What's the Difference Between a Sociopath and a Psychopath?

Talk to various mental health providers and psychological researchers, and you may get different answers to those questions.

"The terms are often used interchangeably in popular literature, criminology writing and within the media at large but they are not diagnostic terms and not exactly the same," psychotherapist, author and podcaster Terri Cole explains via email.

That means you won't find the definition for psychopath or sociopath in the Diagnostic and Statistical Manual of Mental Disorders because doctors don't give an official diagnosis for psychopath or sociopath. Instead they likely diagnose someone with antisocial personality disorder.

"Sociopath is used when describing a person who has antisocial personality disorder (ASPD), whereas psychopathology describes a set of personality traits," Cole says.

Some describe the difference between the two mental health conditions as hot vs. cold. "A sociopath describes someone who acts erratically and impulsively with little or no conscience about how their behavior impacts others," Cole explains. A psychopath, in contrast, would be someone who similarly has no impulse control and few qualms about violent behavior, but "is generally considered to be more calculating and dangerous."

Others say that the two words essentially are different ways of saying the same thing.

"Typically, sociopathy and psychopathy are lay terms to describe what gets diagnosed as antisocial personality disorder," Eileen Anderson, a professor of bioethics and adjunct professor of psychiatry in the School of Medicine at Case Western Reserve University, explains via email. Antisocial personality disorder is a mental health condition in which a person consistently shows no regard for right and wrong and serious lack of empathy.

"However, other personality disorders, such as narcissistic personality disorder or borderline personality disorder could also be invoked," Anderson says. Both diagnoses also tend to refer to someone with a profound lack of empathy, a dominant self importance and a lack of moral compass.

To the extent that there's a difference between a psychopathy and a sociopath, Anderson says research indicates that those whom lay people refer to as sociopaths might feel some remorse but proceed with antisocial behavior that fit their agendas anyway.

"Psychopaths feel no conscience or remorse for risky behavior," she says. "They feel entitled to achieve their personal goals, even when those goals might include acts most would include as unconscionable such as lying, stealing, assault or even killing someone."

Psychopathy and sociopathy have been around for a long time, though their meanings have evolved over time. According to Scholarpedia, the term psychopasticheI — in English, psychopath — was devised by German psychiatrist J.L.A. Koch in 1888, to describe subjects with a tendency to hurt others, as well as themselves.

Psychopathy was a characteristic that Koch believed someone was born with. Another German psychiatrist, Karl Birnbaum, observed the same sort of pervasive pattern of antisocial behavior, but felt that it was caused by societal forces that made it difficult for young adults to learn a more acceptable way to act. He came up with a different term, sociopathy, to describe their problem.

George E. Partridge, a psychologist at Sheppard and Enoch Pratt Hospital in Baltimore, helped introduce Birnbaum's concept in the U.S., according to M. Gregory Kendrick's 2016 book "Villainy in Western Culture: Historical Archetypes of Danger, Disorder and Death."

American psychiatrist Hervey M. Cleckley published a book in 1941 called "The Mask of Sanity: An Attempt to Clarify Some Issues About the So-Called Psychopathic Personality." In it, Cleckley described "Max," a patient at a Veterans Affairs hospital, who could seem intelligent, friendly and even charming when he wasn't committing acts of criminal behavior like forging checks or giving someone a brutal beatdown over some trivial offense.

Over the years, both terms were used in psychological literature, sometimes interchangeably. But these days, both mental health professionals and scientific researchers who study the mind rarely give patients a clinical diagnosis of a psychopath or sociopath, explains David Chester. He's an associate professor of social psychology at Virginia Commonwealth University, whose research focuses upon understanding the psychological and biological processes that motivate and constrain aggressive behavior.

"We're referring to what we call a psychological construct or trait," he explains. "People can't be reduced down to a single trait."

