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.     

Are all psychopathic individuals low-anxious?

Theorists commonly assume that true or primary psychopathic individuals experience little anxiety or neurotic conflict. This study examined the relationship between psychopathy and anxiety in 104 Caucasian and 113 African American incarcerated men using the Psychopathy Checklist--Revised (PCL-R; R. D. Hare, 1991) and multiple self-report measures to tap diverse interpretations of the anxiety construct (i.e., neuroticism, traditional definitions of anxiety, and fear). Analyses involving zero-order, semipartial, and point-biserial correlations indicate that PCL-R psychopathy and the anxiety construct are essentially independent. These findings suggest that either (a) the traditional belief that all psychopathic individuals are low-anxious is incorrect or (b) the PCL-R is not an adequate measure of primary psychopathy.     

Psychopathy and Trait Emotional Intelligence

Psychopathic individuals are infamous for their chronic and diverse failures of social adjustment despite their adequate intellectual abilities. Non-cognitive factors, in particular trait emotional intelligence (EI), offer one possible explanation for their lack of success. This study explored the association between psychopathy and EI, as measured by the Psychopathy Checklist - Revised (PCL-R; Hare, 2003) and Trait Meta-Mood Scale (TMMS, Salovey, Mayer, Golman, Turvey & Palfai, 1995). Consistent with the Response Modulation (RM) model of psychopathy (Newman & Lorenz, 2003), low-anxious psychopathic individuals had significantly lower scores on TMMS Repair and Attention compared to controls. Consistent with proposals by Patrick and Lang (1999) regarding PCL-R factors, these EI deficits related to different aspects of the psychopathy construct. Correlations revealed significant inverse associations between PCL-R factor 1 and Attention and PCL-R factor 2 and Repair. We propose that the multi-dimensional EI framework affords a complementary perspective on laboratory-based explanations of psychopathy.     

Differentiating emotional processing and attention in psychopathy with functional neuroimaging

Individuals with psychopathy are often characterized by emotional processing deficits, and recent research has examined the specific contexts and cognitive mechanisms that underlie these abnormalities. Some evidence suggests that abnormal features of attention are fundamental to emotional deficits in persons with psychopathy, but few studies have demonstrated the neural underpinnings responsible for such effects. Here, we use functional neuroimaging to examine attention–emotion interactions among incarcerated individuals (n = 120) evaluated for psychopathic traits using the Hare Psychopathy Checklist–Revised (PCL-R). Using a task designed to manipulate attention to emotional features of visual stimuli, we demonstrate effects representing implicit emotional processing, explicit emotional processing, attention-facilitated emotional processing, and vigilance for emotional content. Results confirm the importance of considering mechanisms of attention when evaluating emotional processing differences related to psychopathic traits. The affective-interpersonal features of psychopathy (PCL-R Factor 1) were associated with relatively lower emotion-dependent augmentation of activity in visual processing areas during implicit emotional processing, while antisocial-lifestyle features (PCL-R Factor 2) were associated with elevated activity in the amygdala and related salience network regions. During explicit emotional processing, psychopathic traits were associated with upregulation in the medial prefrontal cortex, insula, and superior frontal regions. Isolating the impact of explicit attention to emotional content, only Factor 1 was related to upregulation of activity in the visual processing stream, which was accompanied by increased activity in the angular gyrus. These effects highlight some important mechanisms underlying abnormal features of attention and emotional processing that accompany psychopathic traits.     

Psychopathic traits associated with abnormal hemodynamic activity in salience and default mode networks during auditory oddball task

Psychopathy is a personality disorder accompanied by abnormalities in emotional processing and attention. Recent theoretical applications of network-based models of cognition have been used to explain the diverse range of abnormalities apparent in psychopathy. Still, the physiological basis for these abnormalities is not well understood. A significant body of work has examined psychopathy-related abnormalities in simple attention-based tasks, but these studies have largely been performed using electrocortical measures, such as event-related potentials (ERPs), and they often have been carried out among individuals with low levels of psychopathic traits. In this study, we examined neural activity during an auditory oddball task using functional magnetic resonance imaging (fMRI) during a simple auditory target detection (oddball) task among 168 incarcerated adult males, with psychopathic traits assessed via the Hare Psychopathy Checklist-Revised (PCL-R). Event-related contrasts demonstrated that the largest psychopathy-related effects were apparent between the frequent standard stimulus condition and a task-off, implicit baseline. Negative correlations with interpersonal-affective dimensions (Factor 1) of the PCL-R were apparent in regions comprising default mode and salience networks. These findings support models of psychopathy describing impaired integration across functional networks. They additionally corroborate reports which have implicated failures of efficient transition between default mode and task-positive networks. Finally, they demonstrate a neurophysiological basis for abnormal mobilization of attention and reduced engagement with stimuli that have little motivational significance among those with high psychopathic traits.     

