Psychopathy, antisocial personality, and suicide risk.

H. Cleckley (1976) maintained that psychopaths are relatively immune to suicide, but substantial evidence exists for a relationship between antisocial deviance and suicidal acts. This study was the first to explicitly examine suicidal history among psychopathic individuals as defined by R. D. Hare's (1991) Psychopathy Checklist—Revised (PCL—R). Male prison inmates (N?=?313) were assessed using the PCL—R and DSM-III R and DSM-IV criteria (American Psychiatric Association, 1987, 1994) for antisocial personality disorder (APD), and they completed A. Tellegen's (1982) Multidimensional Personality Questionnaire (MPQ). Presence or absence of prior suicide attempts was coded from structured interview and prison file records. Suicide history was significantly related to PCL—R Factor 2 (which reflects chronic antisocial deviance) and to APD diagnosis but was unrelated to PCL-R Factor 1, which encompasses affective and interpersonal features of psychopathy. Higher order MPQ dimensions of Negative Emotionality and low Constraint were found to account for the relationship between history of suicidal attempts and antisocial deviance, indicating that temperament traits may represent a common vulnerability for both. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and Comorbidity in a Young Offender Sample: Taking A Closer Look At Psychopathy's Potential Importance Over Disruptive Behavior Disorders.

The authors examined the construct of psychopathy as applied to 130 adolescent offenders using 3 psychopathy measures and a broad range of DSM-TV Axis I diagnoses and psychosocial problems. Measures used in the study included the following: (a) Psychopathy Checklist-Youth Version (PCL- PCLYV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003), (b) Antisocial Process Screening Device (APSD; YV; P. J. Frick & R. D. Hare, 2002), (c) a modified version of the Self-Report Psychopathy-II scale (SRP-II; R. D. Hare, 1991b), and (d) the Adolescent Psychopathology Scale (APS; W. M. Reynolds, 1998). Results from this study offer incremental support for the construct validity of psychopathy in youth. Psychopathy evidenced better convergent and discriminant validity results than did the disruptive behavior disorders (DBDs) such as oppositional-defiant disorder (ODD) and conduct disorder (CD). Despite this finding, psychopathy scales nonetheless correlated with other forms of psychopathology at a higher rate than was expected, suggesting that comorbidity is high even when psychopathy is used as a classification scheme. Also, hierarchical multiple regression was used to determine whether psychopathy offered an improvement in the prediction of previous violent and nonviolent offenses. The results for the current study were mixed, with only the PCL-YV significantly predicting previous violent and nonviolent offenses beyond the DBDs. The findings indicate that psychopathy may offer incremental improvement over DBDs with regard to level of comorbidity and perhaps even prediction. However, simply extending the adult construct of psychopathy to youth without considering the array of psychopathology that may accompany adolescent psychopathy could be misleading. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age, suicide, science, and clinical psychology: A review of A. Leenaars (Ed.), Life span perspectives of suicide.

Reviews the book, Life span perspectives of suicide edited by A. Leenaars (see record 1991-97542-000). There is an ever-growing literature on suicide, much of which seems redundant. Accordingly, I look for novel data and true theoretical progress in the context of modern science. This volume promises a unique focus on developmental variations in suicidal behaviour, which should be quite timely. The editor and author of several chapters, Antoon Leenaars, is a highly respected activist in suicide prevention. Among the 20 chapters with 21 authors, the quality varies from enlightening to very disappointing. While this volume has some very strong chapters that meet scientific criteria while providing fresh insights and stimulus for research, some of the chapters unfortunately leave me with serious scientific concerns. I would like to see integration of new data with modern science, rather than conjecture through outdated hypothetical constructs. In particular, much of the chapter on suicide in middle adulthood by Balance and Leenaars reads like a list of Freud's concepts, as if there had been no progress in the psychology of middle adulthood during the last half century. Another concern is that clinical and scientific judgements sometimes become confused in this volume, as is often true of suicide research. Leenaars approaches suicide evaluatively, repeatedly stating that it is tragic and to be eradicated. However noble, when matters of fact are under discussion, this violates the longstanding scientific tradition of objectivity. Finally, none of the authors has made any reference whatsoever to biological theories of aging and senescence, when so much insight could be gained. (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)     

Psychopathy and Suicidality in Female Offenders: Mediating Influences of Personality and Abuse.

