Gender differences in structured risk assessment: Comparing the accuracy of five instruments.

Structured risk assessment should guide clinical risk management, but it is uncertain which instrument has the highest predictive accuracy among men and women. In the present study, the authors compared the Psychopathy Checklist—Revised (PCL–R; R. D. Hare, 1991, 2003); the Historical, Clinical, Risk Management–20 (HCR-20; C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997); the Risk Matrix 2000–Violence (RM2000[V]; D. Thornton et al., 2003); the Violence Risk Appraisal Guide (VRAG; V. L. Quinsey, G. T. Harris, M. E. Rice, & C. A. Cormier, 1998); the Offenders Group Reconviction Scale (OGRS; J. B. Copas & P. Marshall, 1998; R. Taylor, 1999); and the total previous convictions among prisoners, prospectively assessed prerelease. The authors compared predischarge measures with subsequent offending and instruments ranked using multivariate regression. Most instruments demonstrated significant but moderate predictive ability. The OGRS ranked highest for violence among men, and the PCL–R and HCR-20 H subscale ranked highest for violence among women. The OGRS and total previous acquisitive convictions demonstrated greatest accuracy in predicting acquisitive offending among men and women. Actuarial instruments requiring no training to administer performed as well as personality assessment and structured risk assessment and were superior among men for violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting future reconviction in offenders with intellectual disabilities: The predictive efficacy of VRAG, PCL-SV, and the HCR-20.

Accurate predictions of future reconviction, including those for violent crimes, have been shown to be greatly aided by the use of formal risk assessment instruments. However, it is unclear as to whether these instruments would also be predictive in a sample of offenders with intellectual disabilities. In this study, the authors have shown that the Violence Risk Appraisal Guide (V. L. Quinsey, G. T. Harris, M. E. Rice, & C. Cormier, 1998); the Psychopathy Checklist--Screening Version (S. D. Hart, D. N. Cox, & R. D. Hare, 1995); and the History, Clinical, Risk Management--20 (C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997) were all significant predictors of violent and general reconviction in this sample, and in many cases, their efficacy was greater than in a control sample of mentally disordered offenders without an intellectual disability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Multigroup Item Response Theory Analysis of the Psychopathy Checklist-Revised.

Item response theory was used to investigate the functioning of the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) in several offender populations. With male criminal offenders (N=3,847) as a reference group, differential item functioning analyses were performed for 3 comparison groups: female criminal offenders (N=1,219), male forensic psychiatric patients (N=1,246), and male criminal offenders scored from file reviews (N=2,626). Results are discussed in the context of the 2-factor, 4-facet model for the PCL-R (R. D. Hare, 2003; J. Parker, G. Sitarenios, & R. D. Hare, 2003). Application of a multigroup graded response model to all 4 groups suggests scalar equivalence may hold at least approximately for each population, although the PCL-R provided slightly greater information about the latent trait of psychopathy for male criminal offenders scored from the standard procedure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Convergent validity of the CORE measures with measures of depression for clients in cognitive therapy for depression.

Clients (N = 77) undergoing cognitive therapy for depression were assessed before treatment with the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), which encompasses domains of subjective well-being, problems, functioning, and risk of harming self or others, along with the Beck Depression Inventory-II (BDI-II), the Hamilton Rating Scale for Depression (HRSD), the Beck Hopelessness Scale (BHS), and a measure of avoidant (Cluster C) personality problems (Inventory of Interpersonal Problems-Avoidant [IIP-Av]). The CORE-OM and the BDI-II were strongly correlated with each other and showed coherent and similar patterns of correlations with the HRSD, the BHS, and the IIP-Av. Sixty-one of the clients were repeatedly assessed during treatment with alternating versions of the CORE Short Form and with the BDI-II. Results strongly supported the convergent validity of the CORE measures with the BDI-II in across-clients comparisons of means scores and rates of improvement and in across-sessions comparisons within clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Utility of decision support tools for assessing acute risk of violence.

