Antisocial Personality Disorder Vs. Psychopathy: How Do They Differ?
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-V). ASPD was added to the DSM in 1980, but psychiatrists and psychologists have been noting the symptoms since the 1800s.
Because of their disregard for people's rights, people with ASPD may break the law and end up in prison. 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.
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 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. 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-V. However, many experts describe psychopathy as if it is 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.
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.
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.
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
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 that 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. In 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.
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.
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.
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