Mental Health Personality Disorders How to Tell If Someone Is a Psychopath By Laura Dorwart Laura Dorwart Laura Dorwart is a health journalist with expertise in disability rights, mental health, and pregnancy-related conditions. She has written for publications like SELF, The New York Times, VICE, and The Guardian. Learn about our editorial process Published on May 10, 2022 Medically reviewed by Michael MacIntyre, MD Medically reviewed by Michael MacIntyre, MD LinkedIn Michael MacIntyre, MD, is a board-certified general and forensic psychiatrist. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents What Is a Psychopath? Sociopath vs. Psychopath Signs Causes Risk Factors Diagnosis Treatment Frequently Asked Questions The term psychopath refers to someone who does not follow the moral norms of their society and lacks empathy and remorse. People displaying psychopathy are callous, manipulative, and deceitful. They often commit acts of violence, theft, or fraud to get others to do what they want. Psychopathy is not an official mental health diagnosis. However, some psychopathic traits overlap with the symptoms of antisocial personality disorder (ASPD), which is characterized by an ongoing disregard for the rights, feelings, and safety of others. Halfpoint Images / Getty Images Researchers, forensic psychologists, and legal experts often use the term psychopath in criminal settings. People with psychopathic traits are significantly more likely to be incarcerated during their lifetime. Read on to learn more about psychopathy, including traits, signs, and the differences between a psychopath and a sociopath. Is Psychopath a Clinical Diagnosis? Psychopathy is not an official clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). However, researchers often study psychopathic traits, such as callousness, aggression, and manipulativeness. Because there is no single agreed-upon definition of psychopathy as a medical diagnosis, the term is often used in different ways by different people. What Is a Psychopath? Researchers use the term psychopath to describe a person who exhibits consistently callous and unemotional behavior. A person displaying psychopathy lacks empathy, shame, and remorse, which leads them to consistently violate the rights and well-being of others. They may lie, cheat, or steal to get their way. Research suggests that the rate of psychopathy in the general population is about 1.2%. Men are significantly more likely than women to exhibit psychopathic traits. People with psychopathic traits appear in all walks of life. In fact, many of them are highly successful CEOs, surgeons, salespeople, or managers. However, they are also highly overrepresented in the criminal justice system. Estimates suggest that up to 25% of prisoners would be characterized as psychopaths. Among violent offenders, the rate of psychopathy is even higher. In particular, people displaying psychopathy are much more likely to commit severely violent crimes, such as assault, murder, or rape. In addition, incarcerated people with psychopathic traits and a history of violent criminal convictions are also about five times more likely to re-offend multiple times. Study: Mental Health Help Is Crucial For People in Police Custody Sociopath vs. Psychopath Although psychopathy is not a clinical diagnosis, it shares many traits with antisocial personality disorder (ASPD). People with ASPD are sometimes referred to as sociopaths, and some researchers use the terms sociopath and psychopath interchangeably. ASPD was even called psychopathic personality in an earlier version of the Diagnostic and Statistical Manual of Mental Disorders. Antisocial personality disorder is a long-lasting mental health condition that involves a reckless disregard for one’s own safety and the safety of others. Both people displaying psychopathy and people with ASPD lack empathy for others and remorse for their actions. They are both often willing to manipulate and exploit others (through lying, cheating, stealing, or violence, for example) to get what they want. However, only about a third of people with ASPD would be characterized as having psychopathy. Unlike most people with ASPD, people displaying psychopathy are also prone to vanity, arrogance, fearlessness, and an excessive need for praise and admiration. People with ASPD are more likely to be chronically irresponsible, often neglecting their duties at work or school. Signs Most people displaying psychopathy begin to exhibit antisocial traits during childhood, often before age 10. However, someone can develop psychopathic traits later. Some of the personality traits and tendencies associated with psychopathy include: Superficial charm Emotional detachment Lack of empathy Impulsivity Chronic, uncontrolled anger Low tolerance for