What’s the difference between a psychopath and a sociopath? Less than you might think
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Articles about badly behaved people and how to spot them are common. You don’t have to Google or scroll too much to find headlines such as 7 signs your boss is a psychopath or How to avoid the sociopath next door.
You’ll often see the terms psychopath and sociopath used somewhat interchangeably. That applies to perhaps the most famous badly behaved fictional character of all – Hannibal Lecter, the cannibal serial killer from The Silence of the Lambs.
In the book on which the movie is based, Lecter is described as a “pure sociopath”. But in the movie, he’s described as a “pure psychopath”. Psychiatrists have diagnosed him with something else entirely.
So what’s the difference between a psychopath and a sociopath? As we’ll see, these terms have been used at different times in history, and relate to some overlapping concepts.
What’s a psychopath?
Psychopathy has been mentioned in the psychiatric literature since the 1800s. But the latest edition of the Diagnostic Statistical Manual of Mental Disorders (known colloquially as the DSM) doesn’t list it as a recognised clinical disorder.
Since the 1950s, labels have changed and terms such as “sociopathic personality disturbance” have been replaced with antisocial personality disorder, which is what we have today.
Someone with antisocial personality disorder has a persistent disregard for the rights of others. This includes breaking the law, repeated lying, impulsive behaviour, getting into fights, disregarding safety, irresponsible behaviours, and indifference to the consequences of their actions.
To add to the confusion, the section in the DSM on antisocial personality disorder mentions psychopathy (and sociopathy) traits. In other words, according to the DSM the traits are part of antisocial personality disorder but are not mental disorders themselves.
US psychiatrist Hervey Cleckley provided the first formal description of psychopathy traits in his 1941 book The Mask of Sanity. He based his description on his clinical observations of nine male patients in a psychiatric hospital. He identified several key characteristics, including superficial charm, unreliability and a lack of remorse or shame.
Canadian psychologist Professor Robert Hare refined these characteristics by emphasising interpersonal, emotional and lifestyle characteristics, in addition to the antisocial behaviours listed in the DSM.
When we draw together all these strands of evidence, we can say a psychopath manipulates others, shows superficial charm, is grandiose and is persistently deceptive. Emotional traits include a lack of emotion and empathy, indifference to the suffering of others, and not accepting responsibility for how their behaviour impacts others.
Finally, a psychopath is easily bored, sponges off others, lacks goals, and is persistently irresponsible in their actions.
So how about a sociopath?
The term sociopath first appeared in the 1930s, and was attributed to US psychologist George Partridge. He emphasised the societal consequences of behaviour that habitually violates the rights of others.
Academics and clinicians often used the terms sociopath and psychopath interchangeably. But some preferred the term sociopath because they said the public sometimes confused the word psychopath with psychosis.
“Sociopathic personality disturbance” was the term used in the first edition of the DSM in 1952. This aligned with the prevailing views at the time that antisocial behaviours were largely the product of the social environment, and that behaviours were only judged as deviant if they broke social, legal, and/or cultural rules.
Some of these early descriptions of sociopathy are more aligned with what we now call antisocial personality disorder. Others relate to emotional characteristics similar to Cleckley’s 1941 definition of a psychopath.
In short, different people had different ideas about sociopathy and, even today, sociopathy is less-well defined than psychopathy. So there is no single definition of sociopathy we can give you, even today. But in general, its antisocial behaviours can be similar to ones we see with psychopathy.
Over the decades, the term sociopathy fell out of favour. From the late 60s, psychiatrists used the term antisocial personality disorder instead.
Born or made?
Both “sociopathy” (what we now call antisocial personality disorder) and psychopathy have been associated with a wide range of developmental, biological and psychological causes.
For example, people with psychopathic traits have certain brain differences especially in regions associated with emotions, inhibition of behaviour and problem solving. They also appear to have differences associated with their nervous system, including a reduced heart rate.
However, sociopathy and its antisocial behaviours are a product of someone’s social environment, and tends to run in families. These behaviours has been associated with physical abuse and parental conflict.
What are the consequences?
Despite their fictional portrayals – such as Hannibal Lecter in Silence of the Lambs or Villanelle in the TV series Killing Eve – not all people with psychopathy or sociopathy traits are serial killers or are physically violent.
But psychopathy predicts a wide range of harmful behaviours. In the criminal justice system, psychopathy is strongly linked with re-offending, particularly of a violent nature.
In the general population, psychopathy is associated with drug dependence, homelessness, and other personality disorders. Some research even showed psychopathy predicted failure to follow COVID restrictions.
But sociopathy is less established as a key risk factor in identifying people at heightened risk of harm to others. And sociopathy is not a reliable indicator of future antisocial behaviour.