The influence of personality and childhood abuse on suicidal behaviors and psychopathy was examined among female prisoners. Scores on the affective/interpersonal component (Factor 1; F1) and the antisocial deviance (Factor 2; F2) component of psychopathy were obtained from the Psychopathy Checklist-Revised (R. D. Hare, 1991). Suicide attempt and childhood physical and sexual abuse history were coded from interviews and prison files, and personality was assessed using the Multidimensional Personality Questionnaire (A. Tellegen, in press). Suicide attempts were positively associated with F2 and negatively associated with F1, and each factor accounted for unique variance in suicidality. Path analyses demonstrated that personality mediated the effects of physical abuse on F2, but sexual abuse accounted for unique variance in both suicide attempts and F2. Abuse and personality accounted for minimal variance in F1. These results are discussed in relation to the identification of individuals at risk for both self- and other-harm behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attempted, threatened, and completed suicide.

Anamnestic and psychiatric data are analyzed for attempted, threatened, and completed suicide cases. "The conclusion may be drawn that the dangerous patient, suicidally speaking, is the one with a history of previous suicidal attempts or threats, and that the most dangerous period is when the patient appears to have recovered." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and Offending From Adolescence to Adulthood: A 10-Year Follow-Up.

This study examined the predictive validity of the Hare Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, D. S. Kosson, & R. D. Hare, 2003) from adolescence to early adulthood. The authors coded the PCL:YV using file information and collected criminal record information over a 10-year follow-up period on 157 boys, ages 12 through 18, referred to Youth Forensic Psychiatric Services for assessment in 1986. The risk for violence into early adulthood was greater among those with high PCL:YV scores than among those with low scores, even after controlling for conduct disorder, age at first offence, and history of violent and nonviolent offending. These results indicate that the PCL:YV provides meaningful information about young offenders' risk for violence into early adulthood. Clinical implications are discussed, with reference to pertinent ethical issues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In cold blood: Characteristics of criminal homicides as a function of psychopathy.

This study investigated the relationship between psychopathy and the characteristics of criminal homicides committed by a sample of 125 Canadian offenders. It was hypothesized that the homicides committed by psychopathic offenders would be more likely to be primarily instrumental (i.e., associated with premeditation, motivated by an external goal, and not preceded by a potent affective reaction) or "cold-blooded" in nature, whereas homicides committed by nonpsychopaths often would be "crimes of passion" associated with a high level of impulsivity/reactivity and emotionality. The results confirmed these predictions; homicides committed by psychopathic offenders were significantly more instrumental than homicides by nonpsychopaths. Nearly all (93.3%) of the homicides by psychopaths were primarily instrumental in nature compared with 48.4% of the homicides by nonpsychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and Unlawful Confinement: An Examination of Perpetrator and Event Characteristics.

Given their particular constellation of interpersonal, affective, lifestyle, and antisocial features, we hypothesized that psychopaths would be more likely than other offenders to unlawfully confine another person. The present archival study investigated victim and offence characteristics, and the prevalence of psychopathy in offenders who perpetrated criminal acts of unlawful confinement. Of federal offenders incarcerated in the Pacific Region of Canada between the late 1960s and 1998, 136 (11.3%) had committed acts of unlawful confinement, 90 of whom had PCL-R assessments on file. Results indicated that 49% of these perpetrators were psychopathic (i.e., PCL-R > 30). These perpetrators typically were under the age of 30 years, and were characterized by a lack of formal education, substance abuse problems, psychiatric histories, and previous violence. Most of the offences appeared to be instrumental and involved sexual misconduct and the use of weapons. The majority were perpetrated against females, were of short duration, and rarely resulted in the victim's death. Implications for the criminal justice system are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and violence: The importance of factor level interactions.