boredom Intense craving for excitement, novelty, and reward Pathological lying Fearlessness Dominance Self-centeredness Entitlement Arrogance Psychopathy is also often characterized by certain patterns of behavior, including: Disregard for rules, norms, consequences, and the law Physical aggression Willingness to manipulate, con, and exploit others for personal gain Criminal behavior, including theft, fraud, and severe acts of violence History of legal problems Abuse of animals or children Multiple short-term relationships, divorces, and/or custody disputes Lack of close personal connections Low marital satisfaction Substance abuse Causes There is no single known cause of psychopathy. Researchers have identified several possible contributing factors, including: Genetics: Psychopathy frequently runs in families. Twin and family studies suggest that genetic variations often play a role in the inheritability of psychopathic traits. Brain structure: Studies indicate that people with psychopathy have impaired function in several areas of the brain, such as the prefrontal cortex (which is involved in complex thinking, decision-making, and planning) and the amygdala (which is involved in processing emotions, especially fear). Childhood trauma: Early childhood trauma—such as physical, sexual, or emotional abuse, as well as exposure to domestic violence in the home—significantly increases the risk of psychopathy, especially if someone is already genetically predisposed to it. Some researchers refer to psychopathic traits that appear only after severe trauma as “secondary psychopathy.” Risk Factors Anyone from any background can show traits of psychopathy. However, the following risk factors increase the likelihood that someone will develop psychopathic traits: Individual differences: Certain childhood personality traits, such as emotional instability and behavioral impulsivity, have been linked to a higher likelihood of psychopathy. People with psychopathy are also less likely to be afraid of consequences, such as punishment or social isolation. Parent-child relationship: Studies indicate that parenting style plays an important role in psychopathy. Negative, harsh, and neglectful parenting have all been linked to antisocial behavior in children and adolescents. Environmental factors: There are many childhood risk factors for psychopathy, including poverty, housing instability, parental conflict, divorce, negative peer influences, lack of parental involvement, exposure to crime or violence, and legal or criminal problems in the family. Conduct Disorder and Psychopathy Children and adolescents who are diagnosed with conduct disorder (CD)—a condition that involves a pattern of disruptive, aggressive, and/or violent behavior—are more likely to develop ASPD or psychopathy later in life. What Is Conduct Disorder? Diagnosis People with psychopathic traits are highly unlikely to seek a diagnosis or treatment on their own. Usually, they do not believe they have a problem. They may receive a diagnosis only after it is required by a court of law, whether during criminal proceedings or a custody dispute. The Psychopathy Checklist-Revised (PCL-R), originally developed by psychologist Robert D. Hare, is a 20-item assessment tool that measures someone’s level of emotional detachment and antisocial behavior. Forensic psychologists often use the PCL-R in criminal settings to determine a sexually violent offender’s risk of recidivism (the likelihood that they will re-offend and pose an ongoing danger to others). Treatment Psychopathy and ASPD are considered difficult to treat. Not many evidence-based treatments are currently available. Instead, most treatment approaches for psychopathy are focused on reducing the potential for violence, criminal behavior, and other harm. Recent research suggests that the following psychopathy treatment methods may be helpful: Early intervention: Because many people show signs of psychopathy during childhood or adolescence, early intervention is often crucial. Early intervention programs are typically focused on building empathy, managing stress, improving family relationships, and processing emotions in healthy ways. Some of these programs occur in juvenile detention centers as juvenile offenders are significantly more likely to exhibit psychopathic traits. Behavioral therapy: Studies indicate that targeted behavioral interventions may help reduce the risk of violent and criminal behavior among incarcerated people with psychopathic traits. Behavioral therapy for psychopathy usually focuses on reading social cues more accurately, managing anger, developing healthy coping skills, and improving social skills. Psychotherapy: While psychotherapy has sometimes been dismissed as a potentially effective method for treating psychopathy, recent