Effects of comorbid psychopathy on criminal offending and emotion processing in male offenders with antisocial personality disorder.

Antisocial personality disorder (ASPD) and psychopathy are two syndromes with substantial construct validity. To clarify relations between these syndromes, the authors evaluated 3 possibilities: (a) that ASPD with psychopathy and ASPD without psychopathy reflect a common underlying pathophysiology; (b) that ASPD with psychopathy and ASPD without psychopathy identify 2 distinct syndromes, similar in some respects; and (c) that most correlates of ASPD reflect its comorbidity with psychopathy. Participants were 472 incarcerated European American men who met Diagnostic and Statistical Manual (4th ed., American Psychiatric Association, 1994) criteria for ASPD and Psychopathy Checklist criteria for psychopathy, who met the criteria for ASPD but not for psychopathy, or who did not meet diagnostic criteria for either ASPD or psychopathy (controls). Both individuals with ASPD only and those with ASPD and psychopathy were characterized by more criminal activity than were controls. In addition, ASPD with psychopathy was associated with more severe criminal behavior and weaker emotion facilitation than ASPD alone. Group differences in the association between emotion dysfunction and criminal behavior suggest tentatively that ASPD with and ASPD without prominent psychopathic features may be distinct syndromes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance.

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis. (PsycINFO Database Record (c) 2011 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 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)     

Machiavellianism and psychopathy.

An integration of the Machiavellianism (MACH) and psychopathy constructs based on a dimensional view of personality and personality disorders and a recognition of B. Karpman's (1941, 1948) conceptual distinction between primary and secondary psychopathy is presented. Positive associations between MACH and both primary and secondary psychopathy were found. It is concluded that the Mach-lV is a global measure of psychopathy in noninstitutionalized populations (i.e., one that assesses but confounds both primary and secondary psychopathy) and that the primary differences between MACH and psychopathy are not traceable to substantive theoretical issues but to the different professional affiliations they are associated with: personality and social psychology and clinical psychology, respectively. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathic personality traits associated with abnormal selective attention and impaired cognitive control.

The current study investigated how mechanisms of attention that have been well-characterized in the cognitive psychology literature (Lavie, Hirst, De Fockert, & Viding, 2004; Maylor & Lavie, 1998) may be differentially associated with psychopathic traits in nonincarcerated men. Previous research on cognition and psychopathy indicated that primary psychopathic traits were associated with overfocused attention and/or reduced processing of information peripheral to the focus of attention. Conversely, deficits in executive functioning, such as working memory and cognitive control, were implicated in secondary psychopathic traits. Results revealed a significant relationship between traits typically associated with primary psychopathy (e.g., low anxiety, social dominance, fearlessness, callousness) and reduced processing of task-irrelevant distractors, suggesting diminished basic attentional capacity among individuals high on these traits. In contrast, some characteristics linked to secondary psychopathy (e.g., social alienation, cynicism) showed a positive relationship with impaired working memory functioning, indicative of deficits in cognitive control, whereas other traits (i.e., self-centeredness, antagonism) did not. These results suggest that psychopathic traits are differentially related to selective impairments in attentional functioning, which may help explain the observed heterogeneity in psychopathic manifestations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

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)     

"Two subtypes of psychopathic violent offenders that parallel primary and secondary variants." Correction to Skeem et al. (2007).

