One of the reasons that the terms psychopath, sociopath and antisocial personality are so often used interchangeably is that the experts don't agree.

Psychopathy or Sociopathy?

Dr. Robert Hare, one of the leading experts in the study of psychopathy, suggests that the difference between sociopathy and psychopathy may primarily reflect how the person using these terms views the factors contributing to the antisocial disorder.

More apt to view antisocial behavior as arising from social conflicts, sociologists typically prefer the term sociopath. Whereas, psychologists use the term psychopathy to describe a psychological disorder that is the product of a combination of psychological, biological, genetic and environmental factors (Hare 1999).

Is Psychopathy 'Nature'?

In agreement with Hare’s assessment, David Lykken, a behavioral geneticist best known for his work on twin studies, viewed psychopaths as having inherent temperamental differences such as impulsivity, fearlessness, and reduced physiological responsiveness resulting in a high level of risk-seeking behavior and lack of adherence to social norms. Recent research has demonstrated that early signs predictive of psychopathy can be present at a very young age (Viding 2005, Glenn 2007).

Is Sociopathy 'Nurture'?

He considered sociopaths to possess reasonably normal temperaments; their social pathology more a result of negative sociological factors such as parental neglect, running with the wrong crowd, poverty, and extremely low or extremely high intelligence(Lykken 1995).

Although all personality disorders are likely to be the result of some level of interaction between genetic predispositions and environmental factors, according to these definitions, psychopathy is defined primarily by hereditary and sociopathy by environmental influences.

Antisocial PD and Psychopathy

As with the conflict surrounding the nature of psychopathy versus sociopathy, there is also debate over the difference between psychopathy and Antisocial Personality Disorder (APD or ASPD).

What is APD?

According to the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders), in order to be diagnosed with Antisocial Personality Disorder, a patient must have a persistent history of disregard for and violation of the others’ rights, occurring since age 15, evidenced by three (or more) of the following seven traits:

• failure to conform to social norms
• deceitfulness, repeated lying, use of aliases, or manipulation of others
• impulsivity or failure to plan ahead
• irritability and aggressiveness
• reckless disregard for safety of self or others
• consistent irresponsibility
• lack of remorse, indifferent to or rationalizing having hurt or mistreated others

Limitations of ADP Diagnosis

Although the description in DSM-TR reflect the perspective that psychopathy is synonymous with APD, more recent research has cast doubt (Cunningham 1998, Hare 1999, Herve 2006).

The DSM diagnosis of APD is primarily a list of antisocial or criminal behaviors. Hugues Herve, one of the early thought leaders in the study of psychopathy, saw the diagnosis of ADP as lacking in its failure “to capture the personality features that clinicians have noted to be most essential in discriminating psychopaths from other criminals.”

The McCords, a pair of academicians offering us some of the earliest glimpses into psychopathy, share a similar view, stating that “the actions of a psychopath are only outward symptoms of a sick mind … any adequate study of the psychopath must look beyond asociality” (1964).

Psychopathy More Specific than APD

Because the diagnosis of APD is based primarily of a short list of antisocial behaviors, and psychopathy is more clearly defined as including many subjective traits, the diagnosis of APD is, by nature, less discriminating.

Hare wanted to see a more reliable, less subjective method that could more completely assess the complex traits of psychopaths, so his team of clinicians spent more than ten years developing and refining a new, more reliable assessment tool. The diagnostic device that Hare’s team developed was dubbed the Psychopathy Checklist (PCL), and is now widely used to professionally diagnose psychopathy (Hare 1985, 1999).

Using DSM and PCL as tools for assessing APD and psychopathy, respectively, most individuals with psychopathy would be clinically diagnosed as having APD, however, the majority of individuals with APD would not qualify as being psychopathic (Hare 1998).

Criminal Behavior of APD and Psychopathy

Hare’s studies of psychopathy have revealed that the percentage of incarcerated criminals that would meet the criteria of having APD is approximately 85%, however, when assessed for psychopathy, only about 20% of these same criminals would quality. Psychopathy has also proven to be a better predictor of violent and sexual recidivism as well as treatment failure (Cunningham 1998), further evidence supporting a real difference between criminals with APD and true psychopaths.

More Information on Psychopathy

Additional resources on psychopathy and personality disorders in general include: Psychology Prof Online, The Mayo Clinic: Mental Health Center and the articles Personality Disorders and What is Psychopathy?

This Suite 101 article summarizes information on APD, sociopathy and psychopathy. The contents of this article are not meant to be used for diagnosis and are not a substitute for professional help and counseling.

Additional Psychopathy Resources

American Psychiatric Association APA (1994 & 2000) Diagnostic and Statistical Manual of Mental Disorders.

Hare, R. D. (1999) Without Conscience: The Disturbing World of the Psychopaths among Us. Guiford Press.

Hare, R. D. (1985). Comparison of procedures for the assessment of psychopathy. Journal of Consulting and Clinical Psychology, 53, 7.

Herve, H., Ingram Willis A., Yuille, J. (2006) The Psychopath: Theory, Research, And Practice.

Glenn, A. L. et al (2007). Early Temperamental and Psychophysiological Precursors of Adult Psychopathic Personality. Journal of Abnormal Psychology. 116, 508 – 515

Lykken, D.T. (1995) The Antisocial Personalities.

Cunningham, M., Reidy, T. (1998)Antisocial personality disorder and psychopathy: diagnostic dilemmas in classifying patterns of antisocial behavior in sentencing evaluations. Behavioral Sciences and the Law, 16, 3.

McCord, W. & McCord, J. (1964) The Psychopath. Van Nostrand.

Viding, E., R. Blair, J., Moffitt, T., Plomin, R. (2005) Evidence for substantial genetic risk for psychopathy in 7-year-olds. Journal of Child Psychology and Psychiatry, 46, 6.

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