Psychopathy is not a formal clinical diagnosis. The term is often used to refer to symptoms of antisocial personality disorder (ASPD), like low empathy, manipulation tendencies, and lack of remorse.

The word “psychopathy” was first used in the late 1800s to refer to people with some mental health conditions. The term comes from two Greek words that combined mean “suffering soul.”

These days, psychopathy is not a widely accepted clinical term or diagnosis. But people may still commonly use it to refer to antisocial personality disorder (ASPD).

And, while some clinicians still use the term “psychopathy” to refer to a severe subtype of ASPD, the general consensus is that this subtype just falls under the umbrella of ASPD.

ASPD is a pattern of unconcern or disinterest in the rights and needs of others, often paired with a tendency for impulsivity and lack of remorse. It has also been called psychopathy and sociopathy.

ASPD is 1 of 10 personality disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR). This is a reference handbook used by most U.S. mental health professionals when establishing a mental health diagnosis.

A personality disorder is a lifelong mental health condition that affects how you behave and feel about others and yourself, often causing a high degree of distress or impairment. It may affect aspects of your life, like the way you think, how you feel, how you interact with others, and your ability to control your impulses.

Unlike other personality disorders, only people over the age of 18 years can receive a diagnosis of ASPD, although symptoms often develop earlier than that.

Psychopathy in children and teens

Because the diagnosis of antisocial personality disorder (ASPD) is typically delayed until the age of 18, younger people who display similar symptoms are often evaluated for conduct disorder (CD) or oppositional defiant disorder (ODD).

Of the two behavioral disorders, CD tends to manifest with more severe symptoms than ODD.

When determining whether a child has ODD, mental health professionals may 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, school, or with peers, a clinician may decide to evaluate for CD.

To receive a diagnosis of ASPD, there must be enough evidence of problematic conduct or a previous diagnosis of CD by age 15.

According to the DSM-5-TR, these are the criteria to diagnose ASPD:

  • behavior that often conflicts with social norms, particularly not following laws and regulations
  • disregarding or violating the rights and feelings of others
  • difficulty feeling remorse or empathy, or justifying actions that have hurt others
  • tendency to lie, manipulate, and deceive others, often for personal enjoyment or gain
  • general disregard for the safety of self and others
  • avoidance of responsibility, including work and financial commitments
  • aggressive and violent behavior and constant irritability
  • difficulty planning ahead or managing impulses

These symptoms must be evident across different situations and over time, and they are often evident since adolescence, although a diagnosis can only be confirmed after age 18.

Lack of awareness is also often present in antisocial personality disorder, which means most people with the condition don’t realize they have it or see anything problematic with their behavior. As a result, few people seek treatment.

ASPD is more commonly diagnosed in men, and symptoms may slightly improve with age for some people.

Symptoms of ASPD have been referred to as both psychopathy and sociopathy. There is no clinical difference between the two terms.

Both concepts describe the ASPD experience, but “psychopathy” may be used more often to describe symptoms involving personality traits (like low impulsivity and lack of remorse), while “sociopathy” may be used to describe behaviors that directly involve other people (like violence, criminality, and manipulation tactics).

While the exact cause of personality disorders is not known, experts suspect a combination of environmental, experiential, and genetic factors.

More research is needed to understand the genetic aspects of ASPD, but research suggests that almost 20% of people with ASPD have a close relative who also has the condition. In a large study of twins from 2017, researchers found that about 51% of ASPD traits may be hereditary.

Environmental and experiential factors may include:

  • childhood neglect
  • trauma and other adverse experiences, such as childhood abuse
  • growing up with people with ASPD or other mental health conditions

Personality disorders, including ASPD, can be managed to some degree, but they often involve long-lasting symptoms. There is no treatment specifically tailored to treat symptoms of ASPD, though.

Traditional mental health management approaches like psychotherapy (talk therapy) and medication may help manage symptoms like impulsivity and aggression. Medications may also help manage co-occurring conditions like anxiety and depression.

Medication options for ASPD may include:

Psychotherapy may help in understanding how symptoms can impact your life and relationships.

According to a 2015 research review, early interventions in adolescents with CD helps reduce the chance of them developing ASPD.

The word “psychopath” is often informally used to describe someone with ASPD. This personality disorder primarily involves behavior that conflicts with social norms, as well as a general disregard for others and a lack of remorse.

ASPD is a lifelong condition, but therapy and medication may relieve some symptoms like anxiety and low impulse control.