Instead of using the term psychopath, for example, he might describe someone as having high psychopathy. "It's a dimension of personality, kind of a cluster of traits, the same way that extraversion is a personality dimension," Chester says.

Psychopathy "really reflects what we call an antagonistic disposition, in which my own desires and wishes and things like that are placed well above the well-being and desires and outcomes of other people," Chester says.

The five most common psychopathic traits include: negative affect (neuroticism); detachment (low extraversion); disinhibition (low conscientiousness); antagonism (low agreeableness); and psychoticism.

The hallmark feature of psychopathy is "callous indifference to other people's suffering," according to Chester. While most people who see someone else in pain might experience an empathetic or sympathetic response, a person with a high degree of psychopathy might feel a blunted reaction, or a lack of empathy altogether.

Mental health professionals debate whether people with a high degree of psychopathy lack empathy or sympathy, or whether they have the ability, but just choose not to use it.

As Chester explains, the "can't feel" camp has been the dominant narrative, but he and a growing number of other researchers think choice factors into the equation.

When you hear the word psychopath, you may think of a person who has violent tendencies and enjoys hurting others, like Frank Booth, the fiendishly cruel villain portrayed by Dennis Hopper in David Lynch's 1986 psychological movie thriller "Blue Velvet."

In real life, "psychopathy and sadism are highly correlated," Chester says. "That's not to say that every psychopathic person is also sadistic, but there's a high chance that if you're high in psychopathy, you're probably also high in sadism."

While most of us don't walk around snorting from a gas mask and slicing off captives' ears as Frank Booth does, psychopathic behavior unfortunately isn't all that rare. "In the overall population, 1 or 2 percent of people have serious diagnosable levels of psychopathic tendencies," Chester says. "But that's not to say that outside of that, psychopathy isn't an important critical trait that people have varying degrees of."

There are several different tests to measure psychopathic traits and psychopathic behaviors, though the one that Chester favors is the Self-Report Psychopathy scale, or SRP.

While in popular culture, sociopaths tend to be volatile and impulsive and psychopaths cold, heartless and predatory, Chester says those aren't really two distinct disorders. Instead, they're highly correlated.

The same person might act like a hothead and lash out in some situations, but at other times, behave like a cunning, stone-cold killer. "Instead of being hot and cold versions of the antagonistic personality, it's really that there are two strategies occurring in the same individual," he says.

Instead, individuals with psychopathic traits are also likely to have a lot of the same traits that fit this notion of sociopathy, including argumentative and violent behavior. (Indeed, Max, the patient in Cleckley's 1941 study of psychopathy, had all those qualities.)

At the core is a basic antagonism and indifference to others' well-being, especially when it comes to their own personal gain. "If I have a goal, and it requires hurting you to achieve it, most people aren't willing to do that," Chester says. "But psychopathic individuals are happy to do it. I'm willing for you to suffer, for me to succeed."

What complicates things even more is that the traits that we think of as psychopathic or sociopathic are found in varying degrees in different people, along with other less scary or even admirable traits.

A person who has a high degree of psychopathy might even seem kind and empathetic in some situations. Think Tony Soprano, the likable fictional mobster who's the protagonist of the popular and critically acclaimed TV series "The Sopranos."

He's capable of forming attachments and being an affectionate father. He even cares about the welfare of a family of ducks living in his swimming pool, but has no qualms about strangling an ex-mobster who's become a government witness, or savagely beating a local politician who's offended him by dating Tony's ex-mistress.

"Tony Soprano is not a paradoxical character," Chester says. "He's very realistic, in that sometimes he's nice, sometimes he's not interested. He's honestly one of the better examples of psychopathy, because he displays it in all its messiness."

Nobody knows who will develop antisocial personality disorder, though the website PsychopathyIs, which provides information and resources for researchers, clinicians and people affected by psychopathy, suggests there is no single cause.

Instead, research indicates that it results from a complex combination of genetic factors and environmental factors, early family life and emotional attachments to parents during childhood.