Reports an error in "Two subtypes of psychopathic violent offenders that parallel primary and secondary variants" by Jennifer Skeem, Peter Johansson, Henrik Andershed, Margaret Kerr and Jennifer Eno Louden (Journal of Abnormal Psychology, 2007[May], Vol 116[2], 395-409). The headings "Primary (n = 74)" and "Secondary (n = 49)" should be reversed in Table 1 on p. 401. In addition, the means for the Psychic Anxiety scale of the Karolinska Scales of Personality should be 0.52 (rather than -0.52) and -0.34 (rather than 0.34). (The following abstract of the original article appeared in record 2007-06673-015.) Although psychopathy usually is treated as a unitary construct, a seminal theory posits that there are 2 variants: Primary psychopathy is underpinned by an inherited affective deficit, whereas secondary psychopathy reflects an acquired affective disturbance. The authors investigated whether psychopathy phenotypically may be disaggregated into such types in a sample of 367 prison inmates convicted of violent crimes. Model-based cluster analysis of the Revised Psychopathy Checklist (PCL-R; R. D. Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 123; PCL-R ≥ 29) revealed 2 clusters. Relative to primary psychopaths, secondary psychopaths had greater trait anxiety, fewer psychopathic traits, and comparable levels of antisocial behavior. Across validation variables, secondary psychopaths manifested more borderline personality features, poorer interpersonal functioning (e.g., irritability, withdrawal, poor assertiveness), and more symptoms of major mental disorder than primary psychopaths. When compared with the nonpsychopathic subgroup (n = 243), the 2 psychopathic variants manifested a theoretically coherent pattern of differences. Implications for etiological research and violence prevention are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two subtypes of psychopathic violent offenders that parallel primary and secondary variants.

[Correction Notice: An erratum for this article was reported in Vol 116(4) of Journal of Abnormal Psychology (see record 2007-17062-019). The headings "Primary (n = 74)" and "Secondary (n = 49)" should be reversed in Table 1 on p. 401. In addition, the means for the Psychic Anxiety scale of the Karolinska Scales of Personality should be 0.52 (rather than -0.52) and -0.34 (rather than 0.34).] Although psychopathy usually is treated as a unitary construct, a seminal theory posits that there are 2 variants: Primary psychopathy is underpinned by an inherited affective deficit, whereas secondary psychopathy reflects an acquired affective disturbance. The authors investigated whether psychopathy phenotypically may be disaggregated into such types in a sample of 367 prison inmates convicted of violent crimes. Model-based cluster analysis of the Revised Psychopathy Checklist (PCL-R; R. D. Hare, 2003) and trait anxiety scores in the psychopathic subgroup (n = 123; PCL-R ≥ 29) revealed 2 clusters. Relative to primary psychopaths, secondary psychopaths had greater trait anxiety, fewer psychopathic traits, and comparable levels of antisocial behavior. Across validation variables, secondary psychopaths manifested more borderline personality features, poorer interpersonal functioning (e.g., irritability, withdrawal, poor assertiveness), and more symptoms of major mental disorder than primary psychopaths. When compared with the nonpsychopathic subgroup (n = 243), the 2 psychopathic variants manifested a theoretically coherent pattern of differences. Implications for etiological research and violence prevention are discussed. (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)     

Serotonin transporter gene associations with psychopathic traits in youth vary as a function of socioeconomic resources.

Although prior research has examined the genetic correlates of antisocial behavior, molecular genetics influences on psychopathic traits remain largely unknown. Consequently, we investigated the influence of polymorphic variation at the serotonin transporter protein gene (SLC6A4) and socioeconomic resources (SES) on psychopathic traits in youth across two distinct samples in two separate studies. In Study 1, a main effect of serotonin transporter (5-HTTLPR) genotype was associated with the impulsivity dimension of psychopathy. That is, individuals homozygous for the short allele evidenced more impulsivity than did those homozygous for the long allele. In contrast, a gene–environment interaction was associated with the callous-unemotional and narcissistic features of psychopathy. Callous-unemotional and narcissistic traits increased as SES decreased only among youths with the homozygous-long (l/l) genotype, a novel finding replicated and extended in Study 2. These studies provide preliminary results that the l/l genotype confers risk for the emotional deficits and predatory interpersonal traits associated with psychopathy among youths raised in disadvantaged environments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recognition of wives’ emotional expressions: A mechanism in the relationship between psychopathology and intimate partner violence perpetration.

