Generality of Psychopathy Checklist—Revised factors over prisoners and substance-dependent patients.

The Psychopathy Checklist—Revised (PCL—R; R. D. Hare, 1991) is an often-used device for assessment of adult antisociality. This research examined generalizability by replicating the 2-factor model for a sample of 326 male prisoners and assessing its congruence and relative reliability and specificity among 620 substance-dependent patients. Generality was assessed also across addiction subtypes (opioid, cocaine, and alcohol), age, gender, and ethnicity. The 2-factor model was found inappropriate for the substance-dependent samples, whereas a unidimensional model represented by the PCL—R total score was found generalizable across prison and substance-dependent samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The revised Psychopathy Checklist: Reliability and factor structure.

The revised Psychopathy Checklist (PCL) is a 20-item scale scored from interview and file information. Analyses of data from 5 prison samples (N?=?925) and 3 forensic psychiatric samples (N?=?356) indicate that the revised PCL resembles its 22-item predecessor in all important respects. It has excellent psychometric properties, and it measures 2 correlated factors that were cross-validated both within and between samples. Correlations between the original PCL and the revised version approached unity for both the factors and the full scale. We conclude that the revised PCL measures the same construct as the original and that the PCL is a reliable and valid instrument for the assessment of psychopathy in male forensic populations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of the Psychopathy Checklist.

The Psychopathy Checklist (PCL) is a reliable and valid instrument for the assessment of psychopathy in criminal populations. Although it was designed to measure a unitary construct, the instrument has been shown to comprise several factors. To determine whether the PCL contains a factor structure that is stable and replicable, we factor-analyzed data from six samples of male prison inmates (N?=?1,119) in Canada, the United States, and England. Split-half cross-validation and analysis of congruence coefficients indicated that a two-factor solution could be replicated in all six samples. Factor 1 was defined by core personality traits, including superficiality; habitual lying and manipulation; callousness; and lack of affect, guilt, remorse, and empathy. Factor 2 was defined by a chronically unstable and antisocial lifestyle. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and ethnicity: Structural, item, and test generalizability of the Psychopathy Checklist—Revised (PCL-R) in Caucasian and African American participants.

The Psychopathy Checklist--Revised (PCL-R) is an important measure in both applied and research settings. Evidence for its validity is mostly derived from male Caucasian participants. PCL-R ratings of 359 Caucasian and 356 African American participants were compared using confirmatory factor analysis (CFA) and item response theory (IRT) analyses. Previous research has indicated that 13 items of the PCL-R can be described by a 3-factor hierarchical model. This model was replicated in this sample. No cross-group difference in factor structure could be found using CFA; the structure of psychopathy is the same in both groups. IRT methods indicated significant but small differences in the performance of 5 of the 20 PCL-R items. No significant differential test functioning was found, indicating that the item differences canceled each other out. It is concluded that the PCL-R can be used, in an unbiased way, with African American participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Discriminant validity of the Psychopathy Checklist in a forensic psychiatric population.

The association between psychopathy and other mental disorders was investigated in 80 male forensic patients. Psychopathy was assessed with the Psychopathy Checklist (PCL; R. D. Hare [see PA, Vol 67:2477]). Diagnoses of other mental disorders were based on Axis I and Axis II criteria listed in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) and on two standardized psychiatric rating scales. PCL diagnoses were significantly related only to antisocial and histrionic personality disorder (PD) and to nonalcohol substance abuse disorders. PCL ratings were also positively correlated with prototypicality ratings of antisocial, histrionic, and narcissistic PD and negatively correlated with ratings of avoidant PD. The results provide evidence for the convergent and discriminant validity of the PCL and are consistent with the view that psychopathy is a distinct clinical syndrome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contemporary trends in substance abuse.

A clinical consensus has evolved as to the specific areas to be addressed in a comprehensive clinical interview with substance abusers. Knowledge of specific psychopathology and associated comorbidities among addicts will refine this assessment. There are several reasonably reliable and valid objective psychological tests that can be used to provide supplementary information for diagnostic and treatment decisions. Etiological theories, including the disease concept, family systems theory, psychodynamic formulations, and behavioral approaches, have generated treatment interventions of clinical utility. Recent research suggests that psychotherapy, combined with traditional approaches, results in increased therapeutic benefits that were heretofore considered unlikely. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incremental validity of the Psychopathy Checklist facet scores: Predicting release outcome in six samples.

