The utility of the Psychopathy Checklist-Revised (PCL-R) facet and item scores in predicting violent recidivism

There is relatively limited research on psychopathy in non-Caucasian ethnic groups and even less on the utility of the Psychopathy Checklist-Revised (PCL-R) that focuses on PCL-R facet and item scores in predicting violent recidivism. In this study, we assessed the utility of the PCL-R in prospectively predicting violent versus nonviolent recidivism during an 11-year follow-up window. A high-risk sample of 451 incarcerated Korean male offenders was assessed on the PCL-R at baseline. A total of 445 were reconvicted after release (353 violent and 92 nonviolent recidivists). Psychopathy facet scores were higher in violent compared to nonviolent recidivists. Facet 2 (affective) showed the strongest effect size (Cohen's d = 0.53; Percentage change in odds = 22.6%) in predicting violent recidivism. Analyses of the four items constituting the affective facet indicated that callous/lack of empathy (Percentage change in odds = 134.4%) and failure to accept responsibility (Percentage change in odds = 94.5%) were the strongest predictors of violent recidivism. Findings are to our knowledge the first to document the utility of the PCL-R in distinguishing violent from nonviolent recidivism and highlight the role of affective impairment (particularly lack of empathy) in violent recidivism.     

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.     

Predicting institutional adjustment with the Lifestyle Criminality Screening Form and the Antisocial Features and Aggression scales of the PAI

I included scores on the Antisocial Features (ANT) and Aggression (AGG) scales of the Personality Assessment Inventory (PAI; Morey, 1991) and ratings on the Lifestyle Criminality Screening Form (LCSF; Walters, White, & Denney, 1991) along with age and prior disciplinary record in a series of negative binomial regression analyses of total, nonaggressive, and aggressive incident reports (IRs) received in a 2-year follow-up of 120 male maximum security federal prisoners. Findings indicated that the AGG scale, but not the LCSF or ANT, predicted total and nonaggressive IR counts. The LCSF achieved significant receiver operating characteristic (ROC) results in predicting dichotomized aggressive IRs, the ANT achieved significant ROC results in predicting dichotomized total and nonaggressive IRs, and the AGG achieved significant ROC results in predicting all 3 dichotomized categories of IR. Supplemental analyses revealed that the AGG continued to predict total and nonaggressive IRs when the Psychological Inventory of Criminal Thinking Styles (PICTS; Walters, 1995) Proactive scale was included in the negative binomial regression but not when the PICTS Reactive scale was included in the negative binomial regression.     

Field validity of the Psychopathy Checklist-Revised in sex offender risk assessment

Several studies have concluded that scores from Hare's (2003) Psychopathy Checklist-Revised (PCL-R) predict reoffense among sexual offenders, but most of those studies examined the predictive validity of scores from trained research staff, not clinicians in the field scoring the measure as part of actual forensic assessments. Therefore, we examined the field validity of PCL-R scores that forensic evaluators assigned to 333 male sexual offenders who underwent evaluations during a civil commitment selection process. Overall, no PCL-R score was a significant predictor of sexually violent recidivism. Facet 4 was the only PCL-R score with an area under the curve (AUC) greater than .50 (AUC = .53, p = .85) and the only PCL-R score that approached statistical significance for predicting the combined category of violent or sexually violent offending (AUC = .63, p = .08). However, scores from a subset of evaluators revealed stronger predictive effects, indicating that predictive validity was higher for scores from some evaluators than others. Overall, these results suggest that the stronger predictive validity values in controlled research studies may not apply to all evaluators when the PCL-R is administered in the field.     

Reliability and construct validity of the psychopathy checklist - revised for Latino, European American, and African American male inmates

The utility of the psychopathy construct in predicting laboratory deficits, criminal behavior, response to intervention, and recidivism has been well documented in European American populations. However, less is known about the manifestation and correlates of psychopathy in Latino and African American populations. The present study examined the reliability and construct validity of the Psychopathy Checklist - Revised (PCL-R; R. D. Hare, 2003) in 83 Latino inmates compared with matched samples of African Americans and European Americans. Results provide preliminary evidence that the PCL-R provides a reliable and valid measure of psychopathy in Latinos, with generally similar patterns emerging across external correlates; however, some ethnic group differences were noted for relationships between psychopathy indicators and some external correlates.     

