Psychopathy and community violence among civil psychiatric patients: Results from the MacArthur Violence Risk Assessment Study.

Although psychopathy is recognized as a relatively strong risk factor for violence among inmates and mentally disordered offenders, few studies have examined the extent to which its predictive power generalizes to civil psychiatric samples. Using data on 1,136 patients from the MacArthur Violence Risk Assessment project, this study examined whether the 2 scales that underlie the Psychopathy Checklist: Screening Version (PCL:SV) measure a unique personality construct that predicts violence among civil patients. The results indicate that the PCL:SV is a relatively strong predictor of violence. The PCL:SV's predictive power is substantially reduced, but remains significant, after controlling for a host of covariates that reflect antisocial behavior and personality disorders other than psychopathy. However, the predictive power of the PCL:SV is not based on its assessment of the core traits of psychopathy, as traditionally construed. Implications for the 2-factor model that underlies the PCL measures and for risk assessment practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Detecting psychopathy from thin slices of behavior.

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

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)     

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)     

Psychopathy and Suicidality in Female Offenders: Mediating Influences of Personality and Abuse.

The influence of personality and childhood abuse on suicidal behaviors and psychopathy was examined among female prisoners. Scores on the affective/interpersonal component (Factor 1; F1) and the antisocial deviance (Factor 2; F2) component of psychopathy were obtained from the Psychopathy Checklist-Revised (R. D. Hare, 1991). Suicide attempt and childhood physical and sexual abuse history were coded from interviews and prison files, and personality was assessed using the Multidimensional Personality Questionnaire (A. Tellegen, in press). Suicide attempts were positively associated with F2 and negatively associated with F1, and each factor accounted for unique variance in suicidality. Path analyses demonstrated that personality mediated the effects of physical abuse on F2, but sexual abuse accounted for unique variance in both suicide attempts and F2. Abuse and personality accounted for minimal variance in F1. These results are discussed in relation to the identification of individuals at risk for both self- and other-harm behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Assessment of psychopathy as a function of age.

The assessment of psychopathy was examined as a function of age in 889 male prison inmates between the ages of 16 and 69. Ratings of psychopathy were made with the Psychopathy Checklist (PCL), which measures 2 correlated factors. Factor 1 describes a cluster of affective-interpersonal traits central to psychopathy. Factor 2 describes traits and behaviors associated with an unstable, unsocialized lifestyle, or social deviance. Cross-sectional analyses revealed that mean scores on Factor 1 were stable across the age-span; mean scores on Factor 2 declined with age. The prevalence of antisocial personality disorder, and, to a lesser extent of PCL-defined psychopathy, also declined with age. The results are consistent with a conceptualization of psychopathy as encompassing 2 correlated but distinct constructs. They also suggest that age-related differences in traits related to impulsivity, social deviance, and antisocial behavior are not necessarily paralleled by differences in the egocentric, manipulative, and callous traits fundamental to psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of violence prediction: A meta-analytic comparison of nine risk assessment tools.

Actuarial risk assessment tools are used extensively to predict future violence, but previous studies comparing their predictive accuracies have produced inconsistent findings as a result of various methodological issues. We conducted meta-analyses of the effect sizes of 9 commonly used risk assessment tools and their subscales to compare their predictive efficacies for violence. The effect sizes were extracted from 28 original reports published between 1999 and 2008, which assessed the predictive accuracy of more than one tool. We used a within-subject design to improve statistical power and multilevel regression models to disentangle random effects of variation between studies and tools and to adjust for study features. All 9 tools and their subscales predicted violence at about the same moderate level of predictive efficacy with the exception of Psychopathy Checklist—Revised (PCL-R) Factor 1, which predicted violence only at chance level among men. Approximately 25% of the total variance was due to differences between tools, whereas approximately 85% of heterogeneity between studies was explained by methodological features (age, length of follow-up, different types of violent outcome, sex, and sex-related interactions). Sex-differentiated efficacy was found for a small number of the tools. If the intention is only to predict future violence, then the 9 tools are essentially interchangeable; the selection of which tool to use in practice should depend on what other functions the tool can perform rather than on its efficacy in predicting violence. The moderate level of predictive accuracy of these tools suggests that they should not be used solely for some criminal justice decision making that requires a very high level of accuracy such as preventive detention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and violent crime.

