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The topic of personality disorders can be controversial and challenging to navigate. This article aims to provide an overview and offer guidance on the issue.

What is a psychopath?

The term “psychopath” refers to an individual who exhibits psychopathic traits, which are characterized by a profound lack of empathy and remorse, excessive charm, manipulative behaviour, and often an antisocial lifestyle.

It is important to understand that ‘psychopathy’ is not a formal psychiatric diagnosis. Instead, the term is used in psychology and criminology to describe a particular personality trait or behavioural pattern. The diagnosis used in healthcare is antisocial personality disorder, but not all people with psychopathic traits meet all the criteria for diagnosis.

It is important to note that not all people with psychopathic traits commit crimes or are violent. Psychopathic traits vary in degree and intensity among individuals, and some can function relatively well in society. However, there can be problems in relationships and work, often in the longer term.

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What are personality disorders?

Personality disorders, or personality syndromes, are psychological conditions that affect an individual’s thoughts, feelings and behaviours in a way that often differs significantly from societal norms and expectations.

What causes psychopathy?

Psychopathy results from an interaction of genetic, biological and environmental factors. Although the exact causes are not fully understood, several theories and research findings point to the influence of genetic factors. There is also a neurobiological basis, including an underactive stress response, which may explain a lack of remorse and fear. Growing up with neglect and trauma can also have an impact. It is probably an interaction between both heredity and the environment, where an unhealthy environment can also produce the symptoms.

How common is psychopathy?

Antisocial personality disorder occurs in an estimated 3% of men and less than 1% of women. Among those sentenced to prison, the proportion is much higher, with over 50% having antisocial personality traits.

Symptoms of psychopathic traits and antisocial personality syndrome

The most common symptoms and characteristics of people with psychopathic traits and antisocial personality disorder may include:

  1. Superficial charm: An ability to be polite and charming in social settings, often to manipulate or deceive others.
  2. Delusions of grandeur: An exaggerated sense of self-importance or superiority.
  3. Pathological lying: A tendency to consistently lie or mislead others.
  4. Manipulative behaviour: Taking advantage of others for personal gain or pleasure.
  5. Lack of remorse and regret: A lack of guilt or remorse for actions that harm others.
  6. Profound emotional shallowness: A lack of more profound emotional experiences or a real connection with others.
  7. Lack of empathy: The inability to feel or understand the feelings or needs of others.
  8. Impulsivity: Difficulty planning and a tendency to act spontaneously without regard to consequences.
  9. Aggressive or problematic behaviour: This can include physical violence, threats, or other forms of aggressive behaviour.
  10. Irresponsibility: An inability or unwillingness to meet financial, work or social commitments.
  11. Risky behaviour: Engaging in dangerous activities, often without regard for personal safety or the safety of others.
  12. Parasitic lifestyle: Living at the expense of others or taking advantage of others’ hospitality without contributing.

What is the difference between psychopathy and sociopathy?

Neither of these are actual diagnoses but are referred to from antisocial personality syndrome in diagnostic manuals such as the DSM-5. However, they are both used in common parlance and are generalizations. The difference is that psychopaths are thought to have a genetic basis for their behaviour and tend to be superficially charming and manipulative, with little or no capacity for empathy or remorse. They can integrate into society and hide their antisocial behaviours effectively.

Sociopaths are more often thought to develop antisocial behaviour due to environmental factors such as childhood trauma. They are usually more impulsive, have difficulties forming stable relationships, and their antisocial behaviour is more often visible. Sociopaths may have some capacity for emotional response and may experience some form of remorse or guilt, especially towards people they feel close to.


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Assessment for Antisocial Personality Disorder

Personality disorders are usually diagnosed in specialist psychiatry through a personality assessment. For the diagnosis of antisocial personality disorder to be made, the problems must have been present since childhood/adolescence, which means that the diagnosis of “conduct disorder” must often be present before the age of 15. This may differ from expected criminal behaviour, as it is not always present since childhood and may not manifest itself in the same way in relationships.