Screening for Psychopathy: Validation of the Psychopathic Personality Inventory-Short Form with Reference Scores

The current study reports validation results for the Psychopathic Personality Inventory (PPI) and its subscales, and for a newly developed PPI-Short Form (PPI-SF) in forensic and non-forensic populations. We also provide criterion reference scores for the PPI and the PPI-SF. In Study 1, we used PPI data from 1,065 participants and supplementary PCL-R data from a subsample of 91 forensic offenders. Mokken scale analysis was used to construct the PPI-SF. In Study 2, PPI-SF and PCL-R data were collected from 60 participants. The study yielded promising but preliminary support for the construct validity of the PPI and the PPI-SF. The PPI-SF is of interest for risk assessment because of its (a) strong relationship with the PCL-R total score and (b) subscales known for their predictive value for violence and criminal recidivism.     

Psychopathy and the predictive validity of the PCL-R: an international perspective

Its controversial past notwithstanding, psychopathy has emerged as one of the most important clinical constructs in the criminal justice and mental health systems. One reason for the surge in theoretical and applied interest in the disorder is the development and widespread adoption of reliable and valid methods for its measurement. The Hare PCL-R provides researchers and clinicians with a common metric for the assessment of psychopathy, and has led to a surge in replicable and meaningful findings relevant to the issue of risk for recidivism and violence, among other things. Most of the research thus far has been based on North American samples of offenders and forensic psychiatric patients. We summarize this research and compare it with findings from several other countries, including England and Sweden. We conclude that the ability of the PCL-R to predict recidivism, violence, and treatment outcome has considerable cross-cultural generalizability, and that the PCL-R and its derivatives play a major role in the understanding and prediction of crime and violence.     

The Lifestyle Criminality Screening Form and Antisocial Personality Disorder: predicting release outcome in a state prison sample

The Lifestyle Criminality Screening Form (LCSF) was compared with a clinical diagnosis of Antisocial Personality Disorder for the purposes of determining the relative efficiency of each measure in predicting the release outcome of 100 medium security New Mexico state prisoners. An 18-month follow-up revealed that high LCSF scores (total score > or = 10) and clinical diagnoses of Antisocial Personality Disorder effectively identified inmates who were eventually reincarcerated for a parole violation or new offense. However, because substantial overlap occurred between these two predictors (kappa = .58) partial correlations were calculated and revealed that only the LCSF displayed a robust relationship with release outcome independent of the other predictor measure.     

Examining the utility of the PCL:SV as a screening measure using competing factor models of psychopathy

The correspondence between the Hare Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) and the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) was examined in forensic (N = 175) and correctional (N = 188) samples. Intermeasure correlations for Total scores (.95 forensic, .94 correctional) and the original 2-factor, D. J. Cooke and C. Michie's (2001) 3-factor, and R. D. Hare's (2003) 4-facet models (range = .87-.95) were high. Area under the curve values for the PCL:SV were .98 in both samples (cutoff = PCL-R Total score of 25). The PCL:SV performed well as a screen, maximizing false positive relative to false negative errors. Close correlations for prediction of violent recidivism in the correctional sample were obtained for the PCL-R (.42) and PCL:SV (.37). Results indicate the robust relation between the measures is maintained whether they are completed on the basis of file review only or file plus interview and whether the same or different raters score the measures.     

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.     

Cognitive-Behavioral Intervention in School Discipline: A Preliminary Study

This study assessed the utility of a pilot program in rational behavior therapy (RBT) in the disciplinary processes at a large, urban junior high school. Treatment and control students were contrasted on recidivism rate and teacher behavior assessments after they participated in a condensed RBT treatment program. For two behavior ratings and recidivism rate, students who participated in the intervention differed significantly from those in the control group. Such empirical support demonstrates the potential of cognitive-behavioral interventions in school disciplinary procedures and merits further implementation and research.     

Response style versus crime-specific cognition: predicting disciplinary adjustment and recidivism in male and female offenders with the PICTS

Four samples were used to evaluate the incremental validity of the Psychological Inventory of Criminal Thinking Styles (PICTS) General Criminal Thinking (GCT) score and Proactive (P) and Reactive (R) composite scales vis-á-vis response style in predicting disciplinary adjustment and recidivism. Purified Confusion (Cf(p)) and Defensiveness (Df(p)) validity scales were constructed by eliminating items from the PICTS Confusion and Defensiveness scales that overlapped with GCT, P, and R. The four-item Cf(p) and Df(p) scales were employed as measures of response style and entered into binomial probit regression analyses alongside GCT, P, and R. The GCT score consistently predicted disciplinary adjustment and recidivism in male and female offenders when included in regression equations with Cf(p) and Df(p). The P scale only displayed incremental validity relative to Cf(p) and Df(p) in large groups of participants, whereas the R scale was incapable of predicting recidivism in female offenders when paired with Cf(p) and Df(p).     

