Utilization of emotion cues in male and female offenders with antisocial personality disorder: Results from a lexical decision task.

Antisocial personality disorder (ASPD) diagnoses have demonstrated good reliability and validity in male offenders. However, there is a paucity of research assessing utilization of emotion cues in ASPD individuals and the extent to which correlates of ASPD in males generalize to females. This investigation examined emotion utilization in incarcerated men and women with and without ASPD using a lexical decision task with emotional and neutral words. The performance of male offenders with ASPD was similar to that of male controls, whereas women with ASPD demonstrated greater emotional facilitation than female controls. Moreover, the number of violent crimes committed by female inmates with ASPD was related to emotion facilitation, suggesting a link between their sensitivity to emotion cues and antisocial behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Antisocial behavioral syndromes among residential drug abuse treatment clients

We compared residential addictions treatment clients meeting full criteria for antisocial personality disorder (ASPD+) with those reporting syndromal levels of antisocial behavior only in adulthood (AABS+) on demographics, antisocial symptomatology, drug history, axis I comorbidity and characteristics of index treatment episode. We examined these issues in the sample as a whole, as well as separately in male and female respondents. Among both men and women, ASPD+ initiated their antisocial behavior earlier, met more ASPD criteria and endorsed more violent symptoms, than AABS+. Male ASPD+ also met criteria for more lifetime axis I diagnoses and reported more years of drug involvement than male AABS+. Trends were observed toward poorer retention in treatment among ASPD+ than among AABS+ participants of both genders randomized to a planned duration of 180 days, but retention did not differ between ASPD+ and AABS+ randomized to a planned duration of 90 days. Our findings, which replicate and extend previously published results, carry potential implications for treatment programming and for the nosology of ASPD.     

Reliability and construct validity of the psychopathy checklist-revised for Latino, European American, and African American male inmates.

The utility of the psychopathy construct in predicting laboratory deficits, criminal behavior, response to intervention, and recidivism has been well documented in European American populations. However, less is known about the manifestation and correlates of psychopathy in Latino and African American populations. The present study examined the reliability and construct validity of the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 2003) in 83 Latino inmates compared with matched samples of African Americans and European Americans. Results provide preliminary evidence that the PCL-R provides a reliable and valid measure of psychopathy in Latinos, with generally similar patterns emerging across external correlates; however, some ethnic group differences were noted for relationships between psychopathy indicators and some external correlates. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality constellations in incarcerated psychopathic men.

Advances in the operationalization of psychopathy have led to an increased understanding of the boundaries, structure, and nomological network of this construct, although significant questions remain. The empirical identification of replicable and theoretically meaningful psychopathy subtypes may help to improve the classification and diagnosis of this condition. We conducted a classification study of 91 incarcerated men who met conventional criteria for high levels of psychopathy using the Psychopathy Checklist-Revised. We expanded on the methodology of previous research on psychopathy subtypes by utilizing a comprehensive personality assessment instrument and a prototype matching approach to classification. The analyses revealed a primary (narcissistic) subtype and a secondary (hostile and dysregulated) subtype that were broadly consistent with the previous literature. External validation analyses, statistical controls, and incremental validity analyses provided substantial support for the primary and secondary subtypes. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Attribution of antisocial symptoms in coexistent antisocial personality disorder and substance abuse

Two methods for diagnosing antisocial personality disorder (ASPD) were compared based on whether antisocial symptoms that occurred when subjects also experienced alcohol- or other drug-related problems were counted toward the diagnosis of ASPD. From a family study of alcoholism and ASPD, 93 male subjects who met ASPD criteria in the absence of substance-related problems were contrasted with 312 subjects who were diagnosed with ASPD regardless of whether criterion symptoms occurred along with substance-related problems. Subjects did not differ in types of antisocial behaviors, age of onset of behaviors, or comorbid psychiatric disorders except for alcoholism and drug abuse. A subgroup was contrasted on family history of psychiatric illness, with no differences noted between groups. Counting antisocial symptoms toward the diagnosis of ASPD regardless of whether symptoms occur during periods of substance abuse increases the observed population prevalence of the disorder, but does not change the observed phenomenology of ASPD or affect commonly accepted indicators of validity of diagnosis.     

Psychopathy, IQ, and Violence in European American and African American County Jail Inmates.

The accuracy of the prediction of criminal violence may be improved by combining psychopathy with other variables that have been found to predict violence. Research has suggested that assessing intelligence (i.e., IQ) as well as psychopathy improves the accuracy of violence prediction. In the present study, the authors tested this hypothesis by using a contemporary measure of psychopathy, the Psychopathy Checklist-Revised (R. D. Hare, 2003), in a sample of 326 European American and 348 African American male offenders. The postdictive power of psychopathy was evident for both ethnic groups and robust across most changes in the operationalization of violence and the analysis conducted, whereas the postdictive power of IQ was not. No Psychopathy x IQ interactions were identified. Implications of these results for violence prediction are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Occurrence of Male-to-Female Intimate Partner Violence on Days of Men's Drinking: The Moderating Effects of Antisocial Personality Disorder.

In this study, the moderating effects of antisocial personality disorder (ASPD) on the day-to-day relationship between male partner alcohol consumption and male-to-female intimate partner violence (IPV) for men entering a domestic violence treatment program (n = 170) or an alcoholism treatment program (n = 169) were examined. For both samples, alcohol consumption was associated with an increased likelihood of nonsevere IPV among men without a diagnosis of ASPD but not among men with ASPD (who tended to engage in nonsevere IPV whether they did or did not drink). Drinking was more strongly associated with a likelihood of severe IPV among men with ASPD compared with those without ASPD who also drank. These results provide partial support for a multiple threshold model of intoxication and aggression. (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)     

Evaluating the generalizability of a fear deficit in psychopathic African American offenders.

Laboratory studies of psychopathy have yielded an impressive array of etiologically relevant findings. To date, however, attempts to demonstrate the generalizability of these findings to African American psychopathic offenders have been largely unsuccessful. The fear deficit has long been regarded as the hallmark of psychopathy, yet the generalizability of this association to African American offenders has not been systematically evaluated. In this study, we used an instructed fear paradigm and fear-potentiated startle to assess this deficit and the factors that moderate its expression in African American offenders. Furthermore, we conceptualized psychopathy using both a unitary and a two-factor model, and we assessed the constructs with both interview-based and self-report measures. Regardless of assessment strategy, results provided no evidence that psychopathy relates to fear deficits in African American offenders. Further research is needed to clarify whether the emotion deficits associated with psychopathy in European American offenders are applicable to African American offenders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective examination of delayed onset PTSD secondary to motor vehicle accidents.

Seven participants who did not meet the Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev.; American Psychiatric Association, 1987) criteria for posttraumatic stress disorder (PTSD) 1-4 months post-motor vehicle accident (MVA) and developed delayed onset PTSD during a 1-year follow-up interval were compared with 38 MVA controls who did not develop PTSD, as well as to 62 MVA participants who met criteria for acute onset PTSD on variables related to demographics, pre-MVA functioning, post-MVA functioning, and follow-up. The delayed onset participants were more symptomatic at the time of the initial interview than the controls. The delayed onset participants had poorer social support than the controls prior to and after the MVA. For the month prior to the MVA, the delayed onset participants had lower Global Assessment of Functioning scores than the controls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: The impact of method variance and suppressor effects.

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective–interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between eating disorder not otherwise specified (EDNOS) and officially recognized eating disorders: Meta-analysis and implications for DSM.

Eating disorder not otherwise specified (EDNOS) is the most prevalent eating disorder (ED) diagnosis. In this meta-analysis, the authors aimed to inform Diagnostic and Statistical Manual of Mental Disorders revisions by comparing the psychopathology of EDNOS with that of the officially recognized EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). A comprehensive literature search identified 125 eligible studies (published and unpublished) appearing in the literature from 1987 to 2007. Random effects analyses indicated that whereas EDNOS did not differ significantly from AN and BED on eating pathology or general psychopathology, BN exhibited greater eating and general psychopathology than EDNOS. Moderator analyses indicated that EDNOS groups who met all diagnostic criteria for AN except for amenorrhea did not differ significantly from full syndrome cases. Similarly, EDNOS groups who met all criteria for BN or BED except for binge frequency did not differ significantly from full syndrome cases. Results suggest that EDNOS represents a set of disorders associated with substantial psychological and physiological morbidity. Although certain EDNOS subtypes could be incorporated into existing Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) categories, others—such as purging disorder and non-fat-phobic AN—may be best conceptualized as distinct syndromes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment responsivity of cocaine-dependent patients with antisocial personality disorder to cognitive-behavioral and contingency management interventions.

This study compared the efficacy of 2 approaches for the treatment of cocaine dependence among methadone-maintained patients with and without antisocial personality disorder (ASPD). Patients were randomly assigned to 4 study conditions: cognitive-behavioral treatment (CBT), contingency management (CM), CBT with CM, or methadone maintenance. The Structural Clinical Interview for Mental Disorders-IV was administered to 108 patients to assess ASPD. A 2-way analysis of variance showed that patients with ASPD were more likely to abstain from cocaine use during treatment than patients without ASPD. The strong treatment effect for ASPD patients was primarily due to the CM condition. Regression analyses showed that ASPD remained significantly related to CM treatment responsivity while controlling for other factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and suicide: A multisample investigation.

Evidence suggests that behavioral aspects of psychopathy are associated with suicidal behavior, whereas the affective and interpersonal aspects are not. The authors tested the robustness of this bifurcated association across 1,711 persons and 12 samples of adult and juvenile criminal offenders, forensic psychiatric patients, and civil psychiatric patients. The authors observed a small but significant partial correlation (.13) between the behavioral/impulsive lifestyle features of psychopathy and suicidality, but no effect for affective/interpersonal features. Several method and sample features (mental disorder; psychopathy and suicidality measurement format) significantly strengthened or weakened this association. The authors conclude that it is not possible to speak of "the" association between psychopathy and suicide, but that this relationship appears to be partially dependent on methodological (i.e., self-report vs. clinician-administered psychopathy measures) and sample composition (i.e., age; mental illness) factors. Recommendations for practice are provided, including that clinicians should not consider psychopathy a buffer against suicidal behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Deficient response modulation and emotion processing in low-anxious Caucasian psychopathic offenders: Results from a lexical decision task.

The clinical and research literatures on psychopathy have identified an emotion paradox: Psychopaths display normal appraisal but impaired use of emotion cues. Using R. D. Hare's (1991) Psychopathy Checklist--Revised and the G. S. Welsh Anxiety Scale (1956), the authors identified low-anxious psychopaths and controls and examined predictions concerning their performance on a lexical-decision task. Results supported all the predictions: (a) low-anxious psychopaths appraised emotion cues as well as controls; (b) their lexical decisions were relatively unaffected by emotion cues; (c) their lexical decisions were relatively unaffected by affectively neutral word-frequency cues; and (d) their performance deficits were specific to conditions involving right-handed responses. The authors propose that deficient response modulation may underlie both the emotional and cognitive deficits associated with low-anxious psychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of systematic variation in retrospective conduct disorder reports on antisocial personality disorder diagnoses.

A diagnosis of antisocial personality disorder (ASPD) requires a conduct disorder (CD) diagnosis. A CD diagnosis is often obtained retrospectively. This study tested the influence of current behavior on CD recall and the association between recent behavior change and inconsistencies in contemporaneous and retrospective CD reports. Five hundred young adults reported ASPD; retrospective CD; current problem behavior; and, at ages 12 to 15 years, contemporaneous CD. True-positive, true-negative, false-positive, and false-negative CD and ASPD groups were identified. The results supported the hypotheses. Participants whose current behavior agreed with past behavior provided reliable retrospective CD reports. Inaccurate diagnoses occurred among participants whose current behavior was inconsistent with past behavior, either becoming more problematic (CD and ASPD false positives) or less problematic (CD and ASPD false negatives) over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and lateral preference.

Administered a self-report questionnaire to measure lateral preferences (hand, foot, eye, and ear) in 258 male prison inmates (mean age 29.8 yrs) divided into high, medium, and low psychopathy groups on the basis of a 22-item psychopathy checklist. As a group, Ss displayed much the same pattern of lateral preferences as did a normative group of 1,211 male noncriminals described by C. Porac and S. Coren (1981), with the exception that criminals were more likely to be right-side dominant than were noncriminals. The inmate groups did not differ from one another on any of the lateral preference measures, although there was a tendency for the incidence of consistent left-handedness to be higher in the medium than in the high or low psychopathy groups. Lateral preferences were unrelated to type or severity of criminal history or aggressive and violent behavior. Results conflict with models that attempt to use evidence of sinistrality as a basis for global inferences about cerebral dominance and dysfunction in delinquency, criminality, and psychopathy. (21 ref) (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)