The real differences between psychopaths and sociopaths and why you can’t be officially diagnosed as either

• Sociopaths and psychopaths are two distinct subtypes of antisocial personality disorder.
• Psychopaths are typically less anxious and have an easier time holding a job than sociopaths.
• Stigma against these 2 labels has led to harsher criminal sentencing in certain cases.
• Visit Insider's Health Reference library for more advice.

Psychopath. Sociopath. Lots of people throw around these terms, but few understand what they actually mean. 

Even experts disagree on what makes a true psychopath or sociopath. Diagnosis, causes, potential criminality — all of these are subject to long-standing debate.

The topic is complicated, but our explanation doesn't have to be. Here is a quick primer on what psychopathy and sociopathy actually mean.

Antisocial personality disorder

Typically, psychology sources describe psychopathy and sociopathy as two variants of antisocial personality disorder (ASPD). 

Antisocial personality disorder is marked by:

• Antagonistic behavior: Someone may act cruel to others without remorse. They may use manipulation or lies to get what they want.
• Disinhibition: Someone may act without regard for social, ethical, or legal norms. They might act impulsively and take unnecessary risks out of boredom.

Estimates suggest ASPD affects 1%-4% of the general adult population (only those 18 and older can be diagnosed with ASPD). Men are 3-5 times more likely to get an ASPD diagnosis than women. 

Most people with ASPD do not have psychopathy or sociopathy. These variants tend to be more severe versions of ASPD. According to a 2019 literature review:

• 3%-15% of ASPD cases are the psychopathic subtype
• 30% of ASPD cases are the sociopathic subtype

It's important to note that psychopathy and sociopathy are not official diagnoses. You can only be diagnosed with ASPD. 

Diagnosis

If psychopathy and sociopathy aren't official diagnoses, how can professionals tell when someone has one of the conditions? Many clinicians use the Revised Psychopathy Checklist (PCL-R), which scores you on 20 factors outlined in the table below. 

Professional raters score you on a 0-2 scale for each factor: 

• 0 means the factor doesn't describe you at all
• 1 means it describes you a little
• 2 means it describes you very well

If you have a total score of 30 or higher, then you meet the threshold for psychopathy or sociopathy. 

People with psychopathy (PwP) tend to score higher on the interpersonal and emotional factors and have very low levels of anxiety and anger. Moreover, they often have a bold, charming demeanor and an exaggerated self-image. When they do act aggressively, it is often in service of a larger goal, and they will likely have a plan to talk their way out of trouble.

People with sociopathy (PwS) tend to score higher on lifestyle and antisocial factors. High anxiety levels can cause them to avoid responsibilities, and intense anger can lead to violence. PwS are often more impulsive than PwP and more likely to openly disregard laws and social norms. Thus, they are more likely to get into legal trouble.

Causes

Often psychopathy is described as having biological roots, while sociopathy is blamed on environmental triggers. In reality, nature and nurture have a hand in both.

What causes psychopathy?

Studies suggest there's a strong genetic component to psychopathy which may predispose someone to antisocial behavior.

PwP may also have differences in their brain structure which can cause:

• Blunted emotional response: Their amygdalas tend to under-react to stressful stimuli. This may explain why PwP can act boldly and take risks. It may also explain why typical deterrents to behavior, like punishment or guilt, don't seem to affect them much.
• Reduced empathy: PwP can recognize others' emotions — they wouldn't be able to manipulate others without that skill. While they may show the "correct" emotional response back, they may not feel that way inside. Neurological research suggests PwP can "switch on" empathy if it suits a goal, but it isn't present by default. 
• Goal-focused attention: When PwP have a goal, they may develop tunnel vision. It can be harder for them to recall information that doesn't directly help them, such as social norms of right and wrong.

Although biology may have a strong influence on how psychopathy develops, it isn't destiny. Early trauma, especially witnessing violence in the community, can make someone more likely to develop psychopathic traits.

"Psychopathic persons don't fall out of the sky. There is likely to be a background of trauma and abuse, psychophysiological differences, and a complex history of impaired relationships throughout their lives," says Tamatea. 

What causes sociopathy?

Research suggests the environment plays a strong role in sociopathy. PwS are more likely than the general public to have experienced:

• Childhood neglect and a lack of socialization
• Physical and emotional abuse
• Harsh and inconsistent discipline
• Violence in the home or community

"Like other aversive personality patterns, [antisocial] traits may well have emerged to serve a survival function," says Tamatea. 