An empirical investigation of psychopathy in a noninstitutionalized and noncriminal sample

This study examined the construct of psychopathy using the Psychopathy Checklist-Revised (PCL-R) in 54 participants from the general population. To obtain a sample of community participants with psychopathic characteristics, participants were recruited using advertisements for a "personality study" that incorporated the characteristics of psychopathy in a nonpejorative manner. The methodology successfully recruited community participants with moderately elevated PCL-R scores. Participants exhibited the personality features of psychopathy (Factor 1) to a greater extent than the behavioral features (Factor 2), which is consistent with the results obtained with the PCL-R normative samples. Roughly 40% of the sample reported no history of involvement with the criminal justice system, yet these participants exhibited moderately elevated PCL-R scores. Moreover, a sizeable portion of the noncriminal participants reported a substantial history of violent behavior. Comparisons of PCL-R scores between participants with and without a criminal history suggest that these two groups differ in ways unrelated to criminal justice system involvement.     

Validity of factors of the Psychopathy Checklist--Revised in female prisoners: discriminant relations with antisocial behavior, substance abuse, and personality

The validity of the Psychopathy Checklist-Revised (PCL-R) has been examined extensively in men, but its validity for women remains understudied. Specifically, the correlates of the general construct of psychopathy and its components as assessed by PCL-R total, factor, and facet scores have yet to be examined in depth. Based on previous research conducted with male offenders, a large female inmate sample was used to examine the patterns of relations between total, factor, and facet scores on the PCL-R and various criterion variables. These variables include ratings of psychopathy based on Cleckley's criteria, symptoms of antisocial personality disorder, and measures of substance use and abuse, criminal behavior, institutional misconduct, interpersonal aggression, normal range personality, intellectual functioning, and social background variables. Results were highly consistent with past findings in male samples and provide further evidence for the construct validity of the PCL-R two-factor and four-facet models across genders.     

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.     

Two subtypes of psychopathic violent offenders that parallel primary and secondary variants

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 > or = 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.     

Reconstructing psychopathy: clarifying the significance of antisocial and socially deviant behavior in the diagnosis of psychopathic personality disorder

A survey of clinical views suggests that the significance of antisocial and socially deviant behavior in the diagnosis of psychopathic personality disorder is unclear. To investigate this issue, we evaluated Psychopathy Checklist-Revised ratings (PCL-R; Hare, 1991) using structural equation modeling. One model, referred to as the measurement model, included PCL-R ratings related to antisocial behavior as primary symptoms of psychopathy; a second, referred to as the causal model, included the same PCL-R ratings as secondary symptoms or consequences. Compared to the measurement models, the causal model included more PCL-R items, was more parsimonious, and had equal or superior fit indices. These findings suggest that antisocial behavior is best viewed as a secondary symptom or consequence of psychopathy, In addition, the findings have important implications for future research and clinical-forensic practice, especially concerning the assessment of risk for criminality and violence.     

Hare Psychopathy Checklist-Revised

The Hare Psychopathy Checklist-Revised (PCL-R) is among the most frequently used instruments for the assessment of psychopathic traits. In the scope of the German adaptation of the PCL-R, normative data were collected from a sample of adult male offenders. Based on these data the factor structure and reliability of the German language version of the PCL-R are discussed in the first section of the article. The assessment of a model with four facets and two superordinate factors showed a very good agreement with the empirical data. In addition, examination of interrater agreement and internal consistency indicated that the PCL-R is a reliable measure. In the second part of the paper recommendations are provided for the correct application of the PCL-R. The focus lies on the correct performance, evaluation and interpretation of PCL-R test results with respect to key indices and the dimensional structure of the psychopathy construct.     

Personality disorders and psychopathy in men convicted for severe intimate partner violence

In this paper, a study of personality disorders and psychopathy in imprisoned male batterers is carried out. A sample of 76 batterers sentenced for a severe offence of violence against their intimate partner was selected. All the participants were assessed with the MCMI-II before beginning a treatment program in prison for gender violence. Likewise, all participants were assessed with the PCL-R in order to identify psychopathic symptoms. According to the results, 86.8% of the sample showed at least one personality disorder. The most prevalent one was the Obsessive-compulsive Personality Disorder (57.8% of cases), followed by the Dependent Personality Disorder (34.2% of cases) and Paranoid Personality Disorder (25%). Regarding psychopathy, the results of PCL-R showed that there were 11 people (14.4% of the sample) who met the criteria for psychopathy or probable psychopathy. Finally, implications of this study for clinical practice and future research in this field are commented upon.     

Reconstruing the "reconstruction" of psychopathy: a comment on Cooke, Michie, Hart, and Clark

In this comment we highlight critical problems in the estimation of parameters for their hierarchical three-factor model of psychopathy, as assessed with the Hare Psychopathy Checklist, and their interpretation of these factors as causally related to socially deviant behavior. We argue that there is nothing "causal" about a model in which cross-sectional data are used to assert that antisocial tendencies are consequences of other more fundamental psychopathic traits. We present an equally viable model, based on the PCL-R four-factor solution, in which antisocial tendencies play a fundamental role in the construct of psychopathy, consistent with previous research and clinical tradition.     

Turning a deaf ear to fear: impaired recognition of vocal affect in psychopathic individuals

The processing of emotional expressions is fundamental for normal socialization and interaction. Reduced responsiveness to the expressions of sadness and fear has been implicated in the development of psychopathy (R. J. R. Blair, 1995). The current study investigates the ability of adult psychopathic individuals to process vocal affect. Psychopathic and nonpsychopathic adults, defined by the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991), were presented with neutral words spoken with intonations conveying happiness, disgust, anger, sadness, and fear and were asked to identify the emotion of the speaker on the basis of prosody. The results indicated that psychopathic inmates were particularly impaired in the recognition of fearful vocal affect. These results are interpreted with reference to the low-fear and violence inhibition mechanism models of psychopathy.     

Selected Rorschach variables of psychopathic juvenile offenders

Despite the widely accepted utility of assessing psychopathic personality features in forensic and clinical settings, the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991) stands virtually alone in its ability to do so with adequate reliability and validity. Recent studies have demonstrated the effectiveness of the Rorschach Inkblot Method in assessing psychopathy in adult samples, but almost no studies are currently available investigating the Rorschach's ability to assess the condition in younger samples of precisely defined psychopathic groups. In this study, 66 male juvenile offenders, ages 14 to 17, were placed into 3 groups according to level of psychopathy as measured by the youth version of the PCL-R (PCL:YV; Forth, 1995). Nine Rorschach variables conceptually related to various psychopathic features were investigated. Two of the variables (Reflections and Texture Responses) demonstrated statistically significant differences across groups (p < .05). Two additional variables (Vista and White Space) were produced in patterns consistent with existing research, although only to a weak degree. The remaining variables (Egocentricity Index, Form Dimension, Pure Human Content, Inanimate Movement, and Diffuse Shading) did not differ across groups in the predicted directions. Overall, these results offer some support for the validity of the Rorschach as a method of detecting certain psychopathic personality features, including pathological narcissism and interpersonal detachment, in adolescent male offenders.     

The role of psychopathic personality disorder in violence risk assessments using the HCR-20

Antisocial and psychopathic traits are essential to evaluate when assessing risk for violence using the HCR-20. The role of the PCL-R on the HCR-20 was investigated using a series of meta-analytic tests. Across 34 samples in which both tools were rated, AUCs for violence were similar (～.69), and exclusion of the psychopathy item (H7) did not reduce the HCR-20's accuracy. Quantitative synthesis of results from multivariate analyses conducted in 7 raw datasets that used both tools demonstrated that the average probability of observing violence for every point increase on the HCR-20 (without H7), while controlling for the PCL-R, was 23%, whereas for the PCL-R it was -1%. The HCR-20 (without H7) added incremental validity to the PCL-R, whereas the converse was not true, and only the HCR-20 (without H7) possessed unique predictive validity. Results suggest the HCR-20's predictive validity was not negatively impacted by excluding the PCL-R. Areas for future study are discussed, including research on various ways to assess and incorporate into risk assessment personality traits related to violence.     

