A psychopath lacks empathy for others and displays an elevated level of self-esteem while using charm to manipulate others. The term may be frequently used in the media to describe a person with intense criminality, but clinicians rarely use the word to describe patients. While psychopathy is not an official mental health condition, it may be related to certain personality disorders.
What Is a Psychopath?
Because “psychopath” is not an official mental health disorder recognized by any major psychological group like the American Psychiatric Association (APA), there is not one single definition or description. In the most general terms, a psychopath is a person who uses their charisma and appeal to manipulate people into meeting their needs without feeling guilty.1
The psychopath will use other people, organizations, and groups to gain money, power, sex, and other desired items. With their power of persuasion, the psychopath often convinces the victim to freely offer goods and services to them, even though it could result in negative consequences to the person being taken advantage of.2
Commonly, the psychopath feels no remorse, shame, guilt, empathy, or regret concerning their manipulation. They will find ways to justify their behavior by blaming the victim or society for making them follow through on their damaging behaviors.
While psychopathy is not a recognized mental health disorder, it does share many similarities with an official diagnosis called antisocial personality disorder. Personality disorders are mental health concerns with long durations. Compared to conditions like depression and anxiety, personality disorders may last a lifetime with consistent symptoms.
Antisocial personality disorder symptoms may include:3
- Failure to respect and follow laws or conform to expected social functioning
- Frequently lying to people for personal pleasure or profit
- Impulsivity and an inability to plan ahead
- Irritability and aggressive behaviors
- Disregard for the heath, safety, and well-being of others
- Irresponsibility and failing to fulfill work, home, and financial obligations
- Lack of remorse for hurting other people
Psychopath vs. Sociopath
Although the terms psychopath and sociopath are sometimes used interchangeably, the primary difference is the source of the dysfunction. For a psychopath, the person’s symptoms are influenced by their heredity, development, and genetic makeup with the implication that they are born a psychopath. Sociopathy implies that the symptoms are a product of the person’s environment and life experiences.2
Sociopath was a preferred term during the early part of the 1900s as a way to separate these behavioral and relationship symptoms from psychosis, a state where the person has hallucinations or delusions.2 The term sociopath became much less popular in 1980 when the APA expanded the definition of antisocial personality disorder.
Signs of a Psychopath
By their very nature, a psychopath has the ability to go undetected for long periods, which allows them to create more damage and chaos in their environment. Some of the cornerstones of psychopathy involve superficial charm, criminal behavior, manipulation, and lack of remorse, with certain traits more typically found in male or female psychopaths.
Some of the numerous signs of psychopathy are:2
- Inflated sense of self-worth
- Strong desire for stimulation
- Lying, cheating, stealing
- Shallow emotional reactions
- Poor impulse control
- Sexual promiscuity and chaotic romantic relationships
- Lack of responsibility
Psychopaths may seem interesting, mysterious, and oddly compelling at first. They may hide or conceal aspects of their life and past in order to manage the way others perceive their history. The presentation of the psychopath will change over time as others gain a more complete understanding of their life and their goals. Initially, they may appear good-natured or misunderstood, but as time progresses, their facade begins to crumble.
Lies and manipulation become more consistent or blatant over time. They begin to contradict themselves or engage in reckless behaviors that do not match their curated image. Overall, psychopaths will do whatever it takes to get what they want with little to no regard for other people.
Other psychopaths will spend a significant percentage of their lives incarcerated. Studies suggest that psychopaths consume a tremendous proportion of resources in the criminal justice system and frequently fail to be rehabilitated, resulting in high rates of recidivism and longer stints of prison time.2
Causes of Psychopathy
Like many mental health conditions, a combination of genetics and environment play a factor in dictating the emergence of psychopathy.1 Previously, experts believed there were separate versions of the condition triggered by genetic issues or environmental experiences. As understanding progressed, the majority of experts agree that multiple factors contribute to psychopathy.
Some factors that increase the rates of psychopathy include:1,2,3
- Having a close family member with psychopathy or antisocial personality disorder
- Low socioeconomic status
- Growing up in urban settings, which could be linked to feeling unsafe as a child
- Trauma linked to physical, verbal, or sexual abuse and neglect
- Poor academic success
Differences in brain functioning could contribute to psychopathy as well. Experts suggest that psychopaths may have a restricted response to fear, which makes them more willing to engage in dangerous or embarrassing situations. Others suggest that functional differences lead to a psychopath having deficits in their ability to recognize and respond to emotional and social cues.1
Not only are functional differences apparent, but psychopaths may also have structural abnormalities in certain areas of the brain that could result in signs and symptoms of the condition.
Brain scans show differences in regions including:1
- Prefrontal cortex
- Amygdala
- Hippocampus
- Temporal cortex
With these and other areas of the brain showing atypical structure, the person is more likely to exhibit signs like disinhibition, hostility, trouble monitoring conflict, and poor thought control.1 These structural issues do well to illustrate just how ingrained and rigid the symptoms of psychopathology are.
