How Many Female Psychopaths Are There?

Lori Vallow. Kouri Richins. Shanda Vander Ark. Heather Pressdee. Jennifer Faith. I could go on.

I can’t remember a time when there have been so women many accused of such heinous crimes. Can you? Have forensic psychologists historically underestimated the dark potential of women? Are there more female psychopaths than previously thought, or are we just more aware of them?

The question of whether psychopathy is more prevalent in men or women has been a topic of much debate in recent months. Traditionally, psychopathy has been viewed as a disorder that primarily affects men, with the majority of research focusing on male prison populations.

However, some experts are challenging this perspective, arguing that psychopathy may be more common in women than previously thought. This debate has given rise to three main positions, each with distinct implications for how we assess and manage the risk of psychopathic individuals in forensic settings.

Position 1: Psychopathy is a male-dominated disorder.

We have long thought that psychopathy is much more common in men than in women. Based on the research, estimates suggest that for every woman with psychopathy, there are about six men with the disorder.

Several factors support this view. First, the vast majority of psychopathy research has been conducted on male prisoners. Given that men constitute a much larger proportion of the prison population, it's not surprising that more male psychopaths have been identified in these studies. This gender imbalance in the research may simply reflect the true prevalence of the disorder.

Second, many of the traits associated with psychopathy, such as impulsivity, fearlessness, and antisocial behavior, are more frequently observed in men. For example, a male psychopath might engage in risky behaviors like reckless driving or substance abuse, while a female psychopath might be less likely to exhibit these overt behaviors.

Additionally, some studies suggest that certain psychopathic traits, such as interpersonal features (e.g., glibness, narcissism), may be less pronounced in women with high psychopathy scores compared to men. This could be attributed to a combination of biological and sociocultural factors.

Finally, crime statistics indicate that men are far more likely to commit violent offenses than women. Since criminal versatility is a key feature of psychopathy, it follows that psychopathy would also be more prevalent in men.

However, this perspective has some limitations. It may underestimate female psychopathy by failing to consider how psychopathic traits might manifest differently in women. For instance, a female psychopath is more likely to engage in relational aggression, such as spreading rumors or manipulating social networks, rather than physical violence. Additionally, by focusing heavily on prison populations, this view may overlook "successful" female psychopaths who manage to evade detection.

Position 2: We've been underestimating female psychopathy.

Dr. Clive Boddy created quite a media stir when he argued that the ratio of male to female psychopaths is 1.2 to 1, up to five times more female psychopaths than we've realized. He believes one reason for this is that female psychopaths are more subtle in their behavior and, as such, are more skilled at flying under the radar.

This, in combination with the fact that our psychopathy assessment tools and diagnostic criteria were developed primarily based on male samples, has resulted in a male bias when it comes to recognizing psychopathy. This male bias, he argues, may have led us to overlook a significant number of female psychopaths.

Certainly, the most widely used psychopathy assessment, the Psychopathy Checklist-Revised (PCL-R), was initially validated on male offenders. Consequently, it may not fully capture how psychopathic traits manifest in women.

For example, the "psychopathic lifestyle" items on the PCL-R focus more on overt antisocial behaviors, like getting into fights or having numerous short-term marital relationships. These are not things that antisocial women typically do. Research suggests that female psychopaths are more likely to display traits such as verbal aggression, emotional volatility, and dramatic attention-seeking behaviors, which are not well-represented on the PCL-R.

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Moreover, societal stereotypes about psychopathy being a "male" disorder may make clinicians hesitant to diagnose women as psychopathic, even when they exhibit relevant traits. A female offender who is superficially charming and manipulative might be described as "histrionic" or "borderline," while a male offender with the same traits would be labeled a psychopath.

Some recent studies using female-specific measures have found that the gender gap in psychopathy may be much smaller than previously thought. For instance, Colins et al. used a revised version of the PCL-R (PCL-R-2nd Edition) and found that the prevalence of psychopathy was similar in both male and female offenders.

However, it's important to note that research on female-specific psychopathy assessment is still in its early stages. Larger, more representative studies are needed to draw firm conclusions about the true prevalence of psychopathy in women. Additionally, self-report measures can be problematic when assessing psychopathic individuals, who are skilled at manipulation and may not answer honestly.

Position 3: It’s the personality, not the gender, that matters the most.

As a forensic psychologist, I am often asked to evaluate psychopathy as it relates to the risk of violence and criminal recidivism. In my experience, whether an offender is a male or a female is much less important than whether the person is psychopathic.

Breaking it down even further, I believe that when it comes to violence against people, the interpersonal-affective aspects of psychopathy are more important than the lifestyle-antisocial factor. These are the traits we should be focusing on in risk assessment and treatment.

The interpersonal-affective domain of psychopathy encompasses traits like superficial charm, grandiosity, deceitfulness, lack of empathy, shallow emotions, and failure to accept responsibility. Essentially, it captures the psychopath's manipulative and callous way of relating to others. For example, a psychopathic individual might be described as a "smooth talker" who can easily con others, or as someone who seems coldly indifferent to the suffering they cause.

Research has consistently shown that interpersonal-affective psychopathic traits are more strongly associated with violence and aggression than lifestyle-antisocial features (which include things like impulsivity, irresponsibility, and juvenile delinquency). For example, Storey et al. found that offenders who scored high on traits like callousness and lack of remorse were more likely to commit violent crimes than those who scored high on impulsivity and irresponsibility.

A 2024 study also found that the affective facets of psychopathy (callousness, lack of remorse, guilt, and empathy) were most related to crimes against people. Importantly, this seems to be true for both male and female offenders.

Neuroimaging studies have also found that interpersonal-affective traits are linked to deficits in brain regions involved in processing emotions, morality, and empathy. For instance, when shown images of people in distress, psychopathic individuals show reduced activity in the amygdala, a brain area involved in fear and empathy. These brain abnormalities are seen in both male and female psychopaths.

Furthermore, callous-unemotional traits in children and adolescents are a known risk factor for developing psychopathy and lifelong antisocial behavior. These traits involve a lack of guilt, empathy, and concern for others' feelings. Importantly, they seem to manifest similarly in boys and girls. A boy who delights in tormenting animals or bullying weaker peers is just as concerning as a girl who does the same.

From a treatment perspective, programs that target the interpersonal-affective deficits of psychopathy, such as empathy training and moral reasoning exercises, have shown the most promise in reducing recidivism risk (Polaschek & Skeem, 2018). Again, these interventions appear to be effective for both male and female psychopathic offenders.

That said, there are some caveats to this position. Focusing exclusively on interpersonal-affective traits could lead us to neglect the role of behavioral factors like impulsivity and poor self-control in violence risk. A comprehensive risk assessment should consider the full range of psychopathic features. Additionally, understanding gender differences in the behavioral expression of psychopathy is still important for developing gender-responsive risk assessment and treatment strategies.

The Bottom Line

In conclusion, while the debate about the prevalence of psychopathy in women is ongoing, the current evidence seems to favor the view that interpersonal-affective traits are the most critical factor in violence risk assessment, particularly when it comes to proactive aggression.

Whether the "true" gender ratio is 6:1 or 1.2:1, forensic psychologists should carefully evaluate traits like empathy deficits and manipulativeness in all offenders. At the same time, we should continue to study how psychopathy manifests differently in women and develop gender-sensitive assessment tools and interventions.

Ultimately, the goal is to accurately identify and effectively treat psychopathic individuals, regardless of gender, to prevent future harm and promote public safety.

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