Sociopathy Vs. Psychopathy: Understanding Key Differences

Medically reviewed by Julie Dodson, MA, LCSW
Updated October 18, 2024by BetterHelp Editorial Team

Terms like "sociopath" and "psychopath" are often used to describe certain objectionable behaviors, such as “sociopaths tend to have more violent tendencies” or “psychopaths don’t understand social norms.” While many people may be familiar with these terms, neither is a clinical diagnosis. "Psychopathic" and "sociopathic" are clinical descriptor words used to describe the symptoms of certain mental health conditions but can be seen as offensive when used to describe a person. 

Both psychopathic and sociopathic traits are listed under the diagnostic criteria for anti-social personality disorder (ASPD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Getty/AnnaStills
Sociopathy and psychopathy can be difficult to understand

Sociopath vs psychopath: Mental health conditions explained

While many people may use the terms "sociopath" and "psychopath" every so often, each term may be used differently in clinical terminology. Both sociopathy and psychopathy are descriptors for one diagnosis, anti-social personality disorder (ASPD). 

The terms psychopathy and sociopathy stem from different origins, however. 

According to an article published by Forbes Health, the term sociopathy was coined in the era of behaviorism between 1920 to 1950. Neuroscientist Dr. Ken Kiehl explains, "This term has not been used in modern science for several decades—for example, you cannot get funding from the National Institute of Health to study' sociopaths.'"

Psychopathy, while not considered an official diagnosis, is a term that is still utilized in psychology today to describe psychopathic behavioral symptoms that include a lack of emotion or callousness.

Both sociopathy and psychopathy fall under the clinical diagnosis of anti-social personality disorder (ASPD). In ASPD, many behavioral traits attributed to sociopathy and psychopathy overlap, but they may differ socially.

For example, the following are the differences between the two: 

  • Those with sociopathic traits may exhibit erratic or impulsive behaviors, while someone with psychopathic symptoms may act consistently or calculatedly.

  • Those exhibiting sociopathic traits may struggle to maintain work or interpersonal relationships, while those with psychopathic symptoms may be able to maintain both.

  • People with sociopathic symptoms may bond with like-minded individuals, while someone living with psychopathy may struggle to form genuine attachments.

  • Those with sociopathic traits may experience more guilt regarding their actions, while those with psychopathic traits may lack remorse.

It's often helpful to recognize that not all “sociopaths” or people diagnosed with ASPD exhibit the same traits or engage in the same behaviors. Individual experiences and expressions of the condition can vary widely.

How are other conditions like conduct disorder related to sociopathy and psychopathy?

Conduct disorder, characterized by persistent patterns of aggression, rule-breaking, and disregard for others' rights during childhood, is considered a precursor to the development of sociopathy and psychopathy in adulthood. Other mental health conditions, such as narcissistic personality disorder and borderline personality disorder, have overlapping traits with psychopathy and sociopathy, including manipulative or antisocial behaviors, trouble forming genuine emotional attachments, and a lack of empathy, though they may manifest differently in terms of behavioral traits, emotional instability, and identity disturbances.

According to the Canadian Journal of Psychiatry, anti-social personality disorder (ASPD) is characterized by a pervasive pattern of socially irresponsible, exploitative, and guiltless behavior, including risk-taking, lack of empathy, failure to conform to social norms, and difficulties with family life. ASPD is also associated with co-occurring mental health and addictive disorders, and experiences like sexual abuse may contribute to the development of the disorder. 

What is anti-social personality disorder?

While some can recognize the different traits between “sociopaths” and “psychopaths,” the overarching personality disorder that accompanies them is complex. An article published by the American Psychiatric Association states, "Anti-social personality disorder may be one of the most misunderstood mental disorders."

According to information provided by Merck Manuals, a medical reference guide, "estimates of how common anti-social personality disorder vary between 0.2% (one in 500) to a little over 3% of the general population in the United States." 

Additionally, the Merck Manuals website explains that the disorder is six times more common among cisgender men and less common in older age groups. This statistic suggests that people can learn to change their behavior over time. 

