Clarifying the role of defensive reactivity deficits in psychopathy and antisocial personality using startle reflex methodology.

Prior research has demonstrated deficits in defensive reactivity (indexed by potentiation of the startle blink reflex) in psychopathic individuals. However, the basis of this association remains unclear, as diagnostic criteria for psychopathy encompass two distinct phenotypic components that may reflect differing neurobiological mechanisms—an affective–interpersonal component and an antisocial deviance component. Likewise, the role of defensive response deficits in antisocial personality disorder (APD), a related but distinct syndrome, remains to be clarified. In the current study, the authors examined affective priming deficits in relation to factors of psychopathy and symptoms of APD using startle reflex methods in 108 adult male prisoners. Deficits in blink reflex potentiation during aversive picture viewing were found in relation to the affective–interpersonal (Factor 1) component of psychopathy, and to a lesser extent in relation to the antisocial deviance (Factor 2) component of psychopathy and symptoms of APD—but only as a function of their overlap with affective–interpersonal features of psychopathy. These findings provide clear evidence that deficits in defensive reactivity are linked specifically to the affective–interpersonal features of psychopathy and not to the antisocial deviance features represented most strongly in APD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of psychopathy as a function of age.

The assessment of psychopathy was examined as a function of age in 889 male prison inmates between the ages of 16 and 69. Ratings of psychopathy were made with the Psychopathy Checklist (PCL), which measures 2 correlated factors. Factor 1 describes a cluster of affective-interpersonal traits central to psychopathy. Factor 2 describes traits and behaviors associated with an unstable, unsocialized lifestyle, or social deviance. Cross-sectional analyses revealed that mean scores on Factor 1 were stable across the age-span; mean scores on Factor 2 declined with age. The prevalence of antisocial personality disorder, and, to a lesser extent of PCL-defined psychopathy, also declined with age. The results are consistent with a conceptualization of psychopathy as encompassing 2 correlated but distinct constructs. They also suggest that age-related differences in traits related to impulsivity, social deviance, and antisocial behavior are not necessarily paralleled by differences in the egocentric, manipulative, and callous traits fundamental to psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validating female psychopathy subtypes: Differences in personality, antisocial and violent behavior, substance abuse, trauma, and mental health.

Recent empirical investigations utilizing male prisoners have begun to validate clinical conceptualizations of primary and secondary psychopathy subtypes. We extended this literature by identifying similar psychopathic subtypes in female prisoners on the basis of personality structure using model-based cluster analysis. Secondary psychopaths (n = 39) were characterized by personality traits of negative emotionality and low behavioral constraint, an early onset of antisocial and criminal behavior, greater substance use and abuse, more violent behavior and institutional misconduct, and more mental health problems, including symptoms of posttraumatic stress disorder and suicide attempts. Primary psychopaths (n = 31) exhibited few distinguishing personality features but were prolific criminals especially in regards to nonviolent crime, and exhibited relatively few mental health problems despite substantial exposure to traumatic events. The results support alternative etiological pathways to antisocial and criminal behavior that are evident in personality structure as well as gender similarities and differences in the manifestation of psychopathic personalities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of the structure of self-report psychopathy measures and their relations with general traits and externalizing behaviors.

Self-report assessment of psychopathy is plagued by inconsistencies among the relations of the various psychopathy factors. We examined the factor structure of 3 prominent self-report measures of psychopathy—the Self-Report Psychopathy Scale–III (SRP–III; Williams, Paulhus, & Hare, 2007), the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995), and the Psychopathic Personality Inventory–R (PPI–R; Lilienfeld & Widows, 2005). A coherent 4-factor structure resulted from conducting an exploratory factor analysis (EFA) of the psychopathy subscales along with the domains from the five-factor model. Two of these factors were consistent with traditional conceptualizations of a 2-factor structure of psychopathy (i.e., Factor 1, which loaded negatively with Agreeableness; Factor 2, which loaded negatively with Conscientiousness), while 2 additional factors emerged, 1 of which emphasized low Neuroticism and 1 of which emphasized traits related to novelty/reward-seeking and dominance-related personality traits (high Extraversion). We also investigated the relations of these factors with a variety of externalizing behaviors (EB). The psychopathy scales indicative of interpersonal antagonism (i.e., Factor 1) were most consistently and strongly related to EB. Our findings are discussed in terms of the importance of a trait-based perspective in the assessment of psychopathy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: The impact of method variance and suppressor effects.

