What is the difference between Antisocial Personality Disorder and Psychopathy?

The differences are confusing, even to many psychologists but here is my take on it.  APD is a clinical DSM diagnosis.  Psychopathy is not officially recognized by the DSM, but is believed to be a separate disorder by many, particularly Robert Hare who has developed a Psychopathy Checklist (PCL) to diagnose it.  This would have been a good example of problems with the DSM.  Although Hare's PCL seemed to have more validity (to identify a real and specific disorder, likely with a biological basis), the DSM authors were emphasizing reliability (to make sure that different health care professionals would all come up with the same diagnosis) so they stuck with a different set of criteria.  Thus clinicians using the DSM for diagnosis, would probably focus on APD but researchers interested in true psychopaths would use Hare's test.

The DSM criteria for APD include breaking laws, lying, and impulsivity (and a requirement that such behavior has been observed since age 15).  Psychopathy is similar in many ways (lying, lack of remorse) but places less emphasis on criminal behavior and age of onset.  Most importantly, psychopathy includes a much broader profile that characterizes someone as having a true lack of conscience/superego and a lack of genuine emotional reactions.  Though much more research needs to be done, I personally suspect that there is probably more of a biological basis for psychopathy (amydala and/or frontal dysfunction); whereas, APD may include both psychopaths and others who turned to crime for more situational reasons.

There is a close relationship between APD and criminality (not surprising given that criminal acts are one of the DSM criteria).  The relationship between criminality and psychopathy is not so clear.  Many psychopaths are criminals, but as I emphasized in class, many have no criminal record and have become highly successful in careers where manipulativeness can be advantageous (e.g., entrepreneurs, lawyers and politicians).