed into the bloodstream, where (as a matter of chemistry) it improves glucose metabolism, thus lowering blood sugars and indirectly leading (potentially) to weight loss, but even if not, lowered blood sugars are good for most people most of the time, right?
However, there are just a few problems:
Full of gas?
Many people self-report enjoying sparkling water as a way to feel fuller while fasting (or even while eating). However, the plural of “anecdote” is not “data”, so, here be data… Ish:
❝In order to determine whether such satiating effects occur through oral carbonic stimulation alone, we conducted modified sham-feeding (SF) tests (carbonated water ingestion (CW), water ingestion (W), carbonated water sham-feeding (CW-SF), and water sham-feeding (W-SF)), employing an equivalent volume and standardized temperature of carbonated and plain water, in a randomized crossover design.
Thirteen young women began fasting at 10 p.m. on the previous night and were loaded with each sample (15ºC, 250 mL) at 9 a.m. on separate days. Electrogastrography (EGG) recordings were obtained from 20 min before to 45 min after the loading to determine the power and frequency of the gastric myoelectrical activity. Appetite was assessed using visual analog scales. After ingestion, significantly increased fullness and decreased hunger ratings were observed in the CW group. After the load, transiently but significantly increased fullness as well as decreased hunger ratings were observed in the CW-SF group. The powers of normogastria (2-4 cpm) and tachygastria (4-9 cpm) showed significant increases in the CW and W groups, but not in the CW-SF and W-SF groups. The peak frequency of normogastria tended to shift toward a higher band in the CW group, whereas it shifted toward a lower band in the CW-SF group, indicating a different EGG rhythm.
Our results suggest that CO2-induced oral stimulation is solely responsible for the feeling of satiety.❞
~ Dr. Maki Suzuki et al.
Now, that’s self-reported, and a sample size of 13, so it’s not the most airtight science ever, but it is at least science. Here’s the paper, by the way:
Oral Carbonation Attenuates Feeling of Hunger and Gastric Myoelectrical Activity in Young Women
Here’s another small study with 8 people, which found that still and sparkling water had the exact same effect:
Effect of carbonated water on gastric emptying and intragastric meal distribution
However, drinking water (still or sparkling) with a meal will not have anywhere near the same effect for satiety as consuming food that has a high water-content.
See also: Some Surprising Truths About Hunger And Satiety ← our main feature in which we examine the science of volumetrics, including a study that shows how water incorporated into a food (but not served with a food) decreases caloric intake.
As an aside, one difference that carbonation can make is to increase ghrelin levels—that’s the hunger hormone (the satiety hormone is leptin, by the way). This one’s a rat study, but it seems reasonable that the same will be true of humans:
…which is worth bearing in mind even if you yourself are not, in fact, a male rat.
The glucose guzzler?
This one has simply been the case of a study being misrepresented, for example here:
Fizzy water might aid weight loss by providing a small boost to glucose uptake and metabolism
The idea is that higher levels of carbon dioxide in the blood mean faster glucose metabolism, which is technically true. Now, often “technically true” is the best kind of true, but not here, because it’s simply not useful.
In short, we produce so much carbon dioxide as part of our normal respiratory processes, that any carbon dioxide we might consume in a carbonated water is barely a blip in the graph.
Oh, and that article we just linked? Even within the article, despite running with that headline, the actual scientists quoted are saying such things as:
❝While there is a hypothetical link between carbonated water and glucose metabolism, this has yet to be tested in well-designed human intervention studies❞
~ Professor Sumantra Ray
Note: the word “hypothetical” means “one level lower than theoretical”. This is very far from being a conclusion.
And the study itself? Wasn’t even about carbonated water, it was about kidney dialysis and how the carbon dioxide content can result in hypoglycemia:
The mechanism of hypoglycemia caused by hemodialysis
…which got referenced in this paper (not a study):
Can carbonated water support weight loss?
…and even that concluded:
❝CO2 in carbonated water may promote weight loss by enhancing glucose uptake and metabolism in red blood cells.
However, the amount is so small that it is difficult to expect weight loss effects solely from the CO2 in carbonated water.
