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.     

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.     

Criterion-related validity of the three-factor model of psychopathy: personality, behavior, and adaptive functioning

The Psychopathy Checklist-Revised (PCL-R) has been conceptualized as indexing two distinct but correlated factors. Previous research has established that these factors demonstrate distinct patterns of relations with external criteria. However, more recent findings suggest that the PCL-R psychopathy construct may encompass three distinguishable factors, reflecting affective, interpersonal, and behavioral symptoms. Here, we evaluated the validity of this newer three-factor model of the PCL-R factors with reference to external criteria from the domains of personality, antisocial behavior; and adaptive functioning in a sample of 310 incarcerated offenders. The interpersonal factor was related to social dominance, low stress reactivity, and higher adaptive functioning; the affective factor was correlated with low social closeness and violent offending; and the behavioral factor was associated with negative emotionality, disinhibition, reactive aggression, and poor adaptive functioning. These findings provide support for the convergent and discriminant validity of these psychopathy facets.     

Personality disorder and antisocial deviance: comments on the debate on the structure of the psychopathy checklist-revised

The recent debate on the structure of the Psychopathy Checklist-Revised (PCL-R: Hare, 1991; 2003) has been presented primarily as a statistical issue, but underlying it are longstanding conceptual issues about the relationship of personality concepts to deviant behavior and of psychopathy to criminality and personality disorder. I discuss these issues in this paper. The antisocial items of the PCL-R seem to reflect a propensity to commit crimes that has long been of interest to criminology. This disposition overlaps with, but differs conceptually from personality dispositions, but these surface dispositions do not provide a causal account of criminality. I present data that indicate that the core personality characteristics of psychopathy are more closely related to narcissistic and histrionic personality disorders than to antisocial personality disorder. Overemphasis on involvement in crime has obscured the nature of psychopathy as a disorder of personality characterised by interpersonally harmful behavior that need not necessarily take criminal form.     

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.     

The inclusion of antisocial behavior in the construct of psychopathy: A review of the research

The psychopathic personality, or the construct of this disorder, has a long and contentious history. Psychopathy has been identified anecdotally for centuries; however, the ability to accurately define this construct continues to challenge researchers and clinicians. Of preliminary concern is the relevance of antisocial behavior to this disorder. Theoretical conceptualizations of psychopathy have changed over the past 65 years. Some have stressed the interpersonal and affective deficits of psychopathy [Cleckley, H. (1941). The mask of sanity (1st ed.). St. Louis, MO:C.V. Mosby.], while later conceptualizations have included both personality traits as well as antisocial behavior as criteria of psychopathy [Hare, R. D. (1991/2003). The Hare Psychopathy Checklist—Revised. Toronto, Canada: Multi-Health Systems]. This article will review the literature, particularly the relevance of antisocial behavior to the core personality structure of the psychopath. In doing so, historical theories will be reviewed, followed by later theoretical and empirical research. A great deal of this research has been conducted over the past 15 years, since the publication of the Psychopathy Checklist (PCL) and the Psychopathy Checklist-Revised (PCL-R; [Hare, R. D. (1991/2003). The Hare Psychopathy Checklist—Revised. Toronto, Canada: Multi-Health Systems]). The PCL-R has provided the field of psychopathy research with a consistent measurement device, and, therefore will be discussed at length. The limitations of the psychopathy construct will be discussed as well as needed future research and the policy implications of such research.     

The interpersonal measure of psychopathy: construct and incremental validity in male prisoners

The authors examined the construct and incremental validity of the Interpersonal Measure of Psychopathy (IM-P), a relatively new instrument designed to detect interpersonal behaviors associated with psychopathy. Observers of videotaped Psychopathy Checklist-Revised (PCL-R) interviews rated male prisoners (N = 93) on the IM-P. The IM-P correlated significantly with the PCL-R total score. Moreover, the IM-P was preferentially related to the interpersonal rather than the affective and antisocial lifestyle features of psychopathy. IM-P scores were significantly correlated with age, antisocial behaviors, and self-reported fear, anxiety, and socialization (in reverse). Hierarchical multiple regression analyses demonstrated that although the IM-P exhibited incremental validity beyond the PCL-R total score in detecting self-reported fear, anxiety, and several personality traits, it did not exhibit much incremental validity beyond PCL-R Factor 1. These findings raise questions concerning the unique assessment contribution of the IM-P beyond PCL-R Factor 1. Potential reasons for these findings and alternative means of enhancing the interpersonal assessment of psychopathy are discussed.     

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.     

