𝗣𝘀𝘆𝗰𝗵𝗼𝗽𝗮𝘁𝗵𝘆 𝘃𝘀. 𝗦𝗼𝗰𝗶𝗼𝗽𝗮𝘁𝗵𝘆 𝘃𝘀. 𝗔𝗻𝘁𝗶𝘀𝗼𝗰𝗶𝗮𝗹 𝗣𝗲𝗿𝘀𝗼𝗻𝗮𝗹𝗶𝘁𝘆 𝗗𝗶𝘀𝗼𝗿𝗱𝗲𝗿

What’s the difference between these three terms?

This is easily one of the most common questions I get from the hundreds of forensic science students I speak to every year at the University of Toronto (where I teach).

There’s a short answer I often give when time is tight:

“Psychopathy and Antisocial Personality Disorder (ASPD) are essentially—or sort of—the same thing, and sociopathy is an outdated term that is no longer used in clinical or forensic settings.”

But, as is often the case in forensic psychology, the full story is more complicated. Here are a few things worth knowing about the distinctions:

𝟏. 𝐏𝐬𝐲𝐜𝐡𝐨𝐩𝐚𝐭𝐡𝐲 = 𝐀𝐒𝐏𝐃 – 𝐰𝐞𝐥𝐥, 𝐬𝐨𝐫𝐭 𝐨𝐟…

The fifth and current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)—which is supposed to reflect the consensus view among North American psychiatrists—describes ASPD in a way that implies a synonymous relationship with psychopathy. On page 748, the manual describes the common signs and symptoms of ASPD and states:

“This pattern has also been [historically] referred to as psychopathy, sociopathy, or dissocial personality disorder.”

However, the DSM-5-TR also introduces some nuance: psychopathy might be considered a subtype of ASPD. In 2013, the DSM-5 introduced an “Alternative Model for Personality Disorders” that allows clinicians to assess for psychopathic specifiers—traits like grandiosity, superficial charm, lack of empathy, and shallow affect—as specification criteria when diagnosing ASPD (the proper medical nomenclature is “ASPD with psychopathic features”).

It is typically this subtype that researchers tend to target when they conduct experiments on clinically psychopathic individuals. In short, this research is not conducted on subjects who merely meet the diagnostic criteria for ASPD. It is typically conducted on a subgroup that also meets the “psychopathic features” specification.

Although, one complication is that research samples are often selected using criteria that differ slightly from those outlined in the DSM-5-TR, where researchers are instead favoring the criteria set forth by a widely used assessment tool named “The Psychopathy Checklist–Revised” (PCL-R).

Despite these nuances, there’s great overlap between those who are diagnosed with “ASPD with psychopathic features” and those who score high on the “PCL-R” (or similar assessment tools).

𝟐. 𝐓𝐰𝐨 𝐚𝐝𝐝𝐢𝐭𝐢𝐨𝐧𝐚𝐥 𝐨𝐛𝐬𝐞𝐫𝐯𝐚𝐭𝐢𝐨𝐧𝐬.

In the scientific community, there’s ongoing debate about whether psychopathy and ASPD are truly distinct constructs (this debate was very much alive in the 1990s and early 2000s, less so today). ASPD, as defined in the DSM-5-TR, emphasizes impulsive and antisocial behaviors in its definitions. In contrast, many researchers think of psychopathy as more tightly associated with emotional detachment and callous-unemotional traits. So, there are researchers who believe that the DSM-5-TR manual has “drifted” away from the research tradition’s historic definition of psychopathy (I’m personally not convinced that this is the case).

Still, in everyday forensic practice, these two trait clusters (antisocial behavior and callous traits) are typically bundled together under the umbrella of “psychopathy.” This has something to do with how practitioners tend to use the Psychopathy Checklist–Revised (PCL-R) to assess for psychopathy—an assessment tool that includes both callous traits and antisocial behaviors in its scoring mechanism.

𝐒𝐨𝐜𝐢𝐨𝐩𝐚𝐭𝐡𝐲: 𝐀 𝐭𝐞𝐫𝐦 𝐥𝐞𝐟𝐭 𝐛𝐞𝐡𝐢𝐧𝐝.

“Sociopathy” was only used in the first edition of the DSM (1952), as “Sociopathic Personality Disturbance” (with four different subtypes). However, the term was formally replaced by “Antisocial Personality” in the 1968 DSM-II, and then with “Antisocial Personality Disorder” in the third 1980 edition (DSM-III). As these changes rolled out, the term sociopathy was steadily abandoned by clinicians and researchers alike—although it lingered informally through the 1970s and 1980s as a synonym for ASPD.

Today, “sociopathy” survives almost exclusively in popular media and casual conversation. I have personally never heard a forensic practitioner use it.

However, I’ve noticed that “sociopathy” still floats around in the shape of an odd conceptual distinction, as a persistent folk belief that sociopaths are different from psychopaths. The story goes that sociopaths know the difference between right and wrong but choose to ignore it, while psychopaths cannot tell the difference at all (and therefore fails to respect ethical norms).

It sounds clever and intriguing—but it doesn’t really hold up.

For one, consider that we all ignore moral values and social norms from time to time. That doesn’t make us all sociopaths, does it? Second, and more importantly, research has shown time and again that people diagnosed with psychopathy do, in fact, understand the difference between right and wrong. Altogether, this makes the distinction hallow and somewhat nonsensical.

When people diagnosed with psychopathy (or ASPD) commit morally reprehensible acts, what’s missing isn’t moral knowledge or reasoning. It’s something else entirely, something that psychopathy researchers are, in fact, still trying to figure out…

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