Predictive validity of the Psychopathy Checklist: Youth Version for general and violent recidivism

Several authors have expressed concern regarding the use of youth psychopathy assessments in determinations of risk for general and violent offending. The Psychopathy Checklist: Youth Version (PCL:YV) was completed with 182 male adolescent offenders in this prospective study (average 14.5 month follow-up) of general and violent recidivism. Both a two-factor and three-factor model of the PCL:YV significantly predicted general and violent recidivism at a predictive accuracy ranging from 68 to 63%. However, regression analyses indicated these associations were explained primarily by behavioral psychopathic symptoms, rather than interpersonal or affective traits. Implications for the use of psychopathy assessments for risk during adolescence are discussed.     

Psychopathy scores and violence among juvenile offenders: a multi-measure study

This study examined the relations between psychopathy scores and violent behavior in 113 incarcerated adolescents. We compared the results of four different instruments designed to assess psychopathy features among juveniles-the Psychopathy Checklist: Youth Version (PCL:YV), two versions of the Antisocial Processes Screening Device (APSD), and a Psychopathy Content scale on the Millon Adolescent Clinical Inventory (MACI). We found that PCLY:YV scores were significantly correlated with violent offense history, unadjudicated violence, and institutional violence, as well as measures of the severity and instrumentality of prior violence. Receiver operating characteristic analyses generated statistically significant effect sizes (AUC values) ranging from 0.64 to 0.79. The three other measures generated statistically significant correlations with one or more of the violence criteria, although correlations and effect sizes tended to be smaller in magnitude. Our results offer some support for the validity of these measures of psychopathic features, and the value of the PCL:YV in particular, with respect to short-term measures of violence outcome among juvenile offenders.     

The use of a screening device to assess psychopathy in young offenders

The aim of this research was to determine to what extent a psychopath screening device (the APSD) is useful in forensic assessments to predict general and violent offending. For this purpose, a cross-sectional study was done and 238 young people serving a sentence were assessed. The gold standard instrument used to measure psychopathy was the Psychopathy Checklist: Youth Version (PCL:YV; Forth, Kosson & Hare, 2003). The results indicate that the association found between the screening device scores and several indicators of risk is low if compared with those obtained with the PCL:YV, suggesting that it is less useful as a tool in order to predict offending or violent offences. However, an Area Under the Curve of .784 and a validity index of 62.5 support its use as a screening device or as a preliminary approach to assess psychopathy in this population. The usefulness of this instrument to make assessments with young people in the forensic setting is discussed.     

Reliability and construct validity of the Dutch psychopathy checklist: youth version: findings from a sample of male adolescents in a juvenile justice treatment institution

The present study examines the reliability and construct validity of the Dutch version of the Psychopathy Check List: Youth Version (PCL:YV) in a sample of male adolescents admitted to a secure juvenile justice treatment institution (N = 98). Hare's four-factor model is used to examine reliability and validity of the separate dimensions of psychopathy. Interrater reliabilities are good to excellent for the PCL:YV total score and most factor scores, except for the affective factor. Several suggestions are offered for optimizing reliability of this factor. Finally, meaningful associations between PCL:YV scores and scores on the Minnesota Multiphasic Personality Inventory-Adolescent and the Interpersonal Checklist-Revised support the construct validity of the PCL:YV total score as well as the four factors in the Dutch context.     

Psychopathy and APD in Non-forensic Patients: Improved Predictions or Disparities in Cut Scores?