The incremental validity of the 4 facet scores (Interpersonal, Affective, Lifestyle, Antisocial) of the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) and the Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was evaluated in 6 forensic/correctional samples with average follow-ups ranging from 20 weeks to 10 years. Results indicated that whereas Facet 4 (Antisocial) achieved incremental validity relative to the first 3 facets (Interpersonal, Affective, and Lifestyle) in predicting recidivism in all 6 samples, a block of the first 3 facets achieved incremental validity relative to the 4th facet in only 1 sample. Thus, although there was consistent support for the incremental validity of Facet 4 above and beyond the first 3 facets, there was minimal support for the incremental validity of Facets 1, 2, and 3 above and beyond Facet 4. The implications of these findings for the psychopathy construct in general and the PCL-R/SV in particular are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Future trends in substance abuse.

Argues that as illicit drugs with increased abuse liability come into vogue, a broader segment of the population will be at risk for becoming addicted. Consequently, the attendant effects of abuse, including acquired immune deficiency syndrome (AIDS) and human immunodeficiency virus (HIV) infection, will grow proportionately. Health care providers will need to become more astute and creative to provide effective rehabilitation for addicted individuals. (0 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of substance abuse in psychotherapy clients: The effectiveness of the MMPI-2 substance abuse scales.

The Minnesota Multiphasic Personality Inventory—2 (MMPI—2) contains 3 scales, the MacAndrew Alcoholism Scale—Revised (MAC—R), the Addiction Potential Scale (APS), and the Addiction Acknowledgement Scale (AAS), that were developed to identify alcohol and drug abusing individuals. The current study was designed to measure the effectiveness of these scales at detecting substance abuse problems in a community-based mental health sample. MAC—R, APS, and AAS scores were obtained from 64 therapists who identified 68 substance abusing and 392 nonabusing psychotherapy clients. The results indicated that mean scores on all 3 scales were higher for the substance abusers than for nonabusers. Furthermore, discriminant analysis found all 3 scales to be effective screening tools. The AAS was the best single predictor, and a combination of the AAS and MAC—R provided the best overall discrimination. The implications of early substance abuse detection on treatment effectiveness are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confirmatory Factor Analysis of the Psychopathy Checklist: Screening Version in Offenders With Axis I Disorders.

One hundred forty-nine inpatients within a maximum security psychiatric facility were assessed with the Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Within the total sample, 68% had a psychotic disorder and 30% met criteria for psychopathy. Using confirmatory factor analysis, the authors tested the 2-factor PCL:SV model of psychopathy and recent 3- and 4-factor models. Results indicated good fit for each model, with the 4-factor model showing best overall fit. Structural equation modeling was used to determine which psychopathy factors predicted 6-month follow-up of inpatient aggression. The 2-, 3-, and 4-factor models, respectively, accounted for 16%.27%. and 3l% of the variance in aggression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Applicability of traditional and revised models of psychopathy to the Psychopathy Checklist: Screening Version.

Recently, psychopathy has become virtually synonymous with the Psychopathy Checklist (PCL) measures. However, the "gold standard" 2-factor model that underlies these measures has been questioned for its uncertain empirical support and emphasis on antisocial behavior that is not specific to psychopathic personality deviation. This study (N=870 civil psychiatric patients) compares the fit of the traditional 2-factor model with that of a revised 3-factor model of psychopathy. The revised model better describes the structure of the Screening Version of the PCL (PCL:SV) than the traditional model. Although the revised model's exclusion of some items that assess antisocial behavior reduces the PCL:SV's power in predicting patient violence, this model arguably assesses psychopathy in a more specific, theoretically coherent fashion that may reduce misapplications of the construct. Implications for future research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Concurrent and predictive validity of the Psychopathy Checklist: Youth version across gender and ethnicity.

