I am a Professor of Psychology and Neuroscience at Georgetown University. I received my Ph.D. from Harvard University and conducted my post-doctoral research at the National Institute of Mental Health. I am currently the President of the Social and Affective Neuroscience Society. Show My research is aimed at answering the questions: How do we understand what others think and feel? What drives us to help other people? What prevents us from harming them? I use functional and structural brain imaging, as well as behavioral, cognitive, genetic, and pharmacological techniques to answer these questions, and have over 80 publications in journals that include Proceedings of the National Academy of Sciences, Nature Human Behavior, Psychological Science, and JAMA Psychiatry. I have also authored articles for The Washington Post, NPR, Psychology Today, and The Chronicle of Higher Education. My research has received awards that include the Cozzarelli Prize for scientific excellence and originality from the Proceedings of the National Academy of Sciences, The S&R Kuno Award for Applied Science for the Social Good, and the Richard J. Wyatt Fellowship award for translational research from the NIMH. I serve on the advisory boards of the National Kidney Donation Organization and 1Day Sooner, and am the co-founder of Psychopathy Is. Psychopathy is defined as a mental (antisocial) disorder in which an individual manifests amoral and antisocial behavior, shows a lack of ability to love or establish meaningful personal relationships, expresses extreme egocentricity, and demonstrates a failure to learn from experience and other behaviors associated with the condition. From: Dominance and Aggression in Humans and Other Animals, 2017 Medically Reviewed by Smitha Bhandari, MD on February 14, 2022 You may have heard people call someone else a “psychopath” or a “sociopath.” But what do those words really mean? You won’t find the definitions in mental health’s official handbook, the Diagnostic and Statistical Manual of Mental Disorders. Doctors don’t officially diagnose people as psychopaths or sociopaths. They use a different term instead: antisocial personality disorder. Most experts believe psychopaths and sociopaths share a similar set of traits. People like this have a poor inner sense of right and wrong. They also can’t seem to understand or share another person’s feelings. But there are some differences, too. A key difference between a psychopath and a sociopath is whether he has a conscience, the little voice inside that lets us know when we’re doing something wrong, says L. Michael Tompkins, EdD. He's a psychologist at the Sacramento County Mental Health Treatment Center. A psychopath doesn’t have a conscience. If he lies to you so he can steal your money, he won’t feel any moral qualms, though he may pretend to. He may observe others and then act the way they do so he’s not “found out,” Tompkins says. A sociopath typically has a conscience, but it’s weak. They may know that taking your money is wrong, and they might feel some guilt or remorse, but that won’t stop their behavior. Both lack empathy, the ability to stand in someone else’s shoes and understand how they feel. But a psychopath has less regard for others, says Aaron Kipnis, PhD, author of The Midas Complex. Someone with this personality type sees others as objects he can use for his own benefit. In movies and TV shows, psychopaths and sociopaths are usually the villains who kill or torture innocent people. In real life, some people with antisocial personality disorder can be violent, but most are not. Instead they use manipulation and reckless behavior to get what they want. “At worst, they’re cold, calculating killers,” Kipnis says. Others, he says, are skilled at climbing their way up the corporate ladder, even if they have to hurt someone to get there. If you recognize some of these traits in a family member or coworker, you may be tempted to think you’re living or working with a psychopath or sociopath. But just because a person is mean or selfish, it doesn’t necessarily mean they have a disorder. It’s not easy to spot a psychopath. They can be intelligent, charming, and good at mimicking emotions. They may pretend to be interested in you, but in reality, they probably don’t care. “They’re skilled actors whose sole mission is to manipulate people for personal gain,” Tompkins says. Sociopaths are less able to play along. They make it plain that they’re not interested in anyone but themselves. They often blame others and have excuses for their behavior. Some experts see sociopaths as “hot-headed.” They act without thinking how others will be affected. Psychopaths are more “cold-hearted” and calculating. They carefully plot their moves, and use aggression in a planned-out way to get what they want. If they’re after more money or status in the office, for example, they’ll make a plan to take out any barriers that stand in the way, even if it’s another person’s job or reputation. Recent research suggests a psychopath’s brain is not like other people’s. It may have physical differences that make it hard for the person to identify with someone else’s distress. The differences can even change basic body functions. For example, when most people see blood or violence in a movie, their hearts beat faster, their breathing quickens, and their palms get sweaty. A psychopath has the opposite reaction. He gets calmer. Kipnis says that quality helps psychopaths be fearless and engage in risky behavior. “They don’t fear the consequences of their actions,” he says. Medically reviewed by Jeffrey Ditzell, DO — Written by Sara Lindberg — Updated on June 1, 2022
