I work with special needs kids, mostly autism/Aspergers and a little bit of Downs Syndrome. I had one boy who didn't have a diagnosis, but he had a family history of schizophrenia (grandma) and had a ton of symptoms of ASD (autism spectrum disorder). Was insanely wealthy (dad was an anesthesiologist and also came from money), as in I got fucking lost in his house when we did therapy there one day. This kid was very, very sweet unless he didn't get his way or had even a tiny bit of anxiety about something--then he got violent. He was a tiny kid (7, but looked like a very skinny 5), but when he tried to run out the door one day, I stopped from behind by pulling him back into a bear hug and he backwards head-butted me with everything he had. He threw punches, kicked, scratched with every ounce of strength he had. He busted my lip, I had black eyes, scratches all over my arms, etc. (It is worth noting that the company I worked with had us doing "hands off extinction," meaning we were not supposed to physically restrain kids that were misbehaving because we might hurt them if they pulled away so hard that they might dislocated something or if we lost our grip and they fell/ran into something, and because an angry kid can actually beat the shit out of you. This works with kids that have attention-maintained or minimal aggression, in an environment where they can't escape, like at home in a room where you can block the door and the windows are locked. Ideally I would've been trained in PCM, or professional crisis management, but my boss didn't want to train employees in that because her liability insurance would've gone through the roof and she hadn't yet had a kid that warranted that training. She didn't know this kid had such severe aggression, and the alternative to blocking his escape while hoping for the best when I restrained him that day was to let him run away and potentially onto a busy street.) The kid squeezed my forearm while digging his fingernails into it and then said, "Lemme see that pain." I know a lot of people thought that kid was psychopath or sociopath--he had warm, loving parents and everything a kid could want--all the toys, beautiful home, tons of affection and attention from both parents as an only child--but he still behaved like this toward the people he loved and other children on a regular basis. But he really was a sweet kid. A hallmark of autism is not reading social cues, and another big part is feeling overwhelmed from environmental sounds, textures, and unfamiliar attention from others that doesn't faze most people. This kid had no treatment for any of this his whole life. Instead, he grew up learning that if he continued to escalate his behavior when he was uncomfortable or didn't get his way, the "bad" thing or experience of the moment would go away or give him what he wanted. He behaved like this simply because he didn't know otherwise--he had no concept that he was causing emotional anguish or physical pain beyond hearing those words. It's like if I said, "I feel purple monkeys when you grab my arm like that." WTF does that mean?! Empathy is a challenging thing for any kid with autism, especially one who has never had treatment. What blows my mind even more is that mom had a PhD in psychology. Dad had access to the best medical care around. They could easily have had him assessed at any time, and they had the resources to get him the best treatment out there. But instead they kept hoping he'd "grow out of it" while never teaching him that his aggressive behaviors were unacceptable, and now he's going to grow up as a pariah. I didn't work with him for long, maybe a month. My boss wouldn't listen when I told her that hands-off extinction of his problem behaviors (ignoring the behavior to show them it won't work while blocking them from destructing anything--at home it's not hard to do this) wasn't going to work in a school environment. So eventually the kid ended up running out to the driveway of his school, getting a lose brick, climbing onto his teacher's car and throwing the brick at it. A lot. The teacher was really nice about it because she knew I wasn't legally allowed to grab him, but the kid's parents thankfully decided to find a provider with PCM training. I hope to God they found a good one. I would happily have gotten PCM training to continue working with that kid, because I believe he had a ton of potential. But at the very least he taught me the importance of being qualified to appropriately handle a resisting kid/person--PCM training is a good idea for everyone who has or works with kids.

I don't think that all kids and people who behave like this kid did are just misunderstood. Some of them do have personality disorders, either because they were born with their brain wired that way or because they endured some kind of trauma that shaped their thought processes to function psycho- or sociopathically as a defense mechanism. But true psycho- or sociopaths (however you define them) are extremely rare. The majority of these kids probably never learned how to interact functionally with others.