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)     

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 Unlawful Confinement: An Examination of Perpetrator and Event Characteristics.

Given their particular constellation of interpersonal, affective, lifestyle, and antisocial features, we hypothesized that psychopaths would be more likely than other offenders to unlawfully confine another person. The present archival study investigated victim and offence characteristics, and the prevalence of psychopathy in offenders who perpetrated criminal acts of unlawful confinement. Of federal offenders incarcerated in the Pacific Region of Canada between the late 1960s and 1998, 136 (11.3%) had committed acts of unlawful confinement, 90 of whom had PCL-R assessments on file. Results indicated that 49% of these perpetrators were psychopathic (i.e., PCL-R > 30). These perpetrators typically were under the age of 30 years, and were characterized by a lack of formal education, substance abuse problems, psychiatric histories, and previous violence. Most of the offences appeared to be instrumental and involved sexual misconduct and the use of weapons. The majority were perpetrated against females, were of short duration, and rarely resulted in the victim's death. Implications for the criminal justice system are discussed. (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)     

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)     

In cold blood: Characteristics of criminal homicides as a function of psychopathy.

This study investigated the relationship between psychopathy and the characteristics of criminal homicides committed by a sample of 125 Canadian offenders. It was hypothesized that the homicides committed by psychopathic offenders would be more likely to be primarily instrumental (i.e., associated with premeditation, motivated by an external goal, and not preceded by a potent affective reaction) or "cold-blooded" in nature, whereas homicides committed by nonpsychopaths often would be "crimes of passion" associated with a high level of impulsivity/reactivity and emotionality. The results confirmed these predictions; homicides committed by psychopathic offenders were significantly more instrumental than homicides by nonpsychopaths. Nearly all (93.3%) of the homicides by psychopaths were primarily instrumental in nature compared with 48.4% of the homicides by nonpsychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and alexithymia in female offenders.

Determined the comorbidity of psychopathy and alexithymia in 37 female inmates of a medium-security prison. The authors also investigated the association between psychopathy and alexithymia with the use of affective language in response to questions about an emotional event, and with their propensity for violence. The extent of psychopathy and alexithymia were assessed with the Hare Psychopathy Checklist—Revised (PCL-R) and the Toronto Alexithymia Scale (TAS), respectively. Using standard cutoff scores, 30% were identified as psychopaths, and 32% as alexithymics. Three Ss were both psychopaths and alexithymics. The correlation between PCL-R and TAS total scores was not significant, but the socially deviant impulsive factor of the PCL-R significantly correlated with the TAS items that reflect inability to discriminate feelings and bodily sensations. Alexithymia, but not psychopathy, was negatively related to measures of affective speech content. Both psychopathy and alexithymia were associated with a history of violence. In spite of several manifest similarities, psychopathy and alexithymia appear to be different clinical constructs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aberrant neural processing of moral violations in criminal psychopaths.

A defining characteristic of psychopathy is the willingness to intentionally commit moral transgressions against others without guilt or remorse. Despite this “moral insensitivity,” the behavioral and neural correlates of moral decision-making in psychopathy have not been well studied. To address this issue, the authors used functional magnetic resonance imaging (fMRI) to record hemodynamic activity in 72 incarcerated male adults, stratified into psychopathic (n = 16) and nonpsychopathic (n = 16) groups based on scores from the Hare Psychopathy Checklist—Revised (R. D. Hare, 2003), while they made decisions regarding the severity of moral violations of pictures that did or did not depict moral situations. Consistent with hypotheses, an analysis of brain activity during the evaluation of pictures depicting moral violations in psychopaths versus nonpsychopaths showed atypical activity in several regions involved in moral decision-making. This included reduced moral/nonmoral picture distinctions in the ventromedial prefrontal cortex and anterior temporal cortex in psychopaths relative to nonpsychopaths. In a separate analysis, the association between severity of moral violation ratings and brain activity across participants was compared in psychopaths versus nonpsychopaths. Results revealed a positive association between amygdala activity and severity ratings that was greater in nonpsychopaths than psychopaths, and a negative association between posterior temporal activity and severity ratings that was greater in psychopaths than nonpsychopaths. These results reveal potential neural underpinnings of moral insensitivity in psychopathy and are discussed with reference to neurobiological models of morality and psychopathy. (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)     

Identifying Psychopathy Subtypes on the Basis of Personality Structure.

The authors used model-based cluster analysis to identify subtypes of criminal psychopaths on the basis of differences in personality structure. Participants included 96 male prisoners diagnosed as psychopathic, using the Psychopathy Checklist Revised (PCL-R; R. D. Hare, 1991). Personality was assessed using the brief form of the Multidimensional Personality Questionnaire (MPQ-BF; C. J. Patrick, J. J. Curtin, & A. Tellegen, 2002). The best-fitting model yielded two clusters. Emotionally stable psychopaths were characterized by low Stress Reaction and high Agency. Aggressive psychopaths were characterized by high Negative Emotionality, low Constraint, and low Communion. These results suggest that psychopaths as defined by the PCL-R includes distinct subtypes, distinguishable in terms of personality structure, that may reflect different etiologies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Vocal affect recognition and psychopathy: Converging findings across traditional and cluster analytic approaches to assessing the construct.

Deficits in emotion processing have been widely reported to be central to psychopathy. However, few prior studies have examined vocal affect recognition in psychopaths, and these studies suffer from significant methodological limitations. Moreover, prior studies have yielded conflicting findings regarding the specificity of psychopaths’ affect recognition deficits. This study examined vocal affect recognition in 107 male inmates under conditions requiring isolated prosodic vs. semantic analysis of affective cues and compared subgroups of offenders identified via cluster analysis on vocal affect recognition. Psychopaths demonstrated deficits in vocal affect recognition under conditions requiring use of semantic cues and conditions requiring use of prosodic cues. Moreover, both primary and secondary psychopaths exhibited relatively similar emotional deficits in the semantic analysis condition compared to nonpsychopathic control participants. This study demonstrates that psychopaths’ vocal affect recognition deficits are not due to methodological limitations of previous studies and provides preliminary evidence that primary and secondary psychopaths exhibit generally similar deficits in vocal affect recognition. (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)     

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)     

Recognition of facial affect in psychopathic offenders.

The authors examined the reliability of facial affect processing deficits found in psychopathic individuals (R. Blair et al., 2004) and whether they could be modified by attentional set. One hundred eleven offenders, classified using the Psychopathy Checklist-Revised (R. Hare, 2003) and Welsh Anxiety Scale (G. Welsh, 1956), performed a facial affect recognition task under 2 conditions. On the basis of research linking psychopathy, amygdala dysfunction, and deficits in facial affect recognition, the authors predicted that psychopathic offenders would display performance deficits when required to identify the emotional expression of particular faces. In addition, given evidence linking the affective processing deficits in psychopathy to focus of attention, the authors predicted that any deficits in facial affect processing would disappear when participants could anticipate which affective cues would be relevant on a given trial. Contrary to expectation, psychopathic offenders performed as well as controls in both conditions. The authors conclude that the conditions that reveal affective deficits in psychopathic individuals require further specification. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Taxometric Analysis of Psychopathic Personality.

Although a common assumption throughout much of the professional and popular literature is that psychopaths are qualitatively different from others, very few studies have examined the latent structure of psychopathy. Whether psychopathy is a discrete category or a continuous dimension may have implications for research on the assessment, etiology, and treatment of this disorder. This study examined the latent structure of psychopathy in a sample of 309 jail and prison inmates. Three taxometric procedures were used to analyze indicators drawn from the Psychopathic Personality Inventory (S. O. Lilienfeld & B. P. Andrews, 1996), a self-report instrument. Consistent with prior studies that used other measures of psychopathy, none of the analyses was consistent with a taxonic solution, suggesting that psychopathic personality may be best understood as existing on a continuum. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response perseveration in psychopathic women.

Recent attempts to validate the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991) as a measure of psychopathy in female offenders have been limited by a failure to examine laboratory correlates of the syndrome. We assessed 112 incarcerated women by using the PCL-R and examined their performance on a card perseveration task that has been used to demonstrate response perseveration in psychopathic men. Contrary to prediction, psychopathic women did not perseverate responding when the PCL-R was used either dimensionally or categorically. The authors discuss the implications of the results for the PCL-R and for female psychopathy more generally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotion in the criminal psychopath: Startle reflex modulation.

Measured startle-elicited blinks during presentation of affective slides to test hypotheses concerning emotional responding in psychopaths. Ss were 54 incarcerated sexual offenders divided into nonpsychopathic, psychopathic, and mixed groups based on file and interview data. Consistent with findings for normal college students, nonpsychopaths and mixed Ss showed a significant linear relationship between slide valence and startle magnitude, with startle responses largest during unpleasant slides and smallest during pleasant slides. This effect was absent in psychopaths. Group differences in startle modulation were related to affective features of psychopathy, but not to antisocial behavior per se. Psychopathy had no effect on autonomic or self-report responses to slides. These results suggest an abnormality in the processing of emotional stimuli by psychopaths that manifests itself independently of affective report. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological implications of selective attentional functioning in psychopathic offenders.

Several core characteristics of the psychopathic personality disorder (i.e., impulsivity, failure to attend to interpersonal cues) suggest that psychopaths suffer from disordered attention. However, there is mixed evidence from the cognitive literature as to whether they exhibit superior or deficient selective attention, which has led to the formation of several distinct theories of attentional functioning in psychopathy. The present experiment investigated participants' abilities to purposely allocate attentional resources on the basis of auditory or visual linguistic information and directly tested both theories of deficient or superior selective attention in psychopathy. Specifically, 91 male inmates at a county jail were presented with either auditory or visual linguistic cues (with and without distractors) that correctly indicated the position of an upcoming visual target in 75% of the trials. The results indicated that psychopaths did not exhibit evidence of superior selective attention in any of the conditions but were generally less efficient in shifting attention on the basis of linguistic cues, especially in regard to auditory information. Implications for understanding psychopaths' cognitive functioning and possible neuropsychological deficits are addressed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)