Psychopathy has traditionally been viewed as a distinct syndrome that is superior to Antisocial Personality Disorder (APD) for the prediction of violent and aggressive behavior. However, direct comparisons of psychopathy and APD are infrequent and mostly occur in correctional populations. Moreover, any observed differences could simply reflect a disparity in cut scores. The constellation of Psychopathy Checklists (PCL-R, PCL:SV, and PCL:YV) set the minimum cut score at 75% (e.g., ≥30 of 40 for the PCL-R), which is far more stringent than what is required for the DSM-IV APD adult criteria (i.e., ≥ 3 of 7 or 42.9%). For use in a non-forensic setting, we re-examined the MacArthur Risk Assessment data set to evaluate the usefulness of the PCL:SV and APD for short-term predictions of violent and aggressive acts. Using the ≥75% cut score to predict violence produced low sensitivities for both the psychopathy (.18) and APD adult criteria (.14) but very high specificities (.94). Reducing the cut score to approximately 40% greatly improved sensitivity rates (.62 for psychopathy and .85 for Adult APD criteria) at the expense of specificity (.59 and .40 respectively). In making multiple comparisons, psychopathy did not appear superior to APD adult criteria in predicting violent or other aggressive behavior. Instead, both constructs had limited predictive power with patients in a non-forensic setting. On an item level, specific indicators of violent behavior were explored.     

Psychopathy screening of incarcerated juveniles: a comparison of measures

How well do brief screening measures correspond with a full-scale assessment of psychopathy among juvenile offenders? This study compared 3 independent screening measures (the Antisocial Process Screening Device [APSD] Self-Report [A. A. Caputo, P. J. Frick, & S. L. Brodsky, 1999], the APSD Staff Rating [P. J. Frick & R. D. Hare, 2001], and the Psychopathy Content Scale [D. C. Murrie & D. G. Cornell, 2000] on the Millon Adolescent Clinical Inventory [T. Millon, 1993]) with the Psychopathy Checklist: Youth Version (PCL:YV; A. E. Forth, D. S. Kosson, & R. D. Hare, in press) in a sample of 117 incarcerated male juveniles. Modest correlations (.30-.49) were found between PCL:YV scores and those of the 3 screening measures, and there was moderate accuracy (67%-82%) in identifying youth who scored relatively high (> or = 25) on the PCL:YV. Although these results support the construct of adolescent psychopathy, they indicate substantial limitations in the use of psychopathy screening measures with juvenile offenders.     

The reliability and validity of the psychopathy checklist: youth version (PCL:YV) in nonincarcerated adolescent males

Current knowledge about the validity of the psychopathy syndrome in youth is limited largely to studies relying on parent-teacher rating scales or slight modifications of adult measures. Recently, the Psychopathy Checklist: Youth Version (PCL:YV) was designed for use with adolescents. However, most studies that have used this measure examined incarcerated males and addressed only validity criteria related to antisocial behavior. We investigated the generality and construct validity of the psychopathy syndrome in an adolescent sample by assessing 115 adolescent males on probation with the PCL:YV. Reliability of measurement was high. PCL:YV ratings predicted not only antisocial behaviour but also other indices of childhood psychopathology, interpersonal behaviors associated with adult psychopathy, and a lack of attachment to parents. These findings suggest that the PCL:YV identifies a syndrome in adolescence consistent with theory and research on adult males.     

The validity of the Antisocial Process Screening Device as a self-report measure of psychopathy in adolescent offenders

There is a growing interest in the assessment of adolescent psychopathy to enable early treatment and intervention. Recently, a self-report measure has been developed to assess psychopathic traits in adolescents. The Antisocial Process Screening Device (APSD), a self-report measure of psychopathic traits, and the Psychopathy Checklist: Youth Version (PCL:YV), a clinical rating scale, were administered to a sample of 100 incarcerated male adolescent offenders to assess the concurrent validity of the APSD. Results indicated that the APSD had limited concurrent validity with respect to the PCL:YV and that there appears to be a method effect in the measurement of psychopathy. Thus, it appears the APSD did not assess psychopathy in a manner parallel to that of the PCL:YV.     