Factor structure and behavioural correlates of the Psychopathy Checklist-Revised [PCL-R] in a Brazilian prisoner sample

The present study examines the reliability, factor structure, and criterion-related validity of Hare (2003) Revised Psychopathy Checklist [PCL-R] in a Latin American forensic context. Brazilian male inmates (124) were administered the PCL-R, along with relevant subscales of an inventory of normal personality [Personality Factorial Inventory], an intelligence scale [Standard Progressive Matrices], and a semi-structured interview based in DSM IV. Criminal offence records were obtained from prison files. Several theoretical factorial structures for the PCL-R were tested and compared. A bifactor model with three factors, one general factor reflecting the overlap across all items, and two independent subfactors reflecting the unique covariation among particular groups of items, shows the better fit. Overall scores on the PCL-R correlated with the number of criminal offenses committed by participants. No significant correlations were found between PCL-R scores and personality or intelligence measures. It was concluded that the PCL-R is a reliable and valid instrument for the assessment of psychopathy in the Brazilian male forensic population.     

Identifying inmates at risk for disciplinary infractions: a comparison of two measures of psychopathy

Poythress, Edens, and Lilienfeld (1998) recently reported a moderately strong correlation between Hare's (1991) Psychopathy Checklist-Revised (PCL-R) and a newly developed self-report measure of psychopathy, the Psychopathic Personality Inventory (PPI) of Lilienfeld and Andrews (1996), in an ethnically diverse sample of 50 inmates from a youthful offender prison. The present study reports follow-up data regarding disciplinary infractions in this sample and examines the utility of the PCL-R and PPI for identifying those at risk for institutional misbehavior. Generally modest, but statistically significant, correlations were obtained between both measures and indices of aggressive institutional behavior. Multiple regression analyses revealed that both measures accounted for common variance in the criterion but that neither accounted for significant unique variance. Results are discussed in terms of the clinical utility of these measures in populations of young offenders.     

Verläufe bei sexuellen Tötungen

This article summarizes main results of studies on forensic psychiatric court reports on 166 men who had been persecuted between 1963 and 1991 for a sexual offence leading to the death of the victim. Comparing perpetrators with a single victim and those with multiple victims we found similar results as in two previous studies with smaller samples: Multiple sexual homicide perpetrators showed more often sexual sadism and other paraphilias, as well as antisocial, schizoid and sadistic personality disorders. Follow-up data from the federal criminal records could be obtained for 139 offenders. Ninety perpetrators had been released after a mean detention of 12.2 years, whereas the 49 offenders who were still in prison or forensic psychiatric hospitals had been detained for a mean period of 20.6 years. The non-released offenders showed more often paraphilias as well as antisocial and sadistic personality disorders than the released perpetrators. Paraphilias and antisocial personality traits are empirically well proven risk factors for criminal recidivism with sexual reoffences. In addition, the non-released sexual homicide perpetrators had higher scores in all applied risk assessment instruments (PCL-R, HCR-20, SVR-20, Static-99). Among the released offenders only 1.1% (n=1) reoffended with a completed homicide and 2.2% (n=2) with attempted homicide. The recidivism rates with sexual and other violent reoffences in this sample of sexual homicide perpetrators were similar to those in a large meta-analysis on recidivism in sexual offenders by Hanson and Morton-Bourgon (4). Since well established risk factors had apparently been “used-up” for the decisions about release or non-release, in the follow-up data about the released offenders only age at the sexual homicide and age at the time of release were found as risk factors for recidivism with any violent (sexual or non-sexual) reoffence, i.e. the younger the offender at the time of the homicide and the younger at the time of release, the more likely is the risk of violent reoffending.     

