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)     

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)     

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 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)     

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)     

Factor Structure of the Psychopathic Personality Inventory: Validity and Implications for Clinical Assessment.

Psychopathy is a personality disorder characterized by impulsive antisocial deviance in the context of emotional and interpersonal detachment. A factor analysis of the subscales of the Psychopathic Personality Inventory (PPI) yielded evidence for 2 factors. One factor showed relations with external criteria mirroring those of the emotional-interpersonal facet of psychopathy, including high dominance, low anxiety, and venruresomeness. The other factor showed relations paralleling those of the social deviance facet of psychopathy, including positive correlations with antisocial behavior and substance abuse, negative correlations with socioeconomic status and verbal ability, and personality characteristics including high negative emotionally and low behavioral constraint. Findings support using the PPI to assess these facets of psychopathy in community samples and to explore their behavioral correlates and genetic-neurobiological underpinnings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do core interpersonal and affective traits of PCL-R psychopathy interact with antisocial behavior and disinhibition to predict violence?

The utility of psychopathy measures in predicting violence is largely explained by their assessment of social deviance (e.g., antisocial behavior; disinhibition). A key question is whether social deviance interacts with the core interpersonal-affective traits of psychopathy to predict violence. Do core psychopathic traits multiply the (already high) risk of violence among disinhibited individuals with a dense history of misbehavior? This meta-analysis of 32 effect sizes (N = 10,555) tested whether an interaction between the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 2003) Interpersonal-Affective and Social Deviance scales predicted violence beyond the simple additive effects of each scale. Results indicate that Social Deviance is more uniquely predictive of violence (d = .40) than Interpersonal-Affective traits (d = .11), and these two scales do not interact (d = .00) to increase power in predicting violence. In fact, Social Deviance alone would predict better than the Interpersonal-Affective scale and any interaction in 81% and 96% of studies, respectively. These findings have fundamental practical implications for risk assessment and theoretical implications for some conceptualizations of psychopathy. (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)     

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)     

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)     

Continuity and change in psychopathic traits as measured via normal-range personality: A longitudinal-biometric study.

The discriminant validity of the interpersonal-affective and social deviance traits of psychopathy has been well documented. However, few studies have explored whether these traits follow distinct or comparable developmental paths. The present study used the Multidimensional Personality Questionnaire (A. Tellegen, in press) to examine the development of the psychopathic traits of Fearless Dominance (i.e., interpersonal-affective) and Impulsive Antisociality (i.e., social deviance) from late adolescence to early adulthood in a longitudinal- epidemiological sample of male and female twins. Results from mean- and individual-level analyses revealed stability in Fearless Dominance from late adolescence to early adulthood, whereas Impulsive Antisociality declined over this developmental period. In addition, biometric findings indicated greater genetic contributions to stability in these traits and greater nonshared environmental contributions to their change over time. Collectively, these findings suggest distinct developmental trends for psychopathic traits from late adolescence to early adulthood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response perseveration in psychopaths: Interpersonal/affective or social deviance traits?

In order to clarify the role of the two broad components of psychopathy (interpersonal/affective and social deviance; R. D. Hare, 2003) in explaining maladaptive response perseveration in psychopaths, as well as the role of reflection after punished responses in this deficit, the authors administered a card perseveration task to 47 Spanish male inmates assessed using the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). Hierarchical regressions showed that psychopaths' maladaptive perseveration (more cards played and less money earned) was uniquely predicted by the social deviance features of psychopathy (PCL-R Factor 2)--particularly by its impulsive and irresponsible lifestyle facet (PCL-R Facet 3)--and not by its interpersonal/affective features (PCL-R Factor 1). Moreover, perseveration was related to a lack of reflection both after punishment and after reward feedback. The authors' results, in conjunction with previous evidence indicating perseverative deficits in several impulse control disorders, suggest that response perseveration may not be specific to psychopathy but rather is associated more generally with the externalizing dimension of psychopathology. (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)     

Psychopathy and Physiological Response to Emotionally Evocative Sounds.