Relations between psychopathy facets and externalizing in a criminal offender sample

The construct of psychopathy is viewed as comprising distinctive but correlated affective-interpersonal and social deviance facets. Here, we examined these facets of Hare's Psychopathy Checklist-Revised (PCL-R) in terms of their associations with the externalizing dimension of adult psychopathology, defined as the common factor underlying symptoms of conduct disorder, adult antisocial behavior, alcohol use/abuse, and drug abuse, along with disinhibitory personality traits. Correlational analyses revealed a strong relationship between this externalizing dimension and the social deviance facet of psychopathy (r = .84), and a lesser relationship with the emotional-interpersonal component (r = .44). Structural models controlling for the moderate overlap between the PCL-R factors revealed that externalizing was substantially related to the unique variance in the social deviance features of psychopathy, but unrelated to the unique variance of the emotional and interpersonal features whether modeled together or as separate factors. These results indicate that the social deviance factor of the PCL-R reflects the externalizing dimension of psychopathology, whereas the emotional-interpersonal component taps something distinct aside from externalizing. In addition, based on our finding of an association between PCL-R social deviance and externalizing, we were able to predict new relations between this facet of psychopathy and criterion variables, including nicotine use and gambling, that have previously been linked to externalizing. Implications for future research on the causes and correlates of psychopathy are discussed.     

Modification of the startle reflex in a community sample: do one or two dimensions of psychopathy underlie emotional processing?

Recent research on psychopathy has begun to explore two dimensions that possibly underlie psychopathy–one related more to emotional and interpersonal traits, and another related more to antisocial behaviors. A community sample of adults was assessed for psychopathy using Hare's (1991) Psychopathy Checklist-Revised (PCL-R). Eyeblinks elicited by startle probes were recorded while participants viewed pictures of emotionally-laden stimuli. Consistent with previous research, participants scoring high on PCL-R Factor 2 (“antisocial”) showed no affective modification of startle if they also scored high on PCL-R Factor 1 (“emotional detachment”). When the factor scores were analyzed together as continuous variables in a regression analysis, however, affective modification of startle was negatively related to Factor 1 but positively related to Factor 2. The results thus provide further support for a two-factor model of psychopathy.     

Psychopathy and malingering of psychiatric disorder in criminal defendants

Because the use of deception is an important clinical characteristic of psychopathy, there is intuitive appeal to the idea that psychopathy and malingering are associated. There is, however, very little research showing that psychopaths are more likely to malinger. We classified a sample of criminal defendants as high, moderate, or low in psychopathy, based on PCL-R scores, and compared their scores on indices typically used to detect malingering on the MMPI-2, the PAI and the SIRS. The high psychopathy group scored significantly higher on the MMPI-2 F and F-K; the PAI NIM, and the SIRS, but not the MMPI-2 Fb, F(p), or the PAI RDF or Mal, lending some support for the DSM-IV recommendation that malingering should be considered whenever there is a diagnosis of antisocial personality disorder. Logistic regression analysis (LGA) revealed that Factor I but not Factor II of the PCL-R significantly discriminated malingerers from nonmalingerers with 75% correct classification. However, receiver operating characteristic (ROC) analysis revealed that psychopathy ratings had poor sensitivity and specificity in the detection of malingering. Calculation of the percentages of those exceeding accepted cut-offs on each of the malingering measures revealed that a high percentage of severe psychopaths did not attempt to feign psychiatric disorder. The results suggest that psychopathy is not a clinically useful indictor of malingering. The results are discussed in terms of confirmatory bias and the impact such a bias could have on the evaluation of criminal defendants.     

The dark side of normal: A psychopathy-linked pattern called aberrant self-promotion

These studies investigate a personality and behavior pattern called aberrant self-promotion, conceptualized as a subclinical form of psychopathy. Aberrant self-promoters (ASPs) are theoretically defined as individuals characterized by a narcissistic personality configuration in combination with antisocial behavior. The first study verifies the existence of persons who manifest the ASP pattern. The second study validates the pattern, using as criteria the Revised Psychopathy Checklist (PCL-R) interview and records of antisocial behavior. In the first study a 179-item questionnaire, composed of five personality instruments, was administered to two separate samples of normal subjects (N = 214 and 367). ASPs were targeted by three methods: cluster analysis, item factor analysis, and person factor analysis. In Sample 1 the three methods demonstrated a convergence of 92 per cent in identifying the same individuals as ASPs; in Sample 2 the convergence rate was 94 per cent. In the second study 32 ASPs targeted in Study 1 were compared to 30 non-ASPS. The ASPs had significantly higher scores on the PCL-R and had committed significantly more antisocial acts than the non-ASPS. The general discussion focuses on the practical, theoretical, and measurement implications of considering aberrant self-promotion a distinct psychological motif.     

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 Roles of Childhood Maltreatment and Psychopathy in Sexual Recidivism of Treated Sex Offenders

Abstract

The Intensive Treatment Program for Sexual Offenders (ITPSO) at the Correctional Service of Canada (CSC) provides cognitive-behavioral group treatment to federally incarcerated sex offenders. Follow-up data for 81 of these men were examined, looking at psychopathy and childhood maltreatment history as potential predictors of recidivism using Survival Analysis. Offenders who had been placed in foster care as a child were more likely to recidivate; however when PCL-R Factor 2 scores (a history of antisocial behavior) were entered, they predicted over and above foster care history. Childhood physical abuse predicted sexual recidivism; however, childhood sexual abuse and PCL-R scores did not predict sexual recidivism. PCL-R Factor 2 scores predicted violent recidivism.     

