psych
A Syrian patient smokes a cigarette at Dar Al-Ajaza psychiatric hospital in the heart of the Old City of Aleppo, on Dec. 18, 2012. Getty Images

Psychopaths are everywhere. No really, they’re all over the place — on TV, in our favorite movies, in the office, or next to you on the subway. As many as 5 percent of people may possess psychopathic tendencies,but before you freak out over the possibility of Hannibal Lecter-like predators lurking around every corner, take a second to learn what it actually means to be psychopathic. Psychopathy is perhaps the most dramatized and talked about mental condition in the entertainment industry and media, and its definition has been twisted and manipulated along the way. So the facts may surprise you.

Psychopathy Is Not A Psychiatric Diagnosis

Though the term psychopath is often thrown around in criminal justice settings and hypothesizing media, psychopathy is not a recognized psychiatric or psychological disorder. Psychopathy as a term has been inconsistently used in the medical community for years, but is now recognized as either a subcategory or extension of antisocial personality disorder. Critics have argued both for and against the idea that antisocial personality disorder and psychopathy are synonymous, but there has yet to be a concrete decision on the issue. The hallmarks of what’s typically seen as a psychopath include a lack of empathy and feeling for others, selfishness, lack of guilt, and a superficial charm that manifests exclusively to manipulate others.

Psychopathy Is Dimensional In Nature

Psychopathy, contrary to popular belief, does not occur in a binary way. It’s tempting to see psychopathy as black and white, but research has suggested that the condition occurs on a spectrum, not unlike autism. Therefore it’s possible to have minor psychopathic tendencies, or even more moderate or severe characteristics. Some psychopaths may possess certain characteristics of the condition, but not all, and even among severe psychopaths, some manifestations of the “disorder” may be missing. Since psychopathy isn’t a recognizable disorder, there is no brain imaging or biological test that can inarguably identify a person as a psychopath.

The most commonly used device for identifying psychopaths is the psychopathy checklist-revised ( PCL-R), a 20-item inventory of personality traits and recorded behaviors. Developed by Robert D. Hare in the 1970s, the checklist is administered in a semi-structured interview format, and operates on a point system based on whether a behavior (pathological lying, for example) can be reasonably matched to the subject. The subject is assigned a score between 0 and 40, with 40 being the maximum psychopathy and 0 the minimum. The cutoff for being labeled as a psychopath is 30 in the United States and 25 in the UK.

Psychopaths and Sociopaths Aren’t The Same

Some media outlets or older educational materials may refer to psychopathy and sociopathy interchangeably, but the most recent research says this isn’t accurate. Though both conditions are associated with a poor sense of “right and wrong” and a lack of empathy, there are a few key differences between them. According to Dr. L. Michael Tompkins, a psychologist at the Sacramento County Mental Health Treatment Center, the difference lies in having a conscience. A psychopath simply doesn’t have one, he told WebMD. They will steal from you without feeling a twinge of guilt — though they may pretend to if they’re caught, so they aren’t “found out.” A sociopath, on the other hand, will understand that taking your money is wrong and may feel remorse, but it won’t be enough to stop their deviant behavior. A psychopath has less regard for others than a sociopath.

Another difference between the two lies in the psychopath’s incredible ability to blend in. They can come off as charming, intelligent, and may even mimic emotions they really don’t feel. “They’re skilled actors whose sole mission is to manipulate people for personal gain,” Tompkins said. Sociopaths are more likely to come off as “hot-headed,” and may act more impulsively, demonstrating to others their lack of normal empathy.

Psychopaths Aren’t Always Violent…

In the entertainment industry, the word psychopath is pretty much synonymous with murderous madman. Just about all characters described as psychopaths in movies and television are serial killers — Hannibal Lecter from The Silence of the Lambs and Dexter Morgan from Dexter, for example. But in real life, psychopathic tendencies don’t necessarily mean a person is destined to lead a life of despicable crime.

The most important characteristics of a psychopath revolve not around violence, but around lack of empathy, selfishness, and manipulation. True, some psychopaths may use these traits to commit crimes, but others rely on their manipulative nature and ability to charm for other things. Many psychopaths actually find great success in the business world thanks to their ruthless nature — a disproportionate number of CEOs are actually psychopaths. Some other popular career paths for psychopaths include law, media, and being salespeople.

…But They Are Overrepresented In Prison

Not all psychopaths are violent, but many violent people might be psychopaths. It’s not accurate to assume a person with psychopathic tendencies is going to end up a criminal, but we can’t ignore the fact that researchers say there is an abnormally high number of psychopaths in prison. Some studies suggest between 50 and 80 percent of prisoners meet criteria for antisocial personality disorder, and 15 percent of prisoners can be expected to be psychopathic. Compared to the 1 to 5 percent expected in the general population, this is a clear association.

There isn’t much available research on serial killers and mass murderers specifically, but it would be a reasonable assumption that psychopaths are quite overrepresented in those populations as well. Not because being a psychopath is inherently violent, but because a psychopath’s personality makes it easy to act on violent urges or ideas that empathy, guilt, or fear would stomp out in a normal person.

Female And Male Psychopaths May Be Very Different

Research has told us for many years that psychopaths studied in prison are usually male. Scientists and psychologists have suggested many reasons for this, ranging from the biological to the simple idea that women can get away with crimes more than men because society is less likely to expect psychopathic behavior among them.

Though studies have concluded that the few female psychopaths available for study are just as dangerous as their male counterparts, the way their condition manifests may vary. For example, women are more likely to express their psychopathy through behaviors that are often mistaken for other mental illnesses — another clue as to why there are relatively few identified female psychopaths.

The Amygdala May Play A Significant Role In Psychopathic Tendencies

Though it’s difficult to research psychopathy simply because of its murky diagnosis, certain brain structures have been identified as key players in the processing of emotion and empathy — the lack of which is centrally important to psychopathy. Frontal brain regions have been suggested as relevant in psychopathy, particularly the amygdala. Associated with emotional reactions, decision-making, and fear, the amygdala has been identified in several studies as having reduced integrity or function in those scoring highly on the PCL-R. In one of these studies, people with severe antisocial personality disorder showed a distinct thinning of the cortex and deformations in the amygdala.