Drinking carbonated water may also affect blood glucose measurements.❞
Note: the word “may”, when used by a scientist and in the absence of any stronger claims, means “we haven’t ruled out the possibility”.
What breaking news that is.
Stop the press! No, really, stop it!
So… What does work?
There are various ways of going about actually hacking hunger (and they stack; i.e. you can use multiple methods and get cumulative results), and we wrote about them here:
Enjoy!
Share This Post
Related Posts
-
The Truth About Handwashing
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Washing Our Hands Of It
In Tuesdays’s newsletter, we asked you how often you wash your hands, and got the above-depicted, below-described, set of self-reported answers:
- About 54% said “More times per day than [the other options]”
- About 38% said “Whenever using the bathroom or kitchen
- About 5% said “Once or twice per day”
- Two (2) said “Only when visibly dirty”
- Two (2) said “I prefer to just use sanitizer gel”
What does the science have to say about this?
People lie about their handwashing habits: True or False?
True and False (since some people lie and some don’t), but there’s science to this too. Here’s a great study from 2021 that used various levels of confidentiality in questioning (i.e., there were ways of asking that made it either obvious or impossible to know who answered how), and found…
❝We analysed data of 1434 participants. In the direct questioning group 94.5% of the participants claimed to practice proper hand hygiene; in the indirect questioning group a significantly lower estimate of only 78.1% was observed.❞
Note: the abstract alone doesn’t make it clear how the anonymization worked (it is explained later in the paper), and it was noted as a limitation of the study that the participants may not have understood how it works well enough to have confidence in it, meaning that the 78.1% is probably also inflated, just not as much as the 94.5% in the direct questioning group.
Here’s a pop-science article that cites a collection of studies, finding such things as for example…
❝With the use of wireless devices to record how many people entered the restroom and used the pumps of the soap dispensers, researchers were able to collect data on almost 200,000 restroom trips over a three-month period.
The found that only 31% of men and 65% of women washed their hands with soap.❞
Source: Study: Men Wash Their Hands Much Less Often Than Women (And People Lie About Washing Their Hands)
Sanitizer gel does the job of washing one’s hands with soap: True or False?
False, though it’s still not a bad option for when soap and water aren’t available or practical. Here’s an educational article about the science of why this is so:
UCI Health | Soap vs. Hand Sanitizer
There’s also some consideration of lab results vs real-world results, because while in principle the alcohol gel is very good at killing most bacteria / inactivating most viruses, it can take up to 4 minutes of alcohol gel contact to do so, as in this study with flu viruses:
In contrast, 20 seconds of handwashing with soap will generally do the job.
Antibacterial soap is better than other soap: True or False?
False, because the main way that soap protects us is not in its antibacterial properties (although it does also destroy the surface membrane of some bacteria and for that matter viruses too, killing/inactivating them, respectively), but rather in how it causes pathogens to simply slide off during washing.
Here’s a study that found that handwashing with soap reduced disease incidence by 50–53%, and…
❝Incidence of disease did not differ significantly between households given plain soap compared with those given antibacterial soap.❞
Read more: Effect of handwashing on child health: a randomised controlled trial
Want to wash your hands more than you do?
There have been many studies into motivating people to wash their hands more (often with education and/or disgust-based shaming), but an effective method you can use for yourself at home is to simply buy more luxurious hand soap, and generally do what you can to make handwashing a more pleasant experience (taking a moment to let the water run warm is another good thing to do if that’s more comfortable for you).
Take care!
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
Pain Doesn’t Belong on a Scale of Zero to 10
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Over the past two years, a simple but baffling request has preceded most of my encounters with medical professionals: “Rate your pain on a scale of zero to 10.”
I trained as a physician and have asked patients the very same question thousands of times, so I think hard about how to quantify the sum of the sore hips, the prickly thighs, and the numbing, itchy pain near my left shoulder blade. I pause and then, mostly arbitrarily, choose a number. “Three or four?” I venture, knowing the real answer is long, complicated, and not measurable in this one-dimensional way.
Pain is a squirrely thing. It’s sometimes burning, sometimes drilling, sometimes a deep-in-the-muscles clenching ache. Mine can depend on my mood or how much attention I afford it and can recede nearly entirely if I’m engrossed in a film or a task. Pain can also be disabling enough to cancel vacations, or so overwhelming that it leads people to opioid addiction. Even 10+ pain can be bearable when it’s endured for good reason, like giving birth to a child. But what’s the purpose of the pains I have now, the lingering effects of a head injury?