Concurrent and predictive validity of the psychopathy checklist: youth version across gender and ethnicity

The concurrent and predictive validity of the Psychopathy Checklist: Youth Version (PCL:YV) were examined across gender and ethnicity using multiple outcome measures on a community-based sample of 130 adjudicated youths. The PCL:YV demonstrated concurrent validity with externalizing behavior problems but, it is important to note, was also associated with internalizing measures of negative affect. With a mean follow-up period of 3 years, the PCL:YV was found to predict general and violent recidivism in male, Native Canadian, and Caucasian youths. However, the PCL:YV demonstrated weaker concurrent and predictive validity with girls and failed to predict nonviolent recidivism in all subgroups. Implications of the findings for clinical practice are discussed.     

The Structured Assessment of Violence Risk in Youth as a predictor of recidivism in a United Kingdom cohort of adolescent offenders with conduct disorder

This prospective study examined the predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) and the Psychopathy Checklist: Youth Version (PCL: YV) in 99 male adolescents who were assessed in custody and followed up 12 months post release. Outcome data on recidivism were based on official Home Office records. The base rates for violent and general recidivism, respectively, were 38.4% and 70.7%. The predictive validity of the SAVRY Risk Total and the SAVRY Risk Rating was moderate for both violent and general recidivism, but both showed incremental validity in predicting outcomes compared with the PCL: YV. Data are discussed in relation to the limited published international literature.     

Factor structure of the Hare Psychopathy Checklist: Youth Version (PCL: YV) in incarcerated adolescents

Two studies are reported on the underlying dimensions of the psychopathy construct in adolescents as measured by the Hare Psychopathy Checklist-Youth Version (PCL: YV; Forth, Kosson, & Hare, 2003). In Study 1, the PCL: YV item ratings for 505 male adolescents incarcerated in 5 different settings in North America were used to test the fit of 3 models that have been hypothesized to represent the structure of psychopathy in adults. A 4th model based on parceling PCL: YV items was also tested. In Study 2, these models were tested with a sample of 233 male adolescents incarcerated in 2 facilities in the United Kingdom. Model fit results indicated that the 18-item 4-factor model developed by Hare (2003) and a modified version of a 13-item 3-factor model developed by Cooke and Michie (2001) were associated with generally good fit. Because the 4-factor model is a less saturated model than the 3-factor model (better parameter to data point ratio), it survived a riskier test of disconfirmation. Implications for the nature of psychopathy in youth are discussed.     

Stability and predictors of psychopathic traits from mid‐adolescence through early adulthood

High levels of psychopathic traits in youth are associated with multiple negative outcomes including substance misuse, aggressive behavior, and criminality. Evidence regarding stability of psychopathic traits is contradictory. No previous study has examined long‐term stability of psychopathic traits assessed with validated clinical measures. The present study examined the stability of psychopathic traits from mid‐adolescence to early adulthood and explored adolescent factors that predicted psychopathic traits five years later. The sample included 99 women and 81 men who had consulted a clinic for substance misuse in adolescence. At an average age of 16.8 years, the adolescents were assessed using the Psychopathy Checklist: Youth Version (PCL: YV) and five years later using the PCL‐Revised (PCL‐R). Additionally, extensive clinical assessments of the adolescents and their parents were completed in mid‐adolescence. Among both females and males, moderate to high rank‐order stability was observed for total PCL and facet scores. Among both females and males, there was a decrease in the mean total PCL score, interpersonal facet score, affective facet score, and lifestyle facet score. However, the great majority of females and males showed no change in psychopathy scores over the five‐year period as indicated by the Reliable Change Index. Despite the measures of multiple family and individual factors in adolescence, only aggressive behavior and male sex predicted PCL‐R total scores in early adulthood after taking account of PCL:YV scores. Taken together, these results from a sample who engaged in antisocial behavior in adolescence suggest that factors promoting high psychopathy scores act early in life.     

