Is it sociopathy or psychopathy?

Some professionals treat sociopathy and psychopathy as if they refer to the same syndrome or constellation of traits, although they note that this same set of traits may develop as a result of different causal factors. Other investigators (e.g., Lykken, Hare) have used the term sociopathy to describe individuals whose antisocial features stem from family, social, and cultural forces that generate attitudes and behaviors that are at odds with the laws of society at large. According to this perspective, unlike psychopaths, such individuals may have a “conscience” and may be capable of loyalty to their own group or subculture. This implies that there could be differences in the features that characterize psychopaths versus sociopaths. However, there is no way to settle this issue until there is a valid way of assessing sociopathy.

The syndrome psychopathy is a mixture of symptoms that may overlap with several disorders including narcissistic, histrionic and borderline as well as antisocial personality disorders. Together these comprise what psychiatrists call cluster B personality disorders. Although many people use the word “sociopath” to refer to people who have antisocial personality disorder, there is, as we noted above, no consensus definition of the word. In regards to the meaning of the terms sociopath and psychopath: the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association) definition for antisocial personality disorder states:  “Antisocial personality disorder is characterized by a lack of regard for the moral or legal standards in the local culture. There is a marked inability to get along with others or abide by societal rules. Individuals with this disorder are sometimes called psychopaths or sociopaths.” link to DSM-IV]

However, as noted above, most psychopathy researchers disagree with this statement because they believe these two disorders are not the same. In fact a common way of understanding the difference is that, although the current definition of ASPD (in the DSM-IV) captures the impulsive, irresponsible lifestyle and frequent antisocial behaviors that are important components of psychopathy, it does not do a good job of specifying the affective and interpersonal components of psychopathy that many researchers regard as the core features of the disorder.

The issue is clouded by recent evidence that ASPD and psychopathy are dimensional, at least at the measurement level. This means that individuals can differ in the degree to which they are psychopathic. As a result, estimates of prevalence depend on the threshold that is used for “diagnosis.” In preparation for the DSM-V new categories of psychological dysfunction, including new definitions and diagnostic criteria for personality disorders, are currently under study. Although the DSM-V diagnostic categories have not yet been finalized, the previous recommendation by the DSM-V Personality Disorders Work Group was that ASPD be reformulated as the “Antisocial/Psychopathic Type” of personality disorder. The proposed description for this type of personality disorder is based heavily on the PCL-R criteria for psychopathy. Our foundation hopes that the word psychopathy will be included in the name of the specific personality disorder that is ultimately listed in the DSM-V.  We intend to provide more information about changes in the DSM-V category as these are finalized.

We note that those who are concerned about others in their lives with ASPD, or any other personality disorder with psychopathic features, are encouraged and welcome to use this site for support and information.

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