Psychopathy Vs. Sociopathy: Exploring The Differences

Personality disorders can significantly influence how someone thinks, acts, and feels. While the media and popular culture use descriptions like sociopath and psychopath freely and interchangeably, both terms can be outdated. They may be better replaced by proper terminology for the psychiatric conditions they are associated with. 

What are personality disorders?

Personality disorders are mental health conditions involving fixed, unchanging thought, behavior, and emotion patterns that deviate from healthy or average personality standards. Researchers believe factors from multiple sources influence your personality, such as genetic traits, environmental concerns like home life and financial stability, personal experiences, and early childhood care consistency. 

Symptoms related to personality disorders may present during the adolescent or early adulthood years. While there could be a genetic component to personality disorders, their occurrence spans race, gender, culture, and socioeconomic status—anyone can experience them.  

"To be classified as a personality disorder, one's way of thinking, feeling and behaving deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time." — American Psychiatric Association (APA)

What are psychopathy and sociopathy?

While both psychopathy and sociopathy affect personality, as of the release of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), only psychopathy is a clinical term that is still used. 

Some view psychopathy as an extreme variant of antisocial personality disorder (ASPD), though it is listed as an abstract personality disorder in the DSM-5. It was a different condition in previous manual versions but was later included with antisocial personality disorder. As a result, approximately only one-third of the people diagnosed with ASPD meet the criteria for psychopathy. 

What was once known as "sociopathy" is now diagnosed under the antisocial personality disorder label. Sociopathy is considered an outdated and stigmatized term, so using it in a clinical or social setting often isn't correct. 

What is antisocial personality disorder (ASPD)?

Antisocial personality disorder is marked by behaviors involving a consistent indifference to traditional ideas of "right and wrong" or regularly disregarding other people's feelings, needs, or personal rights in pursuit of individual enjoyment or achievement. 

People with ASPD may intentionally anger or upset others, take pleasure from manipulation, and show no regret or remorse over their actions, even if they hurt someone. They may partake in illegal actions due to disregarding rules and believing they are above societal norms. These people may have once been labeled with sociopathy but are now considered people with ASPD.  

Psychopathy

While not a diagnosable mental health disorder by itself, psychopathy is characterized by diagnostic features like intentionally dangerous or violent behavior, poor self-control, and difficulty feeling guilt, shame, or remorse. People with this trait may have a lack of conscience and believe they do not need to follow moral or social conventions. However, they may adapt and pretend when it suits their needs. Some serial killers and mass murderers were later diagnosed with psychopathic traits. However, this statistic doesn't necessarily mean everyone with psychopathic traits is a criminal.  

Psychopathy vs. ASPD 

While there can be similarities between psychopathy and ASPD, the two have critical differences. Below are a few of the symptoms to keep in mind.  

Psychopathy

According to a study on psychopathy, "A great deal of research suggests that the core, precipitating features of psychopathy are developmental in nature, with relatively persistent traits becoming apparent before the age of ten. Furthermore, it seems these traits are predicated by significant genetic risk factors." 

Below are a few of the common symptoms or signs of psychopathy:

• Cold, calculated behavior
• A tendency toward violent criminal acts
• Appearing to maintain a "normal" life as a cover for illegal or harmful activity 
• Pretending to care and mimicking expected behaviors or reactions
• Difficulty recognizing distress in others 
• Superficial charm
• High intelligence
• Poor judgment and failure to learn from experiences
• Grandiose sense of self-worth
• Pathological egocentricity and lying
• Lack of guilt, remorse, or shame
• Promiscuous sexual behavior
• Poor self-control
• Manipulative behavior
• Juvenile delinquency
• No conscience
• A belief that all of one's actions are justified 

ASPD  

People with ASPD have a personality disorder. People with psychopathic traits may not be living with a personality disorder. Below are a few of the most common symptoms of ASPD:

• Disregard for societal norms of right and wrong
• Lying to manipulate others or take advantage
• Insensitive or outright disrespectful of others' feelings or ideas
• Believing one is superior to nearly all others 
• Considering few or no people as equals 
• Personal or legal troubles due to behavior
• Hostility, aggressiveness, violence, or threatening behavior 
• Difficulty maintaining steady employment
• Blaming others or making excuses for behavior
• Willingness to use others for personal gain
• Weak or absent guilt or remorse over hurting others
• A disregard for personal safety or the well-being of others 
• Attempts to justify one's unhealthy actions 

Differences and similarities between psychopathy and ASPD

Antisocial personality disorder and psychopathy may have similarities, including personality characteristics, behavioral tendencies, and adverse childhood experiences. Psychopathy may be a symptom of ASPD in some cases. However, there are a few differences in the presentation of both challenges and how they affect a person's behavior, emotions, or thought patterns, including the following. 

Relationships with others

People with ASPD can form close relationships with others, but the task may be challenging, and maintaining contact with behavioral symptoms can be difficult for them. Those with psychopathic traits often form shallow, fake connections with others and keep everyday life as a cover for criminal activities. They often pretend to be someone else in relationships and can be highly charming. They may appear completely "normal" to someone else, and people may claim they didn't "expect" the behavior of the psychopathic individual when it is revealed. 

An intention to cause harm

While not all people displaying psychopathy are violent, they may intend to cause harm and can also self-harm in response to their emotions. Research suggests that the more socially isolated and sad a person with psychopathic characteristics feels, the higher the risk of violent, impulsive, or reckless behavior. People with ASPD often go out of their way to partake in manipulation and may react with anger or violence if someone doesn't comply. However, they might not seek to harm others. Both people with psychopathic traits and people with ASPD often lack remorse. 

Behavior patterns

People with psychopathic traits may display unkind actions and motivations with a detached, calculated tendency toward behaviors. People with ASPD may be more likely to behave impulsively or erratically without considering how their actions will affect others. 

Social behaviors 

Someone whose actions can be described as psychopathic may pretend to care about others' feelings, while people with ASPD may let others know how they feel or think. Both types of people may experience genuine love and emotional connection but struggle to show it healthily. People with ASPD may have trouble maintaining functional employment, whereas people with psychopathic traits may be charming and social and function well in the workplace. 

Treatments for ASPD and psychopathy 

While there is no cure for psychopathy or ASPD, therapy can often manage symptoms. Working with a licensed therapist can help individuals examine their behavior and thought patterns to reinforce positive traits and reshape harmful tendencies. Treatment may center on addressing problematic behaviors, building practical coping skills, and targeting comorbidities like substance use disorders. 

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Some popular therapeutic modalities for personality disorders may include the following: 

• Cognitive-behavioral therapy (CBT)
• Individual or group psychotherapy
• Mentalization-based therapy (MBT)
• Medications such as antidepressants, mood stabilizers, or antipsychotics
• Counseling for an impulsive lifestyle
• Dialectical behavior therapy (DBT) 

Consult a doctor for support and management before starting, changing, or stopping a medication. 

When to reach out for help

It may be beneficial to reach out to a mental health provider if you notice the symptoms of psychopathy or ASPD in yourself or someone you love. While neither condition has a cure, some people find substantial symptom relief with treatment. 

If you face barriers to in-person therapy or don't want others to see where you're going for treatment, you can also try online therapy through a platform like BetterHelp. Internet-based treatments are often more cost-effective, involve shorter wait times, and provide flexible appointment formats, so the support and guidance of a mental health professional can be more reachable.  

According to a 2020 study, online therapy can be as effective as in-person treatments for people with personality disorders. The study participants reported that the physical separation from the therapist made divulging personal details easier, and others praised the convenience of receiving treatment from home because it made reliable attendance possible.