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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Eat to Beat Depression and Anxiety – by Dr. Drew Ramsey
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Most of us could use a little mood boost sometimes, and some of us could definitely stand to have our baseline neurochemistry elevated a bit. We’ve probably Googled “foods to increase dopamine”, and similar phrases. So, why is this a book, and not just an article saying to eat cashews and dark chocolate?
Dr. Drew Ramsey takes a holistic approach to health. By this we mean that to have good health, the whole body and mind must be kept healthy. Let a part slip, and the others will soon follow. Improve a part, and the others will soon follow, too.
Of course, there is only so much that diet can do. Jut as no diet will replace a Type 1 Diabetic’s pancreas with a working one, no diet will treat the causes of some kinds of depression and anxiety.
For this reason, Dr. Ramsey, himself a psychiatrist (and a farmer!) recommends a combination of talking therapy and diet, with medications as a “third leg” to be included when necessary. The goal, for him, is to reduce dependence on medications, while still recognizing when they can be useful or even necessary.
As for the practical, actionable advices in the book, he does (unsurprisingly) recommend a Mediterranean diet. Heavy on the greens and beans, plenty of colorful fruit and veg, small amounts of fish and seafood, even smaller amounts of grass-fed beef and fermented dairy. He also discusses a bunch of “superfoods” he particularly recommends.
Nor does he just hand-wave the process; he talks about the science of how and why each of these things helps.
And in practical terms, he even devotes some time to helping the reader get our kitchen set up, if we’re not already ready-to-go in that department. He also caters to any “can’t cook / won’t cook” readers and how to work around that too.
Bottom line: if you’d like to get rewiring your brain (leveraging neuroplasticity is a key component of the book), this will get you on track. A particular strength is how the author “thinks of everything” in terms of common problems that people (especially: depressed and anxious people!) might have in implementing his advices.
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‘Emergency’ or Not, Covid Is Still Killing People. Here’s What Doctors Advise to Stay Safe.
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With around 20,000 people dying of covid in the United States since the start of October, and tens of thousands more abroad, the covid pandemic clearly isn’t over. However, the crisis response is, since the World Health Organization and the Biden administration ended their declared health emergencies last year.
Let’s not confuse the terms “pandemic” and “emergency.” As Abraar Karan, an infectious disease physician and researcher at Stanford University, said, “The pandemic is over until you are scrunched in bed, feeling terrible.”
Pandemics are defined by neither time nor severity, but rather by large numbers of ongoing infections worldwide. Emergencies are acute and declared to trigger an urgent response. Ending the official emergency shifted the responsibility for curbing covid from leaders to the public. In the United States, it meant, for example, that the government largely stopped covering the cost of covid tests and vaccines.
But the virus is still infecting people; indeed, it is surging right now.
With changes in the nature of the pandemic and the response, KFF Health News spoke with doctors and researchers about how to best handle covid, influenza, and other respiratory ailments spreading this season.
A holiday wave of sickness has ensued as expected. Covid infections have escalated nationwide in the past few weeks, with analyses of virus traces in wastewater suggesting infection rates as high as last year’s. More than 73,000 people died of covid in the U.S. in 2023, meaning the virus remains deadlier than car accidents and influenza. Still, compared with last year’s seasonal surge, this winter’s wave of covid hospitalizations has been lower and death rates less than half.
“We’re seeing outbreaks in homeless shelters and in nursing homes, but hospitals aren’t overwhelmed like they have been in the past,” said Salvador Sandoval, a doctor and health officer at the Merced County public health department in California. He attributes that welcome fact to vaccination, covid treatments like Paxlovid, and a degree of immunity from prior infections.
While a new coronavirus variant, JN.1, has spread around the world, the current vaccines and covid tests remain effective.
Other seasonal illnesses are surging, too, but rates are consistent with those of previous years. Between 9,400 and 28,000 people died from influenza from Oct. 1 to Jan. 6, estimates the Centers for Disease Control and Prevention, and millions felt so ill from the flu that they sought medical care. Cases of pneumonia — a serious condition marked by inflamed lungs that can be triggered by the flu, covid, or other infections — also predictably rose as winter set in. Researchers are now less concerned about flare-ups of pneumonia in China, Denmark, and France in November and December, because they fit cyclical patterns of the pneumonia-causing bacteria Mycoplasma pneumoniae rather than outbreaks of a dangerous new bug.
Public health researchers recommend following the CDC guidance on getting the latest covid and influenza vaccines to ward off hospitalization and death from the diseases and reduce chances of getting sick. A recent review of studies that included 614,000 people found that those who received two covid vaccines were also less likely to develop long covid; often involving fatigue, cognitive dysfunction, and joint pain, the condition is marked by the development or continuation of symptoms a few months after an infection and has been debilitating for millions of people. Another analysis found that people who had three doses of covid vaccines were much less likely to have long covid than those who were unvaccinated. (A caveat, however, is that those with three doses might have taken additional measures to avoid infections than those who chose to go without.)
