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What is a psychopath? Signs, causes, treatments

Reviewed by Cathy Leeson, SLP

Outline of two heads facing each other showing gears in place of their brains

What Is a Psychopath?

Psychopathy is a neuropsychiatric disorder characterized by a lack of empathy as well as limited or incomplete control over emotional responses. Often, this combination leads to persistent antisocial and criminal behavior. 

“Psychopathy” is not a diagnostic term recognized by the DSM-5. Instead, psychopathy would fall under antisocial personality disorder. ASPD is a personality disorder in which a person shows a disregard for the feelings and rights of others and a lack of remorse. All psychopaths have ASPD, but not everyone with ASPD is a psychopath. 

Psychopaths vs. Sociopaths

Is there a difference between psychopaths and sociopaths? While the two conditions’ tendencies overlap and both fall under the ASPD diagnosis, there are some differences.  

Experts believe that psychopathic tendencies are influenced largely by genetics, in addition to environmental factors. Sociopathic tendencies are influenced more by environmental factors, such as adverse living conditions and childhood trauma, in addition to genetics. Also, psychopaths are much less common than sociopaths, making up less than one percent of the U.S. population.

Psychopathic behavior is often premeditated and more carefully planned than sociopathic behavior. While psychopaths are more controlled and effective at planning their actions, sociopaths are more impulsive and prone to bursts of anger.

What Causes Psychopathy?

We don’t have a definitive link to claim that there are certain causes of psychopathy, but we do know there are risk factors that make it more likely in an individual. Here are four main factors that can put an individual at risk for developing psychopathy.

1. Genetics

While there isn’t a specific gene known to cause psychopathy, experts believe that genetics play a role in an individual exhibiting psychopathy. This means that psychopathy can run in families. Even when an individual doesn’t exhibit psychopathic tendencies, they may carry genes that might influence their children to be more prone to this type of disorder.

2. Brain Chemistry

Another risk factor for psychopathy is an individual’s brain chemistry. According to a study of prisoners run by University of Wisconsin-Madison researchers, individuals diagnosed with psychopathy have reduced connections between the area of the brain responsible for empathy and guilt, and the area of the brain responsible for mediating fear and anxiety. 

3. Lack of Parental Attachment

Growing up in a dysfunctional environment can contribute to psychopathic tendencies, which can involve a lack of parental attachment. Experiencing the trauma of abuse and neglect as a child can increase a person’s risk for developing a variety of mental health disorders, including psychopathy.

4. History of Childhood Behavioral Disorders

The final risk factor that affects the development of psychopathy is an individual’s history of childhood behavioral disorders. If a child has a conduct disorder, oppositional defiant disorder (ODD), or other personality disorders, the individual is at a higher risk of developing psychopathy later in life.

Signs of a Psychopath

Psychopathy is not diagnosed in the DSM-5, but antisocial personality disorder is. An individual is not usually classified as having psychopathic tendencies until they are 18 years old. However, signs tend to become apparent around the age of 15. The following are signs of a psychopath:

  • Lack of empathy
  • Charming
  • Manipulative
  • Inflated sense of self
  • Calculating
  • Narcissistic
  • Lack of remorse/conscience
  • Lying
  • Shallow affect
  • Impulsive behavior

Examples of Psychopathic Behavior

  • Not taking responsibility
  • Lying with comfort and ease
  • Gaslighting others
  • Mimicking “correct” emotional responses
  • Violating boundaries
  • Manipulating or hurting others without remorse
  • Appearing fearless in risky or dangerous situations
  • Engaging in cruel or malicious behavior for enjoyment

Treatment Options for Psychopaths

While psychopathy cannot be cured, it can be managed with various treatments to make individuals with psychopathy less dangerous to themselves and others. Often, multiple treatments are used together.

1. Cognitive Behavioral Therapy (CBT)

One treatment is cognitive behavioral therapy (CBT), which focuses on the relationship between thoughts, feelings, and behaviors. For individuals with psychopathy or other personality disorders, the interconnection between these factors can cause a vicious cycle of repeated triggers, leading to harmful actions. CBT seeks to break down these existing connections in which a trigger causes a harmful action by the creation of new connections with more positive outcomes. Browse our directory to find a CBT therapist near you.

2. Antipsychotics

Another choice for treatment is the use of antipsychotic drugs. Since individuals with psychopathy can be violent and aggressive in their thoughts and actions, antipsychotic drugs may help to reduce the urge to harm others. 

3. Mood Stabilizers

Mood stabilizers are another class of drug that can help treat psychopathy. Mood stabilizers can reduce the agitation and delusions that can lead those with psychopathic tendencies to act violently.

Barriers to Treatment

As psychopathy is a severe form of antisocial personality disorder, there are barriers to these treatment options.

  • Lack of engagement: Since people with psychopathy are often manipulative, they may appear engaged in treatment while not taking it seriously. Narcissism can also cause them to see no need for treatment.
  • Lack of insight: People with psychopathy may lack the insight necessary to truly understand why they need the treatment or what the treatment addresses. They may blame others for negative consequences instead of their own behavior.
  • Unsustainable treatment: Even if the person is genuinely engaged with therapy at times, they may not be able to sustain the level of engagement needed to make a positive difference.
  • Previous negative experience: Individuals may have experienced treatment in the past that failed or to which they attribute recurrences of symptoms.

Frequently Asked Questions (FAQs)

Are Psychopaths Born or Made?

Psychopathy results from a combination of genetic and environmental factors. A strong genetic tendency toward psychopathy may be triggered by environmental factors.

Is My Child a Psychopath?

Psychopathy can begin in childhood, but is not often diagnosed until an individual is 18 years old. Commonly, behavioral signs begin to show around 15 years of age, although they can show earlier. There may be another mental health disorder at play that could be perceived as psychopathy, such as oppositional defiant disorder or conduct disorder.

About the author

The editorial team at works with the world’s leading clinical experts to bring you accessible, insightful information about mental health topics and trends.

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