The Difference Between a Psychopath and a Sociopath
Surprise: there is no difference between a sociopath and a psychopath. Sociopathy is an old synonym that has fallen out of use among psychology professionals. Pop psychologists might make the distinction that sociopaths are more impulsive and hot-headed, while psychopaths are more premeditated, but professional psychologists don’t endorse the term sociopath. Instead, they use the term psychopathy — but not necessarily in the way pop culture would have us understand it.
Psychopathy is the term used by psychology professionals to describe a specific, diagnosable personality type — not a physiological disorder — characterized by four dimensions of traits: interpersonal, affective, lifestyle and antisocial. Interpersonal psychopathic characteristics include “glibness, superficial charm, grandiosity, pathological lying and manipulation of others. The affective traits include a lack of remorse and/or guilt, shallow affect [i.e., emotions], lack of empathy and failure to accept responsibility. The lifestyle behaviors include stimulation-seeking behavior, impulsivity, irresponsibility, parasitic orientation and a lack of realistic life goals. Antisocial behaviors include poor behavioral controls, early childhood behavior problems, juvenile delinquency, revocation of conditional release [that is, violating probation or parole] and committing a variety of crimes,” writes Scott A. Bonn, PhD, for Psychology Today.
Like all personalities, psychopathic personality traits are thought to be formed by a complex interplay of environmental, genetic and biological factors. And psychopathic traits aren’t limited to a particular age group. Even children can have “callous and unemotional” traits that suggest a nascent psychopathic personality.
A psychologist can diagnose a psychopathic personality by using the Psychopathy Checklist-Revised, a clinical tool that measures 20 different markers of psychopathic traits on a scale of 0 to 2. A total score of 30 or above qualifies as psychopathic. But the 10-point range (30-40) of psychopathy is important; it suggests that psychopathy exists on a spectrum, much like, say, autism. In fact, there is some evidence that psychopathy may be a neurotype, not only a personality profile. (Neurotype refers to brain structures that affect an individual’s interpretations and responses to the world and social milieu.)
For instance, brain scans suggest people with psychopathic traits have differently wired brains: fewer connections between the part of the prefrontal cortex responsible for feelings of empathy and guilt, and the amygdala, the region that regulates fear and anxiety. While it’s not clear whether this is a cause or result of psychopathy, it does reinforce the need to think about psychopathy in a more nuanced way than most pop culture references allow. Because despite popular belief, all of this is to say that psychopathy may be a diagnosable psychological profile or neurotype — but it’s not a diagnosis of a physiological, psychiatric disorder.
That said, there is a diagnosable, physiological, psychiatric disorder that has some overlap with psychopathy: antisocial personality disorder (ASPD).
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ASPD is diagnosed by behavioral symptoms, some of which overlap with the personality traits of psychopathy. According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5), the ‘Bible’ of psychiatrists, the symptoms for ASPD focus on a pattern of behavior, since age 15, that signals the willful disregard for others; the pattern may include: disobeying laws and norms through criminal activity, deceiving and manipulating others, acting impulsively, physically assaulting others out of irritability and aggression, showing little concern for the distress of others, behaving irresponsibly, and displaying no remorse for such behaviors. Children under age 15 cannot be diagnosed with ASPD; however, they can demonstrate a pattern of behavior that speaks to similar tendencies. The diagnosis for these children is “conduct disorder.“
Not all people with psychopathic personalities have ASPD, and far more people have ASPD but do not meet the measure for a psychopathic profile. That said, people with psychopathic traits may be more at risk of ASPD, especially the higher they score on the Psychopathy Checklist-Revised. (In acknowledgment of this, and in an attempt to unify 50 years of debate between the psychological and psychiatric communities on this topic, the DSM-5 for the first time included psychopathy as a “specificier” of ASPD — i.e. a unique manifestation of the disorder, but still not a disorder itself.)
While both groups are overrepresented in the prison system, some people with a psychopathic profile — typically lower scoring — can live non-threatening, law-abiding lives and enjoy successful, long-term relationships. They simply respond to the world differently; while they may not feel certain, common emotions, they can cognitively understand such feelings and work within socially acceptable norms. (Those who cannot — typically higher-scoring psychopathic profiles — are more likely to exhibit the harmful and/or criminal behaviors that indicate a physiological disorder like ASPD.) Those with ASPD have, by definition of the disorder, been unable to live such non-threatening, law-abiding lives.
That analogy is not meant to be glib; it’s simply to clarify the difference between psychopathy and ASPD in less fearmongering terms. Psychopaths may be dangerous — or, they may not be. One thing is clear: the more we stigmatize psychopathic personalities/neurotypes in casual conversations and pop culture portrayals, the harder we make it for atypical people of all stripes to navigate a neurotypical world.