The power of scales based on the Psychopathy Checklist (PCL; R. D. Hare, 1980) for prediction of violent behavior is well established. Although evidence suggests that this relationship is chiefly due to the impulsive and antisocial lifestyle component (Factor 2), the predictive power of psychopathy for violence may also reflect the multiplicative effects of this component with interpersonal and unemotional traits (Factor 1). The determination of the extent to which psychopathy subcomponents interact to predict violence has theoretical and practical implications for PCL-assessed psychopathy. However, the relationship between violence and the interactive effects of psychopathy subcomponents remains largely undetermined. The authors used prospective and cross-sectional designs to examine the independent and interactive effects of the factors of PCL-assessed psychopathy in 2 samples: (a) 199 county jail inmates and (b) 863 civil psychiatric patients. The Factor 1 × Factor 2 interaction predicted violence in both samples, such that the predictive power of Factor 2 was attenuated at lower levels of Factor 1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy in a noninstitutional sample: Differences in primary and secondary subtypes.

Early theoretical conceptualizations suggest psychopathy is a heterogeneous construct whereby psychopathic individuals are found in diverse populations. The current study examined male and female psychopathy subtypes in a large sample of undergraduate students (n = 1229). Model-based cluster analysis of the Psychopathic Personality Inventory-Short Form (PPI-SF) revealed two clusters in both male and female students. In males, the primary subtype evidenced greater psychopathic personality traits (i.e., Social Potency, Fearlessness, and Impulsive Nonconformity) and lower anxiety (i.e., higher Stress Immunity), whereas the secondary subtype displayed fewer psychopathic personality traits (i.e., Machiavellian Egocentricity and Blame Externalization) and higher anxiety (i.e., lower Stress Immunity). In females, the primary subtype exhibited higher scores across all PPI-SF subscales and lower anxiety whereas the secondary subtype reported lower PPI-SF subscale scores and higher anxiety. Across a diverse array of personality, affective, and behavioral external correlates, differences between the subtypes and with nonpsychopaths emerged. Implications for psychopathy in noninstitutional populations with respect to theory, research, and gender are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy evidence in legal proceedings involving adolescent offenders.

Despite debates surrounding juvenile psychopathy, we do not know how frequently psychopathy evidence is presented in adolescent court cases or how this information is used. To address this gap, we reviewed 111 American and Canadian adolescent offender cases, which included 143 separate evaluations involving psychopathy. Results suggest that psychopathy evidence has been introduced in a sizable number of cases and is becoming increasingly common. While judges generally did not refer to psychopathy evidence in making ultimate legal decisions, psychopathy evidence appeared influential in some cases. In addition, consistent with concerns voiced by scholars, evidence of psychopathy was frequently used to infer that a youth would be difficult or impossible to treat. Conversely, the absence of psychopathy was occasionally interpreted as a sign of amenability and used to support more lenient sanctions. Whereas some cases appeared to attend to key issues that have been discussed in the research literature, such as the need for caution in applying psychopathy labels to youth and the importance of developmentally appropriate assessment strategies, other cases did not. The implications of these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivation and language behavior: A content analysis of suicide notes.

"Messages produced under heightened drive level should (a) be more stereotyped, (b) be more disorganized, if the motivation level is extremely high, (c) reflect the specific nature of the motives operating, and (d) reflect conflict of responses if two or more competing motives are operating. These hypotheses were tested by (a) a comparison of suicide notes with ordinary letters to friends and relatives and (b) a comparison of genuine suicide notes with simulated suicide notes, written by suicidal people." The hypotheses are supported and the results related to psycholinguistic theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality differences in attempted suicide versus suicide in adults 50 years of age or older.

The authors tested hypotheses concerning personality differences in treatment-seeking suicide attempters (AT; n = 60) and a community sample of suicides (SU; n = 43) over age 50. On the basis of prior research, the authors hypothesized that SU would be lower in Neuroticism and Openness and higher in Conscientiousness. A 2-group (AT vs. SU) multivariate analysis of covariance with NEO Personality Inventory--Revised (Informant Version) domain scores as dependent variables revealed that SU were lower in Neuroticism and higher in Conscientiousness. The authors conclude that AT and SU in this age group can be distinguished on the basis of informant ratings of personality traits. These differences can inform risk detection. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adapting interpersonal psychotherapy for older adults at risk for suicide: Preliminary findings.

