Few psychology terms stir up confusion like the word psychopath. Even though it’s commonly used to describe someone who has a mental illness, psychopath is not an official diagnosis.
The true definition of a psychopath in psychiatry is antisocial personality disorder (ASPD), explains Dr. Prakash Masand, a psychiatrist and the founder of the Centers of Psychiatric Excellence. ASPD describes an individual who shows patterns of manipulation and violation to others.
Masand says the one thing that can be confusing about ASPD are the words “anti-social.”
“Most people might assume this describes someone who is reserved, a loner, keeps to himself, etc. However, this is not the case in ASPD,” he explains. “When we say anti-social in ASPD, it means someone who goes against society, rules, and other behaviors that are more commonplace.”
Since the term psychopath is not an official diagnosis, experts refer to the signs described under ASPD. According to Masand, some of the more common signs to be aware of include:
- socially irresponsible behavior
- disregarding or violating the rights of others
- inability to distinguish between right and wrong
- difficulty with showing remorse or empathy
- tendency to lie often
- manipulating and hurting others
- recurring problems with the law
- general disregard towards safety and responsibility
Other behaviors that may be signs of ASPD include a tendency to take risks, reckless behavior, and being deceitful with frequent lying.
Masand says someone exhibiting this behavior may also lack deep emotional connections, have a superficial charm about them, be very aggressive, and get very angry sometimes.
Additionally, people with ASPD don’t care if they have hurt someone, are impulsive and abusive, and lack remorse. In the case of ASPD, abusive doesn’t necessarily mean violent.
In addition to the signs and behaviors, Masand says there are certain traits associated with ASPD:
- More men than women have this diagnosis.
- Technically, to receive an ASPD diagnosis, you have to be 18 years of age. But some people will show signs of conduct disorder, which may be an early indicator of ASPD, as early as age 11.
- It’s a chronic condition that seems to improve with age.
- Mortality rates are higher in people with ASPD because of their behavior.
Since psychopathy is not an official mental disorder, the condition experts diagnose is ASPD. Before explaining the criteria used to diagnose ASPD, it’s important to mention that diagnosing and treating ASPD presents some unique challenges.
According to Masand, ASPD can be difficult to treat because the person who needs help doesn’t believe there is a problem with their behavior. As a result, they rarely seek treatment.
That said, the established guidelines used to diagnose ASPD is that the behavior generally begins by age 15 or in the teenage years. However, Masand says a true ASPD diagnoses is not made until the age of 18. “For most people, the worst of the behavior occurs in the late teen years throughout the twenties,” he explains.
To get a proper diagnosis, a mental health professional will conduct a full mental health evaluation. During this process, the mental health professional will evaluate a person’s thoughts, feelings, behavior patterns, and relationships. They will identify symptoms and compare them to the ASPD symptoms in the DSM-5.
The mental health professional will also look at medical history. This full evaluation is a critical step since ASPD tends to show comorbidity with other mental health and addictive disorders.
Since a true ASPD diagnosis is typically delayed until the age of 18, adolescents and teens that display similar symptoms are often evaluated for conduct disorder (CD) or oppositional defiant disorder (ODD).
Of the two behavior disorders, CD is more severe than ODD. When determining if a child has ODD, clinicians will look at how they act around people they know.
Typically, someone with ODD is more likely to act oppositional or defiant around family members, teachers, or a healthcare provider. If an adolescent or teen is showing an ongoing pattern of aggression toward others and they regularly make choices that are in opposition of the rules and social norms at home, school, or with peers, a clinician may decide to evaluate for CD.
Like many other terms in the field of psychology, psychopath and sociopath are often used interchangeably, and it’s easy to see why. Since sociopath is not an official diagnosis, it joins psychopath under the umbrella diagnosis of ASPD. There is no clinical difference between the two.
“Some people make an artificial distinction based on severity of the personality disorder but that’s incorrect,” explains Masand. “They will say that psychopathy is a more severe form of sociopathy, but again, that is really incorrect.”
Both psychopath and sociopath are other terms or ways to describe ASPD. The behaviors that are seen in both fall under the symptoms in the ASPD category.
Like the diagnostic process, treating someone with psychopathic traits that fall under the ASPD diagnosis can be difficult. Typically, a healthcare provider will use a combination of psychotherapy (talk therapy) and medication.
However, personality disorders cannot be treated with medication. Psychotherapy can help the person understand their diagnosis and how it impacts their life and their relationships with others. A therapist will also work to develop strategies that decrease the severity of the symptoms.
If medication is part of the treatment plan, a doctor might prescribe medications that treat other metal health conditions such as anxiety, depression, or symptoms of aggression.
The word psychopath is often misused by the general public. That’s why it’s important to de-mystify the term and explain the correct diagnosis and terminology to use when describing this particular set of behaviors. Since it is not an official diagnosis, psychopathy falls under the ASPD diagnosis.