One symptom of anti-social personality disorder is a "persistent disregard for the rights of others." According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this persistent and pervasive pattern of disregard is described as follows:

  • Disregarding the law, such as committing acts that are grounds for arrest repeatedly

  • Pathological lying, deceiving others for personal gain, or using aliases

  • Impulsivity and failure to plan ahead

  • Consistent irresponsible behavior, such as failing to pay bills or quitting a job without the intention of getting another

  • Physical aggression or feeling easily provoked into violent behavior

  • Lacking remorse or experiencing feelings of indifference regarding the mistreatment of others

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Qualifications for an ASPD diagnosis 

Based on the information in the DSM-5, an individual must be at least 18 years old and meet at least three of the DSM-5 criteria to be diagnosed with ASPD. However, in his interview with Forbes, Dr. Kent Kiehl says, "the most utilized method to assess traits of a psychopath in clinical or forensic work is the Hare Psychopathy Checklist-Revised (PCL-R)." 

The PCL-R includes 20 items rated on a scale of zero to two based on how much their behavior matches the item's description. A mental health professional may then determine a score. Dr. Kiehl explains that this score can often be used to predict violence and other adverse outcomes. Additionally, it can be helpful in the exploration of potential treatments. The 20 items on the assessment include the following: 

  1. Glibness/superficial charm

  2. Grandiose sense of self-worth

  3. Need for stimulation

  4. Pathological lying

  5. Conning or manipulative behavior 

  6. Lack of remorse or guilt

  7. Shallow affect

  8. Callous or experiencing a lack of empathy

  9. A lifestyle of living off of others 

  10. Poor behavioral control

  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

These assessment items are looked at in eight groups. For example, the following four items are grouped together and sometimes excluded from analysis: promiscuous sexual behavior, many short-term marital relationships, revocation of conditional release, and criminal versatility. These may not apply to everyone – for example, an individual who has not exhibited criminal behavior would not have “revocation of criminal release” or “criminal versatility” relevant on their checklist. 

Despite common misconceptions, anti-social personality disorder may be treatable. According to Dr. Kiehl, "research work suggests progress in reducing negative outcomes in those who score high on these traits."

Note that many professionals believe that more research is needed for antisocial personality disorders (ASPD) and related conditions. For example, the study titled “Psychopathy in women: theoretical and clinical perspectives” was among the first of its kind in 2012 to take an in-depth look at these symptoms and how they manifest in women instead of men. 

Treatment options for antisocial personality disorder (ASPD)

Due to the stigma surrounding antisocial personality disorder and other personality disorders, effective treatments are not as readily available as treatments for more common mental disorders. The non-profit organization, PsychopathyIs, which advocates for further research of anti-social personality disorder suggests possible treatments, including the following: 

  • Individual and family-focused therapies

  • Residential treatment

  • Medication

Additionally, it is believed that anti-social personality disorder or psychopathy is more easily treated if noticed in early childhood. 

Getty/Vadym Pastukh
Sociopathy and psychopathy can be difficult to understand

Alternative counseling options 

If you recognize the traits of anti-social personality disorder in yourself or a loved one, a therapist or another mental health professional may be able to offer support. If you struggle to leave home or find support in your area, online talk therapy can also offer an outlet for support. Through online therapy, you can attend therapy under a nickname and choose between phone, video, or live chat sessions with your therapist.  

According to research, online therapy is equally effective as in-person therapy when treating common mental health conditions such as anxiety or depression. If you're looking for an internet-based therapist, you can sign up for a platform like BetterHelp to get matched with one of over 30,000 licensed therapists and counselors with specializations in various areas of mental health, including personality disorders. 

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Takeaway

In general vernacular, the terms sociopath and psychopath are typically used to describe people with undesirable traits and behaviors, however, they are not a clinical diagnosis in the field of psychology. Additionally, although psychopathy and sociopathy terms are often associated with mental health disorders, such as personality disorders, narcissistic personality disorder, and conduct disorder, the only officially recognized diagnosis for someone displaying sociopathic or psychopathic traits is anti-social personality disorder (ASPD). So, what can you do with this information? Well, for one, you can take the time to understand that not everyone is who they might appear to be on the outside. It goes to show that you can't judge a book by its cover, especially if that book happens to have a manipulative agenda. Remember, not every psychopath or sociopath is a vicious, cold-blooded killer. They are real people and human beings just like you. Likely, you may even be friends with one without even realizing it.
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