Women Can Be Psychopaths Too

By: Nadia Yassin, MAFP & Andrea Cipriano, MAFP

Even though true crime entertainment content primarily focuses on male psychopath offenders, women can be psychopaths too.

Experts agree that female psychopaths are rare. It’s believed that their antisocial traits and tendencies present differently than male traits — and are harder to spot. 

To that end, there’s a clinical debate on whether the observed differences are real or if our understanding of their personality traits is the result of the diagnostic tools and terminology used since many were created with male psychopaths in mind.

Can you be diagnosed as a Psychopath?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) is the current standard classification of mental disorders used by mental health professionals in the United States. 

“Psychopathy” is not included as a diagnostic entity in the DSM, but it is commonly described as a form of Antisocial Personality Disorder. 

Antisocial Personality Disorder (ASPD), as described in the DSM-5, includes traits of sociopathy and psychopathy—concepts with subtle but important distinctions. 

Individuals with sociopathic Antisocial Personality Disorder usually lack self-control and can generally form attachments with others, while those with psychopathic Antisocial Personality Disorder are extremely manipulative and do not form attachments with others.

Sociopaths are characterized by volatile behavioral patterns and a high disregard for societal rules, while those with psychopathic Antisocial Personality Disorder are often meticulous and highly organized, lacking any feelings of empathy or remorse. 

Diagnosing psychopathy under the DSM-5 is further complicated because an individual does not need to meet all the criteria but instead needs to meet a handful of criteria “strongly.” 

In other words, being diagnosed as a psychopath is incredibly difficult — and rare. 

Because of this difficulty, most evaluators use a more specialized tool — the Hare Psychopathy Checklist-Revised. Psychologists know the Hare Checklist as the PCL-R.

The PCL-R is a 20-item checklist. For each item, the individual must rank whether or not they experience the trait or characteristic.

For example, one of the traits are “History of juvenile delinquency.” The individual would score a 0 for “definitely not present,” a 1 for “somewhat present” or a 2 for “definitely present.”

At the end, their scores get added up.

Any total above a 30 means the person displays psychopathy. Fourty is the maximum score.

The PCL-R is validated and well-researched, but the instrument was created from studies conducted on male populations (along with most of the literature relating to psychopathy).

Male vs. Female Psychopaths

Like any manifestation of mental disorders, clinicians need a biopsychosocial understanding of the cause of the condition, known as etiology.

The Biopsychosocial Model says illnesses result from biological conditions like genetic vulnerabilities and physical health, psychological conditions like coping skills and self-esteem, and social conditions like family circumstances and an individual’s peers.

Because these conditions are innate differences between men and women, psychopathic traits are inherently expressed differently in women and men. 

According to a 2012 study, psychopathy is likely substantially caused by genetic factors which influence the development of the brain and, therefore, the development of personality and temperament characteristics — which are the core components of the disorder. As with most psychological disorders, the development of psychopathy in an individual is likely the result of complex interactions between genetic predispositions and environmental influences.

In the context of a gender breakdown, psychopathy in the general population doubles its prevalence in males compared to females (7.9 vs. 2.9%).

Forouzan and Cooke (2005) suggest that the differences between the sexes manifest in four key dimensions: behavior, interpersonal characteristics, underlying psychological mechanisms, and different social norms for men and women. It is difficult to know whether the noted differences between male and female psychopathy derive from biological or social differences. 

Female Psychopathy Traits

Promiscuous behavior, for example, is one of the most well-known female psychopathy traits. Experts say this behavior may have different underlying motivational and perceptual factors in men and women. 

Promiscuity in female psychopaths may reflect a desire to gain financial or social benefits, which is more socially accepted, while promiscuity in male psychopaths is likely related to grandiose self-image, lack of interpersonal connection, and pursuit of sexual domination. 

Social norms affect the formation and perception of these behaviors; in the West, it is socially and culturally acceptable for a woman to depend financially on a man. However, if a man engages in the same behavior, it may be seen as “parasitic behavior.” 

Studies show female psychopaths seem to have a worse self-image, more anxiety, and a stronger need for others’ approval compared to male psychopaths. 

A 2010 study found that psychopathy was associated with early and promiscuous sexual behavior and affairs in both men and women, which is consistent with previous research, but they also found a marked difference in the esteem correlates of psychopathy between the sexes; in men, psychopathy was associated with high self-rated attractiveness, low appearance anxiety, and low body shame, whereas psychopathy in women was associated with low self-esteem and high body shame. 

It is difficult to distinguish whether this divergence results from female neurological mechanisms intended to maintain social harmony and foster security or is due to gender constructs and social conditioning.

Female psychopaths tend to be less physically violent and antagonistic than their male counterparts and instead engage in manipulation and relational aggression—like harming someone socially through gossip or ostracism. 

Female psychopaths do not tend to engage in ‘violence for the sake of violence.’ They are not generally characterized by superficial charm and a grandiose self-image, as is with male psychopaths, but instead are characterized by unemotionality, callousness, manipulation, and dishonest charm. 

While coldness and unemotionality are considered core characteristics of psychopathy regardless of biological sex, they are central to female psychopathy in a way that is not seen in male psychopaths. 

