You may have heard people call someone else a “psychopath” or a “sociopath.” But what do those words really mean?

You won’t find the definitions in mental health’s official handbook, the Diagnostic and Statistical Manual of Mental Disorders. Doctors don’t officially diagnose people as psychopaths or sociopaths. They use a different term instead: antisocial personality disorder.

Most experts believe psychopaths and sociopaths share a similar set of traits. People like this have a poor inner sense of right and wrong. They also can’t seem to understand or share another person’s feelings. But there are some differences, too.

Do They Have a Conscience?

A key difference between a psychopath and a sociopath is whether he has a conscience, the little voice inside that lets us know when we’re doing something wrong, says L. Michael Tompkins, EdD. He’s a psychologist at the Sacramento County Mental Health Treatment Center.

A psychopath doesn’t have a conscience. If he lies to you so he can steal your money, he won’t feel any moral qualms, though he may pretend to. He may observe others and then act the way they do so he’s not “found out,” Tompkins says.

A sociopath typically has a conscience, but it’s weak. They may know that taking your money is wrong, and they might feel some guilt or remorse, but that won’t stop their behavior.

Both lack empathy, the ability to stand in someone else’s shoes and understand how they feel. But a psychopath has less regard for others, says Aaron Kipnis, PhD, author of The Midas Complex. Someone with this personality type sees others as objects he can use for his own benefit.

They’re Not Always Violent

In movies and TV shows, psychopaths and sociopaths are usually the villains who kill or torture innocent people. In real life, some people with antisocial personality disorder can be violent, but most are not. Instead they use manipulation and reckless behavior to get what they want.

“At worst, they’re cold, calculating killers,” Kipnis says. Others, he says, are skilled at climbing their way up the corporate ladder, even if they have to hurt someone to get there.

If you recognize some of these traits in a family member or coworker, you may be tempted to think you’re living or working with a psychopath or sociopath. But just because a person is mean or selfish, it doesn’t necessarily mean they have a disorder.

“Cold-Hearted Psychopath, Hot-Headed Sociopath”

It’s not easy to spot a psychopath. They can be intelligent, charming, and good at mimicking emotions. They may pretend to be interested in you, but in reality, they probably don’t care.

“They’re skilled actors whose sole mission is to manipulate people for personal gain,” Tompkins says.

Sociopaths are less able to play along. They make it plain that they’re not interested in anyone but themselves. They often blame others and have excuses for their behavior.

Some experts see sociopaths as “hot-headed.” They act without thinking how others will be affected.

Psychopaths are more “cold-hearted” and calculating. They carefully plot their moves, and use aggression in a planned-out way to get what they want. If they’re after more money or status in the office, for example, they’ll make a plan to take out any barriers that stand in the way, even if it’s another person’s job or reputation.

Brain Differences

Recent research suggests a psychopath’s brain is not like other people’s. It may have physical differences that make it hard for the person to identify with someone else’s distress.

The differences can even change basic body functions. For example, when most people see blood or violence in a movie, their hearts beat faster, their breathing quickens, and their palms get sweaty.

A psychopath has the opposite reaction. He gets calmer. Kipnis says that quality helps psychopaths be fearless and engage in risky behavior.

“They don’t fear the consequences of their actions,” he says.

Sources:

Aaron Kipnis, PhD, clinical psychologist.

L. Michael Tompkins, EdD, licensed psychologist, Sacramento County Mental Health Treatment Center.

King’s College London: “Psychopathy Linked to Brain Abnormalities.”

University of California Health: “Psychopaths not all psychos.”

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