Despite considerable evidence that psychopathic criminals are deviant in their emotional reactions, few studies have examined responses to both pleasurable and aversive stimuli or assessed the role of different facets of psychopathy in affective deviations. This study investigated physiological reactions to emotional sounds in prisoners selected according to scores on the 2 factors of Hare's Psychopathy Checklist--Revised (PCL-R; R. D. Hare, 1991). Offenders high on the PCL-R emotional-interpersonal factor, regardless of scores on the social deviance factor, showed diminished skin conductance responses to both pleasant and unpleasant sounds, suggesting a deficit in the action mobilization component of emotional response. Offenders who scored high only on the social deviance factor showed a delay in heart rate differentiation between affective and neutral sounds. These findings indicate abnormal reactivity to both positive and negative emotional stimuli in psychopathic individuals, and suggest differing roles for the 2 facets of psychopathy in affective processing deviations. (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)     

The MMPI—2 Antisocial Practices Content Scale: Construct validity and comparison with the Psychopathic Deviate Scale.

Little is known regarding the construct validity of the Minnesota Multiphasic Personality Inventory—2 Antisocial Practices (ASP) content scale or its differences from the Psychopathic Deviate (Pd) scale. In 3 studies with undergraduates (Ns?=?95, 110, and 100), the ASP scale exhibited convergent and discriminant validity with self-report, interview, family history, and observer measures of psychopathy, personality disorders, and personality traits. The ASP and Pd scales had many similar correlates, but the ASP scale correlated more positively with measures of Machiavellianism and more negatively with interviewer-rated honesty than the Pd scale. The ASP scale demonstrated incremental validity over and above the Pd scale for global indexes of psychopathy and antisocial behavior. Neither scale related highly to the absence of stress and interpersonal anxiety characteristic of psychopathy. The ASP and Pd scales, although overlapping in content, appear to measure somewhat different facets of the psychopathy construct. (PsycINFO Database Record (c) 2010 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 and conduct problems in children.

Factor analysis of a measure of psychopathy was conducted in a sample of 95 clinic-referred children between the ages of 6 and 13 yrs. These analyses revealed 2 dimensions of behavior, one associated with impulsivity and conduct problems (I/CP) and one associated with the interpersonal and motivational aspects of psychopathy (callous/unemotional: CU). In a subset of this sample (n?=?64), analyses indicated that scores on the I/CP factor were highly associated with traditional measures of conduct problems. In contrast, scores derived from the CU factor were only moderately associated with measures of conduct problems and exhibited a different pattern of associations on several criteria that have been associated with psychopathy (e.g., sensation seeking) or childhood antisocial behavior (e.g., low intelligence, poor school achievement, and anxiety). These analyses suggest that psychopathic personality features and conduct problems are independent, yet interacting, constructs in children, analogous to findings in the adult literature. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A new method for assessing the interpersonal behavior of psychopathic individuals: Preliminary validation studies.

Two studies examined whether increased attention to interpersonal behaviors would improve assessments of the personality core underlying psychopathy. After item analysis, 21 items measuring interpersonal interactions and nonverbal behaviors associated with psychopathy were retained as the Interpersonal Measure of Psychopathy (IM-P). Federal prison inmates (Study 1, N?=?98) and undergraduates (Study 2, N?=?92) were rated on occurrence of these behaviors during an interview conducted to complete either Hare's Psychopathy Checklist—Revised (PCL-R) or Psychopathy Checklist: Screening Version (PCL: SV). In both studies, IM-P scores correlated more highly with PCL Factor 1 than with PCL Factor 2 scores. Regression analyses indicated that, after controlling for demographic variables and PCL factor scores, IM-P scores predicted interviewer emotional responses and participants' adult fighting (Study 1) and ratings of participants' interpersonal dominance (Study 2). Thus, measurement of interpersonal behavior appears to permit improved prediction of several criteria linked to the personality core of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)