The authors evaluated the utility of 3 decision support tools for assessing acute risk of violence in patients undergoing behavioral emergencies that warranted hospitalization. Information available at the time of admission to a short-term psychiatric unit was coded from the medical charts of 100 patients using the Historical, Clinical, Risk Management-20 (HCR-20), the Hare Psychopathy Checklist-Screening Version (PCL-SV), and the McNiel-Binder Violence Screening Checklist (VSC). Nurses rated violence that later occurred during hospitalization with the Overt Aggression Scale. Scores on all 3 instruments were associated with the likelihood of violence. The strongest predictive relationships were obtained for indices of clinical risk factors rather than historical risk factors. The results suggest that decision support tools, particularly those that emphasize clinical risk factors, have the potential to improve decision making about violence risk in the context of behavioral emergencies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do some evaluators report consistently higher or lower PCL-R scores than others? Findings from a statewide sample of sexually violent predator evaluations.

This study examined whether some evaluators tend to report consistently higher or lower scores than other evaluators for offenders on the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003). Data for the study were PCL-R total scores for 321 sex offenders, evaluated by 1 or more of 20 different state-contracted evaluators, during a process of screening for civil commitment as sexually violent predators. More than 30% of the variability in PCL-R scores was attributable to differences among evaluators, with mean PCL-R scores given by 2 of the most prolific evaluators differing by almost 10 points. In a subsample of 22 offenders evaluated with the PCL-R on 2 or more occasions, evaluator agreement (intraclass correlation A,1 = .47) was low. Together, these findings raise concerns about the field reliability of the PCL-R and suggest the need for research examining field reliability of other measures used in forensic assessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term prediction of offender recidivism using diagnostic, personality, and risk/need approaches to offender assessment.

The present study examined the prediction of recidivism using diagnostic, personality, and risk/need approaches over a 10-year follow-up in a heterogeneous sample of 61 offenders (i.e., probationers and provincial and federal offenders). The Level of Service/Case Management Inventory (LS/CMI), Psychopathy Checklist-Revised (PCL-R), and DSM-III antisocial personality disorder (APD) were examined. The measures were highly correlated and demonstrated theoretically meaningful patterns of convergent validity. Although psychopathy was highly correlated with both LS/CMI and APD, the majority of the shared variance with LS/CMI and with APD was accounted for by Factor 2 and the criminality facet of the PCL-R. All three assessment measures predicted future violence, any future reincarceration upon release, and recidivism severity (as measured by aggregate sentence length). However, none of these measures made a significant incremental contribution to the prediction of recidivism beyond either of the other two measures. Differences between the predictive validities of the three measures were minimal. The results are discussed in terms of recent debates concerning the use of these instruments in the assessment of offender risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The validity of violence risk estimates: An issue of item performance.

Typically, research conducted on the cross-validation or generalization of risk assessment schemes focuses on the aggregate score accuracy of the schemes within the new sample or population. Often overlooked when the schemes are examined in their aggregate form is the performance of the individual items. This study looks at the association between the items of the HCR-20 (C. D. Webster, K. S. Eaves, D. Douglas, & S. D. Wintrup, 1995) and the Violence Risk Appraisal Guide (VRAG; C. D. Webster, G. T. Harris, M. E. Rice, C. Cormier, & V. L. Quinsey, 1994) and violent recidivism in a sample of predominantly violent offenders. The results show that a number of the items from each scale do not distinguish between violent recidivists and nonrecidivists and that the presence of these items potentially reduces the predictive accuracy of the instruments. In addition, the inclusion of items that do not discriminate between recidivists and nonrecidivists potentially undermines the validity of the risk assessment process. Discussion centers on the application of prediction schemes and their individual risk factors in forensic practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and community violence among civil psychiatric patients: Results from the MacArthur Violence Risk Assessment Study.

Although psychopathy is recognized as a relatively strong risk factor for violence among inmates and mentally disordered offenders, few studies have examined the extent to which its predictive power generalizes to civil psychiatric samples. Using data on 1,136 patients from the MacArthur Violence Risk Assessment project, this study examined whether the 2 scales that underlie the Psychopathy Checklist: Screening Version (PCL:SV) measure a unique personality construct that predicts violence among civil patients. The results indicate that the PCL:SV is a relatively strong predictor of violence. The PCL:SV's predictive power is substantially reduced, but remains significant, after controlling for a host of covariates that reflect antisocial behavior and personality disorders other than psychopathy. However, the predictive power of the PCL:SV is not based on its assessment of the core traits of psychopathy, as traditionally construed. Implications for the 2-factor model that underlies the PCL measures and for risk assessment practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The prediction of criminal and violent recidivism among mentally disordered offenders: A meta-analysis.

