Hare Psychopathy Checklist-Revised Research Articles

Using the PCL-R to Help Estimate the Validity of Two Self-Report Measures of Psychopathy With Offenders

Two self-report measures of psychopathy, Levenson's Primary and Secondary Psychopathy scales (LPSP) and the Psychopathic Personality Inventory (PPI), were administered to a large sample of 1,603 offenders. The most widely researched measure of criminal psychopathy, the Hare Psychopathy Checklist-Revised (PCL-R), served as a provisional referent for estimating the construct validity of these self-report measures with offenders. Compared with the LPSP, the PPI displayed higher zero-order correlations with the PCL-R, better convergent and discriminant validity, and more consistent incremental utility in predicting PCL-R scores. Furthermore, using a variant of Westen and Rosenthal's approach to evaluating the construct validity of a new measure, compared with the LPSP, the PPI's pattern of associations with measures of 35 external criterion variables was more similar to the pattern observed for the PCL-R. Results generally provide stronger support for the validity of the PPI than the LPSP in offender populations using the PCL-R as a provisional benchmark, particularly for assessing interpersonal and affective features of psychopathy.

Abnormal Brain Region Characterizes Those With Psychopathy

Back to table of contents Previous article Next article Clinical & Research NewsFull AccessAbnormal Brain Region Characterizes Those With PsychopathyJoan Arehart-TreichelJoan Arehart-TreichelSearch for more papers by this authorPublished Online:16 Oct 2009https://doi.org/10.1176/pn.44.20.0017aAdrian Raine, D.Phil., chair of criminology at the University of Pennsylvania, has a passion. It is peering into the brains of antisocial people to see whether their brains differ from those of people who are not antisocial.He is finding that such a difference does in fact exist. For instance, in 2000, he and his coworkers reported that the prefrontal cortex was significantly smaller in violent, antisocial men than in controls (Psychiatric News, March 3, 2000). In 2005, he and his colleagues reported that pathological liars had more white matter in the prefrontal cortex than normal control subjects (Psychiatric News, November 18, 2005). And now he and his colleagues reported, in the September Archives of General Psychiatry, that the amygdalae of psychopathic individuals are significantly smaller than those of nonpsychopathic individuals.The amygdala regions of the brain are known to process emotions and especially to play a role in fear. So Raine and his colleagues suspected that the amygdalae of psychopaths might differ from those of nonpsychopaths, and they launched a study to test the hypothesis.Individuals who sought work through temporary employment agencies were recruited for the initial phase of the study. They were screened with the Hare Psychopathy Checklist-Revised. The instrument assesses people for factors such as superficial charm, cunning and manipulation, pathological lying, impulsivity, irresponsibility, callousness, lack of remorse, and other psychopathic traits. A score of 23 or higher is used to define psychopathy.The researchers found 27 individuals who had a score of 23 or higher on the checklist and enrolled them in the second phase of their study. They then found 32 individuals who scored very low on the checklist (scores of 5 to 14) and who matched the 27 psychopathic subjects on age, gender, and ethnicity. These 32 individuals were enrolled as controls in the second phase of the study.During the second phase, the left amygdala and the right amygdala of each of the 59 subjects were measured with structural magnetic resonance imaging. Both the left and right amygdalae in the psychopathic group were found to be significantly smaller than those in the control group. These results held firm even when two possibly confounding factors—socioeconomic status and substance/alcohol dependence—were considered.Thus, “amygdala structural abnormalities are a key element in the neurobiological bases of psychopathy,” the researchers concluded.The researchers suggested that the possession of amygdala abnormalities might “contribute to [the] emotional and behavioral symptoms of psychopathy.” One reason why they believe this might be the case is that rats and monkeys with amygdala damage have been found to display a lack of fear, as psychopathic individuals are likely to do. Another reason may be that some patients who have experienced amygdala damage as a result of disease have been found to have difficulty responding to facial expressions. Psychopathic individuals may have the same problem.It's possible, of course, that the opposite is the case—psychopathy leads to abnormalities in amygdala volume—or that some other factors lead to both psychopathy and amygdala abnormalities.The study was funded by the National Institutes of Health.An abstract of “Localization of Deformations Within the Amygdala in Individuals With Psychopathy” is posted at<http://archpsyc.ama-assn.org/cgi/content/abstract/66/9/986>.▪ ISSUES NewArchived