Callous-Unemotional Traits Modulate Brain Drug Craving Response in High-Risk Young Offenders

Adults with psychopathy have a high propensity for substance abuse, generally starting from a young age. This investigation tested hypotheses about differences in the neural responses associated with drug craving among high-risk young offenders with histories of abuse of stimulants and other drugs as a function of psychopathic traits. Fifty-four male adolescents (44 with a history of stimulant abuse and 10 controls) incarcerated at a maximum-security facility (M age = 17.08 years) completed a drug-cue exposure task while brain hemodynamic activity was monitored using functional magnetic resonance imaging (fMRI) with a mobile MRI scanner stationed at the facility. Psychopathic traits were assessed using the Hare Psychopathy Checklist: Youth Version (PCL:YV). In the stimulant abuser group, drug cues elicited activity in classic reward circuitry. Consistent with studies of adult psychopathic traits and substance abuse, there was a negative association between PCL-YV scores and hemodynamic response related to drug craving in the amygdala and ACC in youth with a history of stimulant abuse. However, there were considerably more negative associations between the PCL:YV and hemodynamic response among youth than adults and this was primarily due to callous-unemotional traits rather than interpersonal or behavioral traits. The implications for how personality traits modulate motivations for drug-seeking behavior among adolescent offenders are discussed.     

Psychopathy in adolescent female offenders: an item response theory analysis of the psychopathy checklist: youth version

The present study examined the applicability of the PCL:YV items to a sample of detained adolescent girls. Item response theory (IRT) was used to analyze test and item functioning of the PCL:YV. Examination of IRT trace lines indicated that the items most discriminating of the underlying construct of psychopathy included "callousness and a lack of empathy", "conning and manipulation", and "a grandiose sense of self-worth". Results from the analyses also demonstrated that the items least discriminating in this sample, or least useful for identifying psychopathy, included "poor anger control", "shallow affect", or engaging in a "serious violation of conditional release". Consistent with previous research (Cooke & Michie, 1997; Hare, 2003), interpersonal and affective components of psychopathy provided more information than behavioral features. Moreover, although previous research has also found affective features to provide the most information in past studies, it was interpersonal features of psychopathy in this case, followed by affective features, that provided greater levels of information. Implications of these results are discussed.     

Convergent validity of the Youth Psychopathic Traits Inventory (YPI): association with the Psychopathy Checklist: Youth Version (PCL:YV)

This study investigates the relationship between the self-report Youth Psychopathic Traits Inventory (YPI) and the clinician-rated Psychopathy Checklist: Youth Version (PCL:YV). A representative sample of 92 girls and 70 boys, 12 to 20 years of age (mean age, 17 years), who received services at a clinic for adolescents with substance misuse problems, was studied. Moderate correlations (r =.30-.51) were found between conceptually corresponding YPI and PCL:YV factor scores among both boys and girls, whereas correlations between individual subscales of the YPI and items of the PCL:YV were not as consistent. A cross-tabulation of groupings based on the three-factor models of the two instruments largely supported the categorical convergent validity of the YPI, particularly for low and high scorers. Although more studies with larger samples are needed, results indicate that the YPI is a cost-effective measure of psychopathic traits in adolescents in research settings.     

Views of the downward extension: comparing the Youth Version of the Psychopathy Checklist with the Youth Psychopathic traits Inventory

Increasing interest in "juvenile psychopathy" has been met with scholarly debate about the validity of directly extending the adult construct of psychopathic personality disorder to youth. To inform this debate, this study of 160 serious adolescent offenders compared two alternative, adult-based conceptualizations of juvenile psychopathy: that of the Psychopathy Checklist: Youth Version (PCL:YV) and the self-report Youth Psychopathic traits Inventory (YPI). The results indicate that these two conceptualizations overlap only partially, with the YPI focusing more tightly on core interpersonal and affective features than the PCL:YV. Each conceptualization is reliable and predicts different forms of short-term institutional misbehavior. However, only the YPI possesses a theoretically coherent, inverse association with anxiety. Despite this promise, these conceptualizations of psychopathy are less strongly associated with one another than they are with psychosocial markers of developmental maturity. This raises questions about their divergent validity and ability to identify a disorder that will remain stable during the transition from adolescence into adulthood. Implications for future longitudinal research on the validity, manifestations, and course of juvenile psychopathy are discussed.     