Incremental validity of the Psychopathy Checklist facet scores: predicting release outcome in six samples

The incremental validity of the 4 facet scores (Interpersonal, Affective, Lifestyle, Antisocial) of the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991, 2003) and the Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was evaluated in 6 forensic/correctional samples with average follow-ups ranging from 20 weeks to 10 years. Results indicated that whereas Facet 4 (Antisocial) achieved incremental validity relative to the first 3 facets (Interpersonal, Affective, and Lifestyle) in predicting recidivism in all 6 samples, a block of the first 3 facets achieved incremental validity relative to the 4th facet in only 1 sample. Thus, although there was consistent support for the incremental validity of Facet 4 above and beyond the first 3 facets, there was minimal support for the incremental validity of Facets 1, 2, and 3 above and beyond Facet 4. The implications of these findings for the psychopathy construct in general and the PCL-R/SV in particular are discussed.     

Suicidal and criminal behavior among female offenders: the role of abuse and psychopathology

Childhood abuse is relatively prevalent among women and is an important risk factor for both criminal behavior and suicide-related behavior (SRB). Based on a sample of 266 female offenders, we address one theoretical and one practical issue. First, from a theoretical perspective, we assess whether internalizing (depression and anxiety) and externalizing (substance abuse and antisocial behavior) psychopathology mediate the relation between abuse on the one hand, and SRB or criminal behavior, on the other. Results indicate that externalizing problems mediate the relation between childhood abuse and both lifetime SRB (fully) and lifetime criminality (partially). Second, at a practical level, results indicate that a subscale of the Revised Psychopathy Checklist (PCL-R; Hare, 1991) that assesses lifetime criminal behavior adds incremental utility to postdicting SRB, beyond the variance accounted for by self-report measures of abuse and externalizing problems. However, none of the measures-including the PCL-R-predicted future recidivism.     

Évaluation des dimensions psychopathiques sur le mode d’adaptation carcérale

IntroductionThe disorders associated with the coping styles of detainees in prisons, including the interaction between individual and the environment, can be approached in two ways. Either as the result of a normal reaction of prisoners with regard to specific components in a pathogenic environment, or resulting from psychopathological determinants inherent to inmates prior to incarceration.ObjectivesThis study aims to measure the impact of components related to personality traits deemed stable and observed among inmates in regards to their modes of adaptations to the prison environment. More specifically, observing the types of adaptation of prisoners, according to their scores on the Hare psychopathy checklist (PCL-R).MethodsThe study is based on a series of interviews conducted on a sample of 26 inmates in three different detention centers located in France.ResultsThe results show a strong relationship between some psychopathic dimensions and characteristics of conduct disorder or disciplinary offenses in prison. High scores in both factor 1 (interpersonal and emotional relationship) and factor 2 (social deviance) strongly correlates with disciplinary problems such as heteroaggressive violence towards staff or other inmates. While a high score of factor 2 only increases the risk of disciplinary problems, such as group violence or involvement in trafficking.ConclusionsThe presence or absence of certain personality traits that characterize psychopathy could determine how an inmate would adapt to the prison environment.     

L’intelligence artificielle peut-elle aider à estimer le risque de récidive dans les comportements violents ?

In forensic psychiatry, magistrates raise the question of the existence of a risk of recidivism and dangerousness to psychiatric experts. Follow-up studies in forensic psychiatry showed that the psychiatric elements predictive of recidivism were mainly related to serious mental illnesses, toxic consumption, addictions, high levels of impulsivity, low insight, associated personality disorders, in particular antisocial personality disorders. There are also protective factors, in particular the observance of treatments. Given the complexity of psychiatric and criminological risk factors and protection, can artificial intelligence (AI) help psychiatrists and magistrates to improve the predictivity of recidivism?MethodsSystematic review of the literature on AI applications in the prediction of recidivism in forensic psychiatry, conducted according to PRISMA criteria, using the: “Artificial Intelligence”, “Recidivism”, “Personality Disorder”, “Impulsive” Behavior”, “Alcohol abuse”, “Drug Abuse”, “Schizophrenia”, “Bipolar disorder” on the PubMed, Science Direct, Clinical Trial and Google Scholar databases.ResultsThe vast majority of studies come from legal or computer reviews and very few from medical databases. The studies evaluating the AI in Forensic Psychiatry most often used Machine Learning based on sociodemographic, sociological and criminological data, notably the age of the first offense and the number of previous convictions. To date, there are very few studies evaluating psychiatric parameters, focusing on psychopathic personality disorders.Discussion/conclusionThe applications of the AI in Forensic Psychiatry are still very premature. However, some psychiatric criteria should be more prominent in this field, especially those from Webster's HCR-20 and Hare PCL-R scales. The challenge will also be to find relevant behavioral, psychological and psychiatric keywords to include in AI.     

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.