Sociopath vs. Psychopath: What Are the Differences?

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The terms "psychopath" and "sociopath" are often used interchangeably—and may be misused—to describe someone with anger issues.

Psychopath and sociopath are not diagnosable conditions. People who are sociopathic or psychopathic exhibit symptoms of antisocial personality disorder (ASPD), a recognized personality disorder in the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSM-5).

The DSM-5 is the handbook used by clinicians and psychiatrists to assess and diagnose mental health disorders. In it, ASPD is characterized by a pattern of disregard for consequences and for the rights of others.

Symptoms of ASPD often begin during childhood, although the condition is often not diagnosed until later in life.

This article covers the differences between the mental disorders psychopathy and sociopathy.

Psychologist holding clipboard with card sitting in front of patient listens his mental health complaints

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The Differences Between Sociopaths and Psychopaths

While psychopaths are classified as people with little or no conscience (a sense of right or wrong), sociopaths do have some ability to feel remorse. Both sociopaths and psychopaths have a persistent pattern of disregard for the safety and rights of others. Deceit and manipulation are central features of both types of personality disorder.

Sociopath
  • Lacks empathy

  • Has volatile behavioral patterns and is prone to rage

  • Uses intelligence, charm, or charisma to manipulate others

  • Displays impulsive behavior

  • Cannot maintain a consistent work and family life

Psychopath
  • Pretends to care


  • Is cold and calculating

  • Fails to recognize other people's distress

  • Has shallow relationships

  • Rarely feels guilt regarding behavior

Sociopaths understand that what they are doing is technically wrong, but they have rationalized their behavior in their own minds. Research has found that psychopaths understand the difference between right and wrong but do not care about the consequences of their morally inappropriate behavior.

Violence

When most people think of psychopaths, they think of serial killers or violent criminals. Violent outbursts may affect a small proportion of people with ASPD but it's a myth that all people with psychopathy are violent.

Causes

It's not known why some people develop antisocial personality disorder, but both genetics and traumatic childhood experiences, such as child abuse or neglect, may play a role.

Sociopathy

It's thought that nature plays more of a role in the creation of a psychopath than a sociopath. This is supported in part by a 2014 review of studies in which as many as one-third of people diagnosed with sociopathy essentially "give up" their antisocial behavior in later life and develop well-adjusted relationships.

Psychopathy

Psychopathy is believed to have genetic components. A well-regarded study suggests that psychopaths often have a history of an unstable family life and/or were raised in disadvantaged neighborhoods prone to violence. Many grew up with parents who were substance abusers who failed to provide parental guidance or attention.

Brain studies have also found that structures relevant for empathy are dysfunctional in people with psychopathic traits.

Prevalence of Antisocial Personality Disorder

According to the DSM-5, 0.2%–3.3% of U.S. adults have an antisocial personality disorder and the condition tends to affect men more than women.

Diagnosis

Psychopathy and sociopathy are not diagnosable conditions in the DSM-5, but there are diagnostic criteria for ASPD.

While the condition may begin in childhood, it cannot be officially diagnosed before the age of 18. To receive a diagnosis of ASPD, the person must show a pattern of at least three of the following seven traits:

  1. Doesn’t respect social norms or laws and consistently breaks laws or oversteps social boundaries
  2. Lies, deceives others, uses false identities or nicknames, and uses others for personal gain
  3. Doesn’t make any long-term plans and often behaves without considering the consequences
  4. Shows aggressive or aggravated behavior, consistently getting into fights or physically harming others
  5. Doesn’t consider personal safety or the safety of others
  6. Doesn’t follow up on personal or professional responsibilities, including repeatedly being late for work or not paying bills on time
  7. Doesn’t feel guilt or remorse for having harmed or mistreated others

People with ASPD may not realize that they have these behaviors. They may live their entire lives without a diagnosis.

The Psychopathy Test

While the term "psychopath" is not an official diagnosis, there are many online tests that claim to diagnose psychopathy. There is a test used for clinical, legal, or research purposes, which is called the Psychopathy Checklist–Revised (PCL-R).

It’s a 20-item inventory used to assess whether an individual exhibits certain traits and behaviors that could indicate psychopathy. It’s intended to be completed by a mental health professional during a semi-structured interview and a review of available records, such as police reports or medical information.

Narcissist vs. Sociopath

The words "narcissist" and "sociopath" are often used interchangeably, but narcissistic personality disorder (NPD) is an entirely different diagnosis than ASPD. According to the DSM-5, narcissists have an excessively heightened sense of importance, a strong need to be admired, or an entitlement to special treatment.

While there is some overlap between ASPD and NPD—and an individual can be diagnosed with both—there are some fundamental differences between these diagnoses.

Treatment

There is no set treatment or cure for ASPD, and the condition can be difficult to treat for a number of reasons.

People with ASPD rarely seek treatment on their own. Those who do may receive help only after some type of legal trouble. Treatment depends on each person's particular situation, their willingness to commit to treatment, and the severity of symptoms.

Psychotherapy

Cognitive behavioral therapy (CBT) can be useful in helping individuals gain insight into their behaviors and to change harmful thought patterns. To be effective, CBT needs to be practiced long term.

Group therapy and family therapy as well as mentalization-based therapy, which targets the ability to recognize and understand the mental state of oneself and others, have also been studied for ASPD. All show promise.

Medication

There are no medications specifically approved by the Food and Drug Administration to treat ASPD. However, medications may be prescribed to treat some of the symptoms experienced, including:

  • Antianxiety drugs
  • Antidepressants
  • Antipsychotics
  • Mood stabilizers

Coexisting Conditions

People with ASPD may have other associated conditions, such as:

They may also have characteristics that meet the diagnostic criteria for borderline, narcissistic, and histrionic personality disorders.

Frequently Asked Questions

What is antisocial personality disorder? 

Antisocial personality disorder (ASPD) is a condition characterized by a lack of empathy and regard for other people. People who have ASPD have issues with their conscience (sense of right or wrong). They often act insensitively or in an unfeeling manner. Individuals with this disorder may lie, engage in aggressive or violent behavior, and participate in criminal activity.

What are the traits of sociopathic and psychopathic behavior? 

A person with sociopathic and psychopathic behavior may:

  • Exploit, manipulate or violate the rights of others
  • Lack concern, regret, or remorse about other people's distress
  • Behave irresponsibly and show disregard for normal social behavior
  • Have difficulty sustaining long-term relationships
  • Be unable to control their anger
  • Lack guilt, or not learn from their mistakes
  • Blame others for problems in their lives
  • Repeatedly break the law

Is narcissism a symptom of sociopathy? 

No, narcissism is not a symptom of sociopathy. A person can be a narcissistic sociopath, but they must be diagnosed with aspects of both narcissistic personality disorder and antisocial personality disorder.

Is there a sociopathy test?

No, there is not a test to determine if someone has the characteristics of a sociopath. In order to diagnose sociopathy, a healthcare professional uses the diagnostic criteria for antisocial personality disorder in the DSM-5.

A Word From Verywell

Many people with ASPD do not seek help on their own, and intervention may only happen when they run into legal problems. There is no cure for ASPD, but treatment can help manage the condition.

And, fortunately, resources are available for everyone affected by this disorder. If you have a loved one who has ASPD, you may find it helpful to talk to a mental health professional yourself. A trained therapist can offer you coping skills that will help you set boundaries to protect yourself from harm. Group therapy and support groups may also be helpful resources of support and information.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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