It’s not too late for an influenza vaccine, either, said Helen Chu, a doctor and epidemiologist at the University of Washington in Seattle. Influenza continues to rise into the new year, especially in Southern states and California. Last season’s shot appeared to reduce adults’ risk of visits to the emergency room and urgent care by almost half and hospitalization by more than a third. Meanwhile, another seasonal illness with a fresh set of vaccines released last year, respiratory syncytial virus, appears to be waning this month.
Another powerful way to prevent covid, influenza, common colds, and other airborne infections is by wearing an N95 mask. Many researchers say they’ve returned to socializing without one but opt for the masks in crowded, indoor places when wearing one would not be particularly burdensome. Karan, for example, wears his favorite N95 masks on airplanes. And don’t forget good, old-fashioned hand-washing, which helps prevent infections as well.
If you do all that and still feel sick? Researchers say they reach for rapid covid tests. While they’ve never been perfect, they’re often quite helpful in guiding a person’s next steps.
When President Joe Biden declared the end of the public health emergency last year, many federally funded testing sites that sent samples to laboratories shut their doors. As a result, people now mainly turn to home covid tests that signal an infection within 15 minutes and cost around $6 to $8 each at many pharmacies. The trick is to use these tests correctly by taking more than one when there’s reason for concern. They miss early infections more often than tests processed in a lab, because higher levels of the coronavirus are required for detection — and the virus takes time to multiply in the body. For this reason, Karan considers other information. “If I ran into someone who turned out to be sick, and then I get symptoms a few days later,” he said, “the chance is high that I have whatever they had, even if a test is negative.”
A negative result with a rapid test might mean simply that an infection hasn’t progressed enough to be detected, that the test had expired, or that it was conducted wrong. To be sure the culprit behind symptoms like a sore throat isn’t covid, researchers suggest testing again in a day or two. It often takes about three days after symptoms start for a test to register as positive, said Karan, adding that such time estimates are based on averages and that individuals may deviate from the norm.
If a person feels healthy and wants to know their status because they were around someone with covid, Karan recommends testing two to four days after the exposure. To protect others during those uncertain days, the person can wear an N95 mask that blocks the spread of the virus. If tests remain negative five days after an exposure and the person still feels fine, Chu said, they’re unlikely to be infected — and, if they are, viral levels would be so low that they would be unlikely to pass the disease to others.
Positive tests, on the other hand, reliably flag an infection. In this case, people can ask a doctor whether they qualify for the antiviral drug Paxlovid. The pills work best when taken immediately after symptoms begin so that they slash levels of the virus before it damages the body. Some studies suggest the medicine reduces a person’s risk of long covid, too, but the evidence is mixed. Another note on tests: Don’t worry if they continue to turn out positive for longer than symptoms last; the virus may linger even if it’s no longer replicating. After roughly a week since a positive test or symptoms, studies suggest, a person is unlikely to pass the virus to others.
If covid is ruled out, Karan recommends tests for influenza because they can guide doctors on whether to prescribe an antiviral to fight it — or if instead it’s a bacterial infection, in which case antibiotics may be in order. (One new home test diagnoses covid and influenza at the same time.) Whereas antivirals and antibiotics target the source of the ailment, over-the-counter medications may soothe congestion, coughs, fevers, and other symptoms. That said, the FDA recently determined that a main ingredient in versions of Sudafed, NyQuil, and other decongestants, called phenylephrine, is ineffective.
Jobs complicate a personal approach to staying healthy. Emergency-era business closures have ended, and mandates on vaccination and wearing masks have receded across the country. Some managers take precautions to protect their staff. Chu, for example, keeps air-purifying devices around her lab, and she asks researchers to stay home when they feel sick and to test themselves for covid before returning to work after a trip.
However, occupational safety experts note that many employees face risks they cannot control because decisions on if and how to protect against outbreaks, such as through ventilation, testing, and masking, are left to employers. Notably, people with low-wage and part-time jobs — occupations disproportionately held by people of color — are often least able to control their workplace environments.
Jessica Martinez, co-executive director of the National Council for Occupational Safety and Health, said the lack of national occupational standards around airborne disease protection represents a fatal flaw in the Biden administration’s decision to relinquish its control of the pandemic.
“Every workplace needs to have a plan for reducing the threat of infectious disease,” she said. “If you only focus on the individual, you fail workers.”
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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A Fresh Take On Hypothyroidism
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The Three Rs To Boost Thyroid-Related Energy Levels
This is Dr. Izabella Wentz. She’s a doctor of pharmacology, and after her own diagnosis with Hashimoto’s thyroiditis, she has taken it up as her personal goal to educate others on managing hypothyroidism.
