Is a psychopath the same as a sociopath?

Popular culture, narrative fiction, the lack of conclusive studies and effective treatments, as well as the complexity of these mental disorders, together cause great confusion when it comes to distinguishing a psychopath from a sociopath. Next, we try illuminate the main differences between sociopathy or antisocial personality disorder (ASP) and psychopathy detailing its main characteristics.

The psychopath: myths, mysteries and certainties

Is a psychopath the same as a sociopath? Source: Unsplash

The considerable fame achieved by some fictional characters recurrently defined as psychopaths has caused the term ‘psychopath’ to become a common adjective to designate unscrupulous criminals that they are capable of perpetrating the greatest atrocities without showing any symptoms of remorse or guilt.

Characters like Alex DeLarge from A Clockwork OrangeHannibal Lecter of The silence of the lambs or John Doe’s Seven have aroused an intense fascination among readers and viewers around the world to the point that we think we know very well the symptoms and behavior of psychopathy.

But psychiatrists do not think so: for them, psychopathy is a highly complex disorder that requires very specific analysis and treatment. Unfortunately you can’t tell a psychopath with a glance just as it happens on the big screen when the psychopath on duty makes an appearance.

Secondly, psychopathy is not considered an exceptional disorder as it is twice as common as schizophrenia or bipolar disorder and as common as obsessive-compulsive personality disorder or narcissism.

The origin of the term psychopastiche is attributed to the German psychiatrist JLA Koch in 1888 literally meaning “suffering soul”gaining clinical popularity until from 1930 it was replaced by the term ‘sociopathy’ since psychopathy was popularly confused with ‘psychosis’. It was the beginning of the confusion between the two terms that still persist today, even at the psychiatric level.

And it is that many professionals they preferred the term sociopath because this focused on the fact that the antisocial behaviors of these people derived from the influence of the environment, while, in parallel, psychopathy seemed to evoke a deeper genetic cause.

Is a psychopath the same as a sociopath?
Is a psychopath the same as a sociopath? Source: Unsplash

As pointed out by the very interesting study The Criminal Psychopath: History, Neuroscience, Treatment, and Economic Costs (2011) Signed by University of New Mexico Professor of Psychology and Neuroscience Kent A. Kiehl and the Denver district judge Morris B Hoffmanthe main symptoms of psychopathy they include lack of empathy, guilt or remorse, irresponsibility and impulsiveness, pathological lying, superficial charm, narcissism, or juvenile delinquency.

According to classification than the canadian robert harePhD in psychology and world-renowned expert in criminal psychology, contributes based on the criteria published by hervey cleckleypioneer in psychopathy research, For a person to qualify as a psychopath, they must meet a sufficient number of criteria according to the table of twenty characteristics classified into four different factors: interpersonal, affective, lifestyle and antisocial.

If we compare these traits with those of the sociopath or TPA we verified that both disorders show very similar characteristics, although with nuances that explain their difference. In this sense, and taking into account that the professional must evaluate each trait with a score from 0 to 40, psychopaths should have a score of 30 or higher in many of the features so that would exclude most people with APD or sociopathy.

Especially relevant to distinguish both disorders are the recent neuroscientific studies that provide hopeful conclusions with a view to establishing more effective treatments, the great workhorse of psychiatry when dealing with psychopathy.

Based on studies that have attempted to trace the neurobiological features of psychopathy supported by modern functional magnetic resonance analyses, it has been concluded that the psychopath’s brain has critical neural deficiency in areas of the limbic system that contribute to limiting moral judgment, producing an inability to recognize moral problems and to make moral decisions regarding the resolution of these problems.

As indicated in the study by Kiehl and Hoffman, just as ordinary people ‘feel’ good and evil, the psychopath must ‘think’ about good and evil to act: “psychopaths know the words of morality, but not its music”. Thus, a combination of Hare’s classification instruments and the most recent neurobiological studies could definitively shed light on the mystery of psychopathy establishing a reliable pattern to optimize psychiatric diagnosis.

Is there an effective treatment for the psychopath?

Is a psychopath the same as a sociopath?
Is a psychopath the same as a sociopath? Source: Pexels

Nothing seems to have worked when it comes to treating psychopaths, to the point that a dogma has been established according to which psychopathy is intractable. This conclusion has been reinforced by some trials of group therapy that not only did not work, but also they made the situation worseby offering more tools to patients in order to optimize manipulation strategies when exposed to the weaknesses of ‘normal people’.

As with most sociopaths, psychopaths are not only more than satisfied with themselves, but in general, they see themselves as superior beings without any kind of psychological or emotional problem. Effective treatment in a patient who does not consider having any disorder becomes extraordinarily complex. As is popularly said, “The first step is to recognize the problem”If this step is not taken, any treatment is sterile.

In any case, along with the great neuroscientific advances in the study of psychopathy, they have also influenced the appearance of new promising treatments that focus on prevention in the early stages of lifeas soon as psychopathic traits are perceived in children or adolescents.

essays with ‘unmanageable’ juvenile delinquents like Michael Caldwell of the University of Wisconsin or the case referred to by Willem HJ Marten in his post on Psychiatric Times -which also affects emotions such as sadness or loneliness of psychopaths traditionally ignored —seem to have hopes for the treatment of psychopathy.

In this sense, a combination of psychotherapy and drugs who cope with the neurological alterations of this disorder could demolish once and for all that dogma that psychopathy is incorrigible and that psychopaths are ruthless devils dressed as humans whose only goal in life is to perpetrate atrocities to terrorize ‘normal people’ in front of a movie screen.

Differences between a sociopath and a psychopath

Is a psychopath the same as a sociopath?
Is a psychopath the same as a sociopath? Source: Depositphotos

After deciphering a good part of the characteristics of psychopathy, as well as its underlying mysteries and its possible treatments, we are now ready to differentiate between the two disorders, always remembering that we are before two polyhedral mental disorders of extraordinary complexity and that psychiatry itself has entangled in a good part of its history.

  • Psychopathy and sociopathy present considerable differences at the neurobiological level so that this field has become the main hope for the treatment of both disorders, especially psychopathy.
  • Despite the belief that a “a psychopath is born and a sociopath is made” the psychiatric reality is much more complex, since both disorders may have inborn featuresso that a baby born with a predisposition to psychopathy does not guarantee that he will become a psychopath (criminal) in the future, though, as Hare put it, “his biological endowment, the raw materials that environmental, social, and learning experiences form in a unique individual, provide a poor foundation for socialization and consciousness formation.”
  • As a general rule, there is a certain professional quorum about which Sociopathy is a disorder that is reinforced or arises in adolescence, including triggers such as child abuse. By contrast, there are no conclusive studies that environmental factors correlate with psychopathy.
  • The social attitude can diverge considerably, tending the psychopath to greater ease in establishing superficial relationships Contrary to what happens with sociopaths who tend to isolate themselves.
  • As for his conduct, both can be impulsive, rejecting that popular cliché reinforced by the narrative fiction that the psychopath is cold and calculating and only commits crimes after a meticulously drawn plan. However, in general, the sociopath might show a greater tendency to emotional instability than the psychopath
  • Finally, it should be mentioned that APD usually shows conduct disorders before the age of 15something that is not so common among psychopaths, in addition to being linked to other mental disorders to a greater extent than it happens with psychopathy.

Anyway, search for generic traits for two such complex disorderseven though it is essential from a psychiatric point of view in order to establish effective treatments, it is very delicate and can incur in a banal generalization.

When treating a patient with one of these two disorders, Psychiatry professionals face a great challengethat of inferring the individuality of some general features to establish an effective specific treatment.

Is a psychopath the same as a sociopath?