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective–interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Testing a Four-Factor Model of Psychopathy and Its Association With Ethnicity, Gender, Intelligence, and Violence.

Although a 2-factor model has advanced research on the psychopathy construct, a 3-factor model was recently developed that emphasized pathological personality and eliminated antisocial behavior. However, dropping antisocial behavior from the psychopathy construct may not be advantageous. Using a large sample of psychiatric patients from the MacArthur Risk Assessment Study (J. Monahan & H. J. Steadman, 1994), the authors used confirmatory factor analysis to test a 4-factor model of psychopathy, which included interpersonal, affective, and behavioral impulsivity dimensions and an antisocial behavior dimension. Model fit was good for this 4-factor model, even when ethnicity, gender, and intelligence variables were included in the model. Structural equation modeling was used to compare the 3- and 4-factor models in predicting proximal (violence) and distal (intelligence) correlates of psychopathy. (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)     

Dual temperamental risk factors for psychopathic personality: Evidence from self-report and skin conductance.

Psychopathy is a personality disorder consisting of dysfunctional affective interpersonal features (Factor 1) and impulsive-antisocial behavior (Factor 2) that exhibit differential associations with palmar skin conductance (SC) reactivity. The goal of this study was to determine whether the distinct SC reactivity observed in incarcerated psychopaths generalizes to university students who score high on personality dimensions hypothesized to be the risk factors for these psychopathy factors. Lilienfeld's Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) was used to compute scores on 2 factor-analytically derived dimensions that have been the focus of recent research in psychopathy. PPI-1 is hypothesized to relate to the low-fear temperamental risk factor, whereas PPI-2 is hypothesized to relate to regulatory dysfunction. SC reactivity was measured during tasks previously used in studies of diagnosed psychopaths. Results indicated that PPI-1 was associated with reduced SC during anticipation of an aversive noise and PPI-2 was associated with enhanced SC reactivity during presentation of a speech about one's faults. Additional analyses explored an 8-factor solution of the PPI and 3 temperament dimensions derived from factor analysis of several personality measures. Together, the SC results suggest that the Factor 1 pathway, best captured with refined assessments of behavioral fearlessness, related to reduced SC reactivity to an aversive noise—consistent with a weak defense system. The Factor 2 pathway, best captured by higher order dimensions reflecting externalizing, disinhibited forms of negative temperament, related to enhanced SC reactivity to a speech stressor—consistent with high stress reactivity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Alcohol and drug abuse-dependence disorders in psychopathic and nonpsychopathic criminal offenders.

Co-occurrence of psychopathy (assessed with the Revised Psychopathy Checklist [R. D. Hare, 1985]) and lifetime Diagnostic and Statistical Manual of Mental Disorders (DSM-III) alcohol and drug disorders (assessed with the Diagnostic Interview Schedule; National Institute of Mental Health) was examined in a sample of 360 male inmates. Consistent with previous research that used diagnoses of antisocial personality disorder, psychopaths were more likely than nonpsychopaths to have lifetime diagnoses of alcoholism, any drug disorder, and multiple drug disorder. The relation between substance abuse and the 2 factors of the Revised Psychopathy Checklist was also examined. Substance abuse was significantly related to general social deviance (Factor 2) but was unrelated to core personality features of psychopathy (Factor 1). Two possible models of psychopathy (unitary syndrome vs dual-diathesis model) are presented that may account for the association between psychopathy and substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Diagnostic labeling in juvenile justice settings: Do psychopathy and conduct disorder findings influence clinicians?