Among a community sample of 88 couples, husbands’ emotion recognition skills were examined as a mechanism accounting for the relationships between two dimensions of psychopathology that commonly describe violent husbands (i.e., borderline/dysphoric and psychopathic personality characteristics) and their perpetration of intimate partner violence (IPV). Husbands’ diminished sensitivity to their wives’ expressions of happiness partially mediated the relationship between their borderline/dysphoric characteristics and their IPV perpetration, supporting Dutton’s (1995) theory of IPV. These relationships were specific to expressions displayed by husbands’ wives (as opposed to unfamiliar men and women), demonstrating the significance of the intimate relationship. Partial support was found for Blair’s (1995) violence inhibition mechanism model, such that husbands’ IPV was associated with their diminished sensitivity to expressions of fear and their psychopathy was associated with misidentifying fearful expressions as neutral. However, the strength of husbands’ diminished sensitivity to fear as a mediator of the psychopathy–IPV relationship was suboptimal. Moreover, sensitivity to wives’ expressions of happiness also mediated the psychopathy–IPV relationship, potentially because of overlap in psychopathology constructs or inadequate examination of the temporal specificity of the two theories tested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are all psychopathic individuals low-anxious?

Theorists commonly assume that true or primary psychopathic individuals experience little anxiety or neurotic conflict. This study examined the relationship between psychopathy and anxiety in 104 Caucasian and 113 African American incarcerated men using the Psychopathy Checklist—Revised (PCL—R; R. D. Hare, 1991) and multiple self-report measures to tap diverse interpretations of the anxiety construct (i.e., neuroticism, traditional definitions of anxiety, and fear). Analyses involving zero-order, semipartial, and point-biserial correlations indicate that PCL—R psychopathy and the anxiety construct are essentially independent. These findings suggest that either (a) the traditional belief that all psychopathic individuals are low-anxious is incorrect or (b) the PCL—R is not an adequate measure of primary psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detecting psychopathy from thin slices of behavior.

This study is the first to demonstrate that features of psychopathy can be reliably and validly detected by lay raters from “thin slices” (i.e., small samples) of behavior. Brief excerpts (5 s, 10 s, and 20 s) from interviews with 96 maximum-security inmates were presented in video or audio form or in both modalities combined. Forty raters used these excerpts to complete assessments of overall psychopathy and its Factor 1 and Factor 2 components, various personality disorders, violence proneness, and attractiveness. Thin-slice ratings of psychopathy correlated moderately and significantly with psychopathy criterion measures, especially those related to interpersonal features of psychopathy, particularly in the 5- and 10-s excerpt conditions and in the video and combined channel conditions. These findings demonstrate that first impressions of psychopathy and related constructs, particularly those pertaining to interpersonal functioning, can be reasonably reliable and valid. They also raise intriguing questions regarding how individuals form first impressions and about the extent to which first impressions may influence the assessment of personality disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathic traits from the perspective of self and informant reports: Is there evidence for a lack of insight?

It has been suggested that psychopathic individuals are incapable of providing valid reports on their own personality functioning because they are either unwilling (i.e., pathologically lie) or unable (i.e. lack insight) to do so. Despite the long-standing nature of this suggestion, almost no empirical research exists on this topic. In the current study, the authors examined the issue of psychopathy and insight by testing self and informant convergence and mean level differences across 3 indices of psychopathy in a community sample (N = 64). Self- and informant-report psychopathy scores were also examined in relation to self and informant reports on traits from the Five-Factor Model (FFM). Convergence was strong across the 3 psychopathy indices and their respective factors (i.e., median r = .64), and there was only modest evidence that individuals rated themselves as less psychopathic than did informants. In addition, the same FFM domains—low Agreeableness and Conscientiousness—characterized individuals with psychopathic traits regardless of reporter. Psychopathic individuals appear capable of reporting accurately on psychopathic traits when there are no direct consequences to accurate reporting (i.e., sentencing). It may be that the lack of concern for the consequences of these traits has been mistaken for a lack of insight into them. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Using a Five-Factor Lens to Explore the Relation Between Personality Traits and Violence in Psychiatric Patients.