Psychopaths & Violence
Not all psychopaths are violent, but many will show aggression and harmful acts against people or property. Some may start out by being only charming and charismatic before shifting to periods of anger, aggression, and violence. These periods may build up over time or arrive without prior warning. Psychopaths are not common among adults in the general population as only about 1% of adults meet the criteria for the label, but in the prison population the numbers soar.1
According to studies:1
- About 20% of the prison population in North America is comprised of psychopaths
- Psychopaths are three times as likely to commit additional crimes than non-psychopaths
- Psychopaths are four times as likely to be violent during the additional crimes compared to others
In a sample of incarcerated people over an extended period of time, 77% of psychopaths committed a violent crime during a 10-year period. During a 20-year period, 90% of psychopaths committed violent crimes. Meanwhile, only about 40% of non-psychopaths engaged in these types of violent behaviors.1
These acts of violence cover the entire spectrum of behaviors ranging from simple assaults to murder. Psychopaths could react impulsively and aggressively in the moment, or they could work to orchestrate an elaborate plan involving an act of terrorism. The violence perpetrated by psychopaths can impact individuals, families, and entire communities.
Is There a Psychopath Test?
There is not one unified test that professionals use to determine someone’s status as a psychopath. Instead, there are several assessments and evaluations utilized in studies and clinical practice to quickly identify psychopathic traits and characteristics.
One of the newest tests, designed in 2016, is called the Psychopathic Personality Traits Scale (PPTS). This measure uses 20 statements to assess a person’s levels of emotional response, cognitive response, manipulation, and self-centeredness.4 With the PPTS, higher scores equate to higher levels of psychopathy, but even answering in the affirmative to several items could indicate troublesome amounts of psychopathy. People concerned about the scores for themselves or their loved ones should consider seeking professional mental health treatment to address these concerns.
Treatment of Psychopathy
Psychopathic features and symptoms can be targeted through a combined approach involving psychotherapy and medication management. Professionals and patients must do well to manage their expectations and focus on symptom reduction rather than full recovery. Although the treatment of psychopathy can be challenging, it is still a worthwhile endeavor, even though many professionals previously believed treatments would intensify symptoms.5
Psychological concerns like depression, anxiety, and even post-traumatic stress disorder (PTSD) often respond well to mental health treatments because these issues are mental health states that are prone to change. Personality issues like antisocial personality disorder and psychopathy tend to be more static and exist for longer periods of time.3
Therapy for Psychopathy
Perhaps the best way to treat psychopathy is by identifying symptoms in younger people to match them to appropriate interventions as early as possible. People under the age of 18 may show signs of conduct disorder, a mental health condition that usually develops into antisocial personality disorder.
Signs and symptoms of conduct disorder include:3
- Aggression to people and animals
- Destruction of property
- Deceitfulness and theft
- Serious violations of rules
By targeting youths with these symptoms and offering them rewards for any and all positive behaviors, treatments can condition desired levels of social engagement. One specific type of treatment called the Decompression Model uses this positive reinforcement schedule to teach and encourage socially appropriate behaviors so they are more likely to continue over time.6
Studies that compare youth who engaged in this program to those who did not found that 98% of those who did not complete the program were arrested again within four years while only 64% who completed the program were arrested.6
This rate illustrated two important conclusions:
- Treating youths with psychopathic tendencies is effective
- Even with the best treatment, more than half of people will continue with psychopathic tendencies
Adults may find symptom relief with similar behavioral reinforcements as well as other therapy styles like:5
- Cognitive behavioral therapy (CBT): Draws on the notion that thoughts, feelings, and behaviors are interconnected. Targeting unwanted thoughts and behaviors can improve a person’s feelings.
- Interpersonal therapy: Focuses on building healthy and reciprocal relationships with trusted supports through assertive communication skills and conflict resolution.
- Dialectical behavioral therapy (DBT): Is based on CBT principles but places additional emphasis on interpersonal communication, emotional regulation, distress tolerance, and mindfulness, which are all common deficits in someone with psychopathy.
Medication for Psychopathy
Unfortunately, research and study devoted to therapy for psychopathy has not been duplicated with the use of medication. Currently, there is no medication specifically recommended or prescribed for the treatment of psychopathy.5 The good news is that there are some medication interventions available.
Rather than attacking the psychopathy directly, medications may be offered to address the co-occurring conditions that may accompany psychopathy. So, if a person has anxiety, depression, attention-deficit/hyperactivity disorder (ADHD), or other mental health conditions in addition to psychopathy, a psychiatric expert could prescribe medications to address these conditions and indirectly improve symptoms of psychopathy.5
In coming years, people can expect to see more research and treatment options available to address and better resolve symptoms of psychopathy in children and adults.
Final Thoughts on Psychopaths
Psychopathy is a serious group of symptoms with the power to influence the person with the condition and their loved ones. If someone you know is showing the signs and symptoms of psychopathy, consult with a trusted mental health professional as soon as possible. Like with other conditions, earlier treatment leads to better outcomes.
For Further Reading
What Is a Psychopath Infographics