In a nutshell
Neither psychopathy nor sociopathy are classed as mental disorders in formal psychiatric diagnostic manuals. They are both personality traits that relate to antisocial behaviours and are associated with certain interpersonal, emotional and lifestyle characteristics.
Psychopathy is thought to have genetic, biological and psychological bases that places someone at greater risk of violating other people’s rights. But sociopathy is less clearly defined and its antisocial behaviours are the product of someone’s social environment.
Of the two, psychopathy has the greatest use in identifying someone who is most likely to cause damage to others.
Bruce Watt, Associate Professor in Psychology, Bond University and Katarina Fritzon, Associate Professor of Psychology, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The SharpBrains Guide to Brain Fitness – by Alvaro Fernandez et al.
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We say “et al.” in the by-line, because this one has a flock of authors, including Dr. Pascale Michelon, Dr. Sandra Bond Chapman, Dr. Elkehon Goldberg, and various others if we include the foreword, introduction, etc.
This is relevant, because those who contributed to the meat of the book (i.e., those listed above), it makes the work a lot more scientifically reliable; one skilled science writer might make a mistake; it’s much less likely to make it through to publication when there are a bevy of doctors in the mix, each staking their reputation on the book’s content, and thus having a vested interest in checking each other’s work as well as their own.
As for what this multidisciplinary team have to offer? The book covers such things as:
- how the brain works (especially the possibilities of neuroplasticity), and what that means for such things as memory and attention
- being “a coach not a patient”; i.e., being active rather than passive in one’s approach to brain health
- the relevance of physical exercise, how much, and what kind
- the relevance (and limitations) of diet choices for brain health
- the relevance of such things as learning new languages and musical training
- the relevance of social engagement, and how some (but not all) social engagement can boost cognition
- methods for managing stress and building resilience to same (critical for maintaining a healthy brain)
- “cross-fit for your brain”, that is to say, a multi-vector collection of tools to explore, ranging from meditation to CBT to biofeedback and more.
The style is pop-science without being sensationalist, just communicating ideas clearly, with enough padding to feel casual, and not like a dense read. Importantly, it’s also practical and applicable too, which is something we always look for here.
Bottom line: if you’d like to be given a good overview of what things work (and how much they can be expected to work), along with a good framework to put that knowledge into practice, then this is a great book for you.
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Resveratrol & Healthy Aging
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Resveratrol & Healthy Aging
Resveratrol is the compound found in red grapes, and thus in red wine, that have resulted in red wine being sometimes touted as a heart-healthy drink.
However, at the levels contained in red wine, you’d need to drink 100–1000 glasses of wine per day (depending on the wine) to get the dose of resveratrol that was associated with heart health benefits in mouse studies.
Which also means: if you are not a mouse, you might need to drink even more than that!
Further reading: can we drink to good health?
Resveratrol supplementation
Happily, resveratrol supplements exist. But what does resveratrol do?
It lowers blood pressure:
Effect of resveratrol on blood pressure: a meta-analysis of randomized controlled trials
It improves blood lipid levels:
It improves insulin sensitivity:
It has neuroprotective effects too:
Resveratrol promotes clearance of Alzheimer’s disease amyloid-beta peptides
Is it safe?
For most people, it is generally recognized as safe. However, if you are on blood-thinners or otherwise have a bleeding disorder, you might want to skip it:
Antiplatelet activity of synthetic and natural resveratrol in red wine
You also might want to check with your pharmacist/doctor, if you’re on blood pressure meds, anxiety meds, or immunosuppressants, as it can increase the amount of these drugs that will then stay in your system:
Resveratrol modulates drug- and carcinogen-metabolizing enzymes in a healthy volunteer study
And as ever, of course, if unsure just check with your pharmacist/doctor, to be on the safe side.
Where to get it?
We don’t sell it, but here’s an example product on Amazon for your convenience
Enjoy!
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What is HRT? HRT and Hormones Explained
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In this short video, Dr. Sophie Newton explains how menopausal HRT, sometimes called just MHT, is the use of exogenous (didn’t come from your body) to replace/supplement the endogenous hormones (made in your body) that aren’t being made in the quantities that would result in ideal health.
Bioidentical hormones are, as the name suggests, chemically identical to those made in the body; there is no difference, all the way down to the atomic structure.
People are understandably wary of “putting chemicals into the body”, but in fact, everything is a chemical and those chemicals are also found in your body, just not in the numbers that we might always like.
In the case of hormones, these chemical messengers are simply there to tell cells what to do, so having the correct amount of hormones ensures that all the cells that need to get a certain message, get it.
In the case of estrogen specifically, while it’s considered a sex hormone (and it is), it’s responsible for a lot more than just the reproductive system, which is why many people without correct estrogen levels (such as peri- or post-menopause, though incorrect levels can happen earlier in life for other reasons too) can severely feel their absence in a whole stack of ways.
