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The Psychopath's Mask of SanotyAlthough neither sociopaths nor psychopaths are recognized as clinical terms in the DSM sense of a diagnostic classification, more than one typology has been developed to differentiate psychopathy subtypes. With the original list of criteria defining a psychopath devised by Hervey Cleckley comprising of 16 items, and Hare’s gold standard psychopathy assessment tool, the Psychopathy Checklist-Revised, or PCL-R, rating 20 different features in lifestyle, interpersonal, affective, and antisocial categories, the classification was not nuanced enough.

The factor-structure of the PCL-R

The most current version of the PCL-R, a psychological assessment tool developed to help predict risk in male criminal offenders and prison inmates, divides 20 personality and behavioral traits into two factors that are sometimes further divided into a four-facet structure.

The first factor comprises of interpersonal and affective features, which rates glibness, grandiosity, lying, and manipulativeness (interpersonal), and lack of empathy, remorse, guilt, and emotional depth (affective), respectively. The second factor describes a person’s social deviance and is divided into lifestyle (impulsivity, irresponsibility, lack of realistic goals, need for stimulation) and antisocial (poor behavioral controls, early conduct problems, delinquency, and criminal versatility) features. As such, the PCL-R emphasizes criminality, for which it has been criticized as too restrictive to assess non-criminal psychopath types, in particular as it relies on a single overall score.

Two and four dimensions of psychopathy

The ability to distinguish consistently and reliably between different subtypes of psychopaths facilitates a more efficient identification and management system that was not previously possible. Such a distinction also improves risk prediction of those with different psychopathic profiles, which enables preemptive and retrospective interventions that are much more targeted to the person’s specific motivational and behavioral makeup.

Cleckley[i] first hinted at the distinction between two major types of psychopathy, namely a prototypical or primary type and a secondary type, but it was work by Hugues Hervé[ii], Jennifer Skeem[iii], and others that refined the distinctions further.

Primary and secondary psychopathy

The dysfunctional characteristics of a primary psychopath are not believed to be caused by environmental and social factors resulting from a socio-economic disadvantage, low intelligence, neurotic anxiety, or another psychopathology. Research has shown that many primary psychopaths have a distinctive pattern of brain activity that causes their lack of empathy and remorse, the instinct to use aggression in a planned way to achieve their objectives, and poor impulse control. In the study, psychopaths displayed significantly reduced gray matter volumes in the anterior rostral prefrontal cortex and temporal poles, which restricted emotional insight and moral decision-making.[iv] This fact means that primary psychopaths have an important underlying physiological or genetic makeup that distinguishes them from the “normal” brain.

In contrast, secondary psychopaths, who are not as prone to violent behavior, are often shaped by an adverse environment during the developmental years. As a learned behavior, they shape their skills of manipulation and deception to survive and achieve their goals. They may imitate others, and their behavioral strategies are reinforced with every success. Although they may have intrinsic characteristics that make them vulnerable to conflict with others in their environment, such as neurotic anxiety, a high sex drive, or stress-reactive, the interaction with their circumstances are more pronounced. As such, they are more fluid and less encumbered by inherited psychopathic traits.

Hervé’s 4-dimensional classification

Hervé expanded the two-dimensional concept of psychopathy to four dimensions, namely the classical/prototypical, manipulative, macho, and pseudopsychopath subtypes. Hervé described the four groups as follows[v]:

  1. Classical/prototypical subtype: Typified by high overall PCL-R scores, as well as high scores on the interpersonal, affective, and lifestyle factors. They are most related to the primary type.
  2. Manipulative subtype: Distinguished by high scores on the interpersonal and affective factors, bur lower scores on the lifestyle factor. These are the “talkers” who use cons and ruses to defraud and deceive their victims.
  3. Macho subtype: Has the second highest overall PCL-R score while scoring high on the affective and lifestyle factors, but low on the interpersonal factor. As such, the group lacks the charm and social skills to con and manipulate others, relying on force and intimidation instead to achieve their objectives.
  4. Pseudopsychopath subtype: These are akin to sociopaths, and have the lowest overall PCL-R scores, low scores on the interpersonal and lifestyle scales, but high in affective characteristics.

So, this all sounds complicated, but what does it mean in practice? In simple terms then, what are the main differences in the motivation and behavior of a sociopath and a psychopath, and does different elements cause each?

Differences between a sociopath and a psychopath in simple terms

Therefore, from the research that is available, sociopaths are believed to be created, not born, while prototypical psychopaths are born and while they are not created by their environment, adverse conditions could have helped to shape their skills in line with their predisposition. Psychopaths rely more on acts and threats of violence, while sociopaths may avoid getting their hands “dirty.” Instead, they employ manipulation and cunning to benefit them. Sociopaths, therefore, rely on their social skills and can empathize with close friends or family. Sociopaths are also more expressive and emotional. As a result, their behavior can appear erratic and opportunistic.

Psychopaths are not able to appreciate emotions, or capable of feeling empathy or guilt, and can be obsessively organized. However, they are skilled at appearing normal in their feelings and relationships, which are often symbiotic or parasitic. Not always violent, they are cruel and have no remorse. With their predatory instinct, they attack proactively rather than the sociopath, who is more reactive in confrontations. Whereas a psychopath lacks a moral compass, that of the sociopath is largely skewed as a result of their adverse development.

However, despite their many (often subtle) differences—psychopaths are fearless, while psychopaths are not; psychopaths do not have a sense of right or wrong, sociopaths do, and psychopaths do not recognize or understand emotions, sociopaths do—both ruin relationships and destroy lives, and do not care at all, as long as they benefit.


[i] Cleckley, H. M. (1941). The mask of sanity: An attempt to clarify some issues about the so-called psychopathic personality. Maryland Heights, MO: C. V. Mosby Co.

[ii] Hervé, H. F. M. (2003). The masks of sanity and psychopathy: A cluster analytical investigation of criminal psychopathy. PhD dissertation. The University of British Columbia.

[iii] Skeem, J. L., Johansson, P., Andershed, H., Kerr, M., & Louden, J. E. (2007). Two subtypes of psychopathic violent offenders that parallel primary and secondary variants. Journal of Abnormal Psychology, 116, 395-409.

[iv] Gregory, S., Ffytche, D., Simmons, A., Kumari, V., Howard, M., Hodgins, S., & Blackwood, N. (2012). The antisocial brain: Psychopathy matters; a structural MRI investigation of antisocial male violent offenders. Archives of General Psychiatry, 69(9), 962-972. DOI: 10.1001/archgenpsychiatry.2012.222

[v] Swart, J. (2016). Psychopaths in film: Are portrayals realistic and does it matter. In M. Arntfield & M. Danesi, The criminal humanities: An introduction (pp. 73-98). New York, NY: Peter Lang Publishing.

Joan Swart, PsyD

Joan Swart, PsyD

Forensic Psychologist | Business Developer at Open Forest LLC
Joan is a forensic psychologist, lecturer, and author of “Treating Adolescents with Family-Based Mindfulness” published by Springer in 2015 and “Homicide: A Forensic Psychology Casebook” published by CRC Press in 2016. She is a business developer at Open Forest LLC. Open Forest LLC provides online psychoeducation and self-help programs aimed at improving many conditions, including depression, anxiety, ADHD, and mindfulness.
Joan Swart, PsyD


Forensic psychologist, #narcissist, #psychopath, other PDs | Business developer at | #pug lover | masters #powerlifting
Joan Swart, PsyD
Joan Swart, PsyD

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