It is also essential to distinguish substance abuse and dependence syndromes from personality syndromes. People can also develop antisocial traits if they have ADHD and are punished for their difficulties by a less understanding environment. So, it is also essential that people with ADHD get the proper care and treatment early on.

Treatment for psychopathy

People with psychopathic traits or antisocial personality disorder rarely seek treatment. They often lack emotional responses of guilt, shame and remorse. Instead, they are usually motivated by anger. It is, therefore, not uncommon for these people to develop a lifestyle of addiction or criminality. Nevertheless, these people must get the proper treatment to reduce harm to themselves and others.

Advice for those who know a psychopath

If you have started a relationship with someone who you think has psychopathic traits, it is best to end the relationship as soon as possible, as it can be very problematic in the long run. If you have a close relative, you can encourage the person to take responsibility for their actions.

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12 FAQs about Psychopathy

What is a personality disorder?

A personality disorder is a persistent pattern of behaviour, worldview and inner experience markedly different from what is expected of those around you. This is because personality disorders can affect one’s ability to relate to others and function effectively in everyday life.

Is psychopathy a type of personality disorder?

Yes, antisocial personality disorder is one of several types. Individuals with psychopathy are characterized by a profound lack of empathy and remorse, excessive charm, manipulative behaviour, and often an antisocial lifestyle.

How does a psychopath differ from other personality disorders?

A psychopath often shows a lack of conscience and empathy and can manipulate others without any sense of guilt or remorse. It is an extreme form of antisocial personality disorder and requires professional evaluation and treatment.

How is psychopathy diagnosed?

The diagnosis of antisocial personality disorder is made in a specialist psychiatric or correctional setting. This means that the symptoms must have been present since childhood/adolescence.

What treatment options are available for antisocial personality disorder?

People with psychopathic traits or antisocial personality disorder rarely seek treatment. They often lack emotional responses of guilt, shame and remorse. They often end up in the criminal justice system.

What causes psychopathy?

Psychopathy results from an interaction of genetic, biological and environmental factors. There is also a neurobiological basis, including an underactive stress response. Childhood neglect and trauma can also have an impact.

Is there any way to prevent antisocial personality disorder?

There is no surefire way to prevent antisocial personality disorder, but early intervention can help alleviate symptoms. If you have ADHD, proper diagnosis and treatment can prevent you from developing psychopathic traits. It is essential to have a correct diagnosis and appropriate treatment.

Can you force someone to go to therapy?

You can’t force someone to go to therapy, but you can encourage them to take responsibility for their behaviour. Therapists rarely see people with the above personality syndromes in the therapy room. These people usually feel that they do not need therapy.

How common is psychopathy?

Antisocial personality disorder occurs in an estimated 3% of men and less than 1% of women. Among those sentenced to prison, the proportion is much higher, with over 50% having antisocial personality traits.

What is the difference between psychopathy and sociopathy?

These can both be part of antisocial personality syndrome. Psychopaths have a genetic basis and act more emotionally cold, whereas sociopathy is based more on childhood trauma, is more impulsive and has more emotion in relationships.

Are there female psychopaths?

There are female psychopaths; less than 1% of the population is female, but it is more common among men.

How can I help someone close to me who has antisocial personality disorder?

If you have started a relationship with someone who you think has psychopathic traits, it is best to end the relationship as soon as possible, as it can be very problematic in the long run. If you have a close relative, you can encourage them to take responsibility for their actions.

Where can I get help?

If you need treatment, you can seek care through your health centre and get a referral to psychiatry. We also have licensed psychologists at Lavendla who can help you with an initial assessment and make further referrals. If you are a victim of violence or psychological abuse, contact 0800 456 789 and the women’s shelter.


Written by Samantha Pieterse

Sr. Samantha Pieterse is a registered psychiatric nurse who is deeply committed to mental health and well-being. Samantha brings a unique and valuable perspective to her role as an editor for Lavendla South Africa. She has worked in Government and Private mental healthcare institutions in Gauteng and her expertise ensures that the articles on our website are accurate and accessible. Samantha is dedicated to enhancing mental health awareness and education in South Africa.