精神病态暴力犯执行功能的缺陷*

为了解精神病态罪犯可能存在的执行功能缺陷及其是否受冲动性影响,研究采用精神病态检核表（PCL-R）筛选出30名精神病态组被试和30名非精神病态组被试,通过爱荷华赌博任务（IGT）和河内塔任务（TOH）对两组被试执行功能的特点进行分析,并结合冲动性量表（BIS-11）对其冲动性进行测量。研究发现精神病态组的冲动性显著高于控制组;精神病态组选择高风险的不利牌显著多于对照组,即对惩罚不敏感;精神病态组在河内塔任务中的错误次数及所消耗时间都显著高于控制组;冲动性水平与两任务得分均无显著相关。结果表明,精神病态暴力犯在与前额叶相关的执行功能上存在缺陷,并与个体的高冲动性无关。     

Domestic violence and psychopathic traits: distinguishing the antisocial batterer from other antisocial offenders

The proliferation of specialized domestic batterer treatment programs suggests that batterers differ from other offenders in important ways. The psychopathic personality represents a constellation of personality traits, which may be relevant to the differentiation of batterers from other offenders. In a sample of 172 county jail inmates, we examined whether antisocial batterers can be distinguished from the larger pool of antisocial offenders on the basis of the four-facet model of psychopathy identified for the Psychopathy Checklist-Revised (PCL-R). Batterer/non-batterer status was positively related to the PCL-R affective facet and negatively related to the lifestyle facet, but there was no significant relationship between PCL-R total scores and this criterion. Results suggest that antisocial batterers are characterized by deficient affective experience and by reduced impulsivity and irresponsibility compared with other antisocial offenders. Implications are discussed in light of specialized treatments for batterers.     

Gender differences in psychopathy in a Swedish offender sample

In this study we examined gender differences in the PCL:SV employing a variety of statistical methods with two subsets of psychopathic individuals drawn from larger samples of 129 female and 499 male Swedish offenders. The larger samples included forensic psychiatric patients, forensic psychiatric evaluees and criminal offenders. We found gender differences in antisocial behavior, as defined in factor 2 of the PCL:SV, with female psychopaths (PCL:SV>or=18) displaying significantly more lying, deceitfulness and lack of control, while male psychopaths were more antisocial as measured by the PCL:SV. We conclude that it might be meaningful to use gender specific definitions in the assessment of psychopathy or, alternatively, slightly revise the diagnostic tools. Our results support the use of the three-factor model of the PCL-R and PCL:SV introduced by Cooke and Michie (2001) in female populations.     

The impact of mental health evidence on support for capital punishment: are defendants labeled psychopathic considered more deserving of death?

Controversy surrounds the use of the Hare Psychopathy Checklist--Revised (Hare, 1991, 2003) in capital murder cases, where it has been introduced to support prosecution claims that a defendant represents a "continuing threat to society". Although widely presumed to have a prejudicial impact (e.g., American Psychological Association, 2004), little is known about how the lay public reacts to data derived from ostensibly stigmatizing assessment instruments such as the PCL-R. The present study examined the effect of psychopathy data on layperson attitudes by having 203 undergraduates review a capital murder case where the results of the defendant's psychological evaluation were experimentally manipulated. When expert testimony described the defendant as psychopathic, a much larger percentage of participants supported a death sentence (60%) than when testimony indicated that he was psychotic (30%) or not mentally disordered (38%). Interestingly, participant ratings of how psychopathic they perceived the defendant to be--regardless of the testimony condition to which they had been assigned--also predicted support for a death sentence. Given the limited probative value of the PCL-R in capital cases and the prejudicial nature of the effects noted in this study, we recommend that forensic examiners avoid using it in these trials.