It has been argued (e.g. Cleckley, 1988) that there exist two types of psychopaths:

  1. Primary (also referred to as ‘true’) psychopaths
  2. Secondary psychopaths
  • Primary psychopaths have been defined as those who commit antisocial acts because of an idiopathic lack of fear and empathy (Dean et al.). According to Karpman, primary psychopathy is largely the result of a congenital (i.e. present at birth) affective deficit (i.e. problem relating to emotional processing and functioning).


  • Secondary psychopaths, whilst sharing several characteristics of primary psychopaths, DO experience feelings of empathy and fear and should, therefore, not be considered ‘true’ psychopaths. It is also believed that secondary psychopaths are created by adverse childhood experiences/trauma that cause them to become detached from their emotions and to develop other emotional disturbances (Craparo et al.).

Further characteristics of primary and secondary psychopaths: 


  • tend to have emotional experiences that are extremely superficial, transient
  • tend to have high levels of testosterone that may lead to high levels of aggression, high levels of risk-taking, a high libido (sex drive), and mood swings
  • they tend to have low levels of cortisol, or, more specifically, lower levels of cortisol secretion in response to stress (O’Leary et al., 2010). Cortisol is sometimes referred to as the stress hormone.
  • impaired ability to reciprocate the emotions of others
  • have a higher level of theta brainwave activity during the waking state (Ortega-Noriega et al., 2015). Such brain wave activity has a frequency of 3.5 to 7.5 Hz and is classified as slow brain activity that is associated with, for example, intuition, fantasizing, and daydreaming).
  • they tend not to be susceptible to social indoctrination and are therefore much less likely to comply with social norms (unless it happens to be in their interests to do so at any given time
  • have a smaller than average region of the brain known as the amygdala (the amygdala is considered to be part of the brain’s limbic system and is associated with the processing of emotions)
  • have a deficient brain region called the orbitofrontal cortex that is associated with decision-making and planning.


  • this type of psychopathy is considered to be linked to adverse childhood experiences such as abuse and neglect
  • these experiences are thought to give rise to emotions that are so painful the individual becomes increasingly, emotionally numb and eventually ‘shuts down’ on an emotional level and loses his/her moral compass, Such individuals then enter a ‘sociopathic process’ before finally emerging from this process as a ‘secondary psychopath.’
  • whilst it takes environmental factors (e.g. early life interpersonal trauma) to trigger the creation of secondary psychopathy, it is thought that some individuals are more genetically predisposed to the disorder than others.


O’Leary MM, Taylor J, Eckel L. Psychopathic personality traits and cortisol response to stress: the role of sex, type of stressor, and menstrual phase. Horm Behav. 2010 Jul;58(2):250-6. doi: 10.1016/j.yhbeh.2010.03.009. Epub 2010 Mar 17. PMID: 20302872.

lO.Ortega-Noriega M.L.Pérez-López F.Ostrosky-Shejet. Quantitative Electroencephalogram and psychopathy. A case study reportElectroencefalograma cuantitativo y psicopatía. Revista Médica Del Hospital General De México. Reporte de un caso. Volume 78, Issue 1, January–March 2015, Pages 43-46