The concept of reducing these shades of pain to a single number dates to the 1970s. But the zero-to-10 scale is ubiquitous today because of what was called a “pain revolution” in the ’90s, when intense new attention to addressing pain — primarily with opioids — was framed as progress. Doctors today have a fuller understanding of treating pain, as well as the terrible consequences of prescribing opioids so readily. What they are learning only now is how to better measure pain and treat its many forms.
About 30 years ago, physicians who championed the use of opioids gave robust new life to what had been a niche specialty: pain management. They started pushing the idea that pain should be measured at every appointment as a “fifth vital sign.” The American Pain Society went as far as copyrighting the phrase. But unlike the other vital signs — blood pressure, temperature, heart rate, and breathing rate — pain had no objective scale. How to measure the unmeasurable? The society encouraged doctors and nurses to use the zero-to-10 rating system. Around that time, the FDA approved OxyContin, a slow-release opioid painkiller made by Purdue Pharma. The drugmaker itself encouraged doctors to routinely record and treat pain, and aggressively marketed opioids as an obvious solution.
To be fair, in an era when pain was too often ignored or undertreated, the zero-to-10 rating system could be regarded as an advance. Morphine pumps were not available for those cancer patients I saw in the ’80s, even those in agonizing pain from cancer in their bones; doctors regarded pain as an inevitable part of disease. In the emergency room where I practiced in the early ’90s, prescribing even a few opioid pills was a hassle: It required asking the head nurse to unlock a special prescription pad and making a copy for the state agency that tracked prescribing patterns. Regulators (rightly) worried that handing out narcotics would lead to addiction. As a result, some patients in need of relief likely went without.
After pain doctors and opioid manufacturers campaigned for broader use of opioids — claiming that newer forms were not addictive, or much less so than previous incarnations — prescribing the drugs became far easier and were promoted for all kinds of pain, whether from knee arthritis or back problems. As a young doctor joining the “pain revolution,” I probably asked patients thousands of times to rate their pain on a scale of zero to 10 and wrote many scripts each week for pain medication, as monitoring “the fifth vital sign” quickly became routine in the medical system. In time, a zero-to-10 pain measurement became a necessary box to fill in electronic medical records. The Joint Commission on the Accreditation of Healthcare Organizations made regularly assessing pain a prerequisite for medical centers receiving federal health care dollars. Medical groups added treatment of pain to their list of patient rights, and satisfaction with pain treatment became a component of post-visit patient surveys. (A poor showing could mean lower reimbursement from some insurers.)
But this approach to pain management had clear drawbacks. Studies accumulated showing that measuring patients’ pain didn’t result in better pain control. Doctors showed little interest in or didn’t know how to respond to the recorded answer. And patients’ satisfaction with their doctors’ discussion of pain didn’t necessarily mean they got adequate treatment. At the same time, the drugs were fueling the growing opioid epidemic. Research showed that an estimated 3% to 19% of people who received a prescription for pain medication from a doctor developed an addiction.
Doctors who wanted to treat pain had few other options, though. “We had a good sense that these drugs weren’t the only way to manage pain,” Linda Porter, director of the National Institutes of Health’s Office of Pain Policy and Planning, told me. “But we didn’t have a good understanding of the complexity or alternatives.” The enthusiasm for narcotics left many varietals of pain underexplored and undertreated for years. Only in 2018, a year when nearly 50,000 Americans died of an overdose, did Congress start funding a program — the Early Phase Pain Investigation Clinical Network, or EPPIC-Net — designed to explore types of pain and find better solutions. The network connects specialists at 12 academic specialized clinical centers and is meant to jump-start new research in the field and find bespoke solutions for different kinds of pain.