The concurrent and predictive validity of the Psychopathy Checklist: Youth Version (PCL:YV) were examined across gender and ethnicity using multiple outcome measures on a community-based sample of 130 adjudicated youths. The PCL:YV demonstrated concurrent validity with externalizing behavior problems but, it is important to note, was also associated with internalizing measures of negative affect. With a mean follow-up period of 3 years, the PCL:YV was found to predict general and violent recidivism in male, Native Canadian, and Caucasian youths. However, the PCL:YV demonstrated weaker concurrent and predictive validity with girls and failed to predict nonviolent recidivism in all subgroups. Implications of the findings for clinical practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigating different factor structures of the Psychopathy Checklist: Youth version: Confirmatory factor analytic findings.

There has been a recent push to extend the construct of psychopathy into adolescence, primarily as a result of the impressive reliability, validity, and utility of this construct in samples of adults. The value of this work rests, however, on creating an equally reliable and valid assessment tool for adolescents. One promising measure is the Psychopathy Checklist: Youth Version (A. E. Forth, D. S. Kosson, & R. D. Hare, 2003). The current study uses a large, diverse sample of serious adolescent offenders to assess the overall fit of various underlying factor structures of this measure and to test the equivalence of these models across sex and race/ethnicity. The results suggest that either a 3- or 4-factor model provides the best overall fit and that these models are invariant across sex and race/ethnicity. The decision to use the 3- or 4-factor model will likely hinge on researchers' underlying conceptualization of psychopathy, specifically whether antisocial behavior is viewed as a core feature of this construct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of the Hare Psychopathy Checklist: Youth Version (PCL: YV) in incarcerated adolescents.

Two studies are reported on the underlying dimensions of the psychopathy construct in adolescents as measured by the Hare Psychopathy Checklist-Youth Version (PCL: YV; Forth, Kosson, & Hare, 2003). In Study 1, the PCL: YV item ratings for 505 male adolescents incarcerated in 5 different settings in North America were used to test the fit of 3 models that have been hypothesized to represent the structure of psychopathy in adults. A 4th model based on parceling PCL: YV items was also tested. In Study 2, these models were tested with a sample of 233 male adolescents incarcerated in 2 facilities in the United Kingdom. Model fit results indicated that the 18-item 4-factor model developed by Hare (2003) and a modified version of a 13-item 3-factor model developed by Cooke and Michie (2001) were associated with generally good fit. Because the 4-factor model is a less saturated model than the 3-factor model (better parameter to data point ratio), it survived a riskier test of disconfirmation. Implications for the nature of psychopathy in youth are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment of behavioral problems in dementia: The Revised Memory and Behavior Problems Checklist.

The Revised Memory and Behavior Problems Checklist (RMBPC), a 24-item, caregiver-report measure of observable behavioral problems in dementia patients, provides 1 total score and 3 subscale scores for S problems (memory-related, depression, and disruptive behaviors) and parallel scores for caregiver reaction. Data were obtained from 201 geriatric Ss and their caregivers. Factor analysis confirmed 3 1st-order factors, consistent with subscales just named, and 1 general factor of behavioral disturbance. Overall scale reliability was good, with alphas of .84 for S behavior and .90 for caregiver reaction. Subscale alphas ranged from .67 to .89. Validity was confirmed through comparison of RMBPC scores with well-established indexes of depression, cognitive impairment, and caregiver burden. The RMBPC is recommended as a reliable and valid tool for the clinical and empirical assessment of behavior problems in dementia Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting recidivism with the Psychopathy Checklist: Are factor score composites really necessary?

