Psychopathy is related to negative affectivity but not to anxiety sensitivity

Although the hypothesis that psychopathic individuals are characterized by a reduced capacity for experiencing anxiety is central to many theories of psychopathy, most prior studies have examined anxiety and fear measures generally considered outdated in the literature. Moreover, prior findings are mixed, with several studies reporting no relationships between psychopathy and anxiety, and others suggesting negative relationships for the affective, interpersonal aspects of the disorder and positive relationships for the antisocial behavior dimension. To examine whether psychopathy dimensions are associated with contemporary measures of anxiety, the Anxiety Sensitivity Index and State Trait Anxiety Inventory-Trait scale were administered to 157 male inmates. Participants also completed the MMPI-derived Welsh Anxiety Scale (WAS), commonly used in psychopathy studies. Analyses provide no evidence for a negative relationship between psychopathy's affective, interpersonal factor and anxiety sensitivity after controlling for trait anxiety. Trait anxiety and WAS scores were positively associated with the antisocial behavior dimension of psychopathy. Findings do replicate prior relationships between the WAS and psychopathy, suggesting the WAS may measure aspects of negative affectivity that differ from anxiety.     

Psychopathy, antisocial personality, and suicide risk

H. Cleckley (1976) maintained that psychopaths are relatively immune to suicide, but substantial evidence exists for a relationship between antisocial deviance and suicidal acts. This study was the first to explicitly examine suicidal history among psychopathic individuals as defined by R. D. Hare's (1991) Psychopathy Checklist--Revised (PCL-R). Male prison inmates (N = 313) were assessed using the PCL-R and DSM-III-R and DSM-IV criteria (American Psychiatric Association, 1987, 1994) for antisocial personality disorder (APD), and they completed A. Tellegen's (1982) Multidimensional Personality Questionnaire (MPQ). Presence or absence of prior suicide attempts was coded from structured interview and prison file records. Suicide history was significantly related to PCL-R Factor 2 (which reflects chronic antisocial deviance) and to APD diagnosis but was unrelated to PCL-R Factor 1, which encompasses affective and interpersonal features of psychopathy. Higher order MPQ dimensions of Negative Emotionality and low Constraint were found to account for the relationship between history of suicidal attempts and antisocial deviance, indicating that temperament traits may represent a common vulnerability for both.     

Psychopathy and Responsibility

Some philosophers have argued that the psychopath serves as the ultimate test of the limits of moral responsibility. They hold that the psychopath lacks a deep knowledge of right and wrong, and that Kant's ethics arguably offers the most plausible account of this moral knowledge. On this view, the psychopath's lack of moral understanding is due to a cognitive failure involving practical reason. I argue that the deep knowledge of right and wrong consists of emotional and volitional components in addition to a cognitive one. Hence it is mistaken to claim that the psychopath's moral deficiency is due solely to a cognitive failure, or that his lack of the deep knowledge of right and wrong can be explained entirely in terms of a defect of practical reason. I refer to empirical research to show that the Kantian model of practical reason does not provide a satisfactory account of responsibility of the psychopath in particular or of moral agents in general. On the basis of both philosophical and empirical considerations, I argue that the psychopath is at least partly responsible for his behaviour.     

Neurological malingering

The detection of malingering in terms of neurologic signs and symptoms is described, including malingered coma, simulated deafness, feigned blindness, feigned weakness, and diminished sensation. While neurologic malingering is not an actual diagnosis, it is best detected through medical procedures. To identify malingering, the physician must demonstrate that the malingered sign or symptom is not caused by a diagnosable order and is instead clearly a consequence of the subject's volition.     

Psychopathy and traumatic stress

This study examined the relationship between psychopathy and traumatic stress. First, a sample of 48 male patients in a security hospital was assessed using the Psychopathy Checklist (Hare, 2003) and the Stanford Acute Stress Reactions Questionnaire (SASRQ; Cardena, Classen, Koopman, & Spiegel, 1996). Linear regression analyses suggested that the affect deficit component of psychopathy was the best negative predictor of avoidance, dissociation, and re-experiencing symptoms. The 13 highest-scoring psychopathy participants were then compared to the 13 lowest-scoring participants. Psychopaths differed from controls in terms of number but not type of traumatic events. They obtained significantly lower SASRQ total score, reflecting a lower level of traumatic symptomatology. The results are discussed in connection with the emotional deficit component of psychopathy.     

Correlates of malingering

The author presented anonymous questionnaires to 172 patients and 160 medical students to assess the frequency and correlates of malingering in various groups in a medical center on a V.A. campus. The results indicate that sociopaths, drug abusers, and alcoholics are more prone to malinger than other individuals, supporting previous assertions that mental health professionals should have a higher index of suspicion for malingering in these diagnostic groups. Race and age were found to have small but significant correlations with malingering, but at present, this finding must be viewed cautiously. No association was found between somatization disorder and malingering.     

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.     

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.     

An examination of the Validity of the Elemental Psychopathy Assessment: Relations with Other Psychopathy Measures,Aggression, and Externalizing Behaviors

The Elemental Psychopathy Assessment (EPA) is a new self-report measure of psychopathy designed to assess the personality traits associated with psychopathy from a Five Factor Model perspective. The current study examined the validity of the EPA in sample of undergraduates by examining the relations between the EPA scales and three validated self-report psychopathy instruments, as well as assessments of aggression, substance use, and antisocial behavior. The EPA scales manifested strong convergent validity with the extant psychopathy measures and an expected pattern of relations with measures of externalizing behaviors. Overall, the EPA appears to be a promising measure of psychopathy which provides new opportunities to explore the underlying structure of this construct and parse its relations with constructs central to its nomological network.     

