Antisocial Personality Disorder Vs. Psychopathy: Mental Health Differences
Antisocial personality disorder (ASPD) and psychopathy are both psychological phenomena that typically involve a person engaging in destructive behavior, manipulating others for their own gain, and experiencing a lack of empathy. Often, these terms arise in the context of criminal behavior, since experiencing either can lead a person to disregard the rights of others and the law.
The two phenomena often overlap, but according to some experts, they also have differences. Antisocial personality disorder can be defined as a diagnosable personality disorder that a person may have for many years of their life. Meanwhile, psychopathy is generally viewed as a set of symptoms or personality traits, and it is not currently one of the diagnosable mental disorders. While individuals experiencing ASPD or psychopathy may not always be inclined to seek professional support, therapy may be helpful.
What is antisocial personality disorder?
Antisocial personality disorder (ASPD) is a personality disorder usually involving a long-term pattern of disregarding and violating others' rights. Most people who have the disorder begin showing symptoms in childhood or adolescence. Antisocial personality disorder is one of the personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). ASPD was added to the DSM in 1980, but psychiatrists and psychologists have been noting the symptoms since the 1800s. ASPD is recognized as a mental health issue that can deeply impact families, communities, and social systems.
Because of their disregard for people's rights, people with ASPD may break the law and end up in prison. Violent behavior is common in more extreme cases. Examples of violating others' rights can include destroying property, stealing, and acting aggressively toward people or animals. Because of these types of behaviors, people with ASPD often have rocky romantic relationships and an unstable family life. Since they are prone to using people for personal gain, they are often unable to successfully maintain healthy, long-term relationships.
Researchers have found that both genetics and childhood experiences may contribute to ASPD. About 20% of people who have antisocial personality disorder also have a first-degree relative with the disorder. Mental health disorders among a person's parents may increase their risk of developing ASPD. Similarly, parental neglect or abuse appears to make developing the disorder more likely. This can then become a negative family cycle, as someone who has ASPD may go on to abuse their children.
Some experts argue that ASPD is one of the two disorders most linked to criminal tendencies, especially in forensic psychology.
Diagnostic criteria
To be diagnosed with antisocial personality disorder, a person must first meet the following criteria:
A long-term pattern of disregarding and violating the rights of others, which began by age 15 and has been present in multiple contexts
Next, a person with antisocial personality disorder also must meet three or more out of the following seven criteria:
- Not conforming to social norms or lawful behavior and engaging in activity that is grounds for arrest
- Repeatedly lying, using fake names, or conning others for their own benefit
- Acting impulsively or failing to plan
- Acting irritably and aggressively, which may lead to getting into fights or committing assault
- Recklessly disregarding the safety of themselves or others
- Being consistently irresponsible and failing to engage in long-term productive work or honor financial obligations
- Lacking remorse for the times they have mistreated or stolen from another person
A person must be at least 18 years old to be diagnosed with ASPD. Their behavior must be pervasive and not only arise while a person is symptomatic with schizophrenia or bipolar disorder. Psychotic schizophrenics are often misdiagnosed due to overlapping behavioral symptoms. If a person shows similar symptoms before age 18, they are often diagnosed with conduct disorder. Many people with antisocial personality disorder had conduct disorder as children or teens, but not all. When a person develops antisocial behaviors for the first time in adulthood, they may be described as having adult antisocial personality disorder.
What is psychopathy?
Psychopathy generally refers to a set of symptoms or personality traits that involve disregarding the rights of others. Around 1% of the general population displays psychopathic traits, but up to 25% of people in prison do. Currently, psychopathy isn't an official diagnostic category in the DSM-5. However, many experts describe psychopathy as if it were a personality disorder. Some experts use the terms "psychopathic personality disorder" or "sociopathic personality disorder" to describe psychopathy, even though these are not diagnosable mental health conditions. Experts continue to debate whether psychopathy should be reclassified as a distinct mental health disorder in future versions of the DSM.
Psychopathy is often viewed as a personality disorder because it involves long-standing aspects of a person's personality. People who experience psychopathy tend to lack empathy for others. They may also lack a conscience telling them what is right and wrong. Instead, the primary motivator of someone with psychopathy is usually personal gain, regardless of whether it's at the expense of others. This forms a classic comparison in criminal psychology literature. Though not officially recognized, psychopathy is often discussed alongside other mental health conditions due to its impact on behavior and relationships.
People who can be described as having psychopathy tend to manipulate others, often by frequently lying or using charm. Some experts point out that while people with psychopathy tend to be more likely to end up in prison, some also go another route, using their traits to become very successful business people or executives. Not everyone with psychopathy is aggressive. Instead, they may become immensely charming or learn to mimic emotions they don't necessarily experience themselves, then use those to manipulate others to their benefit. These traits can sometimes be tied to an obsessive trait related to control or dominance.