Identifying persistently antisocial offenders using the Hare Psychopathy Checklist and DSM antisocial personality disorder criteria

Early starting, lifetime criminal persistence has been called sociopathy, antisocial personality disorder, and psychopathy. There is, however, disagreement about its core features and which measure is best for identifying such individuals. In the 1st of 2 studies of male offenders (n = 74), we found a large association between scores on the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991) and the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994) antisocial personality disorder criteria scored as a scale. The second study (n = 684) replicated this finding and found that, as previously shown for PCL-R scores, a discrete class (or taxon) also underlies scores on items reflecting antisocial personality disorder. The high association among these sets of items and their similarity in predicting violence suggested that the same natural class underlies each. Results indicated that life-course-persistent antisociality can be assessed well by measures of psychopathy and antisocial personality disorder.     

Antisocial personality disorder and psychopathy: diagnostic dilemmas in classifying patterns of antisocial behavior in sentencing evaluations

Antisocial Personality Disorder (APD) and PCL-R psychopathy are critically examined regarding their application to sentencing determinations. PCL-R psychopathy is emerging in the literature as a more useful forensic diagnostic construct than APD, which appears flawed by multiple weaknesses. These include shifting diagnostic criteria, innumeracy problems, absence of symptom weighting, temporal instability, and the equivalence of some symptoms with substance abuse disorders. Additionally, APD overdiagnosis may result from inattention to issues of social context, trauma history, and symptom pervasiveness. Neither objective nor projective personality testing reliably differentiates APD. Finally, an APD diagnosis does not always indicate criminal, much less incorrigible criminal behavior. By contrast, PCL-R psychopathy results are strongly predictive of criminal behavior and violent recidivism for Caucasian males through mid-life residing in the community. Emerging research with the PCL-R regarding other important populations and contexts is promising but generalization is currently limited. © 1998 John Wiley & Sons, Ltd.     

The Association between Anxiety and Psychopathy Dimensions in Children

Although several theoretical models posit that low levels of anxiety are a risk factor for psychopathy and antisocial behavior, a number of studies have reported elevated levels of anxiety among antisocial individuals. Nevertheless, most investigators in this literature have not distinguished between fearfulness and trait anxiety or attempted to separate the antisocial lifestyle dimension from the callous and unemotional dimension of psychopathy. In a study of clinically referred children (N = 143), we found that (a) measures of trait anxiety and fearlessness (low fearfulness) exhibited low correlations; (b) conduct problems tended to be positively correlated with trait anxiety, whereas callous and unemotional traits tended to be negatively correlated with trait anxiety; and (c) controlling statistically for the effects of one dimension increased the divergent correlations of the other dimension with both trait anxiety and fearful inhibition. These findings bear potentially important implications for the diagnosis and etiology of psychopathy and antisocial behavior and suggest that distinctions between trait anxiety and fearful inhibition, as well as between the two dimensions of psychopathy, may help to clarify longstanding confusion in this literature.     

Coercive and precocious sexuality as a fundamental aspect of psychopathy

Sexual behavior is closely associated with delinquency and crime. Although psychopaths, by definition, have many short-term sexual relationships, it has not been shown that sexuality is a core aspect of psychopathy. A Darwinian view of psychopathy led to the hypothesis that psychopaths have a unique sexuality involving early, frequent, and coercive sex. Our subjects were 512 sex offenders assessed on the Hare Psychopathy Checklist (PCL-R). Five variables reflecting early, frequent, and coercive sex loaded on the same principal component in exploratory factor analysis on a subset of the sample, whereas PCL-R items pertaining to adult sexual behavior did not. Confirmatory factor analysis of the remaining subjects yielded a measurement model containing three inter-correlated factors - the traditional two PCL-R factors, and coercive and precocious sexuality. Taxometric analyses gave evidence of a natural discontinuity underlying coercive and precocious sexuality. Coercive and precocious sexuality yielded statistically significant associations with other study variables predicted by the Darwinian hypothesis. The present findings are consistent with prior empirical findings and support the hypothesis that psychopathy has been a nonpathological, reproductively viable, alternate life history strategy.     

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.     

Secondary psychopathy,but not primary psychopathy,is associated with risky decision-making in noninstitutionalized young adults

Although risky decision-making has been posited to contribute to the maladaptive behavior of individuals with psychopathic tendencies, the performance of psychopathic groups on a common task of risky decision-making, the Iowa Gambling Task (IGT; Bechara, Damasio, Damasio, & Anderson, 1994), has been equivocal. Different aspects of psychopathy (personality traits, antisocial deviance) and/or moderating variables may help to explain these inconsistent findings. In a sample of college students (N = 129, age 18–27), we examined the relationship between primary and secondary psychopathic features and IGT performance. A measure of impulsivity was included to investigate its potential as a moderator. In a joint model including main effects and interactions between primary psychopathy, secondary psychopathy and impulsivity, only secondary psychopathy was significantly related to risky IGT performance, and this effect was not moderated by the other variables. This finding supports the growing literature suggesting that secondary psychopathy is a better predictor of decision-making problems than the primary psychopathic personality traits of lack of empathy and remorselessness.