© Benoit Daoust | Dreamstime.com Woman Victim Afraid of her Boyfriend, used with permission
Source: © Benoit Daoust | Dreamstime.com Woman Victim Afraid of her Boyfriend, used with permission

The depiction of colorful, dangerous characters on TV and in film has brought psychological terms into the common vernacular. The words “narcissist” and “sociopath” are bandied about by pundits, on Facebook, and at the dinner table – sometimes (and incorrectly) interchangeably. We weigh in on the mental health of public figures. We think of "Little Finger," or at the extreme, Ramsay Bolton on Game of Thrones, and we assume we know what the labels "narcissist" and "sociopath" mean and that we could easily spot such characters in real life.

There is certainly some overlap between these two personality disorders, which is why they are both part of the “Cluster B” group in the DSM (comprised of narcissistic, histrionic, antisocial, and borderline personality disorders). Sociopathy is captured by the diagnosis of antisocial personality disorder. Despite both being part of this “dramatic erratic”, cluster, however, the two disorders are not interchangeable. Nor are they always so easy to identify in the day-to-day. 

It’s actually much easier to spot narcissists, sociopaths, or those who are “off,” in some way on TV than it is in real life for a variety of reasons. Below I list several of these, as well as what the criteria are for these disorders. The points below may help you to spot the potential problem person before getting in too deep, or at least help you assess what you’re dealing with and get help if need be. (And it will certainly help you to be more accurate when you weigh in on public figures on social media.)

1. It’s a Matter of Degree

Someone can have traits of a disorder without meeting full criteria. So, a person will have a self-centered or callous “flavor,” but we would not find them at the extreme end of the continuum with regard to those traits. Thus, their offenses may be less frequent, less severe, or at least you may be able to give some feedback (if this person is a partner, friend, or family member).

If you are dealing with someone who is narcissistic or sociopathic, you are probably already aware that you will have to tread very, very carefully and be willing to withstand some of the, “No, it’s not me, it you!” when you broach concerns about their behavior towards you. They will also likely “punish” you via criticism, silence, or covert aggression of some sort, but the retaliation is less intense or prolonged than it would be if the person was at the severe end of the spectrum.

With regard to the latter, there is a good chance that the person in question will not to be able to do too much with your feedback, but if they value your relationship, a less impaired person should be able to, once calmer, work with you to a degree. A person who is never wrong, totally unwilling to compromise, or is actively vengeful is dealing with more than just a few “traits.”

2. They are Skilled at “Impression Management

The more skilled a person is at “impression management,” the more difficult it will be to label a personality or behavior as pathological. Thus, even a person with a number of problematic traits can present as very charming, thoughtful, and competent. In fact, they can be extremely skilled at getting you to help them out or do their bidding, take responsibility for their errors or insults, and the like. One reason for this is that narcissists in particular can make you feel extremely special when their attention is on you. This feeling of specialness is particularly seductive. 

Because narcissists in particular tend to pay extra attention to their appearance, they can also be very attractive, which only adds to their allure. And someone who is particularly intelligent, well-mannered, or well-educated is often even better at convincing people that he knows best, is a great catch, and the like. 

3. They Have a “Sixth Sense” for Spotting the Right People to Manipulate

Narcissists and sociopaths are extremely good at sniffing out trusting, vulnerable people, who tend to see the good in others. Thus, they can be very difficult for “nice” people to spot until the offender has wreaked tremendous and undeniable havoc. Relatedly, because people tend to view others as subscribing to a generally accepted moral code (such as that lying and harming others is “wrong”), even an otherwise savvy person can work hard to find the “good reason” why someone is acting “off” rather than identifying problem personalities and behaviors for what they are. Feelings of anger, distrust, or fear about what we “know” about a loved one will cause great distress, otherwise known as “cognitive dissonance.” As a result, most of us wind up resolving this cognitive dissonance by reinterpreting facts that feel at odds with what we need and want to believe about someone.

Michael Mastromarino is a good example of someone who exhibited significant narcissistic and sociopathic traits, but for years, no one around him knew the nefarious things he was capable of. Mastromarino was a very successful dentist with a “perfect” life, a grand home, a trusting wife and beautiful children. He also was a master excuse maker, serial philander, abused prescription drugs, and was convicted of running a multi-million dollar scam in which he took body parts from funeral homes and sold them for medical research.

For years, Mastromarino’s wife believed his lies and excuses because she was so in love with him. As his childhood sweetheart, she saw in him only his drive to succeed and the handsome, charming young man with whom she’d fallen in love. In a recent documentary, she spoke about how it remained incomprehensible to her that Mastromarino could be guilty of the above until the evidence was truly overwhelming. 

