Sociopath vs. Psychopath

The use of the terms "sociopath" and "psychopath" can be confusing. Neither is an official diagnosis within the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the most widely used guide for diagnosing mental health conditions.

Both psychopathy and sociopathy include traits that are incorporated into the official diagnosis of antisocial personality disorder (ASPD). Psychopathy would fit into a subset of antisocial personality. Sociopathy, however, is not considered a clinical condition by the medical community. 

There is historical significance as to how these terms have been used, and they are often confused with one another, considered separate conditions instead of aspects of antisocial personality disorder, or used incorrectly by the general public. 

This article discusses the differences and similarities of sociopathy and psychopathy. It also explains the causes of these conditions, methods for diagnosing antisocial personality disorder, and its treatments.

Traits of Sociopaths and Psychopaths

No one is officially diagnosed as a sociopath or psychopath, but rather as having antisocial personality disorder.

Symptoms of antisocial personality disorder include a pervasive pattern of disregard for the rights of others present since at least adolescence. It presents with behaviors such as:

• Disregard for social norms and laws
• Lack of guilt or remorse
• Repeated lying
• Impulsivity and irresponsibility
• Aggressiveness
• Disregard for the safety of others

Sometimes the term "sociopath" is used to emphasize the antisocial, rule-violating aspects of antisocial personality disorder, and "psychopath" is used to emphasize the internal experience of lack of remorse—pleasure in "getting over on" or inflicting pain on someone—and other emotional deficits.

Although there is a lot of overlap in the ways these terms tend to be used, psychopathy and sociopathy are sometimes considered as having distinct traits.

Conscience

A key difference between people considered sociopaths and psychopaths revolves around how they relate to moral behavior and conscience—the part of a person that makes them feel bad for causing pain to others.

For instance, while sociopaths are considered to have a weak conscience, psychopaths can lack conscience altogether.

Anger and Relationships

People considered as sociopathic are often quick to get angry and defensive when confronted about their behavior. They also often have legal issues and unstable personal lives.

Psychopaths do not typically explode under pressure. They might even underreact in dangerous or stressful situations.

Psychopaths usually avoid getting into relationships, and the relationships they do establish are often for the purpose of using people for their own gain.

Are You Born a Sociopath or Psychopath?

Researchers believe that genetics plays a significant role in the development of antisocial personality disorder. Some researchers in the past had emphasized biology as a cause of psychopathy and environmental factors as a cause of sociopathy. This suggests that some psychopaths may be "born that way," but sociopaths may be more of a product of their upbringing.

Antisocial personality disorder often coexists with other mental health conditions, including:

• Major depressive disorder
• Bipolar disorder
• Gambling disorder
• Sexual and paraphilic disorders
• Substance use disorders
• Somatic symptom disorders (hyperfocus on physical symptoms to the point of distress)

Sociopathy

There are genetic, biological, and environmental factors that contribute to antisocial personality disorder, including what is sometimes considered sociopathy and psychopathy. However, there may be relative differences in the influence of these factors.

The exact causes of sociopathy are not well understood, but it is believed that a person's environment—their childhood and the way they were parented—may play a larger role.

For example, children who experience physical, sexual, or emotional abuse are more likely to become sociopaths. However, not all sociopaths have been abused.

Children who are neglected or don't form bonds with caregivers early in life also have an increased risk of developing sociopathy.

Psychopathy

Psychopathy is associated with dysfunction in an area of the brain called the amygdala, which is responsible for a person's ability to react appropriately to potentially dangerous or threatening events. This part of the brain also helps regulate emotions.

Changes to the structure and function of certain parts of the brain—such as the prefrontal cortex, temporal cortex, and paralimbic structures—have been identified in people with psychopathy. However, environment also is believed to play a role.

Diagnosing Sociopathy and Psychopathy

While psychopathy and sociopathy are not formal mental health diagnoses, a healthcare provider will identify these characteristics as a person's pattern of behavior.

Mental health professionals use the DSM-5 to do this. It defines each mental health condition, including antisocial personality disorder.

Children and adolescents who display early signs of antisocial personality disorder are often first diagnosed with conduct disorder—a condition characterized by a pattern of violating other people's rights and social norms or rules.

Behaviors can include:

• Lying and stealing
• Aggression to people and animals
• Destruction of property
• Serious violation of rules

Screening Tools

Various screening tools can be used to help identify sociopathic or psychopathic traits in people with ASPD. Some tools are made for specific age groups.

However, it is important to remember that these tools are not meant to take the place of a formal assessment by a licensed mental health professional.

Treatment of Sociopathy and Psychopathy

Psychotherapy may be recommended for individuals with these traits. In some cases, medications can help improve certain symptoms associated with antisocial personality disorder.

However, treating sociopaths and psychopaths is often difficult. This is primarily because they do not believe that there is anything wrong with them.

Psychotherapy

Psychotherapy is challenging and not very successful for the people traditionally labeled as sociopaths and psychopaths, mainly because they don't recognize a need to change their behavior and lack of other interpersonal skills.

In some cases, therapy can be helpful in changing certain behaviors. Psychotherapy may be more beneficial, though, when it begins before a person with psychopathic tendencies reaches adulthood.

Medication

There's no medication that directly treats sociopathy or psychopathy. However, drugs that were developed to treat other conditions, such as attention deficit hyperactivity disorder (ADHD) and mood disorders, can sometimes treat symptoms that might accompany these conditions.

Sociopathy and psychopathy may be treated with:

• Psychostimulants: These medications help treat behaviors such as hyperactivity and impulsiveness, and have been shown to reduce aggression in kids and young adults who have ADHD. Examples include Concerta (methylphenidate) and Adderall (dextroamphetamine).
• Antipsychotics: These drugs—such as Risperdal (risperidone)—are commonly used to treat mental health conditions such as bipolar disorder and schizophrenia. They can also reduce aggressive behaviors.
• Mood stabilizers: These medications, commonly prescribed for bipolar disorder, can sometimes decrease aggression and outbursts in people with psychopathy. Examples include Eskalith (lithium) and Depakote (divalproex).

Summary

There often is confusion about the distinction between the terms "sociopath" and "psychopath." Although characteristics of each are associated with the official diagnosis of antisocial personality disorder, psychopathy and sociopathy have somewhat different traits. Also, there has been confusion historically between the two terms and how the conditions they represent are perceived.

The term "sociopathy" is not a clinical term but is often used by people in the general public, while "psychopathy" is an aspect of ASPD.

Traditionally people viewed as sociopaths were considered being angry and hostile and psychopaths were seen as having charming, manipulative personalities.

A Word From Verywell

Having a relationship with a person who you suspect has antisocial personality disorder can be very challenging and might even be unsafe. Talking to a mental health professional can help you learn how to set boundaries and understand more about your loved one's condition.