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)     

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)     

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)     

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)     

Longitudinal evidence that psychopathy scores in early adolescence predict adult psychopathy.

This study examined the relation between psychopathy assessed at age 13 by using the mother-reported Childhood Psychopathy Scale (D. R. Lynam, 1997) and psychopathy assessed at age 24 by using the interviewer-rated Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Data from over 250 participants of the middle sample of the Pittsburgh Youth Study were used to examine this relation; approximately 9% of the sample met criteria for a possible PCL:SV diagnosis. Despite the long time lag, different sources, and different methods, psychopathy from early adolescence into young adulthood was moderately stable (r=.31). The relation was present for the PCL:SV total and facet scores, was not moderated by initial risk status or initial psychopathy level, and held even after controlling for other age 13 variables. Diagnostic stability was somewhat lower. Both specificity and negative predictive power were good, and sensitivity was adequate, but positive predictive power was poor. This constitutes the first demonstration of the relative stability of psychopathy from adolescence into adulthood and provides evidence for the incremental utility of the adolescent psychopathy construct. Implications and future directions are discussed. (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)     

Clinical Decision Making About Psychopathy and Violence Risk Assessment in Public Sector Mental Health Settings.

Although there has been extensive research on psychopathy, it is unknown how, or whether, clinicians in public sector mental health settings consider the Psychopathy Checklist (PCL) for assessing violence risk. Mental health clinicians (N = 135) from 4 facilities were interviewed by using multiple methods for collecting data on decision making. Participants considered clinical information most often when assessing violence risk, indicating that these data were most readily available. Clinicians perceived formal testing results (e.g., PCL) to be least available and considered testing least often, especially if clinicians had less clinical experience. Participants did not explicitly report using the PCL but did implicitly rely on psychopathy factors when assessing violence risk. Clinicians in crisis settings reported less availability of historical data typically needed for the PCL. The data point to specific ways to improve the clinical practice of violence risk assessment in public mental health settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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

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

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)     

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)     

Gender differences in structured risk assessment: Comparing the accuracy of five instruments.

Structured risk assessment should guide clinical risk management, but it is uncertain which instrument has the highest predictive accuracy among men and women. In the present study, the authors compared the Psychopathy Checklist—Revised (PCL–R; R. D. Hare, 1991, 2003); the Historical, Clinical, Risk Management–20 (HCR-20; C. D. Webster, K. S. Douglas, D. Eaves, & S. D. Hart, 1997); the Risk Matrix 2000–Violence (RM2000[V]; D. Thornton et al., 2003); the Violence Risk Appraisal Guide (VRAG; V. L. Quinsey, G. T. Harris, M. E. Rice, & C. A. Cormier, 1998); the Offenders Group Reconviction Scale (OGRS; J. B. Copas & P. Marshall, 1998; R. Taylor, 1999); and the total previous convictions among prisoners, prospectively assessed prerelease. The authors compared predischarge measures with subsequent offending and instruments ranked using multivariate regression. Most instruments demonstrated significant but moderate predictive ability. The OGRS ranked highest for violence among men, and the PCL–R and HCR-20 H subscale ranked highest for violence among women. The OGRS and total previous acquisitive convictions demonstrated greatest accuracy in predicting acquisitive offending among men and women. Actuarial instruments requiring no training to administer performed as well as personality assessment and structured risk assessment and were superior among men for violence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The content validity of juvenile psychopathy: An empirical examination.

This study examined the content validity of a juvenile psychopathy measure, the Childhood Psychopathy Scale (CPS; D. R. Lynam, 1997), based on a downward translation of an adult instrument, the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). The CPS was compared with two other indices of juvenile psychopathy: (a) an index derived from expert ratings and (b) an empirical index based on correlations with adult psychopathy. The 100 items of the Common Language Q-Sort (CLQ; A. Caspi et al., 1992) provided a common metric for the comparison. Psychopathy and personality were assessed at age 13 years with the mother-reported CPS and the CLQ. Psychopathy was assessed at age 24 years with the interviewer-rated Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Data from over 250 participants of the middle sample of the Pittsburgh Youth Study were used to examine these relations. Item content analyses demonstrated considerable overlap among the three indices, indicating that the downward translation utilizes criteria similar to those of experts and the empirically-derived measure. In addition, these indices, even after removing overlapping items, demonstrated considerable convergence, also supporting the content validity of the downward translation. These results suggest that the downward translation method is adequate for understanding the juvenile psychopathy construct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The long-term prediction of offender recidivism using diagnostic, personality, and risk/need approaches to offender assessment.

The present study examined the prediction of recidivism using diagnostic, personality, and risk/need approaches over a 10-year follow-up in a heterogeneous sample of 61 offenders (i.e., probationers and provincial and federal offenders). The Level of Service/Case Management Inventory (LS/CMI), Psychopathy Checklist-Revised (PCL-R), and DSM-III antisocial personality disorder (APD) were examined. The measures were highly correlated and demonstrated theoretically meaningful patterns of convergent validity. Although psychopathy was highly correlated with both LS/CMI and APD, the majority of the shared variance with LS/CMI and with APD was accounted for by Factor 2 and the criminality facet of the PCL-R. All three assessment measures predicted future violence, any future reincarceration upon release, and recidivism severity (as measured by aggregate sentence length). However, none of these measures made a significant incremental contribution to the prediction of recidivism beyond either of the other two measures. Differences between the predictive validities of the three measures were minimal. The results are discussed in terms of recent debates concerning the use of these instruments in the assessment of offender risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multimethod assessment of juvenile psychopathy: Comparing the predictive utility of the PCL:YV, YPI, and NEO PRI.