Attention Moderates the Fearlessness of Psychopathic Offenders

Psychopathic behavior is generally attributed to a fundamental, amygdala-mediated deficit in fearlessness that undermines social conformity. An alternative view is that psychopathy involves an attention-related deficit that undermines the processing of peripheral information, including fear stimuli. We evaluated these alternative hypotheses by measuring fear-potentiated startle (FPS) in a group of 125 prisoners under experimental conditions that 1) focused attention directly on fear-relevant information or 2) established an alternative attentional focus. Psychopathy was assessed using Hare's Psychopathy Checklist-Revised (PCL-R). Psychopathic individuals displayed normal FPS under threat-focused conditions but manifested a significant deficit in FPS under alternative-focus conditions. Moreover, these findings were essentially unchanged when analyses employed the interpersonal/affective factor of the PCL-R instead of PCL-R total scores. The results provide unprecedented evidence that higher-order cognitive processes moderate the fear deficits of psychopathic individuals. These findings suggest that psychopaths' diminished reactivity to fear stimuli, and emotion-related cues more generally, reflect idiosyncrasies in attention that limit their processing of peripheral information. Although psychopathic individuals are commonly described as cold-blooded predators who are unmotivated to change, the attentional dysfunction identified in this study supports an alternative interpretation of their chronic disinhibition and insensitive interpersonal style.

Psychopathy and stalking.

We examined the association between psychopathy, assessed using the Hare Psychopathy Checklist-Revised: Screening Version (Hart et al., Manual for the psychopathy checklist screening version (PCL:SV), 1995), and stalking in 61 men convicted of stalking-related offenses. Psychopathic symptoms were rare, but their presence-especially that of affective deficit symptoms-was associated with victimization of casual acquaintances and with several risk factors from the Guidelines for Stalking Assessment and Management (SAM) (Kropp et al., Guidelines for stalking assessment and management, 2008a), including stalking in violation of supervision orders, degree of preoccupation with victims, and targeting of victims with limited access to external resources. The findings suggest that in spite of their rarity, psychopathic traits may be important in the assessment and management of stalking risk.

Brief Communication: Psychopathy and Recognition of Facial Expressions of Emotion

This study investigated the relationship between symptom clusters of psychopathy, as measured by the Hare Psychopathy Checklist-Revised (PCL-R; Hare 1991), and ability to recognize facial expressions of emotion. Participants were 43 adult male inmates. Facial expressions of emotion were taken from Ekman and Frisen (1976). The present results indicated that there were some significant relationships between facets of psychopathy and processing of disgust facial expressions. The experiment highlighted the importance of studying specific clusters of psychopathic symptoms, as opposed to measures of global symptomatology.

