What's the Difference Between a Psychopath and a Sociopath?

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.

"Sociopaths are generally more clearly aligned with symptoms of APD, but psychopathy can cross over to these characteristics as well," says Hannah Owens, LMSW. "Labeling someone as a sociopath or a psychopath is a big deal - but not distinguishing between the two, and using them interchangeably, doesn't do either of you much good."

Sociopath is a term people use, often arbitrarily, to describe someone who is apparently without conscience and is hateful or hate-worthy. The term psychopath is used to convey a sociopath who is simply more dangerous, like a mass murderer.

Sociopathy vs. Psychopathy

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.

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 someone like Jeffrey Dahmer, they're just as likely to hurt themselves as others.

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.

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.

Signs of Psychopathy vs. Sociopathy

As a reminder, psychopathy and sociopathy are not clinical diagnoses in the The Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM does, however, classify 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

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

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

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
  

Treatment

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-5 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.

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.

If Someone You Know Has APD

If a friend or loved one shows signs of antisocial personality disorder, it can be very difficult for them to get the help they may need. In many cases, they may not accept or acknowledge that there is even an issue with their behavior.

At a certain point, you may have to decide if the relationship is worth preserving. Set clear boundaries, and make it known that you will stick to them, even if it means cutting ties. Letting someone go may be one of the hardest things you'll ever have to do, but ultimately it may be for the best. As always, it's most important to take care of yourself and your needs, and surround yourself with people who enrich your life, support you, and appreciate your support of them.