Examined the relations between psychopathy, violence, and impulsiveness of criminal behavior within a White prisoner sample of 76 Ss, using level of intelligence as a moderator variable. Prisoners were given the MMPI, the California Psychological Inventory, the Wide Range Achievement Test, and the IPAT Culture Free Intelligence Test (Scale 2). Unlike most prior research, psychopathy was found to be predictive of violence but only for less intelligent criminals; about 90% of this group had committed a violent crime compared to 58% for the remainder of the sample. Similarly, the psychopaths with limited intelligence evidenced the greatest impulsivity in the commission of their crimes relative to bright psychopaths or nonpsychopathic criminals at either level of intelligence. The implications of the findings for the importance of moderating cognitive variables in personality predictions are discussed. (45 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of the structure of self-report psychopathy measures and their relations with general traits and externalizing behaviors.

Self-report assessment of psychopathy is plagued by inconsistencies among the relations of the various psychopathy factors. We examined the factor structure of 3 prominent self-report measures of psychopathy—the Self-Report Psychopathy Scale–III (SRP–III; Williams, Paulhus, & Hare, 2007), the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995), and the Psychopathic Personality Inventory–R (PPI–R; Lilienfeld & Widows, 2005). A coherent 4-factor structure resulted from conducting an exploratory factor analysis (EFA) of the psychopathy subscales along with the domains from the five-factor model. Two of these factors were consistent with traditional conceptualizations of a 2-factor structure of psychopathy (i.e., Factor 1, which loaded negatively with Agreeableness; Factor 2, which loaded negatively with Conscientiousness), while 2 additional factors emerged, 1 of which emphasized low Neuroticism and 1 of which emphasized traits related to novelty/reward-seeking and dominance-related personality traits (high Extraversion). We also investigated the relations of these factors with a variety of externalizing behaviors (EB). The psychopathy scales indicative of interpersonal antagonism (i.e., Factor 1) were most consistently and strongly related to EB. Our findings are discussed in terms of the importance of a trait-based perspective in the assessment of psychopathy. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Does Psychopathy Predict Institutional Misconduct Among Adults? A Meta-Analytic Investigation.

Narrative reviews have raised several questions regarding the predictive validity of the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 2003) and related scales in institutional settings. In this meta-analysis, the authors coded 273 effect sizes to investigate the association between the Hare scales and a hierarchy of increasingly specific forms of institutional misconduct. Effect sizes for Total, Factor 1, and Factor 2 scores were quite heterogeneous overall and weakest for physically violent misconduct (rw = .17, .14, and .15, respectively). Moderator analyses suggested that physical violence effect sizes were smaller in U.S. prison samples (rw = .11) than in non-U.S. prison samples (rw = .23). Findings are discussed in terms of the utility of the Hare measures for decision-making in institutional and other contexts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intelligence, personality, and criminal violence: A multivariate analysis.

The L. R. Huesmann et al (1978) Validity (F)?+?Psychopathic Deviate (Pd)?+?Hypomania (Ma) MMPT index of aggression and A. B. Heilbrun's (see record 1979-25100-001) hypothesis regarding the interaction of intelligence and psychopathy in relation to violent behavior were evaluated with 390 adult male offenders, mean age 26.2 yrs. The F?+?Pd?+?Ma composite did not differentiate significantly between inmates who had been classified according to the violent or nonviolent nature of their most recent offenses, although it was positively correlated with Ss' lifetime total number of violent convictions. Nonetheless, this latter correlation was of extremely small magnitude, and the combination of scales F, Pd, and Ma performed no better than Pd alone. Low levels of intellectual functioning were associated with violent crime in all analyses; however, contrary to Heilbrun, the relationship of intelligence and psychopathy to violence was found to be linear and additive rather than interactive, regardless of whether psychopathy was defined as F?+?Pd?+?Ma or as Pd only. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy in female inmates: The SCID-II Personality Questionnaire and the PCL-R.

The authors examined the relationship between personality disorders, as measured by a self-report screening instrument, and psychopathy as measured by the Psychopathy Checklist (PCL-R; R. D. Hare, 1991) in female inmates. Participants included 136 women from a maximum security state prison. There was a positive relationship between the Antisocial Personality Disorder (APD) scale, which measures conduct disorder before age 15, and the Factor 2 scale of the PCL-R; no other significant relationships with other personality scales were obtained, and there were no evident relationships between any of the personality scales and the Factor 1 scale of the PCL-R. A discriminant function analysis and follow-up receiver operating characteristics analysis indicated that the use of a criterion of 3 endorsed conduct disorder items from the 15-item APD scale was sufficient to correctly identify 71.9% of the women who had been identified as meeting the criterion for psychopathy using the PCL-R interview. However, the scale evidenced poor prediction of nonpsychopaths (specificity = 52.8%). Results indicate the value of using the self-report of conduct disorder items as part of a screening procedure in concert with other measures to select inmates who require further assessment of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol and drug abuse-dependence disorders in psychopathic and nonpsychopathic criminal offenders.

Co-occurrence of psychopathy (assessed with the Revised Psychopathy Checklist [R. D. Hare, 1985]) and lifetime Diagnostic and Statistical Manual of Mental Disorders (DSM-III) alcohol and drug disorders (assessed with the Diagnostic Interview Schedule; National Institute of Mental Health) was examined in a sample of 360 male inmates. Consistent with previous research that used diagnoses of antisocial personality disorder, psychopaths were more likely than nonpsychopaths to have lifetime diagnoses of alcoholism, any drug disorder, and multiple drug disorder. The relation between substance abuse and the 2 factors of the Revised Psychopathy Checklist was also examined. Substance abuse was significantly related to general social deviance (Factor 2) but was unrelated to core personality features of psychopathy (Factor 1). Two possible models of psychopathy (unitary syndrome vs dual-diathesis model) are presented that may account for the association between psychopathy and substance abuse. (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)     

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)     

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)     

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)     

Dual temperamental risk factors for psychopathic personality: Evidence from self-report and skin conductance.

Psychopathy is a personality disorder consisting of dysfunctional affective interpersonal features (Factor 1) and impulsive-antisocial behavior (Factor 2) that exhibit differential associations with palmar skin conductance (SC) reactivity. The goal of this study was to determine whether the distinct SC reactivity observed in incarcerated psychopaths generalizes to university students who score high on personality dimensions hypothesized to be the risk factors for these psychopathy factors. Lilienfeld's Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) was used to compute scores on 2 factor-analytically derived dimensions that have been the focus of recent research in psychopathy. PPI-1 is hypothesized to relate to the low-fear temperamental risk factor, whereas PPI-2 is hypothesized to relate to regulatory dysfunction. SC reactivity was measured during tasks previously used in studies of diagnosed psychopaths. Results indicated that PPI-1 was associated with reduced SC during anticipation of an aversive noise and PPI-2 was associated with enhanced SC reactivity during presentation of a speech about one's faults. Additional analyses explored an 8-factor solution of the PPI and 3 temperament dimensions derived from factor analysis of several personality measures. Together, the SC results suggest that the Factor 1 pathway, best captured with refined assessments of behavioral fearlessness, related to reduced SC reactivity to an aversive noise—consistent with a weak defense system. The Factor 2 pathway, best captured by higher order dimensions reflecting externalizing, disinhibited forms of negative temperament, related to enhanced SC reactivity to a speech stressor—consistent with high stress reactivity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

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

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