Intoxication and violent women

Alcohol and drugs have been linked to severe violent offending among women as well as men. The purpose of this study was to make a contribution to the limited knowledge of characteristics related to the state of intoxication in violent female offenders. The putative differences in the characteristics of female offenders and their violent offenses in relation to the state of intoxication at the time of the violent offending were examined. Of a nation-wide sample of 109 female offenders found guilty of homicide and other violent crimes and incarcerated in 1999-2000 in Finland, 60 offenders participated in the study. Of these offenders 49 (81.7%) had been intoxicated at the time the of index offenses. These were compared with 11 (18.3%) non-intoxicated offenders using a structured interview, the Structured Clinical Interview II for DSM-IV (SCID-II) and the Hare Psychopathy Checklist-Revised (PCL-R). The prevalence of substance abuse or dependence (73.3% and 0%), personality disorder (89.6% and 36.4%), particularly antisocial personality disorder (66.7% and 0%), as well as a history of criminality (69.4% and 0%) were significantly higher among the intoxicated women than among the non-intoxicated. The PCL-R scores were also significantly higher among the intoxicated offenders than among non-intoxicated offenders. The victims of the intoxicated women (23.9%) were less often emotionally close to the perpetrator than were the victims of the non-intoxicated women (66.6%). No differences emerged between the groups in experiences of childhood and adulthood abuse or stressful life events prior to the index crime. The findings indicate that intoxicated violent female offenders exhibit more of the characteristics previously found in violent men, than do the non-intoxicated female offenders. Moreover, the non-intoxicated group comprises both psychotic non-responsible and non-psychotic, fairly well-adjusted women, who are educated, working or studying at the time of the offense and has no history of criminality. Substance misuse constitutes an obvious risk factor for violent behavior in women, and therefore the prevention should include substance abuse treatment.

Comparison of Personality Traits in Pedophiles, Abstinent Opiate Addicts, and Healthy Controls

To investigate the model of pedophilia as a disorder of addictive behavior, pedophiles and chemically addicted individuals were compared on personality traits potentially associated with impaired behavioral inhibition. Twenty-nine pedophiles, 25 opiate addicts (OA's), and 27 healthy controls were administered the Barratt Impulsivity Scale, Hare Psychopathy Checklist-Revised (PCL-R), and Structured Clinical Interview for DSM-V for Axis-II. OA's scored higher than either pedophiles or controls on the Barratt. Pedophiles and OA's scored higher than controls on all 3 Psychopathy Checklist-Revised scores but OA's scored marginally higher than pedophiles on factor 2 (behavioral) and total scores. On Structured Clinical Interview for DSM-V for Axis-II, pedophiles scored higher than controls on paranoid and schizoid scores whereas OA's did so on paranoid scores. Thus, both pedophiles and OA's may have elevated psychopathic traits and propensity toward cognitive distortions, as reflected in cluster A traits. Such similarities support the conceptualization of pedophilia as a behavioral addiction. Pedophiles may be less impulsive than OA's, however, and more prone toward cognitive distortions.

A five-factor model perspective on psychopathy and comorbid Axis-II disorders in a forensic–psychiatric sample

The validity of DSM-IV predictions [Widiger, T. A., Trull, T. J., Clarkin, J. F., Sanderson, C. J., & Costa, P. T., (2002). A description of the DSM-IV personality disorders with the five-factor model of personality. In Costa, P. T. & Widiger, T. A. (Eds.), Personality disorders and the five-factor model of personality (2nd ed.). Washington DC: American Psychological Association] concerning Antisocial Personality Disorder and the validity of the hypothesized associations between the Five-Factor Model and psychopathy were examined in 48 male forensic–psychiatric patients. Prevalence of psychopathy and comorbid personality pathology was also investigated, as well as the convergent validity of two Dutch personality disorder inventories. Patients provided self-descriptions on the NEO-PI-R [Costa, P. T., & McCrae, R. R., (1992b). Professional Manual: Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor-Inventory (NEO-FFI). Odessa, FL: Psychological Assessment Resources], and were administered the VKP [Duijsens, I. J., Haringsma, R., & EurelingsBontekoe, E. H. M., (1999). Handleiding VKP (Vragenlijst voor kenmerken van de persoonlijkheid). Gebaseerd op DSM-IV en ICD-10. Leiderdorp: Datec] and the ADP-IV [Schotte, C. K. W., & De Doncker, D. A. M., (1994). ADP-IV Questionnaire. Antwerp Belgium: University Hospital Antwerp] to assess personality pathology. Psychopathy was assessed using Hare's Psychopathy Checklist—Revised (PCL-R; [Hare, R. D., (1990). The Hare Psychopathy Checklist Revised Manual. Toronto: Multi-Health Systems]) based on a semi-structured interview and file records of psychiatric and psychological evaluations and criminal history. Results underscored the validity of the FFM Antisocial PD associations, but the hypothesized correlations between the FFM and Psychopathy were less supported. Results supported the convergent validity of the ADP-IV and the VKP, both at the dimensional and categorical level. Around 55% met the diagnostic threshold of psychopathy, and Antisocial PD was the most prevalent disorder in the psychopathic group, consistent with previous research. Sizeable personality comorbidity was also observed.