What ways? More than we can list here, but some are discussed in the video:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to know more?
You might like our previous main features:
- What Does “Balance Your Hormones” Even Mean?
- What You Should Have Been Told About The Menopause Beforehand
- Menopausal HRT: Bioidentical vs Animal
Take care!
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Getting antivirals for COVID too often depends on where you live and how wealthy you are
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Medical experts recommend antivirals for people aged 70 and older who get COVID, and for other groups at risk of severe illness and hospitalisation from COVID.
But many older Australians have missed out on antivirals after getting sick with COVID. It is yet another way the health system is failing the most vulnerable.
CGN089/Shutterstock Who missed out?
We analysed COVID antiviral uptake between March 2022 and September 2023. We found some groups were more likely to miss out on antivirals including Indigenous people, people from disadvantaged areas, and people from culturally and linguistically diverse backgrounds.
Some of the differences will be due to different rates of infection. But across this 18-month period, many older Australians were infected at least once, and rates of infection were higher in some disadvantaged communities.
How stark are the differences?
Compared to the national average, Indigenous Australians were nearly 25% less likely to get antivirals, older people living in disadvantaged areas were 20% less likely to get them, and people with a culturally or linguistically diverse background were 13% less likely to get a script.
People in remote areas were 37% less likely to get antivirals than people living in major cities. People in outer regional areas were 25% less likely.
Dispensing rates by group. Grattan Institute Even within the same city, the differences are stark. In Sydney, people older than 70 in the affluent eastern suburbs (including Vaucluse, Point Piper and Bondi) were nearly twice as likely to have had an antiviral as those in Fairfield, in Sydney’s south-west.
Older people in leafy inner-eastern Melbourne (including Canterbury, Hawthorn and Kew) were 1.8 times more likely to have had an antiviral as those in Brimbank (which includes Sunshine) in the city’s west.
Why are people missing out?
COVID antivirals should be taken when symptoms first appear. While awareness of COVID antivirals is generally strong, people often don’t realise they would benefit from the medication. They wait until symptoms get worse and it is too late.
Frequent GP visits make a big difference. Our analysis found people 70 and older who see a GP more frequently were much more likely to be dispensed a COVID antiviral.
Regular visits give an opportunity for preventive care and patient education. For example, GPs can provide high-risk patients with “COVID treatment plans” as a reminder to get tested and seek treatment as soon as they are unwell.
Difficulty seeing a GP could help explain low antiviral use in rural areas. Compared to people in major cities, people in small rural towns have about 35% fewer GPs, see their GP about half as often, and are 30% more likely to report waiting too long for an appointment.
Just like for vaccination, a GP’s focus on antivirals probably matters, as does providing care that is accessible to people from different cultural backgrounds.
Care should go those who need it
Since the period we looked at, evidence has emerged that raises doubts about how effective antivirals are, particularly for people at lower risk of severe illness. That means getting vaccinated is more important than getting antivirals.
But all Australians who are eligible for antivirals should have the same chance of getting them.
These drugs have cost more than A$1.7 billion, with the vast majority of that money coming from the federal government. While dispensing rates have fallen, more than 30,000 packs of COVID antivirals were dispensed in August, costing about $35 million.
Such a huge investment shouldn’t be leaving so many people behind. Getting treatment shouldn’t depend on your income, cultural background or where you live. Instead, care should go to those who need it the most.
Getting antivirals shouldn’t depend on who your GP is. National Cancer Institute/Unsplash People born overseas have been 40% more likely to die from COVID than those born here. Indigenous Australians have been 60% more likely to die from COVID than non-Indigenous people. And the most disadvantaged people have been 2.8 times more likely to die from COVID than those in the wealthiest areas.
All those at-risk groups have been more likely to miss out on antivirals.
It’s not just a problem with antivirals. The same groups are also disproportionately missing out on COVID vaccination, compounding their risk of severe illness. The pattern is repeated for other important preventive health care, such as cancer screening.
A 3-step plan to meet patients’ needs
The federal government should do three things to close these gaps in preventive care.
First, the government should make Primary Health Networks (PHNs) responsible for reducing them. PHNs, the regional bodies responsible for improving primary care, should share data with GPs and step in to boost uptake in communities that are missing out.
Second, the government should extend its MyMedicare reforms. MyMedicare gives general practices flexible funding to care for patients who live in residential aged care or who visit hospital frequently. That approach should be expanded to all patients, with more funding for poorer and sicker patients. That will give GP clinics time to advise patients about preventive health, including COVID vaccines and antivirals, before they get sick.
Third, team-based pharmacist prescribing should be introduced. Then pharmacists could quickly dispense antivirals for patients if they have a prior agreement with the patient’s GP. It’s an approach that would also work for medications for chronic diseases, such as cardiovascular disease.
