Name: You’ve probably met a psychopath and didn’t know it | Abigail Marsh
Uploaded: 2026-03-04T18:02:50.000Z
Duration: 18 min 38 s
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I get asked a lot, what's the difference between the term psychopath and sociopath?

The main difference is that the term psychopath or psychopathy is a scientific and clinical term.

And the term sociopath or sociopathy is not.

And so you do see it used a lot in book titles and lots of media coverage.

But there's really no scientific definition of sociopathy.

There's no sort of clinical set of traits that constitute it and no agreed upon definition of what it even means.

The most common thing that is meant by the term sociopath is somebody who is diagnosed with antisocial personality disorder.

So that is a disorder in the Diagnostic and Statistical manual or the DSM 5, which psychiatrists and psychologists use to diagnose any psychological disorder.

And once upon a time it was pretty common to call people who had a diagnosis of antisocial personality disorder a sociopath.

I don't think anybody does that anymore, I don't think.

However, that's just not accepted terminology, really, in any group of professionals.

By contrast, the term psychopathy is an established scientific term.

It has very clearly delineated sort of symptoms and a well understood definition.

There are scientific societies that study psychopathy.

You'll see thousands of mentions of it in the scientific literature.

You will see no mentions of sociopathy in the scientific literature.

And so I wish people would use just the term psychopathy.

It sounds a lot like psychopathology, which means any kind of psychological disorder.

It also has really negative connotations.

People associate the term psychopath with the old idea of like the bad seed, people who were just born bad, which seems, I think, needlessly pejorative.

And for a while, the term sociopath caught on maybe 40 or 50 years ago because beliefs about the origins of antisocial personality traits changed.

And for a while, people assumed that all antisocial personality traits were the result of social experiences.

So you would develop these traits not because you were a bad seed, but

because you would have been exposed to abuse or maltreatment or trauma.

And the term sociopath is sometimes used to signify that origin of antisocial behavior.

Now we know it's a lot more complicated, right?

You can never ask the question, is some outcome the result of nature or nurture?

Because they're always acting in combination.

I think it would be helpful to banish the term sociopath, mostly because I Get a little frustrated by the euphemism treadmill that we sometimes get on for stigmatized disorders.

There's this attempt to keep coming up with new sort of less stigmatized names for the concept that we are studying.

But what I've noticed is that this makes life a lot more difficult for the people and their families affected by these disorders.

It makes it really hard to find information out about what the disorder is, how is it diagnosed, how do you treat it, if you're not even sure, like what the disorder's name is and sort of what to look for, what to ask about.

And so I would prefer if we all just stuck with one word, psychopathy, which has a really well accepted meaning and is already the focus of tons and tons of scientific research.

I don't think adding another term in is really helping anybody.

Adding layers to the confusion is the fact that in the DSM there is a diagnosis called antisocial personality disorder that has a lot of overlap with psychopathy.

At core, they both refer to people who engage in persistent and fairly severe antisocial behavior, don't seem to care about other people's welfare, etc.

The difference is that people who are psychopathic may or may not engage in any criminal behavior.

You can be an uncaring person and not break the law.

And it's really much more about a person's personality and their sort of internal traits.

Whereas antisocial personality disorder is much more about external behaviors, in particular crime.

So almost anybody who's committed more than one crime has a very high likelihood of a diagnosis of antisocial personality disorder.

I think that's inappropriate and also unhelpful.

Most psychological disorders are really focused on how is the person feeling, what is the way that they engage with the world around them, not coming up with a checklist of behaviors that they engage in necessarily.

And I think it would be better if we did that for disorders of aggression and antisociality as well, like psychopathy.

Psychopathy is obviously a very popular topic for the media.

It's a thrilling, sensationalistic topic.

And so there are a lot of really compelling psychopaths in the media that I think unfortunately causes people to develop a lot of false impressions about what psychopathy really is and what it's about.

Unfortunately, most people do have a lot of false beliefs about the reality of psychopathy.