Does interrater (dis)agreement on Psychopathy Checklist scores in sexually violent predator trials suggest partisan allegiance in forensic evaluations?

Many studies reveal strong interrater agreement for Hare's Psychopathy Checklist-Revised (PCL-R) when used by trained raters in research contexts. However, no systematic research has examined agreement between PCL-R scores from independent clinicians who are retained by opposing sides in adversarial legal proceedings. We reviewed all 43 sexual-offender civil-commitment trials in one state and identified 23 cases in which opposing evaluators reported PCL-R total scores for the same individual. Differences between scores from opposing evaluators were usually in a direction that supported the party who retained their services. These score differences were greater in size than would be expected based on the instrument's standard error of measurement or the rater agreement values reported in previous PCL-R research. The intraclass correlation for absolute agreement for the PCL-R Total score from a single rater (ICC 1,A = .39) was well below levels of agreement observed for the PCL-R in research contexts, and below published test-retest values for the PCL-R. Results raise concerns about the potential for a forensic evaluator's "partisan allegiance" to influence PCL-R scores in adversarial proceedings.

Psychopathy as a Clinical and Empirical Construct

In this review, we focus on two major influences on current conceptualizations of psychopathy: one clinical, with its origins largely in the early case studies of Cleckley, and the other empirical, the result of widespread use of the Hare Psychopathy Checklist-Revised (PCL-R) for assessment purposes. Some investigators assert that the PCL-R, ostensibly based on Cleckley's work, has "drifted" from the construct described in his Clinical Profile. We evaluate this profile, note its basis in an unrepresentative sample of patients, and suggest that its literal and uncritical acceptance by the research community has become problematical. We also argue that the idea of construct "drift" is irrelevant to current conceptualizations of psychopathy, which are better informed by the extensive empirical research on the integration of structural, genetic, developmental, personality, and neurobiological research findings than by rigid adherence to early clinical formulations. We offer some suggestions for future research on psychopathy.

A magnetic resonance spectroscopy study of antisocial behaviour disorder, psychopathy and violent crime among military conscripts.

Prefrontal and/or temporo-limbic abnormalities associated with antisocial personality disorder (APD), high psychopathy scores and violent behaviours can readily be evaluated by neuroimaging methods. In this study, we compared the brain metabolites in adult male military conscripts with APD, high psychopathy scores and serious violent crimes (n = 15) with age- and educational-level-matched healthy controls (n = 15) by means of magnetic resonance spectroscopy. All cases were diagnosed by means of the Diagnostic Statistical Manual-IV APD module of the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II) semistructured questionnaire in Turkish. The psychopathy scores were evaluated by means of the Hare Psychopathy Checklist-Revised translated into Turkish (PCL-R). PCL-R is a 20-item, reliable and valid instrument for assessment of psychopathy, both in categorical and dimensional natures. All patients had a total score of 29 (of possible 40) or higher from PCL-R, indicating a high degree of psychopathy. Our results showed no significant differences in ratio of N-acetyl aspartate (NAA), creatine (Cr) and choline-related compounds in the right dorsolateral prefrontal cortex, anterior cingulate cortex (ACC) and amygdala-hippocampus regions of cases compared with controls. ACC NAA/Cr was significantly negatively correlated with both the PCL-R total score and the PCL-R factor I score (interpersonal/affective problems) among the cases. As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.

Review of Handbook of psychopathy.