Psychopathy and the personality dimensions of psychoticism,extraversion and neuroticism

The Eysenck Personality Questionnaire (EPQ) was administered to 173 male prison inmates for whom reliable assessments of psychopathy were available. Psychopathy was significantly correlated with the Psychoticism (P) scale (r = 0.16) and the Lie scale (r = 0.14), but not with the Extraversion (E) or Neuroticism (N) scales. Zone (octant) analysis indicated that psychopathy was not associated with any particular combination of P, E and N scores. Additional analyses, based on the discriminant function procedure described in the EPQ manual, indicated that inmates with high assessments of psychopathy were significantly less psychiatrically abnormal, in the EPQ sense, than were those with low assessments of psychopathy. A series of comparisons was also made between the P scale and a 22-item psychopathy checklist. The P scale was significantly correlated with six of the items, and with factors 1 (r = 0.30) and 4 (r = 0.19) that emerged from a principal components analysis of the checklist. Factor 1 is related to an impulsive, unstable lifestyle with no long-term commitments and factor 4 to the early appearance of antisocial behavior. It is argued that the P scale reflects the criminal, antisocial aspects of psychopathy and that the results probably have no direct implications for the suggestion that psychopathy and psychoticism are related in some fundamental way. A canonical analysis indicated that some interesting relations may exist between the EPQ variables and the psychopathy factors.     

Mythos and Mental Illness: Psychopathy, Fantasy, and Contemporary Moral Life

Medical accounts of the absence of conscience are intriguing for the way they seem disposed to drift away from the ideal of scientific objectivity and towards fictional representations of the subject. I examine here several contemporary accounts of psychopathy by Robert Hare and Paul Babiak. I first note how they locate the truth about their subject in fiction, then go on to contend that their accounts ought to be thought of as a "mythos," for they betray a telling uncertainty about where "fact" ends and "fantasy" begins, as well as the means of distinguishing mental health from mental illness in regard to some social roles.     

Health anxiety, hypochondriasis, and the anxiety disorders

Although clinical observations suggest that health-related anxiety is present, to some extent, in a number of anxiety disorders, this relationship has not been examined empirically. The present study therefore utilized the Short Health Anxiety Inventory (SHAI) to elucidate the structure of such symptoms among patients with anxiety disorders and to empirically investigate the presence of health anxiety in various anxiety disorders. Confirmatory factor analysis yielded equivalent support for either a 2-factor or 3-factor model of the SHAI's latent structure. The measure demonstrated good reliability, convergent validity, and discriminant validity. Comparison of SHAI scores across groups of patients with various anxiety disorders revealed elevated levels of health anxiety among patients with hypochondriasis and panic disorder relative to those with other anxiety disorders. Receiver operating characteristic analyses supported the utility of the SHAI as a diagnostic tool for screening patients with hypochondriasis utilizing empirically derived cut scores. Findings are discussed in terms of cognitive-behavioral models of anxiety disorders.     

Psychopathy, criminal responsibility, and civil commitment as a sexual predator

Recent judicial decisions regarding commitment under sexual predator statutes and commentary addressing the legal significance of psychopathy provide an interesting opportunity to reflect upon the exculpatory significance of psychopathy and the appropriate relationship between criminal conviction and police power civil commitment. This paper examines the legal significance of psychopathy for the purposes of criminal responsibility and of civil commitment under sexual predator statutes. By examining the significance of psychopathy for each of these legal institutions, it clarifies our understanding of the legal significance of psychopathy and of the relationship between these institutions. This process illuminates the defensible functions and boundaries of each institution and clarifies the nature of the impairment that should qualify an individual for confinement by each. This analysis interprets criminal conviction and police power commitment, including sexual predator commitment, as integrated institutions of social control intended to provide a coherent approach to psychopaths as well as to others who require state intervention under the police power.     

Psychopathy in Bulgaria: The cross-cultural generalizability of the Hare Psychopathy Checklist

The generalizability of the psychopathy construct to Eastern European cultures has not been well-studied, and no prior studies have evaluated psychopathy in non-offender samples from this population. The current validation study examines the factor structure, internal consistency, and external validity of the Bulgarian translation of the Hare Psychopathy Checklist: Screening Version. Two hundred sixty-two Bulgarian adults from the general community were assessed, of which 185 had a history of substance dependence. Confirmatory factor analysis indicated good fit for the two-, three-, and four-factor models of psychopathy. Zero-order and partial correlation analyses were conducted between the two factors of psychopathy and criterion measures of antisocial behavior, internalizing and externalizing psychopathology, personality traits, addictive disorders and demographic characteristics. Relationships to external variables provided evidence for the convergent and discriminant validity of the psychopathy construct in a Bulgarian community sample.     

The detection of malingering.

A 60-item paper-and-pencil inventory showed a 98% "hit-rate" in distinguishing between honest and simulated malingering protocols produced by 29 nonclinical subjects who took the inventory in both the honest and faked conditions. When instructed to take the Wildman Symptom Cheklist "as if applying for some kind of disability compensation," subjects endorsed a significantly higher number of the self-statements which appear clinically unbelievable. Independent replication is now required.     

Temperament and Psychopathy: A Dual-Pathway Model

ABSTRACT— The concept of psychopathy refers to a pattern of chronic antisocial behavior and personality features, such as emotional detachment, lovelessness, and guiltlessness, attributable in part to a temperament deficit. Historically, that deficit has been seen as a low reactivity to fear, but recent research has documented a second temperament deficit in adults that involves poor emotional and behavioral control. Both pathways are found in the child psychopathology literature, pointing to multifactorial developmental pathways from childhood to adult psychopathy.