A zero-to-10 scale may make sense in certain situations, such as when a nurse uses it to adjust a medication dose for a patient hospitalized after surgery or an accident. And researchers and pain specialists have tried to create better rating tools — dozens, in fact, none of which was adequate to capture pain’s complexity, a European panel of experts concluded. The Veterans Health Administration, for instance, created one that had supplemental questions and visual prompts: A rating of 5 correlated with a frown and a pain level that “interrupts some activities.” The survey took much longer to administer and produced results that were no better than the zero-to-10 system. By the 2010s, many medical organizations, including the American Medical Association and the American Academy of Family Physicians, were rejecting not just the zero-to-10 scale but the entire notion that pain could be meaningfully self-reported numerically by a patient.
In the years that opioids had dominated pain remedies, a few drugs — such as gabapentin and pregabalin for neuropathy, and lidocaine patches and creams for musculoskeletal aches — had become available. “There was a growing awareness of the incredible complexity of pain — that you would have to find the right drugs for the right patients,” Rebecca Hommer, EPPIC-Net’s interim director, told me. Researchers are now looking for biomarkers associated with different kinds of pain so that drug studies can use more objective measures to assess the medications’ effect. A better understanding of the neural pathways and neurotransmitters that create different types of pain could also help researchers design drugs to interrupt and tame them.
Any treatments that come out of this research are unlikely to be blockbusters like opioids; by design, they will be useful to fewer people. That also makes them less appealing prospects to drug companies. So EPPIC-Net is helping small drug companies, academics, and even individual doctors design and conduct early-stage trials to test the safety and efficacy of promising pain-taming molecules. That information will be handed over to drug manufacturers for late-stage trials, all with the aim of getting new drugs approved by the FDA more quickly.
The first EPPIC-Net trials are just getting underway. Finding better treatments will be no easy task, because the nervous system is a largely unexplored universe of molecules, cells, and electronic connections that interact in countless ways. The 2021 Nobel Prize in Physiology or Medicine went to scientists who discovered the mechanisms that allow us to feel the most basic sensations: cold and hot. In comparison, pain is a hydra. A simple number might feel definitive. But it’s not helping anyone make the pain go away.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails:
-
What’s the difference between a psychopath and a sociopath? Less than you might think
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as 7 signs your boss is a psychopath or How to avoid the sociopath next door.
You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from The Silence of the Lambs.
In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with something else entirely.
So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts.
Benoit Daoust/Shutterstock What’s a psychopath?
Psychopathy has been mentioned in the psychiatric literature since the 1800s. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) doesn’t list it as a recognised clinical disorder.
Since the 1950s, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with antisocial personality disorder, which is what we have today.
Was Hannibal Lecter from The Silence of the Lambs a psychopath, a sociopath or something else entirely? Ralf Liebhold/Shutterstock Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions.
To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves.
US psychiatrist Hervey Cleckley provided the first formal description of psychopathy traits in his 1941 book The Mask of Sanity. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame.
Canadian psychologist Professor Robert Hare refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM.
When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others.
Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions.
So how about a sociopath?
The term sociopath first appeared in the 1930s, and was attributed to US psychologist George Partridge. He emphasised the societal consequences of behaviour that habitually violates the rights of others.
Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some preferred the term sociopath because they said the public sometimes confused the word psychopath with psychosis.
“Sociopathic personality disturbance” was the term used in the first edition of the DSM in 1952. This aligned with the prevailing views at the time that antisocial behaviours were largely the product of the social environment, and that behaviours were only judged as deviant if they broke social, legal, and/or cultural rules.
Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 definition of a psychopath.
In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy.
Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead.
Born or made?
Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes.
For example, people with psychopathic traits have certain brain differences especially in regions associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their nervous system, including a reduced heart rate.
However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to run in families. These behaviours has been associated with physical abuse and parental conflict.
What are the consequences?
Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series Killing Eve – not all people with psychopathy or sociopathy traits are serial killers or are physically violent.
But psychopathy predicts a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature.
In the general population, psychopathy is associated with drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted failure to follow COVID restrictions.
But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour.
In a nutshell
Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics.
Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment.
Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.
Bruce Watt, Associate Professor in Psychology, Bond University and Katarina Fritzon, Associate Professor of Psychology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Don’t Forget…
Did you arrive here from our newsletter? Don’t forget to return to the email to continue learning!
Learn to Age Gracefully
Join the 98k+ American women taking control of their health & aging with our 100% free (and fun!) daily emails: