Sexual offender treatment outcomes among psychopathy subtypes

Abstract

PurposeThe purpose of this paper is to examine sexual offender treatment responses as a function of psychopathy subtype.Design/methodology/approachMeasures of sexual violence risk, treatment change and outcome variables were coded retrospectively on a sample of 86 high Psychopathy Checklist-Revised (PCL-R) scoring sexual offenders. Psychopathy subtypes were identified through cluster analysis of PCL-R facet scores.FindingsTwo subtypes were identified labeled classic and aggressive. They were comparable in their level of risk and need and did not differ in rates of treatment completion or change. The aggressive subtype had higher rates of violent and general recidivism and higher frequencies of major mental disorder and cognitive disability. Results of Cox regression survival analysis demonstrated that treatment-related changes in risk were associated with reductions in violent recidivism for the aggressive, but not classic, psychopathy variant.Practical implicationsPsychopathy is a heterogeneous syndrome. Moreover, psychopathic offenders can demonstrate risk relevant treatment changes. PCL-R facet profiles have important responsivity implications. However, not all psychopathic offenders fare poorly in treatment.Originality/valueThis is one of very few studies to examine treatment response and links to outcome among psychopathic offenders, particularly as this relates to subtype.