The term psychopath is not an official diagnosis. Instead, a doctor may diagnose someone with specific traits they associate with antisocial personality disorder.
The general public and some researchers may still use the term psychopath to describe individuals who display some personality traits.
Examples of such traits include lack of empathy and remorse and persistent antisocial behavior.
In this article, we discuss psychopathy and antisocial personality disorder (ASPD), including the relevant definitions, signs and symptoms, and treatment options.
The American Psychological Association (APA) define psychopathy as “a synonym for antisocial personality disorder.”
The APA also describe ASPD as involving a pattern of disregarding or violating the rights of other people.
Even though it is not an official diagnosis, some older research considers psychopathy to be a separate condition from ASPD. These researchers believe that ASPD only considers the increased risk for antisocial behavior and not the specific cause of it.
Other research considers the prevalence of psychopathic personality in the population to be 1%, with it being three times more common among males than females.
Doctors may consider ASPD to be a cluster B personality disorder. People with a cluster B personality disorder may behave in a way that others consider overly emotional, dramatic, or erratic.
Both psychopath and sociopath are terms that people use to describe ASPD. Neither psychopathy nor sociopathy are official diagnoses.
However, the general public and some researchers still use both terms. They also tend to make distinctions between psychopathy and sociopathy, with some viewing sociopathy as a milder form of psychopathy.
Officially, people in either group fall under the umbrella diagnosis of ASPD.
Doctors use a diagnostic manual called The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5, to help diagnose mental health conditions.
Typical traits of ASPD according to the DSM-5, may include:
- Having three or more of the following behaviors:
- acting impulsively
- avoiding conformity to societal norms and expectations
- regularly engaging in lies and deception
- disregard for safety
- irresponsible behavior
- lack of remorse
- irritability and aggressiveness
2. Being at least 18 years of age.
3. Showing signs of conduct disorder before 15 years of age.
4. Antisocial behavior with no association with other mental health conditions.
Those with ASPD may also experience recurrent legal problems, including criminal behavior.
Research indicates that people who have psychopathic traits are 20–25 times more likely than others to be in prison, and 4–8 times more likely to violently reoffend. They may also be more resistant to most types of treatment.
Despite these figures, violence and criminality are not diagnostic features of psychopathy or ASPD. People who fit the criteria can lead meaningful lives in many walks of life, including business, politics, law enforcement, and entertainment.
Neuroimaging studies suggest that people who display the characteristics of psychopathy have differences in brain structure compared with the general population.
In many cases, the signs and symptoms begin in early childhood, affecting a person’s relationships, education, and work.
As psychopathy is not an official mental health disorder, doctors cannot diagnose a person with the condition. Instead, they may diagnose someone with ASPD.
Diagnosis of ASPD can be challenging because people with the disorder often do not believe that they need help. Occasionally, they may seek help for a co-occurring condition, such as depression, anxiety, sexual disorders.
Diagnosis of ASPD may involve:
- an account of signs and symptoms from the individual and their loved ones if possible
- a physical evaluation to rule out other issues
- a psychological evaluation
- comparison with the ASPD symptoms in the DSM-5
- genetic testing and neuroimaging to identify potential causes and patterns
Typically, a doctor will not give an ASPD diagnosis until a person is 18 years of age or older. People younger than this may initially receive a diagnosis of:
- conduct disorder (CD)
- oppositional defiant disorder (ODD)
- attention-deficit/hyperactivity disorder (ADHD)
ASPD can be challenging to treat. People with the condition may be resistant to most types of treatment. With treatment, however, some individuals with ASPD and their loved ones may experience long-term benefits.
The primary treatment is psychotherapy, in particular, Caldwell’s decompression therapy. Therapy can help individuals with ASPD to:
- understand their condition
- understand how it affects their lives and relationships
- learn coping skills and ways to manage their symptoms
- manage feelings of anger
- reduce violent behaviors
- deal with substance misuse
If individuals with ASPD have co-occurring conditions, such as depression or anxiety, a doctor may prescribe medications to treat these too.
People with ASPD are unlikely to seek out help, unless they have a co-occurring problem that is causing them issues, such as depression or substance misuse.
Those who suspect that a loved one may have ASPD could gently suggest that they seek help from a mental health professional. It can also be helpful for the loved ones of people with ASPD to seek support themselves from a counselor.
Personality disorders are lifelong conditions. There is no cure, but treatment can help people to manage their symptoms and improve their quality of life.
Psychotherapy for ASPD is not successful for everyone, however. Its effectiveness depends on several factors such as the severity of a person’s symptoms, the length of therapy, and their willingness to engage in therapy.
The term psychopath is not an official diagnosis. However, people often use it as a synonym for ASPD. Those with ASPD tend to lack empathy and remorse and may engage in antisocial or criminal behaviors.
People with ASPD may benefit from treatment with psychotherapy or medications. However, many with the condition tend to be resistant to treatment and may not seek it out, unless other issues present in their lives.