Female psychopaths score better on tests of emotional intelligence than males with psychopathy and tend to engage in more manipulative and self-destructive behaviors; they may use flirtation and promiscuity, fake suicide attempts, or pretend to be the victim of an assault to get what they want from others. Female psychopaths may not care about the consequences of hurting others. Still, they do not necessarily wish to commit violent acts and do not have the same propensity for violence as other groups. 

In fact, women with psychopathy are found to be less likely to murder non-psychopathic women and are much more likely to employ coercion and manipulation to get what they want. Some of this motivation stems from a fear of abandonment, researchers note.

A study conducted at the University of Zurich in 2012 also found that those with psychopathy often use laughter as an intentional manipulative device to control the conversation — often laughing at, not with, the person they are speaking to.

Female Psychopath Examples 

Aileen Wurnos

One of the most well-known real-life examples of a female psychopath is Aileen Wuornos. 

While engaging in sex work along the highways in Florida, Wurnos shot dead and robbed at least seven of her male clients over one year. After being arrested, she claimed that the men had either raped or attempted to rape her and that the homicides of the men were committed in self-defense. 

Before she became the infamous killer, she was a young girl who suffered countless bouts of abandonment, economic struggles, and sexual abuse. 

Wuornos’s mother was only 16 years old when Aileen was born. Even though Aileen never met her father, he was later sentenced to life imprisonment for kidnapping and raping a child. 

When Aileen was four, her mother abandoned her with her maternal alcoholic grandparents. By age 11, Aileen began engaging in sexual activities in school in exchange for cigarettes, drugs, and food. At 14, she was raped by a family member and left pregnant. By 15, she was thrown out of her house, living in the woods, and supporting herself through sex work. 

Her life continued to be tumultuous through her thirties, when she eventually began killing.

While in prison waiting for her death sentence to be carried out, she was assessed using the PCL-R. Wuornoss scored 32/40. She was also known to meet the relevant criteria for determining borderline personality disorder and antisocial personality disorder.

The psychiatrists who studied her case while she was incarcerated believe her psychopathy diagnosis was likely caused by her traumatic childhood and the physical and sexual abuse that she experienced, which can disrupt normal human development. They also concluded that there may have been a genetic influence towards violence that she inherited from her father, where those genes could have contributed to her choices to murder others.

Candy Montgomery

Married to Pat Montgomery and a mother of two children, Candace “Candy” Montgomery was a seemingly typical, 30-year-old housewife living in Collin County, Texas. While at church in the 1970s, the Montgomery family became close with the Gore family. Candy and Betty Gore, a fellow housewife, mother, and middle school teacher, immediately became fast friends. 

Candy was outwardly a charming and friendly woman. But, when emotions bubbled to the surface in a fit of rage, Candy snapped and became violent in an other-worldly sense.

In 1978, Candy and Betty’s husband, Allan, had an affair that Candy initiated. Candy was known to crave acceptance and be strategic about her relationships to get things she wanted — and sex with Allan was no exception. 

As their affair became more serious and Allan attempted to end it once he had another newborn baby with Betty, Candy sometimes became emotionally unstable and anxious. She reacted with anger and jealousy, not wanting to sever their entanglement. 

On June 13, 1980, Candy went to Betty’s house while Allan was out of town to get their daughter’s swimsuit since she was staying over at the Montgomvery’s house another night. Once there, Candy said Betty confronted her about having an affair, and their encounter became violent. Candy maintains that Betty got an ax from the family’s garage, which Candy took away from Betty and struck her 41 times.

The laundry room crime scene was a bloodbath.

According to court documents, Candy Montgomery claimed that she killed Gore in self-defense after Betty shushed her, causing her to be triggered and experience a flood of childhood trauma. She was acquitted of murder charges on October 29, 1980.

Candy Montgomery is alive and was recently working as a therapist in Georgia. Born in November 1949, she is currently 72 years old.

Dorothea Puente

Even though Dorothea Puente appeared sweet — insisting everyone called her “Grandma” and graciously housed vulnerable and homeless people in her Sacramento, California boarding house — she was actually a cold-blooded killer.

Between the years of 1982 and 1998, Puente poisoned and strangled some of her guests before disposing of their bodies in various ways, and cashing their social security checks. 

After too many people went missing from her house than coincidence would allow, Judy, an outreach counselor with Volunteers of America, spoke to one of the tenants of the boarding house who said Dorothea was “digging a lot of holes.” 

Ultimately, the police discovered six bodies in her back garden.

When questioned by police initially, Puente remained calm and denied everything.

The documentary’s policeman who interrogated her reveals: “She was emotionless, and she would look straight into my eyes and answer every question. She never flinched. She never said anything. She denied everything.”

Before these murders, Puente had a long rap sheet convicted of forgery, prostitution, illegally cashing state and federal checks, and drugging clients when she worked as a personal caretaker. While in Sacramento County jail in 1961, doctors diagnosed her as a pathological liar with an unstable personality.

In 1982, while in prison for one of her theft crimes, a state psychologist diagnosed her as a schizophrenic with no “remorse or regret” who should be “closely monitored.”

She died in prison from natural causes at the age of 82, on March 27, 2011.