4. They Look Just Like You...

Related to number 3, reading criteria for either disorder or watching news reports of criminals after their capture can lead one to assume that narcissists and sociopaths are easy to spot. Yet, narcissists and sociopaths typically look just like you and me (or even “better,” given the narcissist’s devotion to appearance). Think Bernie Madoff, “Dapper Don” John Gotti, Michael Mastromarino, - all “normal” looking people who were very polished, well-dressed, smooth, and successful. Your colleague, relative, neighbor, physician, dog walker, or anyone else can have these traits and you probably wouldn’t know it.

5. Sometimes They Just Don’t Seem to Fit the “Profile”

Although men are much more likely to meet criteria for both narcissism and sociopathy, women, too, can fit into these categories. Thus, the nice old lady down the street may be much more complex (and less kind) than you assume she is. Related to the impression management tendency, narcissists may become involved in charitable or other “good guy” causes – not because they care so much as because it makes them look “good.” Sociopaths would only engage in "good works" if it gave them an opportunity to scam people or otherwise work a system they’ve gained entry into.

6. They Won’t Necessarily Commit an Obvious Crime

Rates of sociopathy are higher in prisons and other forensic settings than in the general population (70% vs. 0.2 – 3.3%, respectively), so it’s logical to associate sociopathy with obvious criminality. Yet, money and privilege can enable someone to commit either a type of crime or a callous act that is more difficult to detect or for which someone is less likely to be convicted of something illegal. As an example, a wealthy business owner or executive can repeatedly default on debts, bully workers, harass employees, or misrepresent a product to consumers. These behaviors are callous, immoral, and in some cases, illegal. They are also much more difficult to prosecute than a petty theft caught on a surveillance camera, for a variety of reasons. And again, because these personalities are particularly good at selecting their victims, often their targets are in a social or economic position that makes it difficult or impossible to fight back.

7. They Can Be Harmful without Being “Dangerous”

Particularly in the case of narcissists, they can be emotionally hurtful, manipulative and vengeful. Some narcissists are physically aggressive when they feel psychologically injured, but all aren’t. Similarly, although narcissists, like sociopaths, believe they are exempt from the normal rules that govern the rest of us, they are typically less impulsive and less likely to cause physical harm or commit a crime than sociopaths are. Thus, a cheating or verbally abusive partner, friend who betrays you repeatedly, or a personally exploitative colleague can cause hurt and havoc that leaves no visible scars.

Below I have paraphrased the criteria for both narcissistic and antisocial personality disorders. Keep in mind that someone can meet many criteria for both of these, as well as of other disorders.

Narcissistic Personality Disorder:

A pervasive pattern of grandiosity, need for admiration, and lack of empathy as indicated by 5 or more of the following:

  • Has a grandiose sense of self-importance (exaggerates achievements, expects to be recognized as superior without commensurate achievements)
  • Is preoccupied with fantasies of unlimited power, success, brilliance, beauty or ideal love
  • Believes her or she is “special” and can only be understood by similarly special, high status people
  • Requires excessive admiration
  • Has a sense of entitlement
  • Is interpersonally exploitative
  • Lacks empathy
  • Is envious of others or believes others are envious of him/her
  • Shows arrogant, haughty behaviors or attitudes

Antisocial Personality Disorder

A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15, as evidenced by 3 or more of the following:

  • Failure to conform to social norms as evidenced by repeatedly performing acts that are grounds for arrest
  • Deceitfulness
  • Impulsivity
  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  • Reckless disregard for the safety of others
  • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial commitments
  • Lack of remorse, as being indifferent to or rationalizing having hurt others
  • The individual is at least 18 years of age

In addition to the above:

  • There is evidence of Conduct Disorder with onset before age 15
  • The occurrence of the above is not exclusively during the course of schizophrenia or bipolar disorder

Finally, more research has shown that several types of harmful personalities have traits in common. Paulhus and colleagues have studied what they refer to as the “Dark Tetrad,” consisting of narcissists, psychopaths, Machiavellians, and sadists. Traits such as callousness and lack of empathy are common to all of them, and someone can be a narcissist who is also sadistic, or a sociopath who is also Machiavellian, etc. 

The bottom line is that although the terms narcissist and sociopath are in our common vernacular, there are important differences between them. That said, they are not mutually exclusive. If you find yourself in a toxic relationship, or feel a situation is too much to handle, it’s worth seeking counseling to help you take good care of yourself and prevent further problems.

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013.

Buckels, E. E., Jones, D. N., & Paulhus, D. L. (2013). Behavioral confirmation of everyday sadism. Psychological Science, 24(11), 2201-2209.

Furham, A., Richards, S. C., & Paulhus, D. L. (2013). The dark triad of personality: A 10 year review. Social and Personality Psychology Compass, 7(3), 199-216.

Simon, G. K. (2011). In Sheep's Clothing: Understanding and Dealing with Manipulative People. Tantor Media, Incorporated.

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