studies suggest that it may be possible. For example, evidence suggests that schema therapy (ST)—based loosely on cognitive behavioral therapy (CBT) and works to disrupt negative thinking patterns—may help reduce recidivism among violent offenders with psychopathic traits. Substance abuse counseling: Many people with psychopathy or ASPD also have at least one substance use disorder (SUD). Targeted substance abuse counseling and psychoeducation (which teaches people about the negative consequences of their actions) can reduce the risk of harmful drug and alcohol use among people with antisocial and/or psychopathic traits. No medications are currently approved by the Food and Drug Administration (FDA) to treat psychopathy or ASPD. However, some healthcare providers may prescribe certain medications (such as lithium, antidepressants, or antipsychotics) to target symptoms like aggression and anger. Summary Researchers use the term psychopath to describe someone who is callous, unemotional, and manipulative. They lack empathy and remorse and often exploit others to get what they want. In many cases, they are also superficially charming. They are often prone to criminal behavior, including theft, fraud, and violence. Psychopathy is not an official clinical diagnosis. However, it is related to antisocial personality disorder (ASPD)—a long-lasting mental health condition that involves reckless disregard for the needs, feelings, and safety of others. There is no single known cause of psychopathy. Genetics, trauma, brain structure, exposure to violence during childhood, and environmental conditions are possible contributing factors. Research about effective treatments for psychopathy is ongoing. Behavioral therapy, early intervention programs, and certain kinds of psychotherapy have shown promise in reducing the harmful effects of psychopathic traits. A Word From Verywell If you think someone you know may have psychopathic traits, it’s important to protect your mental health and well-being. Set clear boundaries with anyone who is mistreating you, and reach out to your support system for help. If you’re in an unsafe situation, get away as soon as it is possible to do so safely. Frequently Asked Questions How do you tell if you are a psychopath? Some of the most common signs of psychopathy include a lack of empathy for others, a shallow range of emotions, a lack of guilt and remorse, and a willingness to break rules for personal gain.Many people with psychopathy have a history of legal problems, broken relationships, and criminal behavior, although that is not true of all people with psychopathic traits. It may help to remember that most people with psychopathy don’t seek treatment on their own, as they often have trouble recognizing that they have a problem. What is a narcissistic psychopath? Narcissistic psychopathy is not an official clinical diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). However, some people have both psychopathic traits—such as callousness and manipulativeness—and traits associated with narcissistic personality disorder (NPD), such as extreme entitlement and self-centeredness.Both people with narcissism and people with psychopathy lack empathy and remorse. Both can be superficially charming, and both may use deceit, violence, and other antisocial means to get what they want. How can you best communicate with a psychopath? When communicating with a person with psychopathy, try to keep calm as much as possible. State your boundaries and expectations clearly in order to steer clear of ambiguity.To avoid the potential for manipulation, exploitation, or deceit, it may be helpful to communicate in writing—whether by email, letters, or text—or in the presence of a witness who can verify what was said.If you are in an unsafe situation, leave as soon as it is safe and possible for you to do so. What should you do if you feel your child is a psychopath? If you are concerned that your child is exhibiting psychopathic traits, talk to your healthcare provider right away. 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Front Psychol. 2019;10:360. doi:10.3389/fpsyg.2019.00360 Crossley L, Woodworth M, Black PJ, Hare R. The dark side of negotiation: examining the outcomes of face-to-face and computer-mediated negotiations among dark personalities. Pers Individ Differ. 2016;91:47-51. doi:10.1016/j.paid.2015.11.052 By Laura Dorwart Laura Dorwart is a health journalist with particular interests in mental health, pregnancy-related conditions, and disability rights. She has published work in VICE, SELF, The New York Times, The Guardian, The Week, HuffPost, BuzzFeed Reader, Catapult, Pacific Standard, Health.com, Insider, Forbes.com, TalkPoverty, and many other outlets. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit