How is psychopathy diagnosed?

Since psychopathy is not an official mental disorder, the condition experts diagnose is ASPD. Before explaining the criteria used to diagnose ASPD, it’s important to mention that diagnosing and treating ASPD presents some unique challenges.

According to Masand, ASPD can be difficult to treat because the person who needs help doesn’t believe there is a problem with their behavior. As a result, they rarely seek treatment.

That said, the established guidelines used to diagnose ASPD is that the behavior generally begins by age 15 or in the teenage years. However, Masand says a true ASPD diagnoses is not made until the age of 18. “For most people, the worst of the behavior occurs in the late teen years throughout the twenties,” he explains.

To get a proper diagnosis, a mental health professional will conduct a full mental health evaluation. During this process, the mental health professional will evaluate a person’s thoughts, feelings, behavior patterns, and relationships. They will identify symptoms and compare them to the ASPD symptoms in the DSM-5.

The mental health professional will also look at medical history. This full evaluation is a critical step since ASPD tends to show comorbidity with other mental health and addictive disorders.

Since a true ASPD diagnosis is typically delayed until the age of 18, adolescents and teens that display similar symptoms are often evaluated for conduct disorder (CD) or oppositional defiant disorder (ODD).

Of the two behavior disorders, CD is more severe than ODD. When determining if a child has ODD, clinicians will look at how they act around people they know.

Typically, someone with ODD is more likely to act oppositional or defiant around family members, teachers, or a healthcare provider. If an adolescent or teen is showing an ongoing pattern of aggression toward others and they regularly make choices that are in opposition of the rules and social norms at home, school, or with peers, a clinician may decide to evaluate for CD.

Psychopath Vs. Sociopath

Like many other terms in the field of psychology, psychopath and sociopath are often used interchangeably, and it’s easy to see why. Since sociopath is not an official diagnosis, it joins psychopath under the umbrella diagnosis of ASPD. There is no clinical difference between the two.

“Some people make an artificial distinction based on severity of the personality disorder but that’s incorrect,” explains Masand. “They will say that psychopathy is a more severe form of sociopathy, but again, that is really incorrect.”

Both psychopath and sociopath are other terms or ways to describe ASPD. The behaviors that are seen in both fall under the symptoms in the ASPD category.


Like the diagnostic process, treating someone with psychopathic traits that fall under the ASPD diagnosis can be difficult. Typically, a healthcare provider will use a combination of psychotherapy (talk therapy) and medication.

However, personality disorders cannot be treated with medication. Psychotherapy can help the person understand their diagnosis and how it impacts their life and their relationships with others. A therapist will also work to develop strategies that decrease the severity of the symptoms.

If medication is part of the treatment plan, a doctor might prescribe medications that treat other metal health conditions such as anxiety, depression, or symptoms of aggression.

The Take-away

The word psychopath is often misused by the general public. That’s why it’s important to de-mystify the term and explain the correct diagnosis and terminology to use when describing this particular set of behaviors. Since it is not an official diagnosis, psychopathy falls under the ASPD diagnosis