What Causes Psychopathy?
A common question is: “What causes psychopathy?” This is a question a lot of people have. And as is true for other developmental disorders, there is no single cause of psychopathy. Instead, psychopathy results from a complex combination of genetic and environmental factors, any of which can increase risk.
Increased risk is not the same as a cause: It is important to keep in mind that saying a factor increases risk for psychopathy is not the same as saying it causes psychopathy. For example, some genetic changes associated with psychopathy can also be seen in people who don’t have psychopathy. Similarly, many children exposed to a particular environmental risk factor for psychopathy will not develop the disorder.

Genetic Risk Factors
There is no such thing as a “psychopathy gene.” But research tells us that psychopathy tends to run in families. Even if a parent does NOT have psychopathy, they may carry one or more genetic variants that increases their child’s chance of developing psychopathy.
Most psychological outcomes are caused by the combined effects of many hundreds or thousands of genes. The combined effects of many genes account for about HALF of the variation in psychopathic traits. This means that some children are born at higher risk for developing psychopathy. But the answer to the question “Is psychopathy something people are born with” is complicated. No one is born with psychopathy – or any other psychological disorder. However, some children are born at high risk for developing psychopathy due to inherited, which is to say genetic, factors.

Environmental Risk Factors
Environmental influences can increase—or reduce—the odds of developing psychopathy in people who are at risk because of inherited factors. There are many environmental risk and protective factors for psychopathy, only some of which have been identified to date. Each of these factors likely has only a small impact. In other words, each of these factors might only affect the severity of psychopathic symptoms a little bit. Factors that increase risk for psychopathy include:
- Prenatal and perinatal factors, such as smoking during pregnancy, high-stress levels during pregnancy, or birth complications
- Low resting heart rate, which may reflect low physiological arousal
- A fearless temperament
It is not clear if low resting heart rate and/or a fearless temperament cause psychopathic traits to emerge, or whether they are simply correlated with psychopathic traits.
A protective factor against developing psychopathy is experiencing highly warm and responsive parenting in early childhood. But it is of the UTMOST importance for parents to understand that the type of warm parenting that can reduce psychopathy symptoms in at-risk children can be unintuitive and often seems to be the opposite of what affected children want. But parents who are trained to use therapeutic techniques of warm parenting with high-risk children can reduce those children’s chances of developing psychopathy, similar to the way ABA therapy can reduce symptoms of autism. – You’ll hear more about warm parenting in a minute.
Again, it is important to remember that risk factor is not synonymous with cause. Many children with psychopathy have none of these risk factors and DID experience warm and responsive parenting. Similarly, most children with these risk factors will not develop psychopathy.

Differences in Brain Biology
Genetic and environmental influences do not cause psychopathy directly. Instead, they influence the way certain brain structures and circuits develop in a way that increases the risk a person will develop psychopathy. For example, one brain region that seems to be particularly important is the amygdala. This structure is involved in social responsiveness, empathy, and outcomes related to fear. Children with psychopathy seem to have amygdalas that develop differently from other children. In children who are psychopathic, this region may be smaller and/or less active than in other children. This may be why they are relatively fearless and less socially responsive. The amygdala also sends and receives information from other brain regions that may also be affected in psychopathy. These include parts of the cortex, or surface, of the brain, as well as other brain systems that regulate emotion and decision-making. Research continues to explore these differences with the aim of developing treatments that can improve behavior and quality of life for individuals affected by psychopathy.
Some children are born at higher risk for psychopathy—but what parents do still matters
Some children are born at higher risk for psychopathy due to genetic variables that affect brain development. But parents still play an important role. Learning to use specific therapeutic techniques with high-risk children can reduce their chances of developing psychopathy.
Some research suggests that children with psychopathy are less sensitive than other children to positive social and emotional cues. As a result, these children may benefit from unusually strong displays of positive emotion from their parents–beyond what parents would naturally use.
Right now, one of the few interventions known to help children at risk of psychopathy are family therapy programs that train parents to use very specific techniques related to warm and responsive parenting. What does it mean for a parent to be “warm and responsive?” Warm parenting means showing your child positive emotion using your face, voice, and body. Warm parenting behaviors include smiling, speaking in a warm tone of voice, and using positive touch -for example, a gentle touch on the arm, a hug, or a high-five. Responsive parenting means responding appropriately to your child’s needs and emotions. Responsive parenting behaviors include, for example, expressing concern through your face and voice, asking questions, or offering a hug if your child is upset.
It is important for parents of children with psychopathy to learn effective techniques in part because a child’s psychopathy can change parents’ behavior toward their child over time in maladaptive ways. For example, some children with psychopathy resist affection. So parents may be less verbally or physically affectionate with these children because they believe that is what the child prefers. But children at risk for psychopathy may actually need MORE verbal and physical warmth than other children.
Parents often feel guilty about their child’s mental disorders. And it is common for parents–particularly mothers–to be blamed by others, including mental health providers, for their child’s difficulties. For decades, psychiatrists and psychologists blamed autism and schizophrenia on, respectively, “refrigerator mothers” and “schizophrenogenic mothers!” But as scientific research on autism and schizophrenia accumulated, it became clear that these complex developmental disorders are caused by a combination of genetic, prenatal, and environmental factors–NOT specific parenting practices–even though specific forms of family therapy can help children with symptoms of these disorders. The same is true for psychopathy.