Sociopath vs. Psychopath: What's The Difference? (2023)

Today, both psychopathy and sociopathy may be used as terms implying an antisocial personality disorder, the official diagnosis for an individual displaying the traits of either term. While there is much overlap between psychopathy and sociopathy, they are not one and the same.

What Is a Sociopath?

The term sociopathy was coined in the era of behaviorism between 1920 to 1950 as a primary psychological theory, but it has since fallen out of use. “This term has not been used in modern science for several decades—for example, you cannot get funding from the National Institute of Health [NIH] to study ’sociopaths,'” says Kent Kiehl, Ph.D, a neuroscientist studying brain imagine, criminal psychopathy and other psychotic disorders in Albuquerque, New Mexico.

When the term was still in use, it was believed that people were born as blank slates and subsequently shaped by their environment or social forces, ultimately resulting in a good or bad personality, says Kiehl. However, this view was determined to be incorrect and, as focus shifted to increasing accuracy and reliability in diagnosis, the term “sociopathy” was dropped from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) about 20 years ago.

What Is a Psychopath?

Even though the term is not an official diagnosis per the DSM-5, psychopathy remains a term in psychology today to indicate individuals who display high levels of unemotionalism or callousness, as well as impulsiveness or developmental antisocial traits, such as destructive or aggressive behavior.

Symptoms of psychopathy generally appear in early childhood and impact all areas of an individual’s life, including relationships with family, friends, at school and at work. About 1.2% of the adult population has psychopathy, according to a 2021 study in Frontiers of Psychology^[1]Sanz-García A, Gesteira C, Sanz J, García-Vera MP. Prevalence of Psychopathy in the General Adult Population: A Systematic Review and Meta-Analysis. Front Psychol. 2021;12:661044. . Those with psychopathy tend to display antisocial behaviors, such as a lack of empathy and disregard for the well-being and emotions of others, which can negatively impact relationships both personally and professionally as they struggle to connect and trust the world around them.

The traits of a psychopath and a sociopath are “the same,” according to Kiehl, with both falling under the clinical diagnosis of antisocial personality disorder.

However, in terms of social construction, the two terms are viewed somewhat differently. Specifically:

• Sociopaths tend to act more impulsively and erratically compared to psychopaths.
• Sociopaths generally struggle to maintain a job or a family life, whereas psychopaths may be able to do so.
• While psychopaths generally struggle to form attachments, sociopaths may be able to do so with a like-minded individual.
• Psychopaths may be better able to disassociate from their actions and experience less guilt than sociopaths.

In order for a patient to be diagnosed with antisocial personality disorder, they must display a “persistent disregard for the rights of others,” according to the DSM-5 clinical criteria as listed in the Merck Manual, a medical reference guide. This disregard is indicated by the presence of three or more of the following traits:

• Disregarding the law (such as committing acts that are grounds for arrest repeatedly)
• Acting in a deceitful manner (lying repeatedly, deceiving others for personal gain or using aliases)
• Being impulsive or failing to plan ahead
• Acting irresponsibly on a consistent basis (quitting a job without plans to get another or failing to pay bills)
• Being easily provoked or aggressive (frequently getting into physical fights)
• Failing to feel remorse (feeling indifferent to or rationalizing the mistreatment of others)

However, the most utilized method to assess traits of a psychopath in clinical or forensic work is the Hare Psychopathy Checklist-Revised (PCL-R), says Kieh. The assessment can be used to predict violence and other negative outcomes, as well as explore treatment potential.

The assessment includes 20 items on which individuals are rated on a scale of zero to two based on how much their personality or behavior matches the item’s description. This results in two primary scales—one to measure emotional detachment and one for antisocial behavior—which combine for a total score. The highest score an individual can get on the PCL-R is 40, and a score of at least 30 is needed for someone to be classified as a psychopath.

Items on the assessment include:

1. Glibness/superficial charm
2. Grandiose sense of self-worth
3. Need for stimulation
4. Pathological lying
5. Conning/manipulative
6. Lack of remorse or guilt
7. Shallow affect
8. Callous/lack of empathy
9. Parasitic lifestyle
10. Poor behavioral controls
11. Promiscuous sexual behavior
12. Early behavioral problems
13. Lack of realistic, long-term goals
14. Impulsivity
15. Irresponsibility
16. Failure to accept responsibility
17. Many short-term relationships
18. Juvenile delinquency
19. Revocation of conditional release (meaning someone was granted a conditional release from prison and that release has been revoked.)
20. Criminal versatility

While sociopathy—when the term was still in use—was a disorder believed to stem from a person’s environment, psychopathy is believed to arise mostly from biology and genetics with some environmental influence, though research on psychopathy’s causes is ongoing.

“There’s a lot of current research examining how biology/social forces interact and contribute to the development of psychopathic traits,” says Kiehl. “We generally review ‘primary’ psychopathy as coming from a larger biology/genetic component, contrasted with ‘secondary’ psychopathy, which is hypothesized to come from more social forces (such as bad parenting or perhaps trauma as a child) contributing more than biology.”

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There are a number of risks associated with psychopathy. Indeed, psychopathy is “one of the best predictors of future violence that we know of,” Kiehl notes. Although not all people with psychopathy are physically violent, studies find that while psychopaths account for less than 1% of the general population, they are responsible for between 30% and 50% of all violent crimes^[2]Reidy DE, Kearns MC, DeGue, S. Reducing psychopathic violence: A review of the treatment literature. Aggress Violent Behav. 2013 ; 18(5): 527–538. .

Still, psychopathy does increase a person’s tendency toward antisocial and aggressive behavior, which can manifest in various ways in school, the workplace and social situations. “Interpersonal relationships are also highly prone to failure,” Kiehl notes.

An affected individual struggles to form trusting bonds and tends to manipulate others and engage in antisocial behaviors, all of which can pose challenges to forming positive interpersonal relationships. That being said, how a person with psychopathy ultimately behaves varies based on the individual, their environment and their community.

Despite common misconceptions about the disorder, psychopathy can be treatable. “Research work suggests good progress in reducing bad outcomes in those who score high on these traits,” Kiehl says.

Possible approaches to treating psychopathy, according to the non-profit organization PsychopathyIs, may include:

• Individual and family-focused therapies
• Residential treatment
• Medication

In general, the organization states that “the most successful approaches to treating psychopathy are multimodal,” meaning they include a number of approaches simultaneously.

Kiehl also emphasizes the importance of addressing issues early. Specifically, factors parents may look for include a lack of guilt, low levels of empathy, fearlessness, a tendency towards deceitfulness and low affiliative behaviors, which are generally those that promote human connection, such as smiling and nodding.

“Generally, the earlier you curb bad tendencies, monitor, prevent consolidation of bad behaviors, etc., the more likely you will prevent the full manifestation of the condition,” he says. “Educating parents is important, [as] it will help to train parents on how to use positive reinforcement, minimize negative reinforcement (it doesn’t work) and help to promote positive outlets.”