Expanded question: What are the differences and overlaps between narcissism, sociopathy, and psychopathy?

Answered on October 30, 2024
Narcissism, sociopathy, and psychopathy are distinct but overlapping constructs within the realm of personality disorders.
Narcissism is characterized by grandiosity, a need for admiration, and a lack of empathy. It can be divided into grandiose and vulnerable subtypes. Grandiose narcissism involves overt self-importance and entitlement, while vulnerable narcissism includes hypersensitivity and defensiveness.[1-2]
Sociopathy and psychopathy are often used interchangeably but have nuanced differences. Both fall under the umbrella of Antisocial Personality Disorder (ASPD) in the DSM-5. Sociopathy is generally considered to be more environmentally influenced, with individuals displaying impulsive and erratic behaviors, and forming attachments to specific individuals or groups. Psychopathy, on the other hand, is thought to have a stronger genetic basis and is characterized by more calculated, manipulative behaviors, and a profound lack of empathy and guilt.[3-5]
Overlaps between these constructs include low agreeableness (antagonism) and moral disengagement, which are common to both narcissism and psychopathy. Both psychopathy and narcissism can involve grandiosity and a sense of superiority, but psychopathy also includes traits like impulsivity and a lack of remorse, which are less central to narcissism.[1][6-8]
In summary, while narcissism, sociopathy, and psychopathy share some traits, they are distinct constructs with unique features. Narcissism is marked by grandiosity and a need for admiration, sociopathy by impulsive and erratic behaviors, and psychopathy by manipulative behaviors and a profound lack of empathy.

References

1.
Are Pathological Narcissism and Psychopathy Different Constructs or Different Names for the Same Thing? A Study Based on Italian Nonclinical Adult Participants.

Fossati A, Pincus AL, Borroni S, Munteanu AF, Maffei C.

Journal of Personality Disorders. 2014;28(3):394-418. doi:10.1521/pedi_2014_28_127.

To understand the similarities and differences in personality traits and moral disengagement associated with pathological narcissism and psychopathy, 740 Italian active community members who voluntarily participated in the study were administered the Italian versions of the Pathological Narcissism Inventory, the Levenson Self-Report Psychopathy Scale, the HEXACO Personality Inventory, and the Moral Disengagement Scale. Hierarchical regression analyses showed that low Honesty-Humility and Antagonism (i.e., low Agreeableness) were personality traits common to both pathological narcissism and psychopathy, whereas low Conscientiousness was only related to psychopathy. Different associations with the HEXACO-PI scales and facets were observed for narcissistic grandiosity and narcissistic vulnerability, as well as for primary psychopathy and secondary psychopathy. Moral disengagement represented a common feature of pathological narcissism and psychopathy that was related to narcissistic vulnerability and to primary and secondary psychopathy, but not to narcissistic grandiosity.

2.
Comparing Self-Report Measures of Grandiose Narcissism, Vulnerable Narcissism, and Narcissistic Personality Disorder in a Male Offender Sample.

Krusemark EA, Campbell WK, Crowe ML, Miller JD.

Psychological Assessment. 2018;30(7):984-990. doi:10.1037/pas0000579.

Despite a growing interest in the use of self-report measures of narcissism among student, community, and clinical samples, the research on narcissism in prison samples is sparse, despite elevated rates of narcissism in these samples. The current study examined the relations between commonly used measures of grandiose narcissism (Narcissistic Personality Inventory-13 [NPI-13]), vulnerable narcissism (Hypersensitive Narcissism Scale [HSNS]), and narcissistic personality disorder (NPD; Personality Diagnostic Questionnaire [PDQ]) in a sample of adult male offenders (N = 179). The NPI-13 and PDQ NPD scales overlapped substantially with one another and manifested similar empirical profiles (rICC = .81), with both being substantially correlated with interview-based symptoms of NPD, entitlement, psychopathy, and externalizing behaviors. Conversely, the HSNS manifested more limited relations with other measures of NPD and related traits (e.g., entitlement), as well as externalizing behaviors, and was more strongly related to internalizing symptoms. Consistent with previous work, NPD appears to be a blend of grandiose and vulnerable narcissism as the PDQ's empirical profile overlapped with that of the HSNS (rICC = .51), which was not true for the NPI-13 (rICC = .18). Analyses of the incremental validity of the 3 measures suggested that the NPI-13 was particularly successful in accounting for unique variance in these relevant criteria. These results underscore the benefit of utilizing multiple measures to distinguish empirical correlates of grandiose narcissism, vulnerable narcissism, and NPD. (PsycINFO Database Record

3.
Psychopathic Disorder Subtypes Based on Temperament and Character Differences.

Martínez-López JNI, Medina-Mora ME, Robles-García R, et al.