A meta-analysis was conducted to examine whether the predictors of recidivism for mentally disordered offenders are different from the predictors for nondisordered offenders. Effect sizes were calculated for 35 predictors of general recidivism and 27 predictors of violent recidivism drawn from 64 unique samples. The results showed that the major predictors of recidivism were the same for mentally disordered offenders as for nondisordered offenders. Criminal history variables were the best predictors, and clinical variables showed the smallest effect sizes. The findings suggest that the risk assessment of mentally disordered offenders can be enhanced with more attention to the social psychological criminological literature and less reliance on models of psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Homicidal sex offenders: psychological, phallometric, and diagnostic features

Homicidal sex offenders represent an understudied population in the forensic literature. Forty-eight homicidal sex offenders assessed between 1982 and 1992 were studied in relation to a comparison group of incest offenders. Historical features, commonly used psychological inventories, criminal histories, phallometric assessments, and DSM diagnoses were collected on each group. The homicidal sex offenders, compared with the incest offenders, self-reported that they had more frequently been removed from their homes during childhood and had more violence and forensic psychiatric contact in their histories. On the self-report psychological inventories, the homicidal sex offenders portrayed themselves as functioning significantly better in the areas of sexuality (Derogatis Sexual Functioning Inventory) and aggression/hostility (Buss-Durkee Hostility Inventory). However, on the Psychopathy Checklist-Revised (PCL-R), researchers rated the homiciders significantly more psychopathic than the incest offenders on Factor 1 (personality traits) and Factor 2 (antisocial history). Police records revealed the homicidal subjects also had been charged or convicted of more violent and nonviolent nonsexual offenses. The phallometric assessments indicated that the homicidal sex offenders demonstrated higher levels of response to pedophilic stimuli and were significantly more aroused to stimuli depicting assaultive acts to children, relative to the incest offenders. Despite the homiciders' self-reports of fairly good psychological functioning, DSM-III diagnoses reliably discriminated between the groups. A large number of homicidal sex offenders were diagnosed as suffering from psychosis, antisocial personality disorder, paraphilias, sexual sadism, sexual sadism with pedophilia, and substance abuse. Seventy-five percent of the homicidal sex offenders had three or more diagnoses compared with six percent of the incest offenders. The article addresses the role of "hard" versus "soft" measures in the assessment and treatment of violent sex offenders. In addition, the usefulness of phallometric assessments and the PCL-R and its subscales are considered.     

Validating the factor structure of the Self-Report Psychopathy Scale in a community sample.

Currently, there is no standard self-report measure of psychopathy in community-dwelling samples that parallels the most commonly used measure of psychopathy in forensic and clinical samples, the Psychopathy Checklist. A promising instrument is the Self-Report Psychopathy scale (SRP), which was derived from the original version the Psychopathy Checklist. The most recent version of the SRP (SRP-III; D. L. Paulhus, C. S. Neumann, & R. D. Hare, in press) has shown good convergent and discriminate validity and a factor structure similar to the current version of the Psychopathy Checklist (PCL-R; R. D. Hare, 1991, 2003). The analyses in the current study further investigated the viability of the SRP-III as a PCL-R-analogous measure of psychopathy in nonforensic and nonclinical samples by extending the validation process to a community sample. Using confirmatory factor analyses and logistic regressions, the results revealed that a four-factor oblique model for the SRP-III was most tenable, congruent with the PCL-R factor structure of psychopathy and previous research in which the SRP-III was administered to a student sample. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Suspension "hypokinesia/hypodynamia" may decrease bone mass by stimulating osteoclast production in ovariectomized mice