For example, if your parents regularly hit you when they're in a bad mood, you may grow up seeing violence as normal. In that environment, it may make sense to "get the first punch in" as soon as you sense conflict so you aren't put on the defensive. Outside that home, however, physical aggression is usually less helpful when resolving conflicts.

However, biological factors can also contribute to sociopathy. Studies suggest PwS have differences in their prefrontal cortex, the part of the brain that helps make decisions. These differences may explain why PwS have difficulty controlling their tempers and tend to take dangerous risks. 

A person's prefrontal cortex may develop differently due to early trauma and hardship. Brain injuries can also damage this area and cause a transition from normal development to sociopathic behavior. A 2019 systematic review found 85 cases of brain injuries causing sociopathy recorded in the past century.

Careers

Psychopathy

PwP can struggle with employment, especially if they have impulsive tendencies. However, some find their charisma and bold decision-making suit them well in their careers. Research suggests around 4.5% of corporate professionals score high enough on the PCL-R to indicate psychopathy.

Some PwP are genuinely good at their jobs. Others may rise the ranks through deceit and manipulation rather than merit.

"Any field that utilizes "'experts'" is vulnerable," says Scott Allen Johnson, author and forensic consultant for the US Department of Defense. 

"Surgeons, military, educators, business executives and of course politicians who possess psychopath traits effectively persuade others of their superiority and expertise, even when their educational and experiential backgrounds do not appear to warrant their success or expertise. They are able to hide their intentions, lie and mislead, yet portray themselves as a rose, a savior to all."

Sociopathy

Sociopathy can make it hard to maintain employment for extended periods. "Sociopaths are not able to hide their antisociality, but rather … quite open and quick to demonstrate their thoughts and violent behaviors," says Johnson.  

Some PwS may find more successful careers after therapy and rehabilitation. Contrary to what older studies claimed, personality disorders, including antisocial personality disorder, are treatable. Research on psychopathy and sociopathy treatment is still very new though. 

The studies that do exist claim treatment works best when it:

• Is highly structured
• Addresses comorbid conditions like anxiety or PTSD
• Has realistic goals with explicit expectations

Crime

Research has shown a strong link between psychopathy, sociopathy, and criminal behavior. Studies have linked these traits to severe crimes such as interpersonal violence or sexual coercion. 

Estimates suggest up to 30% of the prison population meets the criteria for psychopathy and sociopathy. PwP and PwS also have higher rates of reoffending after release.

However, PwP and PwS are not born criminals. Robert Hare, creator of the PCL-R checklist for measuring psychopathy and sociopathy, emphasizes in a 2016 paper that "antisociality" is the core of these conditions, not law-breaking or violence. 

But since the DSM-5 and PCL-R criteria both include criminal behaviors, it is likely that studies overlook PwP and PwS without a criminal background. Therefore, without a clear picture of the whole group, studies may overestimate the prevalence of criminal behavior in PwP and PwS. 

There are also concerns that psychopathy and sociopathy labels may lead to worse sentencing for criminal defendants. According to a 2021 paper, when juries perceive a defendant as psychopathic (regardless of the person's actual mental condition), they are more likely to support a death penalty for that case.

This is an especially serious risk for Black defendants. The same 2021 paper listed past findings such as:

• The PCL-R may skew results against Black respondents.
• Jurors are more likely to see Black defendants as "antisocial" or "psychopathic."
• Black defendants are more likely to be cast as "dangerous," even when their behavior is identical to white defendants.

A 2012 survey of legal professionals found labels of ASPD, psychopathy, or sociopathy had a significant effect on court rulings. Although defense teams often objected to the use of PCL-R and similar screening tools due to their subjectivity, the court typically admitted them as evidence of the defendant's mental health and threat to society.

Psychopathy vs. sociopathy

That was a lot of information, so here is a table summarizing the main differences between psychopathy and sociopathy:

It's important to note that these traits aren't absolute. Someone with sociopathy can have a career, and a person with psychopathy may have impulsive tendencies. But this table can give you a general idea of how to recognize sociopathy or psychopathy in the real world.

Insider's takeaway

To summarize, psychopathy and sociopathy are rare forms of antisocial personality disorder. 

Pop culture tends to mythologize people with these conditions as evil masterminds or born criminals. 

And criminal defendants labeled with psychopathic or sociopathic traits are typically subject to harsher sentences, regardless of their actual mental health.

The truth, however, is they're simply humans with mental health issues and should be treated as such.