COVID antivirals, unlike vaccines, have been keeping up with new variants without the need for updates. If a new and more harmful variant emerges, or when a new pandemic hits, governments should have these systems in place to make sure everyone who needs treatment can get it fast.
In the meantime, fairer access to care will help close the big and persistent gaps in health between different groups of Australians.
Peter Breadon, Program Director, Health and Aged Care, Grattan Institute
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The BAT-pause!
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When Cold Weather & The Menopause Battle It Out
You may know that (moderate, safe) exposure to the cold allows our body to convert our white and yellow fat into the much healthier brown fat—also called brown adipose tissue, or “BAT” to its friends.
If you didn’t already know that, then well, neither did scientists until about 15 years ago:
The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
You can read more about it here:
Cool Temperature Alters Human Fat and Metabolism
This is important, especially because the white fat that gets converted is the kind that makes up most visceral fat—the kind most associated with all-cause mortality:
Visceral Belly Fat & How To Lose It ← this is not the same as your subcutaneous fat, the kind that sits directly under your skin and keeps you warm; this is the fat that goes between your organs and of which we should only have a small amount!
The BAT-pause
It’s been known (since before the above discovery) that BAT production slows considerably as we get older. Not too shocking—after all, many metabolic functions slow as we get older, so why should fat regulation be any different?
But! Rodent studies found that this was tied less to age, but to ovarian function: rats who underwent ovariectomies suffered reduced BAT production, regardless of their age.
Naturally, it’s been difficult to recreate such studies in humans, because it’s difficult to find a large sample of young adults willing to have their ovaries whipped out (or even suppressed chemically) to see how badly their metabolism suffers as a result.
Nor can an observational study (for example, of people who incidentally have ovaries removed due to ovarian cancer) usefully be undertaken, because then the cancer itself and any additional cancer treatments would be confounding factors.
Perimenopausal study to the rescue!
A recent (published last month, at time of writing!) study looked at women around the age of menopause, but specifically in cohorts before and after, measuring BAT metabolism.
By dividing the participants into groups based on age and menopausal status, and dividing the post-menopausal group into “takes HRT” and “no HRT” groups, and dividing the pre-menopausal group into “normal ovarian function” and “ovarian production of estrogen suppressed to mimic slightly early menopause” groups (there’s a drug for that), and then having groups exposed to warm and cold temperatures, and measuring BAT metabolism in all cases, they were able to find…
It is about estrogen, not age!
You can read more about the study here:
“Good” fat metabolism changes tied to estrogen loss, not necessarily to aging, shows study
…and the study itself, here:
Brown adipose tissue metabolism in women is dependent on ovarian status
What does this mean for men?
This means nothing directly for (cis) men, sorry.
But to satisfy your likely curiosity: yes, testosterone does at least moderately suppress BAT metabolism—based on rodent studies, anyway, because again it’s difficult to find enough human volunteers willing to have their testicles removed for science (without there being other confounding variables in play, anyway):
Testosterone reduces metabolic brown fat activity in male mice
So, that’s bad per se, but there isn’t much to be done about it, since the rest of your (addressing our male readers here) metabolism runs on testosterone, as do many of your bodily functions, and you would suffer many unwanted effects without it.
However, as men do typically have notably less body fat in general than women (this is regulated by hormones), the effects of changes in BAT metabolism are rather less pronounced in men (per testosterone level changes) than in women (per estrogen level changes), because there’s less overall fat to convert.
In summary…
While menopausal HRT is not necessarily a silver bullet to all metabolic problems, its BAT-maintaining ability is certainly one more thing in its favor.
See also:
Dr. Jen Gunter | What You Should Have Been Told About The Menopause Beforehand
Take care!
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What Your Doctor Wants You to Know to Crush Medical Debt – by Dr. Virgie Ellington
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First things first: this one’s really only of relevance to people living in the US. That’s most of our readership, but if it’s not you, then apologies, this one won’t be of interest.
For the US Americans, though, Dr. Ellington starts strong with “you got a bill—now get the right bill”, and then gives a step-by-step process for finding the mistakes in your medical bills, fixing them, dealing with insurers who do not want to live up to their part of the bargain, and how to minimize what you need to pay, when you actually arrive at your final bill.
The biggest strength of this book is the wealth of insider knowledge (the author has worked as a primary care physician as well as as a health insurance executive), and while this information won’t stay current forever, its relatively recent publication date (2022) means that little has changed since then, and once you’re up to speed with how things are now, it’ll be easy to roll with whatever changes may come in the future.
Bottom line: if you’re living in the US and would like to not be ripped off as badly as possible when it comes to healthcare costs, this book is a very small, very powerful, investment.
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