The factorial structure of the Beck Hopelessness Scale (BHS; A. T. Beck, A. Weissman, D. Lester, & L. Trexler, 1974) was examined in a nonclinical sample (N = 154) in Japan, and the relationships between dimensions of hopelessness and psychosocial variables were analyzed. A semistructured interview was used, as well as a questionnaire consisting of the BHS, the Eysenck Personality Questionnaire (EPQ; H. J. Eysenck & S. B. Eysenck, 1975), and the Parental Bonding Instrument (PBI; G. Parker, H. Tupling, & L. B. Brown, 1979). A factor analysis with principal components solution after oblimin rotation yielded 2 factors--Doubt About a Hopeful Future (Factor 1) and Belief About a Hopeless Future (Factor 2). Significant, positive correlations were found between Factor 2 and (a) the number of emotional symptoms of depression in a 4-day depressive episode and (b) scores on the Neuroticism subscale of the EPQ. The Factor 1 score was significantly and negatively correlated with the Extraversion subscale of the EPQ and the Paternal Care subscale of the PBI.     

Emotions, defenses, coping mechanisms, and symptoms.

Used L. A. Gottschalk and G. C. Gleser's (1969) method of content analysis to examine 5-min samples of speech elicited from 6 different groups of Ss: 30 young normal men (mean age 25.7 yrs), 30 normative adults (aged 20–50 yrs), 30 normative schoolchildren (aged 6–26 yrs), 20 adults with psychoneuroses, 44 emotionally disturbed criminal offenders (mean age 25.6 yrs), and 22 acute schizophrenics (aged 21–55 yrs). Ss were given purposely ambiguous standardized instructions simulating the request to free-associate. Findings indicate that displacements and denials in mentally healthy individuals are more likely to function as coping mechanisms in contrast to their function as defenses or symptoms in mentally disordered people. No significant effects of sex, age, intelligence, or state of consciousness were found. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychodynamics of partner, stranger, and generally violent male college students.

Understanding the dynamics of partner violence has been complicated by the fact that "partner violence" may include both partner and generally violent men. The authors hypothesized that partner violence may involve intimacy-related threats to masculinity, violence toward strangers may relate to alcohol abuse, and both partner and stranger violence may relate to object relations pathology. College men were nonviolent or violent toward partners, strangers, or partners and strangers (n?=?10 men in each group). Partner violence was related to higher Schwartz Castration Anxiety Scale scores (B. Schwartz, 1991), from Thematic Apperception Test responses. Stranger violence was related to higher Minnesota Multiphasic Personality Inventory (MMPI-2) and MacAndrew Alcoholism Scale-Revised scores. Neither partner nor stranger violence was related to MMPI-2 anxiety or Westen's Social Cognition and Object Relations Scale (D. Westen, A. Barends, J. Leigh, M. Mendel, & D. Silbert, 1990). The authors discussed implications for understanding the dynamics of partner violence and treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The content validity of juvenile psychopathy: An empirical examination.

This study examined the content validity of a juvenile psychopathy measure, the Childhood Psychopathy Scale (CPS; D. R. Lynam, 1997), based on a downward translation of an adult instrument, the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). The CPS was compared with two other indices of juvenile psychopathy: (a) an index derived from expert ratings and (b) an empirical index based on correlations with adult psychopathy. The 100 items of the Common Language Q-Sort (CLQ; A. Caspi et al., 1992) provided a common metric for the comparison. Psychopathy and personality were assessed at age 13 years with the mother-reported CPS and the CLQ. Psychopathy was assessed at age 24 years with the interviewer-rated Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Data from over 250 participants of the middle sample of the Pittsburgh Youth Study were used to examine these relations. Item content analyses demonstrated considerable overlap among the three indices, indicating that the downward translation utilizes criteria similar to those of experts and the empirically-derived measure. In addition, these indices, even after removing overlapping items, demonstrated considerable convergence, also supporting the content validity of the downward translation. These results suggest that the downward translation method is adequate for understanding the juvenile psychopathy construct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Construct validity of psychopathy in a female offender sample: A multitrait–multimethod evaluation.