Handbook of Psychopathy, by Christopher J. Patrick (Ed.). The Guilford Press, 2007, 651 pages (ISBN: 978-1-59385-591-8, CA$36.00 Paperback) Reviewed by HUGUES HERVE DOI : 10.1037/0708-5591.49.1.70 Although accounts of psychopaths are found across time and cultures, it was not until the mid-to-late 20th century that psychopathy became an accepted clinical syndrome. It was Cleckley, in his influential book, The Mask of Sanity (1941/1988), who first introduced a well-defined set of symptoms anchored in rich case examples. It served as the basis for the development of the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003), which has since established itself as the measure of choice for assessing psychopathy. The emergence of the PCL-R and its derivatives has not only served to clarify the distinction between psychopathy and other externalizing conditions, particularly antisocial personality disorder (APD), but has also led to great empirical and clinical advancements, as well as new debates. The Handbook of Psychopathy aims to address these new developments. It is a well-written text edited by Christopher J. Patrick, a well-published researcher in the area of psychopathy and affect. The book includes 31 chapters from leading researchers in the field. Chapters are organised into six sections, although the final one consists solely of a summary commentary by Patrick. The first section, Theoretical and Empirical Foundations, begins with Lykken's short but apt review of the construct of psychopathy. Fowles and Dindo, and Blackburn, respectively, then provide an overview of relevant theories. Together, these chapters offer a nice introduction to this volume. This section concludes with a review of the history of the PCL-R by Hare and Neumann, with a strong argument for the statistical strengths of the recent reconceptualisation of the PCL-R as reflecting a hierarchical construct comprised of two superordinate factors (Interpersonal/Affective and Social Deviance), which each contain two subordinate facets (Interpersonal and Affective, and Lifestyle and Antisocial, respectively). The second section, Issues in Conceptualization and Assessment, begins with Cooke, Michie and Hart defending their three facet model of psychopathy, one in which the Antisocial facet is relegated to a simple manifestation of the disorder, not a core feature. They also provide insights into the implications of Item Response Theory in understanding currently debated topics (e.g., whether symptom sensitivity/specificity generalise across groups or can be improved). Lilienfeld and Fowler then review the current evidence in support of, as well as the need for, self-report measures of psychopathy. The next two chapters attempt to map the PCL-R construct of psychopathy onto other popular nomenclatures, with Lynam and Derefinko doing so compellingly from the perspective of structural (or dimensional) models of personality and Widiger via the association between psychopathy and various DSM disorders. Poythress and Skeem then discuss the newly revived notion of psychopathic subtypes and provide a strong but overly focused review of the primary-secondary distinction. This section concludes with a summary chapter by Krueger. The third section, Etiological Mechanisms, largely focuses on the neurobiological correlates of psychopathy. Waldman and Rhee review twin and adoption studies, as well as important methodological issues associated with externalizing conditions to help clarify the genetic by environment underpinnings of psychopathy. Minzenberg and Siever present a mechanical discussion of the neurochemistry and pharmacotherapy of externalizing conditions. In contrast, Raine and Yang provide a strong chapter reviewing the evolving research on structural and functional neuroanatomical correlates of antisociality and psychopathy, as well as associated features, with attention to the limits and implications of this line of enquiry. …

Effects of Diagnostic Comorbidity and Dimensional Symptoms of Attention-Deficit–Hyperactivity Disorder in Men with Antisocial Personality Disorder