Dr. Wentz is also trained in functional medicine through The Institute for Functional Medicine, Kalish Functional Medicine, and the American Academy of Anti-Aging Medicine. She is a Fellow of the American Society of Consultant Pharmacists, and holds certifications in Medication Therapy Management as well as Advanced Diabetes Care through the American Pharmacists Association. In 2013, she received the Excellence in Innovation Award from the Illinois Pharmacists Association.
Dr. Wentz’s mission
Dr. Wentz was disenchanted by the general medical response to hypothyroidism in three main ways. She tells us:
- Thyroid patients are not diagnosed appropriately.
- For this, she criticises over-reliance on TSH tests that aren’t a reliable marker of thyroid function, especially if you have Hashimoto’s.
- Patients should be better optimized on their medications.
- For this, she criticizes many prescribed drugs that are actually pro-drugs*, that don’t get converted adequately if you have an underactive thyroid.
- Lifestyle interventions are often ignored by mainstream medicine.
- Medicines are great; they truly are. But medicating without adjusting lifestyle can be like painting over the cracks in a crumbling building.
*a “pro-drug” is what it’s called when the drug we take is not the actual drug the body needs, but is a precursor that will get converted to that actual drug we need, inside our body—usually by the liver, but not always. An example in this case is T4, which by definition is a pro-drug and won’t always get correctly converted to the T3 that a thyroid patient needs.
Well that does indeed sound worthy of criticism. But what does she advise instead?
First, she recommends a different diagnostic tool
Instead of (or at least, in addition to) TSH tests, she advises to ask for TPO tests (thyroid peroxidase), and a test for Tg antibodies (thyroglobulin). She says these are elevated for many years before a change in TSH is seen.
Next, identify the root cause and triggers
These can differ from person to person, but in countries that add iodine to salt, that’s often a big factor. And while gluten may or may not be a factor, there’s a strong correlation between celiac disease and Hashimoto’s disease, so it is worth checking too. Same goes for lactose.
By “checking”, here we mean testing eliminating it and seeing whether it makes a difference to energy levels—this can be slow, though, so give it time! It is best to do this under the guidance of a specialist if you can, of course.
Next, get to work on repairing your insides.
Remember we said “this can be slow”? It’s because your insides won’t necessarily bounce back immediately from whatever they’ve been suffering from for what’s likely many years. But, better late than never, and the time will pass anyway, so might as well get going on it.
For this, she recommends a gut-healthy diet with specific dietary interventions for hypothyroidism. Rather than repeat ourselves unduly here, we’ll link to a couple of previous articles of ours, as her recommendations match these:
She also recommends regular blood testing to see if you need supplementary TSH, TPO antibodies, and T3 and T4 hormones—as well as vitamin B12.
Short version
After diagnosis, she recommends the three Rs:
- Remove the causes and triggers of your hypothyroidism, so far as possible
- Repair the damage caused to your body, especially your gut
- Replace the thyroid hormones and related things in which your body has become deficient
Learn more
If you’d like to learn more about this, she offers a resource page, with resources ranging from on-screen information, to books you can get, to links to hook you up with blood tests if you need them, as well as recommended supplements to consider.
She also has a blog, which has an interesting relevant article added weekly.
Enjoy, and take care of yourself!
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- Thyroid patients are not diagnosed appropriately.
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Tourette’s Syndrome Treatment Options
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Is there anything special that might help someone with Tourette’s syndrome?❞
There are of course a lot of different manifestations of Tourette’s syndrome, and some people’s tics may be far more problematic to themselves and/or others, while some may be quite mild and just something to work around.
It’s an interesting topic for sure, so we’ll perhaps do a main feature (probably also covering the related-and-sometimes-overlapping OCD umbrella rather than making it hyperspecific to Tourette’s), but meanwhile, you might consider some of these options:
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Superfood-Stuffed Squash
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This stuffed squash recipe is packed with so many nutrient-dense ingredients, yet it feels delightfully decadent—a great recipe to have up your sleeve ready for fall.
You will need
- 1 large or two medium butternut squashes, halved lengthways and seeds removed (keep them; they are full of nutrients! You can sprout them, or dry them to use them at your leisure), along with some of the flesh from the central part above where the seeds are, so that there is room for stuffing
- 2 cups low-sodium vegetable stock
- 1 cup wild rice, rinsed
- 1 medium onion, finely chopped
- ½ cup walnuts, roughly chopped
- ½ cup dried
cranberriesgoji berries ← why goji berries? They have even more healthful properties than cranberries, and cranberries are hard to buy without so much added sugar that the ingredients list looks like “cranberries (51%), sugar (39%), vegetable oil (10%)”, whereas when buying goji berries, the ingredients list says “goji berries”, and they do the same culinary job. - ¼ cup pine nuts
- ½ bulb garlic, minced
- 1 tbsp dried thyme or 2 tsp fresh thyme, destalked
- 1 tbsp dried rosemary or 2 tsp fresh rosemary, destalked
- 1 generous handful fresh parsley, chopped
- 1 tbsp chia seeds
- 1 tbsp nutritional yeast
- 1 tbsp black pepper, coarse ground
- ½ tsp MSG or 1 tsp low-sodium salt
- Extra virgin olive oil, for brushing and frying
- Aged balsamic vinegar, to serve (failing this, make a balsamic vinegar reduction and use that; it should have a thicker texture but still taste acidic and not too sweet; the thickness should come from the higher concentration of grape must and its natural sugars; no need to add sugar)
Method
(we suggest you read everything at least once before doing anything)
1) Preheat the oven to 400°F / 200°C.
