Psychopaths, or Sociopaths, are villains associated with antisocial personality disorder, otherwise known as psychopathy. They lack and/or have an absence of empathy, guilt and/or emotional connections; as a result they tend to be violent, twisted and also cannot be remorseful, exceptions aside.

As stated by Lecter's quote above, Psychopaths are NOT crazy or psychotic and are often mistaken for being so. Psychopaths are completely aware of reality while psychotic people are polar opposites; they hear voices, hallucinate, suffer from violent and/or delusional episodes and often do not fully understand what they are doing.

In fiction, it is common for Psychopaths to come in two different forms:

• High Functioning: The cold-hearted and, in theory, more dangerous kind of social predator. If a villain is consistently apathetic towards other people's feelings, but is capable of using a facade to blend in with society, you are usually left with a high functioning psychopath. These kind of psychopaths maintain high impulse control and are able to recognize the consequences of their actions, but are generally more cunning, calculating and manipulative. They exercise superficial charm to adapt to society and tend to be expert liars. When committing wrongdoings, they may plan them in advance to avoid getting caught easily or at least carry them out when in a situation where they are guaranteed to not get caught. Though they try to make themselves look normal to the public, they are often emotionally hollow, callous, possess a grandiose sense of entitlement and care little for anyone but themselves, seeing people as tools to use for their own benefit. However, this does not mean that every psychopath is villainous; in fact, psychopaths in real-life may be people living completely normal lives and, in fiction, some may even be heroic (though as anti-heroes). An example is Roose Bolton.
• Low Functioning: Usually, low functioning psychopaths do not conform to basic social standards, are eager to flaunt their pride, act on destructive impulse and have very little regard for the consequences of their actions. As such, these variants are hot-headed villains who seemingly live without shame and may or may not bring harm to others or themselves depending on the circumstances of their situation through careless misdeeds. While minor symptoms of a high functioning psychopath may be present in a low functioning one, such as a constant need for stimulation, grandiose self-importance or habitual lying, these kinds of psychopaths do not usually hide behind a facade and easily become openly hostile (if not, violent) when things are not going their way. If caught or confronted for committing villainous deeds, it is very easy for them to not show remorse or outright refuse to accept responsibility for their actions. An example is Ramsay Bolton.

Antisocial personality disorder is usually a persistent condition from birth, but it can be induced by a succession of horrific events that twisted the sanity of said characters.

Also, just because a villain is vengeful or wrathful and therefore adapts violent tendencies does not necessarily make them Psychopaths unless they are that particularly antisocial in nature.

Psychopaths are also the opposite of sympathetic heroes.