Psychopathy is a common term used to describe a grouping of personality traits that includes such things as impulsive behavior, lack of regard for others, lack of a normal range of emotional responsiveness and frequent deception or manipulation of others. People who have these traits are known as psychopaths or sociopaths. However, the American Psychiatric Association (APA), which publishes the primary guidebook for diagnosing mental illness in the United States, does not use the term psychopath or the term sociopath. The closest equivalent to psychopathy in the APA guidebook is a condition called antisocial personality disorder.
Use of the term psychopathy dates back to the 1800s; however, it only became a common concept in the U.S. in the 1940s. Initially, psychiatrists proposed that all psychopaths have a superficially outgoing personality that hides a fixed pattern of psychotic (i.e., hallucination-based or delusion-based) and antisocial behaviors. Later, the concept of psychopathy widened as mental health professionals realized that affected individuals can have a much wider range of dysfunctional personality traits. In line with the understanding that not all psychopaths are literally psychotic, psychiatrists and other mental health experts started using the term sociopathy as a substitute for psychopathy, and also started using the term sociopath as a substitute for psychopath.
Personality traits associated with psychopathy/sociopathy fall into four main groups, known as antisocial traits, interpersonal traits, affective traits and lifestyle traits. Antisocial traits associated with the condition include childhood behavioral disturbances, teen or preteen delinquency, and involvement in criminal conduct. Interpersonal traits associated with the condition include an inflated notion of self-importance, frequent participation in manipulation or deception, a deeply ingrained pattern of lying, and a superficially appealing social style. Affective traits associated with psychopathy/sociopathy include callousness toward others, limited emotional responsiveness, a deeply ingrained pattern of avoiding personal responsibility, and an absence of guilt or regret for one’s actions. Lifestyle traits associated with psychopathy/sociopathy include frequent impulsive behavior, recurring pursuit of highly stimulating experiences, a pattern of unrealistic life expectations, and frequent reliance on others for financial or material support.
The U.S. criminal justice system and many mental health researchers measure psychopathy with a standardized test called the Psychopathy Checklist – Revised, or PCL-R. This test ranks 20 psychopathy-related personality traits on a scale of 0 to 2. People who receive a score of 30 or higher on the PCL-R are designated as psychopathic; by comparison, a person lacking psychopathic traits would typically receive a score of 5 or 6. Generally speaking, physically violent psychopaths receive higher PCL-R scores than nonviolent psychopaths.
Psychopathy Vs. Antisocial Personality Disorder
The American Psychiatric Association definition for antisocial personality disorder is found in the Diagnostic and Statistical Manual of Mental Disorders (DSM), which the vast majority of U.S. mental health professionals use when diagnosing mental health-related conditions. The DSM also includes definitions for nine other conditions classified as personality disorders. In many respects, the symptoms found in people diagnosed with antisocial personality disorder mirror the symptoms commonly associated with psychopathy. For instance, people with the disorder typically do such things as disregard the welfare of others, display superficial charm in social situations, display a lack of guilt or regret, break the law, behave irresponsibly, manipulate or lie to others, act impulsively, seek stimulation through reckless activity, and maintain an inflated sense of self-importance.
However, the definition for antisocial personality disorder also differs from the definition for psychopathy in important ways. First, and perhaps most significantly, an adult who receives a diagnosis for antisocial personality disorder must have an earlier history of another mental health condition called conduct disorder. The DSM doesn’t allow doctors to diagnose any personality disorder in children, and in many ways, conduct disorder functions as the childhood equivalent of antisocial personality disorder. In addition, a person diagnosed with antisocial personality disorder must experience his or her symptoms outside of the context of the hyper-aroused state called mania or the severe mental disorder called schizophrenia.
In a study published in 2013 in the journal Assessment, a team of researchers from Florida State University compared the criteria for antisocial personality disorder to the personality traits associated with psychopathy. These researchers concluded that the antisocial personality disorder definition captures many of the deviant or abnormal behaviors associated with psychopathy, but does not capture many of the psychopathic personality traits classified as interpersonal traits or affective traits.
Prior to the publication of the latest edition of the Diagnostic and Statistical Manual in 2013, the American Psychiatric Association considered creating a newly defined condition called psychopathic personality disorder. This step would have been just one part of a larger reorganization of the personality disorders category. However, the APA ultimately decided not to make any major changes to any of the personality disorder definitions contained in the DSM.