Psychopathy checklist
Since psychopathy doesn't have explicit diagnostic criteria in the DSM-V, experts often use the Hare Psychopathy Checklist to identify the personality traits associated with psychopathy. This checklist contains 22 items, and each item is given a score of zero, one, or two, with zero meaning the trait is "definitely not present" and two meaning it is "definitely present." A person can score between zero and 44 on the checklist, and the higher one's score, the more psychopathic traits they can be said to possess. Here are descriptions of the 22 items on the checklist:
- Superficial charm
- Previous diagnosis of psychopathy or something similar
- Overblown sense of self-worth
- Low tolerance for frustration or boredom
- Pathological lying
- Lack of sincerity or tendency to con people
- Lack of guilt or remorse
- Lack of emotional depth
- Lack of empathy
- Tendency to use others
- Tendency to become angry easily
- Sexual promiscuity
- Behavior problems early in life
- Lack of long-term plans or unrealistic plans
- Impulsivity
- Irresponsible parenting behavior
- Multiple marriages
- Juvenile delinquency
- Probation or parole risk
- Inability to accept responsibility for one's actions
- Multiple legal offenses
- Behaviors don't stem from substance or alcohol use
Similarities between antisocial personality disorder and psychopathy
Disregard for people’s rights: Commonality in antisocial personality disorder vs. psychopathy
Officially, psychopathy is currently defined as a set of personality traits or symptoms that people have to varying degrees. Often, people with antisocial personality disorder tend to have many psychopathic traits.
The largest commonality between antisocial personality disorder and psychopathy is usually a disregard for other people's rights. People with ASPD or psychopathy tend to lack empathy, which can lead them to engage in behaviors that hurt others. When they hurt others, they tend to lack guilt or remorse. As a result, both ASPD and psychopathy can majorly damage a person's ability to maintain healthy, long-term relationships.
Many experts believe that both antisocial personality disorder and psychopathy exist on a spectrum. This means that some people may have low levels of antisocial or psychopathic tendencies, while others may be at the more extreme end and have these factors dominate their personalities and lives.
Differences between antisocial personality disorder and psychopathy
As with the similarities, the differences between antisocial personality disorder and psychopathy aren't agreed upon by all experts. Some experts argue that there are no differences, and these terms describe the same mental illness, while others view them as distinct mental illnesses.
Experts who claim psychopathy is a personality disorder distinct from antisocial personality disorder argue that ASPD primarily involves a person's behaviors, while psychopathy involves their personality traits. From this point of view, ASPD can be identified by a person's tendency to break the law, lie, or act aggressively, while psychopathy can be characterized by a chronic lack of empathy and remorse. This theory could help explain why some people who rate high in terms of psychopathy do not break the law or act aggressively—they might be primarily concerned with meeting their own needs and disregard the feelings of others, but might not decide to do so through illegal or aggressive means. This distinction is one reason psychopathy is often described as unlike ASPD in emotional regulation.
Remote therapy for antisocial personality disorder
People experiencing traits or symptoms associated with antisocial personality disorder are often uninterested in receiving treatment. However, they may decide to seek treatment at the request of others or if the results of their actions have led to stress or other mental health concerns.
Treatment options for antisocial personality disorder usually involve medication and therapy. People with antisocial traits interested in therapy may prefer remote therapy, as it provides the option of receiving treatment from the location of their choice. BetterHelp is one remote therapy platform that can match people with the best therapist for their needs.
Efficacy of online therapy on antisocial behaviors
Researchers haven't directly studied the effect of remote therapy on antisocial behaviors or traits, and the research on ASPD and therapy in general is limited. A 2020 review of 19 studies concluded that there's "limited evidence available" on therapy for antisocial personality disorder. However, three of the studies reviewed found that therapy helped reduce symptoms among people with antisocial personality disorder. According to the Brazilian Journal of Psychiatry, the field needs more research into long-term outcomes for the treatment of personality disorders. Some clients also seek professional help to better understand co-occurring medical conditions that influence behavior and treatment success. Remote therapy may offer a more accessible path for individuals hesitant to engage with traditional mental health services.
Takeaway
Is an antisocial personality disorder the same as a psychopath?
Many people confuse antisocial personality disorder (ASPD) with psychopathy, but they're not identical. A clinical diagnosis of antisocial personality disorder (ASPD) is based on repeated violations of others' rights, while "psychopath" is more of a behavioral description. The Hare Psychopathy Checklist helps assess whether someone fits traits often linked to people with psychopathy. Both can involve aggressive and antisocial behavior, but not everyone with antisocial personality disorder (ASPD) shows a complete lack of empathy. Some researchers argue there's a lot less intentional harm in ASPD than what is portrayed in movies. The American Psychiatric Association doesn't recognize "psychopath" as a formal label, even though it overlaps with antisocial personality disorder (ASPD).
