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Unlike previous Hitman games, the "sociopath" rating has strict requirements, just like the "silent assassin" (SA) rating. To get it, you need high violence (additional people killed, excluding your targets and accidents) and absolutely zero noise (no bodies found, no covers blown, no witnesses, not caught on camera, just like SA). Basically, you murder a large number of random people without anyone ever noticing anything. What makes it interesting is that, given these strict requirements, it's kind of like getting SA, but in some ways much more difficult. Unlike previous games, a body can be "found" by anyone, not just guards. And bodies are counted as "found" as soon as they're noticed. (Before, guards usually had to "inspect" the dead body before it counted.)
You can think of the sociopath rating as an additional challenge after completing all missions with SA rating. After that you can try getting SA rating on all levels without using a disguise. This is actually possible on every single level. (This is made easier by the fact that getting caught trespassing usually doesn't create any witnesses, though it's probably possible to move around without ever being seen in a restricted area.) "Sociopath rating" and "no disguise SA" are sort of the logical next challenge after completing silent assassin. It's too bad the game doesn't keep track of whether such things have been completed. The game doesn't even record which missions have been completed with SA rating. I think the game would have more replay value for many players if it kept track of these things.
one last thing: I'm pretty certain all the ratings in Blood Money are determined solely by "noise" and "violence", with the exception of a few special ratings. They're all listed on this page on hitmanforum: http://www.hitmanforum.com/index.php/topic/31761-blood-money-ratings-collection/page__st__20 Kind of odd that they're discussing how the ratings are obtained when it's pretty obvious everything is written as a combination of (violence)x(noise). There are 49 possibilities for regular ratings (7x7), though some ratings like serial killer can occur with more than 1 combination. The rating system also has 4 extremes, silent assassin (0 noise, 0 violence), sociopath (0 noise, high violence), exhibitionist (high noise, 0 violence), and mass murderer (high both). Deranged slayer and serial killer are the ratings that lead up to sociopath, i.e. they're almost, but not quite sociopath.
Actually, I may have made a mistake. I thought it didn't matter whether your targets' bodies were found when getting SA (which seems to be the case on some levels), but there might be exceptions. Killing Vaana and Maynard in plain view in A Dance with the Devil didn't get me the SA rating for some reason. Both bodies were apparently counted as found.
Ok, my above post is incorrect. All bodies found are recorded, but the bodies of your targets never count towards your rating. You can test this by using cheats, going invisible, killing your targets, and letting the bodies be found. You'll still get silent assassin. I guess it's possible there are glitches sometimes. For example, I once got SA rating even though a guard shot at me on the boat mission.