Psychopath, Sociopath or Antisocial Personality

Are These All the Same Psychological Disorder?

© Tami Port

Antisocial Behavior: Tomatoe or Tomahto?, public domain
One of the reasons the terms psychopathy, sociopathy and antisocial personality disorder (aspd) are so often used interchangeably is that even 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:

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.


The copyright of the article Psychopath, Sociopath or Antisocial Personality in Personality Disorders is owned by Tami Port. Permission to republish Psychopath, Sociopath or Antisocial Personality in print or online must be granted by the author in writing.


Antisocial Behavior: Tomatoe or Tomahto?, public domain
       

Comments
Sep 21, 2007 11:44 PM
redback :
I don't know whether you're checking back here, Tami, but this article reminded me that once I thought of pursuing criminology studies...a lifetime ago. I hadn't re-visited these problems esp from the discipline or viewpoint of your latest article, til now. So, I'm finding them VERY interesting.

Whether the diagnosis is available pre-sentence or pre-release create interesting challenges. There is 'reward' available that may corrupt the results. There are inconsistencies in sentencing that may make either diagnosis academic. And...it's over once time is served. Until next time.

I tend to favour the less discriminating 'label' generally, but in context of crime, I'm not persuaded 'APD' is particularly descriptive as by definition all crime has soem element of anti-social behaviour in it, doesn't? There is an alleged 'victimless' crime and white collar crime...as if they both somehow should be more tolerable. And as far as stigma goes, my pet concern, here it seems the stigma is more related to the tag 'criminal'?

PS: I thought you guys pronounced it tom-AR-toe, not tom-aht-2. :)
Sep 24, 2007 3:49 PM
Tami Port :
Tom-AR-toe? What US movies have you been watching? Up here in Michigan, we tend towards a nasally Tah-MAAAAAAYY-do dont-cha-no?

Regarding the rest of your response, I also find the whole semantics discussion on PD labels to be very fascinating.

Some of the dialogue seems very much academic, and while I can see the utility of thoroughly defining what PD traits and etiology, we are talking about...i.e. sociopath, psychopath...If an antisocial individual goes on a murdering, abusing or swindling spree, does it really matter if he/she is considered a sociopath of psychopath?

I am interested on your input on this discussion from a forensic psych and criminology perspective. And would you mind sharing more about your background, since you seem to have been more exposed to the legal interpretation of these labels.

Also, by your comment, "I tend to favour the less discriminating 'label' generally, but in context of crime, I'm not persuaded 'APD' is particularly descriptive ..." do you mean that you see the more behavior-based APD label to be more useful in a criminal/forensic context than, for example, a PCL assessment that includes the less tangible aspects of psychopathy?
Sep 26, 2007 4:27 AM
redback :
As I stated, I thought of pursuing those studies...but didn't ...so have no great input from the forensic or criminologist perspective.

I got a generalist Jack o all trades, master o none degree a lifetime ago that covered probation & parole, welfare, health education & related stuff. Studied abnormal psych only at that level. Then did not use the skills until rust set in. :)

43 years ago, worked in researching war-caused illnesses, their links to POW camps etc. My career background's been in the development of social welfare policy and of disability policy specialising in disability-based welfare payments. The issues of premature diagnosis, medical opinions outside their field/s of expertise, setting diagnostic standards of evidence based on DSM, fraud protection etc. What is realistically treatable: 'permanent' vs 'temporary'. Worked on a daily basis with senior doctors. "continuous improvement' etc. At least 3 sides to every coin and heady stuff for my memoirs. :)

Personality disorders were not a significant part of any reviews...but there were clearly unrealistic policy/law expectations of recovery for mental illnesses...and the consequences of untreated, undiagnosed problems.

I was thinking of just avoiding stigma generally BUT to your question re APD/PCL: it seems to me both APD and PCL may be relevant to the jigsaw that is criminal profiling. Look at the NPD posts here and ponder filling in the clinical assessments for the diagnosis or profile. It just seems to me these tools ought to be rigorously tested, re-jigged where needed and receive 'accreditation' if they meet the purpose. Otherwise they're loose indicators, not determinative.

I did practice the way you say tomato. :) Crikey, stalk Strine**: Tm-ar-t slurring it into the adjoining words. Dja eatcha tmart,Tami? (**lets talk Australian)
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