People have an unquenchable fascination with psychopaths in our movies. At least from a fictional perspective, they’re thought of as borderline supernatural, as though they exchanged some portion of sanity for heightened mental abilities. Even more so for horror movie serial killers.

You no doubt have your favorites, and might even have a perfectly folded list in your pocket right now. If you do, today’s your day to augment it with this list containing movie serial killers, diagnosed for your pleasure. Because the truth is, most movie psychopaths are exaggerated, overblown, or just plain fictional.

But not all.

Two enterprising doctors, Samuel Leistedt and Paul Linkowski, decided to study 400 films made between 1915 and 2010 and pulled 126 realistic characters that exhibited some form of psychopathy. Which, by the way, is a fantastic job – who wouldn’t want to figure out who the most realistic killers in movies are?

Anyway, the two released a paper with their findings in the Journal of Forensic Sciences, entitled Psychopathy and the Cinema: Fact or Fiction? They, along with senior forensic psychologists and film critics, placed those characters into categories to determine just how accurate and realistic they are in terms of clinical psychopathy.

The first category the characters are put into is based on the primary-secondary psychopathy method developed by Benjamin Karpman.

Both types have clear boundaries between the behaviors that the characters exhibit, for example: if a character is highly manipulative, then they’d be categorized into primary, however if a character has poor impulse control, then they’d be categorized secondary.

They then categorized them further based on the PCL-R, a comprehensive psychopathy test. The categories are: Classic/Idiopathic, macho, manipulative, and pseudopsychopath. They more or less measure just how much empathy the characters lack, with Classic/Idiopathic having the least empathy, while pseudopsychopaths don’t qualify being labeled as psychopaths at all, being more along the lines of a sociopath.

Without further ado, here’s a list of the most realistic horror movie psychopaths, as diagnosed by real psychologists.

Patrick Bateman – American Psycho

Photo: Lionsgate Films

Cards on the table: Patrick Bateman is an exemplary psychopath. There’s excessive narcissism at play, everything is about him and his desires, and everyone else is just window dressing. He kills because he’s used to getting what he wants, and because the thrill of the kill drives him beyond anything else in the world.

More so, he leads a double-life, pretending to be a successful, charming businessman, but underneath he’s just a base serial killer with a lust for blood. What’s scariest about Patrick Bateman is that he’s a cold, dark reflection of America itself.

Psychopathy Classifications: Primary, Classical/Idiopathic

Actor: Christian Bale

Norman Bates – Psycho

Photo: Universal Pictures

Norman Bates, the titular Psycho, isn’t a psychopath at all. He’s certainly psychotic and might even have an Oedipal complex. But even those combined will not get him closer to psychopathy.

Leistedt and Linkowski both note that he’s deranged and delusional, however he lacks almost all of the necessary traits needed to be labeled as psychopathic. While he does suffer from antisocial personality disorder and dissociative personality disorder, he doesn’t have any charm or charisma, nor does he exhibit any sort of narcissism.

Both of which are crucial traits in determining what makes a psychopath.

Psychopathy Classifications: Secondary, Pseudopsychopath

Actor: Anthony Perkins

Jame Gumb – The Silence Of The Lambs

Photo: MGM

Isn’t it interesting that Buffalo Bill, one of our most favorite film crazies, isn’t quite listed as a full-blown psychopath? As other psychologists have noted, Gumb most certainly has antisocial personality disorder, and is a psychotic.

However, he is a far cry from full-blown psychopathy. Though he certainly shows that he’s without any sort of empathy or remorse, and has a taste for peeling his victims’ skin off, he doesn’t have the high levels of narcissism, charisma, and serious lack of impulse control that defines psychopathy. He’s sick, but not dead inside.

Psychopathy Classifications: Secondary, Pseudopsychopath

Actor: Ted Levine

Billy Loomis & Stu Macher – Scream

Photo: Miramax

It is both telling and interesting that Stu himself says the line, “We prefer the term psychotic,” which is exactly the term that helps differentiate realistic psychopaths from the ones who aren’t. Stuart’s blurring between reality and movies simply make him psychotic, while Billy is a through-and-through psychopath, making him far more interesting of the two.

Billy’s eyes are totally cold and uncaring, even towards Stuart, his co-conspirator in the murders. The fact that he’s able to hide his psychopathic side from his girlfriend Sidney, amply shows the depth of his true nature. In fact, he’s completely driven by his irrational anger towards Sidney’s mother, whom he’s already killed, but still motivates his murderous intent. And his psychopathy is perfectly evidenced when he stabs Stu too deeply and gives a curt smile about it – he clearly enjoys inflicting pain, even to his only ally. And when he lashes out at Stu and stabs him further? Just more nails on the psychopathic coffin.

