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Psychopathic personality disorder – or psychopathy as it is commonly called – is one of the oldest and most researched mental health diagnoses. The first account of psychopathy seems to be a short text from 1786 by the American physician Benjamin Rush who described a mysterious medical condition that he called anomia – and later moral derangement – where people allegedly lost the ability to distinguish between good and evil. Although his work is highly speculative, it sketched out the idea of ‘the psychopath’ in a way that could be passed on to a scientific audience: as a biological disorder so extreme that it impairs the innate human capacity for moral attitudes and prosocial behaviours.

In modern science, psychopaths are typically described with reference to concrete symptoms, like a lack of empathy, remorse and conscience, or more explicit behavioural signs, like predatory violence, pathological lying and impaired impulse control. As the prominent psychopathy researcher Robert Hare writes in his book Without Conscience (1993):

"Psychopaths are social predators who charm, manipulate, and ruthlessly plow their way through life, leaving a broad trail of broken hearts, shattered expectations, and empty wallets. Completely lacking in conscience and in feelings for others, they selfishly take what they want and do as they please, violating social norms and expectations without the slightest sense of guilt or regret."

The psychopath has also become a well-known figure of fascination in popular culture, frequently portrayed in bestselling novels and cinematic thrillers. One of the more jarring examples is the assassin Anton Chigurh, played by Javier Bardem in the movie No Country for Old Men (2007). Utterly deprived of any emotional resonance, Chigurh wanders through the arid Texas landscape as he slaughters innocent people like cattle. Though characters such as Chigurh are, of course, works of fiction and not serious attempts to portray real people clinically diagnosed with psychopathy, Chigurh-like characters still animate many of the central traits associated with psychopathy, such as emotional detachment and moral emptiness.

However, there’s a problem with this idea of psychopathy. While it has been researched across hundreds of empirical studies – especially since the explosion of research in the late-1990s – there is still remarkably little evidence that corroborates popularised claims about the diagnosis. Despite enthusiasm among researchers in the 1990s and 2000s, when a few studies seemed to validate theories about psychopathy, the past two decades have been sobering. Today, virtually every single claim about psychopathy has been either thoroughly refuted or failed to find empirical support in experimental settings. Psychopathy may not exist at all.