The estimate is that about 1% of adults have clinical levels of psychopathy.

Which is just as common as schizophrenia or bipolar disorder or some other relatively common disorders.

Another is that people who are psychopathic are sort of born, not made.

And that's not 100% true, because we now know that psychopathy results from a mix of genetic and environmental factors, just like every other psychological disorder.

Interestingly, other people have the alternate false belief, which is that psychopathy is 100% about life experiences, not about anything that you bring to the world.

And I think it's a really pernicious myth that the only way to end up psychopathic is if you were abused or maltreated as a child.

Because many families of children who end up psychopathic are too ashamed to come forward with their problems because they assume everybody will blame them.

Another common myth about psychopathy is that it's a disorder exclusively seen in men, which is also not true.

These numbers are always a little bit fuzzy because, again, they're continuous and we draw the line.

But however, it is true that men are more likely to have high levels of psychopathy, with men being roughly twice as likely to have a clinical assessment of psychopathy as women are.

And when they are psychopathic, it's more likely to manifest in violence or physical aggression.

Women can also be psychopathic and sometimes can be violent or aggressive, although they're more likely to show behaviors like emotional aggression, threatening, emotional blackmail, bullying and ostracizing, to manipulate people or to get what they want.

It's a very common myth that conflates psychopathy with violence, that assumes that psychopathy and, for example, serial killers, are basically the same thing.

That's definitely not true, although people who are psychopathic are more likely to be violent than the average person, especially if they're men.

There are plenty of reasons that people can be violent that have nothing to do with psychopathy.

And there's some evidence that most people who have high levels of psychopathy are not violent.

They may not always do the nicest things, but their disorder doesn't always manifest as physical aggression.

Another myth is that psychopathy is untreatable.

A lot of people believe that if you are a psychopathic, then that's that, and

Psychopathy is difficult to treat because often people with psychopathy don't believe they need treatment and sometimes don't want treatment.

But if they can come to believe correctly that their own behavior and the way they treat people is blowing up their own life and they are the root cause of those problems, you know, you have to use Validated treatment approaches, which sometimes involve medication and sometimes involve psychotherapy to help them learn new ways to behave and new ways to engage with other people, which we know can help both them and the people around them.

Some of the medications that seem to help people with psychopathy include psychostimulants that are used to treat adhd, for example, that seem to reduce the impulsiveness and disinhibitedness of people with psychopathy.

There's some evidence that antipsychotic medication can also help, not because people with psychopathy are psychotic unnecessarily, although some are also psychotic.

But antipsychotic medications act on the dopamine system as well as other neurotransmitters that also seem to be implicated in the behavior of people with psychopathy.

So this medication may help them as well.

Forms of psychotherapy that seem to be effective in adults include cognitive behavioral therapy, which involves simply learning new behaviors, Learning that there are other ways to respond to situations that crop up in your life, and

new ways of thinking about the world that involve overcoming false assumptions about other people.

For example, many people who are at risk for aggression have what's called a hostile attribution bias.

That means they interpret other people's ambiguous behavior as hostile, which makes you more likely to respond aggressively as a result.

And you can retrain people so that they don't interpret other people's behavior through that hostile lens.

When it comes to children, the very best forms of treatment for children at risk for psychopathy are various forms of parent management training.

So the therapist trains the parents to use new approaches to managing their child's disruptive behavior.

There's a form of therapy called parent management training.

There's another very effective therapy called PC P C I T that coaches parents on ways to reduce their child's disruptive and aggressive behavior.

I think the most effective resource for learning about effective ways to treat psychopathy is to go to the psychopathyis.org website.

And we have a whole section for clinicians and for parents and for adults affected by psychopathy on what the effective forms of treatment out there are.

The way we think about psychopathy now derives from the work of a psychiatrist named Herbie Cleckley, who was a really legendary clinician who spent many, many years studying people with psychopathy in psychiatric hospitals.

And he wrote a book called the Mask of sanity.

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You’ve probably met a psychopath and didn’t know it | Abigail Marsh

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