What is the difference between BPD and antisocial personality disorder?
Bipolar personality disorder (BPD) involves emotional swings and unstable self-image, while antisocial personality disorder (ASPD) includes rule-breaking and disregard for others. Both can involve impulsive behavior, but for different reasons. People with ASPD may also struggle with impulse control. Clinical psychologists examine long-term behavior to distinguish between them. Talk therapy can help manage symptoms. Mental health professionals consider trauma and environment during diagnosis.
What is the difference between antisocial personality disorder and narcissism?
While both involve a lack of empathy, the goals are different. People with narcissism seek admiration; those with ASPD tend to violate others’ rights. One trait common to both is difficulty forming relationships that are healthy and mutual. Psychopathic behavior may appear calm and calculated, unlike the more emotionally reactive narcissist. Some people with psychopathy are also charming, making it harder to spot warning signs. Treating either condition means looking into underlying issues like trauma, neglect, or emotional invalidation. These can become complicated versions of other psychiatric disorders.
Is personality disorder the same as psychopathy?
No. Psychopathy is considered a pattern of traits, while personality disorders are a broader clinical category. Research shows that these terms are often confused, but they aren’t used interchangeably in treatment. Certain mental health conditions are diagnosed using detailed interviews and checklists like the Hare Psychopathy Checklist-Revised. Traits like manipulation, shallow emotions, and lack of remorse are among certain symptoms linked to people with psychopathy. Understanding these helps professionals plan long-term care, especially to manage symptoms of overlapping disorders.
What is the hardest mental illness to live with?
That depends on the individual. Some struggle most with mental health conditions like bipolar disorder or schizophrenia. A person experiencing a psychotic episode may feel disconnected from reality. For others, problems differentiating reality make day-to-day life confusing and scary. Many people diagnosed with mood or personality disorders face stigma that adds to the challenge. It often takes the right support, a clear diagnosis, and time to learn how to cope. Mental health experts note that violent behavior in extreme cases may escalate the risk for harm.
Can people with ASPD love?
Some people assume those with antisocial personality disorder (ASPD) are incapable of love, but it’s more nuanced than that. While emotional connection may be limited, people with psychopathy can still form attachments, though they may not be typical. Difficulties with trust and empathy often hinder the formation of stable, loving relationships. Some individuals with ASPD receive support through mental health services, which help them explore emotional bonds in healthier ways. The ability to love may depend on early environment, personal insight, and ongoing support from mental health professionals.
Why is psychopathy not considered a mental illness?
Though it sounds like one, psychopathy isn't officially listed as a separate disorder by the American Psychiatric Association. Instead, it's grouped under antisocial personality disorder (ASPD), which reflects a broader set of behaviors. Some experts argue that psychopathy doesn't reflect mental health dysfunction in the same way as depression, anxiety, or other personality disorders. It tends to be more about personality traits than mood or thought disorders. Even so, some people with psychopathy seek help from mental health systems when distress, sensory perceptions, and emotional dysregulation become unmanageable. This distinction may affect personality development over time.
What famous person has antisocial personality disorder?
Some public figures are suspected of having antisocial personality disorder (ASPD), but no confirmed diagnosis exists without medical records. Professionals avoid labeling individuals without a thorough evaluation using assessment instruments.
People often cite serial killers like Ted Bundy, John Wayne Gacy, and Jeffrey Dahmer as examples. However, these cases lack clinical confirmation. Speculation in documentaries and biographies isn’t reliable. These claims can spread myths about mental health. Instead of guessing, researchers study the general population to understand how ASPD traits relate to success or notoriety. There’s often not enough evidence to make a formal diagnosis.
What is the main difference between a psychopath and a sociopath?
The distinction between psychopathic behavior and sociopathy mostly lies in emotional control and planning. Sociopaths tend to act out impulsively, while psychopathic behavior is more calculated. Some experts believe environmental factors may play a bigger role in sociopathy, whereas psychopathy might have stronger biological roots. Neither is a formal diagnosis, but both fall under the larger umbrella of mental health concerns. Learning how these traits form is a focus of comprehensive psychiatry and related fields. Criminal activity is more common among sociopaths, according to several studies.
Can psychopaths fall in love?
There’s no clear answer. Some people with psychopathy report feeling attachment, but it may not resemble typical love. Their relationships often lack empathy and depth, which can cause harm. Mental health professionals, clinical psychologists, and experts warn against assuming that all people with psychopathy are incapable of love. Some studies show people suffer from emotional emptiness, even if they hide it. Other research suggests differences in sensory perceptions linked to bonding and connection. Sometimes, they also present symptoms that don’t meet full diagnostic criteria but still cause disruption in someone’s life.
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