Do provocative diagnostic labels such as psychopathy or conduct disorder influence clinicians who work in juvenile justice settings? Juvenile justice clinicians (N = 109) responded to a mock psychological evaluation of a juvenile, which varied antisocial history, psychopathic personality features, and diagnosis (psychopathy, conduct disorder, or none). Psychopathic personality features and antisocial behavioral history led to higher clinician ratings of the juvenile's risk for future criminality. A psychopathy label also led to higher clinician ratings of risk, but only when there was a minimal history of antisocial behavior. No diagnostic labels influenced clinician ratings regarding treatment. Viewed alongside other research on labeling in the juvenile justice system, clinicians appear to be somewhat more responsive to mention of the psychopathy construct than are nonclinical juvenile justice professionals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding psychopathy through an evaluation of interpersonal behavior: Testing the factor structure of the interpersonal measure of psychopathy in a large sample of jail detainees.

Interpersonal characteristics are core features of the psychopathy construct which have a unique pattern of correlations with a variety of external correlates. To improve the assessment of interpersonal traits, the current study evaluated the internal structure of the Interpersonal Measure of Psychopathy (IM–P) through exploratory and confirmatory factor analyses (CFA) in a large sample of jail inmates. A 17-item, 3-factor (Dominance, Grandiosity, and Boundary Violations) structure evidenced good fit in European American inmates. A second CFA demonstrated good fit for this structure in a sample of African American inmates. Moreover, a multigroup CFA indicated structural invariance between European and African American inmates. External validity was tested and demonstrated through positive correlations between IM–P factor scores and Psychopathy Checklist—Revised total and facet scores (R. D. Hare, 2003) and antisocial personality disorder symptoms and diagnoses. Modest correlations between Grandiosity scores and scores on the Shipley Institute of Living Scale—Revised (R. A. Zachary, 1994) were also observed. Finally, a step-down hierarchical regression was conducted to test for racial bias of the IM–P factor scores in relation to external correlates. Little evidence was found for slope bias, but there was evidence of intercept bias for some analyses. Implications and advantages of assessing psychopathy through a comprehensive evaluation of interpersonal traits are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing psychopathic attributes in a noninstitutionalized population.

Examined antisocial dispositions in 487 university students. Primary and secondary psychopathy scales were developed to assess a protopsychopathic interpersonal philosophy. An antisocial action scale also was developed for purposes of validation. The primary, secondary, and antisocial action scales were correlated with each other and with boredom susceptibility and disinhibition but not with experience seeking and thrill and adventure seeking. Secondary psychopathy was associated with trait anxiety. Multiple regression analysis revealed that the strongest predictors of antisocial action were disinhibition, primary psychopathy, secondary psychopathy, and sex, whereas thrill and adventure seeking was a negative predictor. This argues against a singular behavioral inhibition system mediating both antisocial and risk-taking behavior. These findings are also consistent with the view that psychopathy is a continuous dimension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunohistochemical examination of intraspinal serotonin neurons and fibers in the chicken lumbar spinal cord and coexistence with Leu-enkephalin

This study compares Psychopathy Checklist-Revised (PCL-R) scores, DSM-III-R diagnoses, and select behavioral indices between hospitalized insanity acquittees (N = 18) and hospitalized insanity acquittees who successfully malingered (N = 18). The malingerers were significantly more likely to have a history of murder or rape, carry a diagnosis of antisocial personality disorder or sexual sadism, and produce greater PCL-R factor 1, factor 2, and total scores than insanity acquittees who did not malinger. The malingerers were also significantly more likely to be verbally or physically assaultive, require specialized treatment plans to control their aggression, have sexual relations with female staff, deal drugs, and be considered an escape risk within the forensic hospital. These findings are discussed within the context of insanity statutes and the relevance of malingering, psychopathy, and treatability to future policy concerning the disposition of insanity acquittees.     

Parallel syndromes: Two dimensions of narcissism and the facets of psychopathic personality in criminally involved individuals.