The relation of psychopathy to concurrent aggression and antisocial behavior in high-risk adolescent girls and boys

The present study examined the concurrent relationship between psychopathy characteristics as measured by the PCL:YV and aggressive and antisocial behavior in a sample of 142 high-risk adolescent girls and boys. The unique relationship between each of three PCL:YV factors (Arrogant and Deceitful Interpersonal Style, Deficient Affective Experience, and Impulsive and Irresponsible Behavioral Style) and outcomes was evaluated to determine which aspects of psychopathy are most crucially linked to aggressive and antisocial behavior in adolescents. Dependent measures were expanded to include both relational and physical forms of aggression to better capture meaningful outcomes for girls and boys. Regression analyses showed that the relationships between psychopathic features and outcomes were equivalent for boys and girls, and that deficits in affect were most consistently associated with aggression. These findings are concordant with the well established finding in developmental research showing that deficits in empathy and affect regulation are associated with aggression.     

Testing factor models of the Psychopathy Checklist: Youth Version and their association with instrumental aggression

Although there is a documented link between psychopathy and instrumental violence in adult offenders, the association between these constructs has not garnered significant attention in adolescent offenders. In this study, we evaluated the relationship between psychopathy and instrumental aggression in a sample of 122 male adolescents incarcerated in a state facility for serious and chronic offenders. We evaluated the primary (2-, 3-, and 4-factor) models of the Psychopathy Checklist: Youth Version (PCL:YV; Forth, Kosson, & Hare, 2003) and assessed their relationship to a separate 5-item measure of instrumental violence. CFA revealed good model fit for the 3- and 4-factor latent variable models of adolescent psychopathy and a single-factor model reflecting a 5-item measure of instrumental violence. Structural equation modeling results indicate that the 4-factor model accounted for 20% of the variance for instrumental violence. In contrast, the 3-factor model of the PCL:YV accounted for 8%, and the 2-factor model accounted for 5% of the variance associated with instrumental violence.     

Incremental validity analyses of the violence risk appraisal guide and the psychopathy checklist: screening version in a civil psychiatric sample

This study compares two instruments frequently used to assess risk for violence, the Violence Risk Appraisal Guide (VRAG) and the Psychopathy Checklist: Screening Version (PCL:SV), in a large sample of civil psychiatric patients. Despite a strong bivariate relationship with community violence, the VRAG could not improve on the predictive validity of the PCL:SV alone, even though the VRAG includes several ostensible violence risk factors other than psychopathy. Moreover, incremental validity analyses indicated that the remaining VRAG items accounted for little or no variance in violent outcomes once psychopathy scores were controlled. Conversely, the PCL:SV continued to account for considerable variance after controlling for the VRAG. These results reflect the limited validity of the VRAG items in civil psychiatric samples beyond the variance that is explained by the PCL:SV alone.     

A comparative study of adolescent risk assessment instruments: predictive and incremental validity

Promising new adolescent risk assessment tools are being incorporated into clinical practice but currently possess limited evidence of predictive validity regarding their individual and/or combined use in risk assessments. The current study compares three structured adolescent risk instruments, Youth Level of Service/Case Management Inventory (YLS/CMI), Structured Assessment of Violence Risk in Youth (SAVRY), and Psychopathy Checklist: Youth Version (PCL:YV), for both predictive and incremental validity with respect to general and violent recidivism. Receiver operating characteristic and hierarchical logistic regression analyses revealed that the risk tools predicted general and violent recidivism to varying degrees of accuracy, but the SAVRY offered the most in incremental validity. Clinical implications and future directions for youth risk assessment are discussed.