International Journal of Environmental Research and Public Health. 2019;16(23):E4761. doi:10.3390/ijerph16234761.

The concept of psychopathy has shifted from people who commit crimes to those with a particular personality and deviant behaviors. Although antisocial personality disorder is associated with psychopathy, it also seems common in individuals with narcissistic personality traits. Psychopathy may be the expression of earlier, persistent patterns of individual characteristics as personality. The psychobiological model of personality can be useful for determining whether the expression of psychopathy differs in accordance with personality dimensions and specific personality disorders. The aim was to compare temperament and character dimensions between individuals with psychopathy with comorbid predominant antisocial or narcissistic personality traits and control subjects and to determine which dimensions distinguish these groups. Control subjects ( = 80) and individuals with psychopathy ( = 80) were assessed using the Psychopathy Checklist-Reviewed, the Structured Clinical Interview for DSM-IV Axis II disorders and the Temperament and Character Inventory-Revised. Reward dependence and Self-Directedness distinguish psychopathic individuals with predominant narcissistic personality traits whereas Novelty Seeking and Self-Transcendence characterize those with antisocial personality traits. Individuals with antisocial or narcissistic psychopathy could be identified by their temperament and character traits. The expression of psychopathy differed in accordance with biologically based, environmentally shaped personality traits.

4.
Variants of Psychopathy in Adult Male Offenders: A Latent Profile Analysis.

Mokros A, Hare RD, Neumann CS, et al.

Journal of Abnormal Psychology. 2015;124(2):372-86. doi:10.1037/abn0000042.

As measured with the Psychopathy Checklist-Revised (PCL-R), psychopathy is a dimensional construct underpinned by 4 correlated factors: Interpersonal, Affective, Lifestyle, and Antisocial. Theorists and clinicians (e.g., Karpman and Arieti) have posited 2 variants of "primary" or "true" psychopathy, both distinct from so-called "secondary" or "pseudopsychopathy." We used latent profile analysis to determine if homogeneous classes exist within a sample of 1,451 male offenders with high PCL-R scores (≥ 27). The 4 PCL-R factors were the dependent variables for clustering. A solution with 3 latent classes showed a better fit to the data than did a unitary model without latent classes. Tentative labels for the latent classes are Manipulative (Latent Class 1 [LC1]), Aggressive (Latent Class 2 [LC2]), and Sociopathic (Latent Class 3 [LC3]). The latter class represented an antisocial group that lacked the emotional detachment observed in the other 2 groups. We propose that LC1 and LC2 reflect phenotypic variations on a theme of the traditional construct of psychopathy, and that LC3 is consistent with conceptions of antisocial personality disorder and sociopathy. Replication and external classification with an independent data set of 497 adult male offenders again yielded clearly separable clusters, as well as meaningful differences or trends among latent classes on education, intelligence, symptoms of antisocial personality disorder, and self-reported psychopathic traits and negative affect. The conceptualization of psychopathy in terms of manipulative and aggressive variants is consistent with clinical theory and is empirically grounded.

5.
Psychopathy.

De Brito SA, Forth AE, Baskin-Sommers AR, et al.

Nature Reviews. Disease Primers. 2021;7(1):49. doi:10.1038/s41572-021-00282-1.