We report preliminary findings of the first-ever study testing a 16-week course of interpersonal psychotherapy (IPT) modified for older outpatients at elevated risk for suicide. Participants were referred from inpatient and outpatient medicine and mental health services. Psychotherapy sessions took place in a therapist’s office in a teaching hospital. Twelve adults 60 years or older (M = 70.5, SD = 6.1) with current thoughts of suicide (suicide ideation), a wish to die (death ideation), or with recent self-injurious behavior were recruited into weekly sessions of IPT; 1 participant was subsequently excluded due to severe cognitive impairment. Participants completed measures of suicide ideation, death ideation, and depressive symptom severity at pretreatment, midtreatment, posttreatment, and at 3-month follow-up periods, and measures of therapeutic process variables. Preliminary findings of this uncontrolled pretreatment/posttreatment study support the feasibility of recruiting and retaining older adults at risk for suicide into psychotherapy research and suggest that adapted IPT is tolerable and safe. Findings indicate a substantial reduction in participant suicide ideation, death ideation, and depressive symptoms; controlled trials are needed to further evaluate these findings. We discuss implications for clinical care with at-risk older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and punishment.

An experiment to test the hypothesis that psychopathy is associated with deficient passive avoidance learning under punishment. 75 High Pd and 75 Low Pd female undergraduates, equated for intelligence, learned a list of 10 nonsense syllables under 1 of 3 conditions of reinforcement: verbal reward, verbal punishment, and absence of comment by E. Punishment significantly retarded the learning of Low Pd Ss, but not that of High Pd Ss. No significant differences occurred under reward or neutral conditions. The hypothesis was considered confirmed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disentangling the Underlying Dimensions of Psychopathy and Conduct Problems in Childhood: A Community Study.

The psychometric and predictive validity of callous-unemotional (CU) traits as an early precursor of conduct disorder and antisocial behavior were assessed. A community sample of children (4-9 years of age) were tested 12 months apart with the Antisocial Process Screening Device (APSD; P. J. Frick & R. D. Hare, 2002), a measure of early signs of psychopathy in children. Factor analysis supported the structure of the APSD. Given controversy surrounding construct overlap between psychopathy and conduct problems, a factor analysis was conducted on pooled items from the Strengths and Difficulties Questionnaire and APSD. A 5-factor solution resulted: antisocial, hyperactivity, CU traits, anxiety, and peer problems. CU traits added small but significant improvements in the 12-month prediction of antisocial behavior for boys and older girls, after controlling for Time 1 measures. These results indicate that although the dimensions of the APSD overlap with dimensions of the disruptive behavior disorders, CU traits have unique predictive validity in childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prison inmate characteristics and suicide attempt lethality: An exploratory study.

Working with suicidal inmates is among the most demanding elements of clinical practice in corrections, yet few studies regarding the characteristics of prison inmate suicide attempters or their attempts exist. This represents a significant gap as the method of attempt, the prison context, and the resulting lethality of these incidents may be different from attempts made outside of prison. This exploratory study is the first to apply a continuous scale rating of suicide attempt lethality to incidents where an inmate survived a suicide attempt. It describes the attempt incident dynamics and resulting range of lethality scores found within the study sample. It also examines the inmate adjustment and mental health characteristics that were associated with the lethality rating. Preliminary findings suggest that increases in suicide attempt lethality are associated with the presence of Axis II disorders, favorable staff interactions, and the decreased use of drugs other than marijuana, alcohol, cocaine, or depressants. A call for research to extend this exploration through replication is made and recommendations for clinical practice are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults.

The interpersonal-psychological theory of suicidal behavior (T. E. Joiner, 2005) proposes that an individual will not die by suicide unless he or she has both the desire to die by suicide and the ability to do so. Three studies test the theory's hypotheses. In Study 1, the interaction of thwarted belongingness and perceived burdensomeness predicted current suicidal ideation. In Study 2, greater levels of acquired capability were found among individuals with greater numbers of past attempts. Results also indicated that painful and provocative experiences significantly predicted acquired capability scores. In Study 3, the interaction of acquired capability and perceived burdensomeness predicted clinician-rated risk for suicidal behavior. Implications for the etiology, assessment, and treatment of suicidal behavior are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)