Recent work suggests that predictors of violence are similar for individuals with and without mental illness. Although psychopathy is among the most potent of such predictors, the nature of its relation to violence is unclear. On the basis of a sample of 769 civil psychiatric patients, the authors explore the possibility that measures of psychopathy provide a glimpse of higher order personality traits that predispose individuals toward violence. Results indicate that general traits captured by a measure of the 5-factor model, particularly antagonism, were relatively strongly associated with violence and shared most of their violence-relevant variance with a leading measure of psychopathy. Because interpersonal and affective features of psychopathy are less important than basic traits of antagonism in postdicting violence, it may be appropriate to broaden focus in risk assessment to patients' basic personality traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The problems of internal validation without a theoretical context: The different conceptual underpinnings of psychopathy and the disruptive behavior disorder criteria.

G. Burns (see record 2001-17304-012) has concluded that the Psychopathy Screening Device's content is limited because it contains items that overlap with criteria for several disorders in the Diagnostic and Statistical Manual of Mental Disorders. The problem with Burn's analysis is that it was conducted without an adequate understanding or specification of the conceptual underpinnings of either the construct of psychopathy or the constructs assessed by the DSM criteria. This reply attempts to clarify these conceptual frameworks to illustrate that to judge the adequacy of the content of a measure of psychopathy by comparing it with DSM criteria is inconsistent with the differing theoretical frameworks underlying these classification systems. Forcing measures of psychopathy to be designed around DSM criteria leads to inadequate measures of psychopathy and can limit advances both in our understanding of developmental precursors to psychopathy and in the classification of DSM disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictive validity of childhood oppositional defiant disorder and conduct disorder: Implications for the DSM-V.

Data are presented from 3 studies of children and adolescents to evaluate the predictive validity of childhood oppositional defiant disorder (ODD) and conduct disorder (CD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM–IV; American Psychiatric Association, 1994) and the International Classification of Diseases, Version 10 (ICD-10; World Health Organization, 1992). The present analyses strongly support the predictive validity of these diagnoses by showing that they predict both future psychopathology and enduring functional impairment. Furthermore, the present findings generally support the hierarchical developmental hypothesis in DSM–IV that some children with ODD progress to childhood-onset CD, and some youth with CD progress to antisocial personality disorder (APD). Nonetheless, they reveal that CD does not always co-occur with ODD, particularly during adolescence. Importantly, the present findings suggest that ICD-10 diagnostic criteria for ODD, which treat CD symptoms as ODD symptoms when diagnostic criteria for CD are not met, identify more functionally impaired children than the more restrictive DSM–IV definition of ODD. Filling this “hole” in the DSM–IV criteria for ODD should be a priority for the DSM–V. In addition, the present findings suggest that although the psychopathic trait of interpersonal callousness in childhood independently predicts future APD, these findings do not confirm the hypothesis that callousness distinguishes a subset of children with CD with an elevated risk for APD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is criminal behavior a central component of psychopathy? Conceptual directions for resolving the debate.

The development of the Psychopathy Checklist—Revised (PCL–R; R. D. Hare, 2003) has fueled intense clinical interest in the construct of psychopathy. Unfortunately, a side effect of this interest has been conceptual confusion and, in particular, the conflating of measures with constructs. Indeed, the field is in danger of equating the PCL–R with the theoretical construct of psychopathy. A key point in the debate is whether criminal behavior is a central component, or mere downstream correlate, of psychopathy. In this article, the authors present conceptual directions for resolving this debate. First, factor analysis of PCL–R items in a theoretical vacuum cannot reveal the essence of psychopathy. Second, a myth about the PCL–R and its relation to violence must be examined to avoid the view that psychopathy is merely a violent variant of antisocial personality disorder. Third, a formal, iterative process between theory development and empirical validation must be adopted. Fundamentally, constructs and measures must be recognized as separate entities, and neither reified. Applying such principles to the current state of the field, the authors believe the evidence favors viewing criminal behavior as a correlate, not a component, of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)