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Psychopathy

Psychopathy is a condition characterized by the absence of empathy and the blunting of other affective states. Callousness, detachment and a lack of empathy enable psychopaths to be highly manipulative. Nevertheless, psychopathy is among the most difficult disorders to spot.

Psychopaths can appear normal, even charming. Underneath, they lack any semblance of conscience. Their antisocial nature inclines them often (but by no means always) to criminality.

Psychopaths spark popular fascination and clinical anguish: Adult psychopathy is largely resistant to treatment, though programs exist to treat callous, unemotional youth in hopes of preventing them from maturing into psychopaths.

Brain anatomy, genetics, and a person’s environment may all contribute to the development of psychopathic traits. For more on causes, symptoms, and treatments of the related condition called antisocial personality disorder, see our Diagnosis Dictionary.

The Signs of a Psychopath

Psychopathy is a spectrum disorder and can be diagnosed using the 20-item Hare Psychopathy Checklist, which features traits such as lack of empathy, pathological lying, and impulsivity, each scored on a three-point scale based on whether the item does not apply (0), applies to a certain extent (1), or fully applies (2) to the individual. The bar for clinical psychopathy is a score of 30 or higher; serial killer Ted Bundy scored 39.

The checklist was developed in the 1970s by the Canadian researcher Robert Hare. A true assessment should be conducted by a mental health professional.

The revised version of the checklist includes the following characteristics:

  • glibness/superficial charm

  • grandiose sense of self-worth

  • need for stimulation/proneness to boredom

  • pathological lying

  • conning/manipulative

  • lack of remorse or guilt

  • shallow affect (i.e., reduced emotional responses)

  • callous/lack of empathy

  • parasitic lifestyle

  • poor behavioral controls

  • promiscuous sexual behavior

  • early behavioral problems

  • lack of realistic, long-term goals

  • impulsivity

  • irresponsibility

  • failure to accept responsibility for one's own actions

  • many short-term marital relationships

  • juvenile delinquency

  • revocation of conditional release (from prison)

  • criminal versatility (i.e., commits diverse types of crimes)

What percentage of people are psychopaths?

Psychopaths exist across cultures and ethnic groups. It has been estimated that approximately 1 percent of males and 0.3–0.7 percent of females could be classified as psychopaths. An individual may show elevated levels of multiple traits associated with psychopathy without qualifying as a psychopath according to a measure such as the Hare checklist.

When does psychopathy begin?

An individual may exhibit early characteristics associated with psychopathy—called “callous-unemotional traits”—as early as childhood (before age 10) and may receive a formal diagnosis such as conduct disorder. However, showing psychopathic features in childhood does not mean that a person will necessarily become an adult psychopath.

Psychopathy, Sociopathy, and Antisocial Personality Disorder

Individuals with antisocial personalities have distinct histories and combinations of traits—and their misbehavior can vary in nature and severity—so the terminology used to describe such people can get a little complicated. People often conflate the terms “psychopath” and “sociopath” or use both of them to describe those who flagrantly disregard moral rules.

While these terms are widely used in clinical and common language, the Diagnostic and Statistical Manual of Mental Disorders (DSM) uses neither “psychopath” nor “sociopath” as diagnostic terms. These descriptions are most closely represented in the DSM by a condition called antisocial personality disorder (ASPD).

What is the difference between a psychopath and a sociopath?

The terms “psychopath” and “sociopath” are often used interchangeably, but a “sociopath” refers to a person with antisocial tendencies that are ascribed to social or environmental factors, whereas psychopathic traits are thought to be more innate. That said, both genetic and non-genetic causes likely play a role in shaping any person with antisocial traits.

What is the difference between psychopathy and antisocial personality disorder?

Antisocial personality disorder overlaps with psychopathy, but is not the same condition. A person can meet the criteria for antisocial personality disorder—which focus largely on antisocial behaviors—without showing core traits associated with psychopathy. Psychopaths are thought to comprise just a fraction of people with antisocial personality disorder.

Psychopaths and Violence

For some, “psychopath” may seem synonymous with “criminal” or “killer, but the reality of psychopathy is more complicated. Scientists have indeed found statistical associations between psychopathy scores and violent behavior, as well as other forms of criminality. Elevated impulsiveness, tendency to deflect blame, and other antisocial traits may make a psychopath more inclined than other people to cross moral boundaries and threaten, hurt, or kill.

Yet the link between psychopathy and violence is far from one-to-one. Not all psychopaths are killers or even criminals, and there are other personality traits and forms of pathology aside from psychopathy that may contribute to aggressive behavior.

How many psychopaths are killers?

It is unknown how many psychopaths commit severe acts of violence. Among convicted killers, more than a quarter could be considered psychopaths (compared to about 1 percent of the general population), according to one estimate—and there’s evidence that psychopathic criminals are more likely to re-offend. But many psychopaths do not have histories of violence.

Are all serial killers psychopaths?

Not necessarily—though many (perhaps most) serial killers exhibit psychopathic personalities, showing a lack of empathy for their victims and no remorse for their crimes.

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