Psychopathy, while not a clinical diagnosis, often refers to someone with antisocial personality disorder. Few psychology terms stir up confusion like “psychopath.” Even though it’s commonly (though incorrectly) used to describe someone who has a mental health condition, “psychopath” is not an official diagnosis. Instead, it’s an informal term often used for a condition called antisocial personality disorder (ASPD). The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) does not list psychopathy as an official clinical diagnosis. The true definition of a psychopath in psychiatry refers to someone with ASPD, explains Dr. Prakash Masand, a psychiatrist and co-founder of the Centers of Psychiatric Excellence. ASPD describes a condition marked by patterns of manipulation tactics and violation of others. ASPDMasand says one thing that can be confusing about ASPD is the phrase “antisocial.” “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 antisocial in ASPD, it means someone who goes against society, rules, and other behaviors that are more commonplace.” While some clinicians regard psychopathy as a more severe subtype of ASPD, the general consensus is that psychopathy falls under the umbrella of ASPD. In this article, we refer to information about ASPD. Read on to learn more important information about ASPD, such as the signs, diagnostic criteria, and treatment options. Share on PinterestIllustration by Sophia Smith 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 of ASPD can include:
Other possible signs of ASPD include a tendency to engage in behavior that’s reckless, impulsive, or may lead to harmful consequences. Masand says someone exhibiting this behavior may also:
Additionally, people with ASPD may not react as if they have hurt someone, and they may be impulsive or abusive and may 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 characteristics that are more prevalent in people with ASPD:
Since psychopathy is not an official mental health condition, the condition experts diagnose is ASPD. This is one of four cluster B personality disorders outlined by the DSM-5, and the other three are: 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 often doesn’t believe there is a problem with their behavior. As a result, they rarely seek treatment. That said, according to the established guidelines used to diagnose ASPD, the behavior generally begins by age 15 or in the teenage years. However, Masand says a true ASPD diagnosis 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. Diagnostic criteriaTo 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:
The mental health professional will identify symptoms and compare them with the ASPD criteria in the DSM-5. In order to receive a diagnosis of ASPD, a person must show a pattern of disregard for and violation of the rights of others. This is indicated by three or more of the following criteria, according to the DSM-5:
The mental health professional will also look at a person’s medical history. This full evaluation is a critical step since people with ASPD often have other mental health and substance use disorders. AgeBecause a true ASPD diagnosis is typically delayed until the age of 18, adolescents and teens who 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, mental health professionals 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 professional. If an adolescent or teen shows an ongoing pattern of aggression toward others and regularly makes choices in opposition to the rules and social norms at home, at school, or with peers, a clinician may decide to evaluate for CD. To receive a diagnosis of ASPD before the age of 18, a teen must also have a previous diagnosis of CD by age 15. “Psychopath” and “sociopath” are often used interchangeably to informally describe someone with ASPD. Since sociopath is also not an official diagnosis, it typically joins psychopath under the umbrella diagnosis of ASPD. There is no clinical difference between the two terms. Both psychopathy and sociopathy are other terms or ways to describe ASPD. The behaviors that are often seen in both tend to fall under the criteria of ASPD. Like the diagnostic process, treating someone with traits that fall under the ASPD diagnosis can be difficult. Typically, a doctor may recommend a combination of psychotherapy (talk therapy) and medication. While no evidence supports that any medication or form of psychotherapy can cure ASPD, these methods may still help manage some of the symptoms, like impulsivity and aggression, and improve quality of life. According to a 2015 review, early interventions in adolescents and teens who received a diagnosis of CD may also help prevent ASPD. The researchers in the 2015 review also found that for some people with ASPD, the condition may improve or remit as they get older — with improvement occurring at a median age of 35. They also found that people with stronger social ties and support, such as a spouse or family, were more likely to experience remission. Psychotherapy may be helpful in understanding how the disorder can impact your life and relationships. A mental health professional will work to develop strategies that help decrease the severity of the symptoms. If medication is part of the treatment plan, a doctor might prescribe medications that treat related mental health conditions, such as anxiety, depression, or symptoms of aggression. Options may include: The word “psychopath” is often informally used to describe someone with ASPD. ASPD is notthe same as being “antisocial.” It primarily involves behavior that conflicts with social norms, as well as a general lack of disregard for others. Despite the complexities surrounding ASPD, a mental health professional may be able to identify this condition and offer treatment that can help. Read this article in Spanish. Last medically reviewed on June 1, 2022 |