The Clinical Use of the Hare Psychopathy Checklist–Revised (PCL-R) in Contemporary Risk Assessment

Abstract

This chapter focuses on how clinicians might best utilize the Psychopathy Checklist-Revised (PCL-R) in completing risk appraisals. It discusses the predictive literature as it pertains to the PCL-R will be reviewed, followed by some of the ethical, legal, and practical challenges that have emerged as a result of the PCL-R's increased popularity. The chapter considers base rate, type of recidivism, standard error of measurement, time to failure, overlapping confidence intervals, and the impact of differential PCL-R cutoffs on estimated failure rates and decision errors is empirically demonstrated. The PCL-R continues to capture the interest of clinicians, and the diagnosis is routinely employed in risk assessment strategies for prisoners and forensic patients at various stages within the criminal justice process, from pretrial assessments to post-release risk management. The PCL-R is also highly correlated with other risk scales, such as the Level of Service Inventory-Revised, the VRAG, and the Structured Interview of Reported.