Leading Journal

Psychopathy is a personality disorder characterized by a constellation of affective, interpersonal, lifestyle and antisocial features whose antecedents can be identified in a subgroup of young people showing severe antisocial behaviour. The prevalence of psychopathy in the general population is thought to be ~1%, but is up to 25% in prisoners. The aetiology of psychopathy is complex, with contributions of both genetic and environmental risk factors, and gene-environment interactions and correlations. Psychopathy is characterized by structural and functional brain abnormalities in cortical (such as the prefrontal and insular cortices) and subcortical (for example, the amygdala and striatum) regions leading to neurocognitive disruption in emotional responsiveness, reinforcement-based decision-making and attention. Although no effective treatment exists for adults with psychopathy, preliminary intervention studies targeting key neurocognitive disturbances have shown promising results. Given that psychopathy is often comorbid with other psychiatric disorders and increases the risk of physical health problems, educational and employment failure, accidents and criminality, the identification of children and young people at risk for this personality disorder and preventative work are important. Indeed, interventions that target the antecedents of psychopathic features in children and adolescents have been found to be effective.

6.
The Importance of Antagonism: Explaining Similarities and Differences in Psychopathy and Narcissism's Relations With Aggression and Externalizing Outcomes.

Vize CE, Collison KL, Lynam DR.

Journal of Personality Disorders. 2020;34(6):842-854. doi:10.1521/pedi_2020_34_342.

Psychopathy and narcissism are multidimensional constructs with substantial overlap. Low agreeableness (i.e., antagonism) features prominently in clinical and theoretical descriptions of both disorders. The authors examined whether antagonism components of their assessments accounted for the overlap between narcissism and psychopathy. Next, they tested whether the antagonism components were responsible for the relations that narcissism and psychopathy bore to aggression outcomes. Using multiple regression, the authors found that the low agreeableness component accounted for the majority of overlap between psychopathy and narcissism, nearly all of the variance in narcissism's relations with aggression outcomes, and the majority of variance in psychopathy's relations with aggression outcomes. Disinhibitory traits, which serve to distinguish psychopathy from narcissism, accounted for incremental variance in aggression outcomes for psychopathy. Results are discussed in the context of the overlap between narcissism and psychopathy. The authors argue that low agreeableness is largely responsible for the maladaptive outcomes associated with grandiose narcissism and psychopathy.

7.
Differentiating Narcissistic and Antisocial Personality Disorders.

Gunderson JG, Ronningstam E.

Journal of Personality Disorders. 2001;15(2):103-9. doi:10.1521/pedi.15.2.103.19213.

The conceptual, clinical, and empirical overlap between the constructs of narcissistic personality disorder (NPD) and antisocial personality disorder (ASPD) is reviewed and their descriptive discriminability is investigated. Twenty-four patients with NPD and 16 patients with ASPD were compared on 33 characteristics for pathological narcissism assessed with the semistructured Diagnostic Interview for Narcissism. The results confirm a sufficiently broad array of similarities that the question of whether these categories should be kept separate (as they are in DSM-IV) is underscored. The results also indicate important areas of difference. The NPD sample was best discriminated from the ASPD sample by their grandiosity, that is, the tendency to exaggerate their talents, and to regard themselves as more unique and superior.

8.
Unique and Shared Features of Narcissistic and Antisocial Personality Disorders: Implications for Assessing and Modeling Externalizing Traits.

Stanton K, Zimmerman M.

Journal of Clinical Psychology. 2019;75(3):433-444. doi:10.1002/jclp.22708.

Objectives: We aimed to determine which, if any, features distinguish antisocial and narcissistic personality disorders (ASPD and NPD), two overlapping externalizing disorders.

Methods: A large sample of outpatients (N = 2,149) completed interview measures assessing personality pathology, other psychopathology, and impairment. The structure of antisocial and narcissistic traits was examined using both exploratory bifactor and traditional exploratory factor analytic approaches, and we examined relations for our emergent factors.

Results: Factor analytic results indicated that most narcissistic and antisocial traits were strongly overlapping, although some features emerged as relatively distinct (e.g., arrogance defining NPD). Factors modeling our specific bifactor dimensions showed very weak psychopathology and impairment relations.

Conclusions: The structure of ASPD and NPD traits does not align neatly with Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Section II conceptualizations, Regardless of the factor analytic approach used. Our findings also indicate that specific dimensions defining these PDs show modest predictive power after accounting for a general externalizing dimension.