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)     

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)     

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)     

Review of The psychopath: Theory, research and practice.

Reviews the book, The psychopath: Theory, research and practice edited by Hugues Hervé and John C. Yuille (see record 2006-11788-000). This book begins with an historical overview of the construct of psychopathy and then works its way through a variety of important issues, including measurement, etiology, behavioural manifestations of the disorder, typologies, and practice considerations. A few notable exceptions notwithstanding, this text is a fine primer on psychopathy: It includes a number of outstanding chapters and other important issues in the area of psychopathy receive solid treatment. Although there is occasionally some drop-off in quality, I suspect that even the less outstanding chapters in this book would prove informative for students, lay consumer groups, and clinicians who do not routinely work with psychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating the construct validity of psychopathy in Black and White male inmates: Three preliminary studies.

Although Black inmates represent almost half the population of United States prisons and have been included in several studies of psychopathy, there appear to be no published studies to date addressing the validity of the psychopathy construct in Black inmates. Three studies were conducted to assess the validity of the construct in Black male inmates using Hare's Psychopathy Checklist (PCL). In Study 1, we examined the internal structure of the PCL and the relation of checklist scores to several constructs relevant to psychopathy. We observed differences between Blacks and Whites in the distribution of psychopathy scores, in the relation of psychopathy to measures of impulsivity, and in the congruence of the underlying factor structure of the PCL. In Study 2, Black psychopaths were found to manifest a pattern of passive avoidance deficits similar but not identical to that reported for White psychopaths in Newman and Kosson's study. Study 3 demonstrated that psychopaths of both races receive more criminal charges in a wider variety of offense categories than do nonpsychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Two subtypes of psychopathic violent offenders that parallel primary and secondary variants." Correction to Skeem et al. (2007).

Reports an error in "Two subtypes of psychopathic violent offenders that parallel primary and secondary variants" by Jennifer Skeem, Peter Johansson, Henrik Andershed, Margaret Kerr and Jennifer Eno Louden (Journal of Abnormal Psychology, 2007[May], Vol 116[2], 395-409). 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). (The following abstract of the original article appeared in record 2007-06673-015.) 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)     

One measure does not a construct make: Directions toward reinvigorating psychopathy research—reply to Hare and Neumann (2010).

In our article by J. L. Skeem & D. J. Cooke, (2010), we outlined the dangers inherent in conflating the Psychopathy Checklist—Revised (PCL–R; R. Hare, 1991) with psychopathy itself. In their response, R. Hare and C. Neumann (2010) seemed to agree with key points that the PCL–R should not be confused with psychopathy and that criminal behavior is not central to psychopathy; at the same time, they said we provided no clear directions for theory or research. In this rejoinder, we clarify our argument that progress in understanding the unobservable construct of psychopathy hinges upon setting aside procrustean dependence on a monofocal PCL–R lens to test (a) actual theories of psychopathy against articulated validation hierarchies and (b) the relation between psychopathy and crime. In specifying these conceptual and applied directions, we hope to promote constructive dialogue, further insights, and a new generation of research that better distinguishes between personality deviation and social deviance. (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)     

Facial affect recognition in criminal psychopaths.

Prior studies provide consistent evidence of deficits for psychopaths in processing verbal emotional material but are inconsistent regarding nonverbal emotional material. To examine whether psychopaths exhibit general versus specific deficits in nonverbal emotional processing, 34 psychopaths and 33 nonpsychopaths identified with Hare's (R. D. Hare, 1991) Psychopathy Checklist-Revised were asked to complete a facial affect recognition test. Slides of prototypic facial expressions were presented. Three hypotheses regarding hemispheric lateralization anomalies in psychopaths were also tested (right-hemisphere dysfunction, reduced lateralization, and reversed lateralization). Psychopaths were less accurate than nonpsychopaths at classifying facial affect under conditions promoting reliance on right-hemisphere resources and displayed a specific deficit in classifying disgust. These findings demonstrate that psychopaths exhibit specific deficits in nonverbal emotional processing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathic, not psychopath: Taxometric evidence for the dimensional structure of psychopathy.

Although psychopathy is frequently regarded as qualitatively distinct from other conditions, relatively little research has examined whether psychopaths represent a distinct class of individuals. Using a sample of 876 prison inmates and court-ordered substance abuse patients who were administered the Psychopathy Checklist-Revised (R. D. Hare, 2003), the authors examined the latent structure of psychopathy using several taxometric procedures developed by Meehl and colleagues (P. E. Meehl & L. J. Yonce, 1994; N. G. Waller & P. E. Meehl, 1998). The results across these procedures offer no compelling support for the contention that psychopathy is a taxonic construct and contradict previous reports that psychopathy is underpinned by a latent taxon. The authors discuss the theoretical, public policy, and practice-level implications of these findings. (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)     

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)     

Reduced lateralization in verbal dichotic listening in adolescent psychopaths.

One possible explanation for previous findings of abnormal linguistic processing in psychopaths is that they are less lateralized for verbal processes. This study tests the hypothesis that adolescent psychopaths show evidence of reduced lateralization on a verbal dichotic listening task. Four self-report and behavioral measures of psychopathy were used to define psychopathy using cluster analytic techniques in 40 juvenile offenders aged 13 to 18 years. Psychopaths were found to have reduced ear asymmetries relative to nonpsychopaths, a result indicating reduced lateralization for verbal material. The effect does not appear to be mediated by group differences in age, ethnic background, IQ, overall performance, left-handedness, selective attention to one ear, or interhemispheric transfer deficits. This result suggests that the previous finding by R. D. Hare and L. M. McPherson (see record 1984-23362-001) is robust, provides some preliminary validity for the assessment of psychopathy before age 18, and indicates initial support for the utility of cluster analytic techniques in the assessment of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive abstraction, shifting, and control: Clinical sample comparisons of psychopaths and nonpsychopaths.

Gorenstein (1982) suggested that psychopaths exhibit deficits in cognitive processes commonly associated with frontal lobe functioning, but other investigators reported collecting findings (Hare, 1984; Sutker, Moan, & Allain, 1983). There is also evidence indicating that intellectual level influences performances in measures of frontal lobe integrity and mitigates against expression of cognitive dyscontrol especially among psychopaths. The present study extended previous research by comparing clinical samples of psychopaths and nonpsychopaths identified by object instrument and behavioral self-report data. Dependent measures included test of concept formation, abstraction, flexibility, planning, and control. Compared to men defined as normal controls, male psychopaths showed no greater deficits in abstraction, flexibility, control, or planning. Intelligence significantly influenced performances on dependent measures for both groups. Results suggest that analogies between psychopathy and frontal lobe deficits are premature, if not unsupported. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Validity of Rorschach Inkblot scores for discriminating psychopaths from nonpsychopaths in forensic populations: A meta-analysis.

Gacono and Meloy (2009) have concluded that the Rorschach Inkblot Test is a sensitive instrument with which to discriminate psychopaths from nonpsychopaths. We examined the association of psychopathy with 37 Rorschach variables in a meta-analytic review of 173 validity coefficients derived from 22 studies comprising 780 forensic participants. All studies included the Hare Psychopathy Checklist or one of its versions (Hare, 1980, 1991, 2003) and Exner's (2003) Comprehensive System for the Rorschach. Mean validity coefficients of Rorschach variables in the meta-analysis ranged from ?.113 to .239, with a median validity of .070 and a mean validity of .062. Psychopathy displayed a significant and medium-sized association with the number of Aggressive Potential responses (weighted mean validity coefficient = .232) and small but significant associations with the Sum of Texture responses, Cooperative Movement = 0, the number of Personal responses, and the Egocentricity Index (weighted mean validity coefficients = .097 to .159). The remaining 32 Rorschach variables were not significantly related to psychopathy. The present findings contradict the view that the Rorschach is a clinically sensitive instrument for discriminating psychopaths from nonpsychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathy and autonomic responsivity: A note on the importance of diagnosis.

Claims that criticism by R. D. Hare (see record 1972-29421-001) of the authors' findings of autonomic responsivity to epinephrine in psychopaths arises from misunderstanding of their program and lack of concern with the biology of psychopathy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reliability of file-based retrospective ratings of psychopathy with the PCL-R

A rapidly emerging consensus recognizes Hare's Psychopathy Checklist-Revised (PCL-R; Hare, 1991) as the most valid and useful instrument to assess psychopathy (Fulero, 1995; Stone, 1995). We compared independent clinical PCL-R ratings of 40 forensic adult male criminal offenders to retrospective file-only ratings. File-based PCL-R ratings, in comparison to the clinical ratings, yielded categorical psychopathy diagnoses with a sensitivity of .57 and a specificity of .96. The intraclass correlation (ICC) of the total scores as estimated by ICC(2,1) was .88, and was markedly better on Factor 2, ICC(2,1) = .89, than on Factor 1, ICC(2,1) = .69. The findings support the belief that for research purposes, file-only PCL-R ratings based on Swedish forensic psychiatric investigation records can be made with good alternate-form reliability.     

The role of antisociality in the psychopathy construct: Comment on Skeem and Cooke (2010).

J. Skeem and D. J. Cooke (2010) asserted that Hare and Neumann consider criminality to be an essential component of the psychopathy construct. The assertion, presented in the guise of a debate on the nature of psychopathy, is neither accurate nor consistent with the clinical and empirical literature on psychopathy to which Hare and Neumann have contributed. Broadly defined antisociality, not criminality per se, is considered to be part of the psychopathy construct. Skeem and Cooke also expressed concerns that the popularity of the Psychopathy Checklist—Revised (R. D. Hare, 2003) inhibits the development and use of other instruments, that it has become the construct it measures, that it deviates from its clinical roots, and that it conflates criminality with personality. These and related issues are addressed, and it is suggested that the arguments proffered by Skeem and Cooke are not convincing, nor do they provide clear directions for theory and research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A clinical and virological study of hepatitis C virus-related cryoglobulinemia in Germany

A key feature of psychopathy is the ability to deceive, manipulate, and con the unwary, while seeming to be perfectly sincere. Is this impression of sincerity achieved solely through body gestures and facial expression, or is there also something different about the voice quality of psychopaths? We analyzed the acoustic characteristics of speech in 20 male offenders (10 psychopaths and 10 nonpsychopaths), assessed with the Psychopathy Checklist--Revised (Hare, 1991). We used a computer program developed by Alpert, Merewether, Homel, Martz, and Lomask (1986) to measure variations in amplitude and prosody. Results indicated that psychopaths spoke more quietly than controls and did not differentiate, in voice emphasis, between neutral and affective words. These findings are consistent with the developing view that psychopaths are insensitive to the emotional connotations of language. In addition, their vocal characteristics may be part of a self-presentation mode designed to manipulate and control interpersonal interactions.     

Emotion in the criminal psychopath: Fear image processing.

We tested the hypothesis that the response mobilization that normally accompanies imagery of emotional situations is deficient in psychopaths. Cardiac, electrodermal, and facial muscle responses of 54 prisoners, assigned to low- and high-psychopathy groups using R. D. Hare's (1991) Psychopathy Checklist—Revised, were recorded while subjects imagined fearful and neutral scenes in a cued sentence-processing task. Groups did not differ on self-ratings of fearfulness, imagery ability, or imagery experience. Low-psychopathy subjects showed larger physiological reactions during fearful imagery than high-psychopathy subjects. Extreme scores on the antisocial behavior factor of psychopathy predicted imagery response deficits. Results are consistent with the idea that semantic and emotional processes are dissociated in psychopaths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)