The current study compares 3 distinct approaches for measuring juvenile psychopathy and their utility for predicting short- and long-term recidivism among a sample of 1,170 serious male juvenile offenders. The assessment approaches compared a clinical interview method (the Psychopathy Checklist: Youth Version [PCL:YV]; Forth, Kosson, & Hare, 2003), a new self-report measure (the Youth Psychopathic Traits Inventory; Andershed, Kerr, Stattin, & Levander, 2002), and a personality-based approach (the NEO Psychopathy Resemblance Index; Lynam & Widiger, 2007). Results indicate a modest overlap between the 3 measures (rs = .26–.36); however, youths were often identified as psychopathic by 1 measure but not by others. Measures were weakly correlated with reoffending during subsequent 6- and 12-month periods. Findings suggest that although such scores may be useful indicators of the need for heightened monitoring in the short term, care should be taken when making predictions about long-term recidivism among adolescents. Moreover, the lack of long-term predictive power for the PCL:YV and the inconsistent psychopathy designations obtained with different measures raise serious questions about the use of such measures as the basis for legal or clinical treatment decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathic traits in a large community sample: Links to violence, alcohol use, and intelligence.

Numerous studies conducted with offender or forensic psychiatric samples have revealed that individuals with psychopathic traits are at risk for violence and other externalizing psychopathology. These traits appear to be continuously distributed in these samples, leading investigators to speculate on the presence of such traits in the general population. Nonetheless, few studies of psychopathy have been conducted with large random samples of individuals from the community. The community sample from the MacArthur Violence Risk Assessment Study provides an opportunity to examine the prevalence and structural nature of psychopathic traits, as well as their association with external correlates in an urban community. The community data (N = 514) represent a stratified random sample of persons between the ages of 18 and 40 who were assessed on the Psychopathy Checklist: Screening Version (PCL: SV) and also for violent behavior, alcohol use, and intellectual functioning. Structural equation model analyses revealed that a 4-factor model found in offender and forensic psychiatric samples fit the community data well and was invariant across sex and ethnicity. Also, a superordinate factor comprehensively accounted for the 4 psychopathy first-order factors and significantly predicted the external correlates. The findings offer insight into the dimensional nature of the psychopathy construct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the Personality Assessment Inventory to assess psychopathy in offender populations.

The authors investigated the validity of the Antisocial Features (ANT) scale of the Personality Assessment Inventory (PAI; L. C. Morey, 1991) with respect to assessments of psychopathy in 2 offender samples. Study 1 included 46 forensic psychiatric inpatients who were administered the Screening Version of the Hare Psychopathy Checklist (PCL:SV; S. D. Hart, D. N. Cox, and R. D. Hare, 1995). In Study 2, 55 sex offenders were administered the Hare Psychopathy Checklist—Revised (PCL—R; R. D. Hare, 1991). ANT scores correlated highly with the PCL:SV total score (r?=?.54) and moderately with the PCL—R total score (r?=?.40). ANT tapped primarily behavioral symptoms of psychopathy rather than interpersonal and affective symptoms. Also, ANT had low to moderate diagnostic efficiency regarding diagnoses of psychopathy, suggesting that it may be better used as a dimensional rather than categorical measure of this construct. (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)     

Review of Without conscience: The disturbing world of the psychopaths among us.

Reviews the book, Without conscience: The disturbing world of the psychopaths among us by Robert D. Hare (see record 2001-00418-000). Too often we hear about adults, and now more than ever, adolescents, who perpetrate violence so horrific and seemingly meaningless that their actions defy the understanding of professionals, let alone of the perpetrators' families. The republication of Robert Hare's popular work on the psychopathic personality is a testament to the success and importance of this book. Hare paints an intriguing yet scary portrait of this, the most dangerous type of personality disorder. His colourful, but accurate portrayal of the psychopath makes this book equally important alike for parents and clinicians. Without conscience is based on more than 30 years of the author's research on psychopathy. The book is written in a sincere and easily readable fashion for a general audience. The research and clinical literature is described in nontechnical terms with a minimum of jargon, making the work accessible to a wide audience. Much of Hare's research has been devoted to the reliable identification of psychopaths. His development of the Psychopathy Checklist (PCL) may represent the single, most important advancement to date toward what hopefully will become our ultimate understanding of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the Screening Version of the Hare Psychopathy Checklist—Revised (PCL:SV): An item response theory analysis.

The Screening Version of the Psychopathy Checklist—Revised (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was developed to complement the Psychopathy Checklist—Revised (PCL-R; R. D. Hare. 1991), and for use outside forensic settings. The PCL:SV takes less time to administer and requires less collateral information than the PCL-R. An item response theory approach was adopted to determine similarities in the structural properties of the 2 instruments and whether the PCL:SV could be regarded as a short form of the PCL-R. Eight of the 12 items in the PCL:SV were strongly parallel to their equivalent PCL-R items. Of the 4 items PCL:SV items which differed from their equivalent PCL-R items, all 4 were found to be equal or superior to their equivalent PCL-R item in terms of discrimination. The analyses confirmed previous results that the interpersonal and affective features of psychopathy have higher thresholds than do the impulsive and antisocial behavioral features; individuals have to be at a higher level of the psychopathic trait before the interpersonal and affective features become evident. The PCL:SV is an effective short form of the PCL-R. (PsycINFO Database Record (c) 2010 APA, all rights reserved)