In two previous studies on general and violent recidivism (Walters & Heilbrun, 2010; Walters, Knight, Grann, & Dahle, 2008), the summed composite antisocial facet of the Psychopathy Checklist displayed incremental validity relative to the other 3 facets (interpersonal, affective, lifestyle), whereas the other 3 facets generally failed to demonstrate incremental validity relative to the antisocial facet. Because summed composite scores do not account for ordinal item distributions, the 6 Walters et al. (2008) samples were reanalyzed with factor score composites derived from a 4-factor confirmatory factor analysis. The results, however, showed little change from what had been obtained earlier with summed composite scores. Two additional samples not previously included in any incremental validity analyses of the Psychopathy Checklist evidenced a 3-factor structure, with the lifestyle and antisocial facets merged into a single factor. This single factor displayed incremental validity relative to the interpersonal and affective facets, but the reverse was not true regardless of whether summed composite scores or factor score composites were used. A comparison of zero-order correlations from all 8 samples revealed that the antisocial summed composite score predicted significantly better than the summed composite scores for the other 3 facets and that a superordinate factor failed to improve on the performance of either the antisocial summed composite score or the antisocial factor score composite. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Assessing risk for violence among psychiatric patients: The HCR-20 violence risk assessment scheme and the Psychopathy Checklist: Screening Version.

This study examined the predictive validity of the HCR–20 (Historical, Clinical, and Risk Management) violence risk assessment scheme and the Psychopathy Checklist: Screening Version (PCL:SV). Files of 193 civilly committed patients were coded. Patients were followed up in the community for an average of 626 days. Receiver operating characteristic analyses with the HCR–20 yielded strong associations with violence (areas under curve [AUCs?=?.76–.80). Persons scoring above the HCR–20 median were 6 to 13 times more likely to be violent than those scoring below the median. PCL:SV AUCs were more variable (.68–.79). Regression analyses revealed that the HCR–20 added incremental validity to the PCL:SV and that only HCR–20 subscales predicted violence. Implications for risk assessment research, and the clinical assessment and management of violence, are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intervening in adolescent substance abuse

Violence towards health professionals is defined as any incident in which a health professional experiences abuse, threat, fear or the application of force arising out of the course of his or her work, whether or not they are on duty. It emerges that no single theory can adequately explain the phenomenon, and perceptions about incidence and prevalence are distorted by the media. There is consistent and variable reporting but a high incidence and prevalence undoubtedly exists within health care. Health professionals and less experienced nurses in particular have been found to be most at risk. A strategic approach is needed to the development and implementation of workplace-specific solutions. Health professionals have a right to expect that violence at work is minimized but it would be unrealistic to expect it to be eradicated.     

Identifying persistently antisocial offenders using the Hare Psychopathy Checklist and DSM antisocial personality disorder criteria.

Early starting, lifetime criminal persistence has been called sociopathy, antisocial personality disorder, and psychopathy. There is, however, disagreement about its core features and which measure is best for identifying such individuals. In the 1st of 2 studies of male offenders (n = 74), we found a large association between scores on the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991) and the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV; American Psychiatric Association, 1994) antisocial personality disorder criteria scored as a scale. The second study (n = 684) replicated this finding and found that, as previously shown for PCL-R scores, a discrete class (or taxon) also underlies scores on items reflecting antisocial personality disorder. The high association among these sets of items and their similarity in predicting violence suggested that the same natural class underlies each. Results indicated that life-course-persistent antisociality can be assessed well by measures of psychopathy and antisocial personality disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factor structure of the Hare Psychopathy Checklist: Youth version in German female and male detainees and community adolescents.

Substantial evidence exists for 3- and 4-factor models of psychopathy underlying patterns of covariation among the items of the Psychopathy Checklist—Revised (PCL–R) in diverse adult samples. Although initial studies conducted with the Psychopathy Checklist: Youth Version (PCL:YV) indicated reasonable fit for these models in incarcerated male adolescents in the United States and the United Kingdom, only one published study has addressed the factor structure of PCL:YV psychopathy in female adolescents, and no prior studies have addressed it outside of these countries. We used confirmatory factor analysis to investigate the factor structure underlying PCL:YV scores in 314 incarcerated (143 male, 171 female) and 193 in-school (99 male, 94 female) adolescents, ages 14 to 19 years. The 2-factor model provided adequate fit only for incarcerated male adolescents and the 4-factor model was problematic in all samples, but the 3-factor solution provided an adequate model in incarcerated and community male adolescents. None of the models provided consistently acceptable fit among female adolescents. Current findings provide evidence for the robustness of the 3-factor model of psychopathy in incarcerated and community male adolescent samples but raise doubts about the applicability of this model to female adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)