You may have heard people call someone else a “psychopath” or a “sociopath.” But what do those words really mean?
You won’t find the definitions in mental health’s official handbook, the Diagnostic and Statistical Manual of Mental Disorders. Doctors don’t officially diagnose people as psychopaths or sociopaths. They use a different term instead: antisocial personality disorder.
Most experts believe psychopaths and sociopaths share a similar set of traits. People like this have a poor inner sense of right and wrong. They also can’t seem to understand or share another person’s feelings. But there are some differences, too.
Do They Have a Conscience?
A key difference between a psychopath and a sociopath is whether he has a conscience, the little voice inside that lets us know when we’re doing something wrong, says L. Michael Tompkins, EdD. He’s a psychologist at the Sacramento County Mental Health Treatment Center.
A psychopath doesn’t have a conscience. If he lies to you so he can steal your money, he won’t feel any moral qualms, though he may pretend to. He may observe others and then act the way they do so he’s not “found out,” Tompkins says.
A sociopath typically has a conscience, but it’s weak. They may know that taking your money is wrong, and they might feel some guilt or remorse, but that won’t stop their behavior.
Both lack empathy, the ability to stand in someone else’s shoes and understand how they feel. But a psychopath has less regard for others, says Aaron Kipnis, PhD, author of The Midas Complex. Someone with this personality type sees others as objects he can use for his own benefit.
They’re Not Always Violent
In movies and TV shows, psychopaths and sociopaths are usually the villains who kill or torture innocent people. In real life, some people with antisocial personality disorder can be violent, but most are not. Instead they use manipulation and reckless behavior to get what they want.
“At worst, they’re cold, calculating killers,” Kipnis says. Others, he says, are skilled at climbing their way up the corporate ladder, even if they have to hurt someone to get there.
If you recognize some of these traits in a family member or coworker, you may be tempted to think you’re living or working with a psychopath or sociopath. But just because a person is mean or selfish, it doesn’t necessarily mean they have a disorder.
Sociopath is a term people use, often arbitrarily, to describe someone who is apparently without conscience, hateful, or hate-worthy. The term psychopath is used to convey a sociopath who is simply more dangerous, like a mass murderer.
Although sociopath and psychopath are often used interchangeably and may overlap, each has its own clear lines of distinction. For example, sociopathy is the unofficial term for antisocial personality disorder (APD), while psychopathy is not an official diagnosis and is not considered an APD.
Click Play to Learn the Difference Between Psychopaths and Sociopaths
This video has been medically reviewed by Rachel Goldman, PhD, FTOS.
Differences Between Sociopath vs. Psychopath
Psychopaths are classified as people with little or no conscience but are able to follow social conventions when it suits their needs. Sociopaths have a limited, albeit weak, ability to feel empathy and remorse. They’re also more likely to fly off the handle and react violently when confronted by the consequences of their actions.
Make it clear they do not care how others feels
Behave in hot-headed and impulsive ways
Prone to fits of anger and rage
Recognize what they are doing but rationalize their behavior
Cannot maintain a regular work and family life
Can form emotional attachments, but it is difficult
Pretend to care
Display cold-hearted behavior
Fail to recognize other people’s distress
Have relationships that are shallow and fake
Maintain a normal life as a cover for criminal activity
Fail to form genuine emotional attachments
May love people in their own way
Willem H.J. Martens argues in his infamous article “The Hidden Suffering of the Psychopath” that psychopaths do at times suffer from emotional pain and loneliness. Most have lead hurt-filled lives and have an inability to trust people, but like every human being on the planet, they, too, want to be loved and accepted.
However, their own behavior makes this extremely difficult, if not impossible, and most are aware of this. Some feel saddened by the actions they are unable to control because they know it isolates them from others even more.
Approach to Violence
While it’s common to think of sociopaths and psychopaths as being inherently dangerous, this is more a construct of a TV drama than a true reflection of the disorder. Violence, while certainly possible, is not an inherent characteristic of either sociopathy or psychopathy.
With that being said, people with APD will often go to extraordinary lengths to manipulate others, whether it be to charm, disarm, or frighten them, in order to get what they want. When psychopaths do become violent, as in the case of Jeffrey Dahmer, they’re just as likely to hurt themselves as others.
Martens notes that the more a psychopath feels socially isolated, sad, and alone, the higher his or her risk for violence and impulsive and/or reckless behavior.
Origins and Development
There are some who say that “sociopaths are made and psychopaths are born,” but this characterization may be too far broad. Although it is true that psychopathy is believed to have genetic components (perhaps caused by the underdevelopment of the parts of the brain that regulate emotion and impulsiveness), there are clearly other factors that contribute to the behavioral disorder.