2) Brush the cut sides of the squash with olive oil; sprinkle with a pinch of MSG/salt and a little black pepper (grind it directly over the squash if you are using a grinder; hold the grinder high though so that it distributes evenly—waiters in restaurants aren’t just being dramatic when they do that with pepper or Parmesan or such)
3) Arrange them cut-sides-down on a baking tray lined with baking paper, and roast for at least 30 minutes or until tender.
4) While that is roasting, add the chia seeds to the wild rice, and cook them in the low-sodium vegetable stock, using a rice cooker if available. It should take about the same length of time, but if the rice is done first, set it aside, and if the squash is done first, turn the oven down low to keep it warm.
5) Heat some oil in a sauté pan (not a skillet without high sides; we’re going to need space in a bit), and fry the chopped onion until translucent and soft. We could say “about 5 minutes” but honestly it depends on your pan as well as the heat and other factors.
6) Add the seasonings (herbs, garlic, black pepper, MSG/salt, nooch), and cook for a further 2 minutes, stirring thoroughly to distribute evenly.
7) Add the rice, berries, and nuts, cooking for a further 2 minutes, stirring constantly, ensuring everything is heated evenly.
8) Remove the squash halves from the oven, turn them over, and spoon the mixture we just made into them, filling generously.
9) Drizzle a lashing of the aged balsamic vinegar (or balsamic vinegar reduction), to serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Brown Rice vs Wild Rice – Which is Healthier?
- Why You Should Diversify Your Nuts!
- Goji Berries: Which Benefits Do They Really Have?
- Chia: The Tiniest Seeds With The Most Value
- The Many Health Benefits Of Garlic
- Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
- 10 Ways To Balance Blood Sugars
Take care!
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How Your Sleep Position Changes Dementia Risk
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This is not just about sleep duration or even about sleep quality… It really is about which way your body is positioned.
Goodnight, glymphatic system
The association between sleeping position and dementia risk is about glymphatic drainage, which is largely powered by gravity (and thus dependent on which way around your head and neck are oriented), and very important for clearing toxins out of the brain—including beta-amyloid proteins.
This becomes particularly important when the glymphatic system becomes less efficient in midlife, often 15–20 years before cognitive decline symptoms appear.
The video’s thumbnail headline, “SCIENTISTS REVEAL: THE WAY YOUR SLEEP CAN CAUSE DEMENTIA” is overstated and inaccurate, but our adjusted headline “how your sleep position changes dementia risk” is actually representative of the paper on which this video was based; we’ll quote from the paper itself here:
❝This paper concludes that 1. glymphatic clearance plays a major role in Alzheimer’s pathology; 2. the vast majority of waste clearance occurs during sleep; 3. dementias are associated with sleep disruption, alongside an age-related decline in AQP4 polarization; and 4. lifestyle choices such as sleep position, alcohol intake, exercise, omega-3 consumption, intermittent fasting and chronic stress all modulate* glymphatic clearance. Lifestyle choices could therefore alter Alzheimer’s disease risk through improved glymphatic clearance, and could be used as a preventative lifestyle intervention for both healthy brain ageing and Alzheimer’s disease.❞
…and specifically, they found:
❝Glymphatic transport is most efficient in the right lateral sleeping position, with more CSF clearance occurring compared to supine and prone. The average person changes sleeping position 11 times per night, but there was no difference in the number of position changes between neurodegenerative and control groups, making the percentage of time spent in supine position the risk factor, not the number of position changes❞
Read the paper in full here: The Sleeping Brain: Harnessing the Power of the Glymphatic System through Lifestyle Choices
*saying “modulate” here is not as useful as it could be, because they modulate it differently: side-sleeping improves clearance; back sleeping decreases it; front-sleeping isn’t great either. Alcohol intake reduces clearance, exercise (especially cardiovascular exercise) improves it; omega-3 consumption improves it up a degree and does depend on omega-3/6 ratios, intermittent fasting improves it, and chronic stress worsens it.
And for a more pop-science presentation, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
How To Clean Your Brain (Glymphatic Health Primer)
Take care!
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