The authors examined the construct of psychopathy as applied to 103 female offenders, using the multitrait-multimethod matrix proposed by D. T. Campbell and D. W. Fiske (1959). Instruments used in the study included the following: (a) Antisocial Scale of the Personality Assessment Inventory (L. C. Morey, 1991); (b) Psychopathy Checklist–Revised (R. D. Hare, 1990); and (c) Antisocial scale of the Personality Disorder Examination (A. W. Loranger, 1988). Criterion-related validity was also evaluated to determine the relationship between psychopathy and staff ratings of aggressive and disruptive behavior within the institution. Results revealed significant convergence and divergence across the instruments supporting the construct of psychopathy in a female offender sample. The measures of psychopathy demonstrated moderate convergence with staff ratings of violence, verbal aggression, manipulativeness, lack of remorse, and noncompliance. It is interesting to note that an exploratory factor analysis of the PCL-R identified a substantially different factor structure for women than has been previously found for male psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse.

This study compared the effectiveness of cognitive processing therapy for sexual abuse survivors (CPT-SA) with that of the minimal attention (MA) given to a wait-listed control group. Seventy-one women were randomly assigned to 1 of the 2 groups. Participants were assessed at pretreatment and 3 times during posttreatment: immediately after treatment and at 3-month and 1-year follow-up, using the Clinician-Administered Posttraumatic Stress Disorder (PTSD) Scale (D. Blake et al., 1995), the Beck Depression Inventory (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), the Structured Clinical Interview for the DSM-IV (R. L. Spitzer, J. B. W. Williams, & M. Gibbon, 1995; M. B. First et al., 1995), the Dissociative Experiences Scale-II (E. M. Bernstein & F. W. Putnam, 1986), and the Modified PTSD Symptom Scale (S. A. Falsetti, H. S. Resnick, P. A. Resick, & D. G. Kilpatrick, 1993). Analyses suggested that CPT-SA is more effective for reducing trauma-related symptoms than is MA, and the results were maintained for at least 1 year. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three-year follow-up after presymptomatic testing for Huntington's disease in tested individuals and partners.

The 3-year psychological effects of presymptomatic DNA diagnosis for Huntington's disease are described in 20 identified carriers of the Huntington's disease gene (mean age = 31 years), 29 noncarriers (mean age = 32 years), and 37 partners. The Intrusion and Avoidance subscales of the Impact of Event Scale (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979) and the Beck Hopelessness Scale (A. T. Beck, 1986; A. T. Beck, A. Weissman, D. Lester, & L. Trexler, 1974) measured psychological distress at 4 time points: baseline (before disclosure of test results) and 1 week, 6 months, and 3 years after testing. Multivariate testing on course of distress revealed similar patterns of intrusive thoughts about Huntington's disease over the 3-year follow-up in carriers and noncarriers but showed opposite patterns of avoidance at the 6-month assessment. One week after disclosure, carriers had increased and noncarriers had decreased levels of hopelessness. These effects disappeared after 6 months and did not recur. Carrier partners followed the same course of distress as carriers. Carrier partners with children were significantly more distressed than those without offspring. Noncarrier partners were significantly less distressed than noncarriers after 3 years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role and relevance of the Psychopathy Checklist-Revised in court: A case law survey of U.S. courts (1991-2004).

The Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) is the most empirically validated instrument for measuring psychopathy in correctional and forensic psychiatric populations. The PCL-R's predictive utility with criminal justice populations has led to its frequent use by clinicians conducting forensic assessments in criminal and sexually violent predator (SVP) cases. Despite its apparent wide acceptance in U.S. courts, little is known about how often the PCL-R is being introduced, the types of cases in which it is being used, and whether claims made in court regarding psychopathy are empirically defensible and/or relevant to the question at hand. This project documents some uses of the PCL-R in U.S. courts from 1991 through 2004 by year, jurisdiction, type of evaluation, and party. The results suggest that the PCL-R is being used by expert witnesses with increasing regularity across U.S. jurisdictions, primarily to assess risk of future violence. A review of 3 recent cases is also provided that illustrates concerns about the validity of the PCL-R for certain types of legal questions that may arise in criminal and SVP trials. (PsycINFO Database Record (c) 2010 APA, all rights reserved)