A well-regarded study into psychopathy suggested that psychopaths often have a history of an unstable family life and/or were raised in poorer neighborhoods prone to violence. Many have had parents who were substance abusers and who failed to provide parental guidance or attention.
This typically translates to unstable and failed relationships in adulthood and a fixated sense that you have been “robbed” of opportunities and advantages afforded to everyone else. Sociopathy also tends to be associated with harmful childhood experiences, including sexual abuse, physical violence, or parental instability.
Sociopaths have a conscience, albeit a weak one, and will often justify something they know to be wrong. By contrast, psychopaths will believe that their actions are justified and feel no remorse for any harm done.
This differentiation may suggest that nature plays more of a role in the creation of a psychopath than a sociopath. This is supported in part by a 2014 review of studies in which as many as a third of people diagnosed with sociopathy essentially “give up” their antisocial behavior in later life and develop well-adjusted relationships.
The Diagnostic and Statistical Manual of Mental Disorders (DSM) classifies APD by a range of personality and behavioral traits that describe how a person functions, how they relate to others, and how those beliefs express themselves by actions.
Self-functioning characteristics are those that reflect what a person is like and how that person views his or her actions or goals. In order to be diagnosed with APD, you must exhibit all of the following characteristics:
- Attaining self-esteem from power, personal gain, or pleasure
- Egocentricity or self-centeredness
- Setting goals based on personal gratification with little regard to law or ethics
Interpersonal characteristics are those that describe how a person interacts with others in general. You must also exhibit these traits to be diagnosed with APD:
- A lack of empathy for other people’s suffering or hurt or when confronted with the hurt or anger of people they have manipulated
- The inability to have a truly mutually emotionally intimate relationship because of the instinct to control (by dominance or intimidation), coerce, or deceive
Behavioral characteristics complete the clinical diagnosis by describing the route a person will take to either control, coerce, or deceive, such as:
- A strong tendency to disregard commitments, promises, and agreements, including financial ones
- Difficulty in making plans, preferring to believe you’re able to nimbly navigate problems as they appear
- It is not uncommon for someone with APD to be in repeated fights or assaults.
- Lying as a means to gain social entry or advantage, such as proclaiming yourself a decorated war hero when you have never served
- Making decisions on the spur of the moment with little regard to consequence if an immediate goal is to be achieved
- Persistent anger or irritability, even over small things, as well as mean, spiteful behavior
- Reacting with callousness, aggression, remorselessness, or even sadism when confronted by the fallout of your actions
- Risk taking, becoming easily bored, and an ability to ignore personal boundaries and justify even the most outrageous of actions
- The emotional manipulation of others—for example, pretending to be interested in someone simply to achieve a goal
APD has no cure or first-line recommended treatment. Instead, therapeutic strategies often focus on problematic behavior, coping skills, and comorbidities such as substance use disorders. Typical approaches include:
- Talk therapy (individual and group)
- Cognitive behavioral therapy (CBT)
- Mentalization-based therapy (MBT)
- Democratic therapeutic community (DTC)
- Impulsive lifestyle counseling
- Medications (antidepressants, antipsychotics, mood stabilizers)
Psychopaths and Sociopaths vs. Narcissists
Despite common usage and some overlap of features, not all people with narcissism are sociopaths/psychopaths, and not all sociopaths/psychopaths are narcissists.
Sociopathy falls under the classification of antisocial personality disorders, which are marked by ”a pervasive pattern of disregard for, and violation of, the rights of others.” In contrast, narcissism is a distinct personality disorder.
However, DSM-V classifies both antisocial and narcissistic personality disorders as cluster B personality disorders, a category that also comprises borderline and histrionic personality disorders.
In practical application to daily life, the main differences lie in the person’s intent. People with narcissistic personality disorder (NPD) are self-serving; they exaggerate their self-importance, crave constant praise, go to great lengths to feed their ego, and are exceedingly concerned with image, For these reasons, narcissists often appear to be successful and high-functioning. Unlike sociopaths, some narcissists are capable of empathy and remorse. People whom the narcissist hurts are merely unintended casualties on the way to a desired result.
The American Psychiatric Association (APA) estimates the prevalence of NPD at 0% to 6.2% of the population.
On the other hand, sociopaths intend to harm others and often derive pleasure in the act. They aren’t concerned with what others think of them; they lack the narcissist’s preoccupation with image, which frequently translates to an inability to hold a job and maintain relationships.
The APA estimates the rate of APD at 0.2-3.3%. It’s most common among men who have alcohol and/or substance use disorder, those in prison and other forensic settings, and those living in poverty and other adverse conditions.