Psychopathy Classifications:

Billy – Primary, Classical/Idiopathic

Stu – Secondary, Pseudopsychopath

Actor: Skeet Ulrich & Matthew Lillard

Henry – Henry: Portrait Of A Serial Killer

Photo: Maljack Productions, Inc

Henry is based on a real serial killer: Henry Lee Lucas. Henry is a totally cold, remorseless killer without any loyalty to his friends or anyone close to him. Unlike other movie serial killers, he doesn’t do this necessarily because he enjoys it, or because he’s driven by it.

It’s as though it’s a part of him, like he’s going through the normal motions of life, the same way you might behave while doing something rote or routine. Mowing the lawn. For him, killing is simply business as usual. And his every kill is methodical, almost ritualistic, exhibiting a total lack of empathy, which places him right at the top. Henry exists only to be a psychopath.

Psychopathy Classifications: Primary, Classical/Idiopathic


Max Cady – Cape Fear

Photo: Amblin Entertainment

Alright, Cady is more of a serial rapist than a serial killer but he definitely deserves a mention mostly because of his total lack of repentance to his own crimes. And his absolute willingness to take on whatever identities he needs to in order to get closer to the Bowden family; a classic psychopathic trait.

He has the absolute intent of performing bloody, brutal vengeance on Bowden and his family for landing him in jail in the first place. Moreso, he enjoys the power he has over them, knowing that his very presence inspires fear. His narcissism is off the charts as well, cementing his position as a truly realistic psychopath.

“I ain’t no white trash piece of shit. I’m better than you all! I can out-learn you. I can out-read you. I can out-think you. And I can out-philosophize you. And I’m gonna outlast you…”

Psychopathy Classifications: Primary, Classical/Idiopathic

Actor: Robert De Niro

Francis Dolarhyde – Red Dragon

Photo: Universal Pictures

As with Jame Gumb, the psychotic main antagonist in Silence of the Lambs, Francis Dolarhyde is psychotic, but he is not psychopathic. Dolarhyde meets many, but not all of the criteria that defines a psychopath.

For example, he leads a dual life – one where he is a regular, but withdrawn member of society, and another where he is the murderous Tooth Fairy on his way to transforming into the Red Dragon. He believes that every murder he commits brings him closer to that transformation.

However, he can’t be labeled as a psychopath for one simple reason: he has empathy.

In fact, he has a deep emotional attachment towards Reba McClane, his blind coworker. And throughout the film, he is torn by his obsession with transforming, and his very real emotions for another human being, each one pulling him in separate directions

Psychopathy Classifications: Secondary, Pseudopsychopath

Actor: Ralph Fiennes

Krug Stilo – The Last House On The Left

Photo: MGM Studios

Krug is a sadistic rapist and torturer who has total command of the people around him, and very clearly doesn’t care about anyone or anything but his own visceral needs. Most tellingly, he finds serious, almost profound pleasure in torturing his victims as evinced by that wry smile he wears as he cuts his name into his victim’s chest.

And his psychopathy is full front and center twice. First is when Krug forces another one of the women he kidnaps to urinate on herself, taking the time to light a cigar in order to revel in the woman’s humiliation. The second: through sheer force of will, he makes his own son kill himself with a single bullet through the head. This shows that he lives only for the depraved pleasure of the moment, with no attachments to anyone at all.

Psychopathy Classifications: Primary, Classical/Idiopathic

Actor: David Hess

Baby Firefly – The Devil’s Rejects

Photo: Lionsgate Films

Leistedt and Linkowski note that female psychopaths in films are most often sexually manipulative. That fact, combined with a love of taunting her victims and deriving enjoyment from inflicting them pain easily puts Baby Firefly among the top spots.

She’s almost like a wild animal, catering only to her desires. It’s exemplified by her desire for a simple ice cream cone. Although she’s resisted initially, she gets what she wants eventually.

She would rank higher, except she’s almost completely remorseless. Many believe that they go out in a blaze of glory at the end, seemingly unrepentant. But note that they kill exactly zero cops on their way out. The moment in fact, is them coming to terms with their actions and accepting their final, brutal punishment. And that edges her out from the very top spots, but only by a little bit.

Psychopathy Classifications: Primary, Classical/Idiopathic

Reverend Harry Powell – The Night Of The Hunter

Photo: MGM Studios

Powell, like other realistic film psychopaths, has an alter-ego – a disguise if you will – one that keeps his true nature hidden. He may look like a friendly, charitable, and passionate preacher on the outside, but on the inside he’s a storm of contradictions and a wholly manipulative murderer.

To reflect the duality he lives with, his knuckles are tattooed with LOVE and HATE, supposedly as a symbol of humankind’s struggle against their inner evil. And he most certainly gives an incredibly convincing sermon. The fact is though, that’s his modus operandi. It’s all an elaborate con in order to lure his victims in so that he can murder them and steal their wealth. A con he hates to love.

Psychopathy Classifications: Primary, Classical/Idiopathic

Actor: Robert Mitchum

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