Little research has examined different dimensions of narcissism that may parallel psychopathy facets in criminally involved individuals. In this study, we examined the pattern of relationships between grandiose and vulnerable narcissism, assessed using the Narcissistic Personality Inventory–16 and the Hypersensitive Narcissism Scale, respectively, and the four facets of psychopathy (interpersonal, affective, lifestyle, and antisocial) assessed via the Psychopathy Checklist: Screening Version. As predicted, grandiose and vulnerable narcissism showed differential relationships to psychopathy facets, with grandiose narcissism relating positively to the interpersonal facet of psychopathy and vulnerable narcissism relating positively to the lifestyle facet of psychopathy. Paralleling existing psychopathy research, vulnerable narcissism showed stronger associations than grandiose narcissism to (a) other forms of psychopathology, including internalizing and substance use disorders, and (b) self- and other-directed aggression, measured with the Life History of Aggression and the Forms of Aggression Questionnaire. Grandiose narcissism was nonetheless associated with social dysfunction marked by a manipulative and deceitful interpersonal style and unprovoked aggression. Potentially important implications for uncovering etiological pathways and developing treatment interventions for these disorders in externalizing adults are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Assessing the basic traits associated with psychopathy: Development and validation of the Elemental Psychopathy Assessment.

A new self-report assessment of the basic traits of psychopathy was developed with a general trait model of personality (five-factor model [FFM]) as a framework. Scales were written to assess maladaptive variants of the 18 FFM traits that are robustly related to psychopathy across a variety of perspectives including empirical correlations, expert ratings, and translations of extant assessments. Across 3 independent undergraduate samples (N = 210–354), the Elemental Psychopathy Assessment (EPA) scales proved to be internally consistent and unidimensional, and were strongly related to the original FFM scales from which they were derived (mean convergent r = .66). The EPA scales also demonstrated substantial incremental validity in the prediction of existing psychopathy measures over their FFM counterparts. When summed to form a psychopathy total score, the EPA was substantially correlated with 3 commonly used psychopathy measures (mean r = .81). Finally, in a small male forensic sample (N = 70), the EPA was significantly correlated with scores on a widely used self-report psychopathy measure, disciplinary infractions, alcohol use, and antisocial behavior. The EPA provides an opportunity to examine psychopathy and its nomological network through smaller, more basic units of personality rather than by scales or factors that blend these elements. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Criterion-related validity of the Psychopathic Personality Inventory in a prison sample.

The Psychopathic Personality Inventory (PPI; S. 0. Lilienfeld & B. P. Andrews, 1996), a self-report measure of psychopathic personality features, and R. D. Hare's (1991) Psychopathy Checklist–Revised (PCL–R) were administered to adult youthful offender prison inmates (N?=?50). As hypothesized, PPI scores were significantly correlated with scores on the PCL–R, providing evidence of concurrent validity for the PPI. Moreover, unlike existing self-report psychopathy measures, the PPI showed a moderate and positive correlation with PCL–R Factor 1 (i.e., the core personality traits of psychopathy). Discriminant function analysis using the optimal PPI total score value to predict PCL–R classifications of psychopath (n?=?10) and nonpsychopath (n?=?40) resulted in accurate classification of 86% of the cases (sensitivity?=?.50, specificity?=?.95). Results are discussed in terms of the relative merits of these 2 measures of psychopathy and the validation of the PPI for clinical use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Psychophysiology of Aggression, Psychopathy, and Conduct Problems: A Meta-Analysis.

A meta-analysis of 95 studies was conducted to investigate the relations of heart rate (HR) and electrodermal activity (EDA) with aggression, psychopathy, and conduct problems. Analyses revealed a complex constellation of interactive effects, with a failure in some cases of autonomic patterns to generalize across antisocial spectrum behavior constructs. Low resting EDA and low task EDA were associated with psychopathy/sociopathy and conduct problems. However, EDA reactivity was positively associated with aggression and negatively associated with psychopathy/sociopathy. Low resting HR and high HR reactivity were associated with aggression and conduct problems. Physiology-behavior relations varied with age and stimulus valence in several cases. Empirical and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)