Although children with attention deficit hyperactivity disorder (ADHD) are at increased risk for later onset of antisocial personality disorder (APD) as adults, the utility of ADHD as either a comorbid diagnosis (ADHD(c)) or dimensional symptoms (ADHD(d)) in predicting behaviour and substance use problems in APD subjects has not been examined. A total of 105 adult male offenders with Structured Clinical Interview for Axis II Disorders (SCID-II)-based DSM-III-R APD were studied in terms of: (i) psychopathy scores on the Hare Psychopathy Checklist-Revised (PCL-R); (ii) ADHD(c) diagnostic comorbidity on clinically administered DSM-IV questionnaire; and (iii) ADHD(d) dimensional symptoms by means of Wender Utah Rating Scale (WURS) and Conners Adult ADHD Rating Scale (CAARS) during a 12 month study period (May 2005-May 2006). Sixty five per cent of APD subjects met criteria for ADHD(c) diagnostic comorbidity with significantly increased rates of childhood neglect, parental divorce and suicide attempt, but not of psychopathy. APD subjects with ADHD(d) symptoms were noted to have earlier onset and increased rate of self-injurious behaviour (SIB), suicide attempt, and psychopathy. The psychopathy scores, in turn, were predictive of earlier onset of SIB and behavioural problems. Both ADHD(c) diagnostic comorbidity and ADHD(d) symptoms need to be assessed in APD subjects and the dimensional measures may be better in detecting earlier onset SIB, suicide attempt and other behavioural problems.

Facets of Psychopathy, Heart Rate Variability and Cognitive Function

The aim of the present study was to investigate whether the four facets of Hare's Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Bolt, Hare, Vitale, & Newman, 2004) were related to physiological and cognitive mechanisms. Fifty-three male prisoners participated in this study. Physiological responses were measured as heart rate variability (HRV) and heart rate (HR). Cognitive functions were measured using a continuous performance test (CPT; California Computerized Assessment Package, Abbreviated version) and a working memory test (WMT); based on Baddeley & Hitch (1974). The regression analysis of the HRV revealed that the interpersonal facet explained most of the variance during baseline (28%), CPT (16%), and WMT (12%). This was also true for the HR data during baseline (28%), CPT (20%), WMT (10%), and recovery (13%). The antisocial facet explained 10% of the variance only during baseline. Subjects scoring high compared to low on the interpersonal facet also showed better cognitive functioning. The study suggests that the different facets were differently associated with both physiological and cognitive functions.

The content validity of juvenile psychopathy: An empirical examination.

This study examined the content validity of a juvenile psychopathy measure, the Childhood Psychopathy Scale (CPS; D. R. Lynam, 1997), based on a downward translation of an adult instrument, the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). The CPS was compared with two other indices of juvenile psychopathy: (a) an index derived from expert ratings and (b) an empirical index based on correlations with adult psychopathy. The 100 items of the Common Language Q-Sort (CLQ; A. Caspi et al., 1992) provided a common metric for the comparison. Psychopathy and personality were assessed at age 13 years with the mother-reported CPS and the CLQ. Psychopathy was assessed at age 24 years with the interviewer-rated Psychopathy Checklist: Screening Version (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995). Data from over 250 participants of the middle sample of the Pittsburgh Youth Study were used to examine these relations. Item content analyses demonstrated considerable overlap among the three indices, indicating that the downward translation utilizes criteria similar to those of experts and the empirically-derived measure. In addition, these indices, even after removing overlapping items, demonstrated considerable convergence, also supporting the content validity of the downward translation. These results suggest that the downward translation method is adequate for understanding the juvenile psychopathy construct.

Response perseveration in psychopaths: Interpersonal/affective or social deviance traits?

In order to clarify the role of the two broad components of psychopathy (interpersonal/affective and social deviance; R. D. Hare, 2003) in explaining maladaptive response perseveration in psychopaths, as well as the role of reflection after punished responses in this deficit, the authors administered a card perseveration task to 47 Spanish male inmates assessed using the Hare Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991). Hierarchical regressions showed that psychopaths' maladaptive perseveration (more cards played and less money earned) was uniquely predicted by the social deviance features of psychopathy (PCL-R Factor 2)--particularly by its impulsive and irresponsible lifestyle facet (PCL-R Facet 3)--and not by its interpersonal/affective features (PCL-R Factor 1). Moreover, perseveration was related to a lack of reflection both after punishment and after reward feedback. The authors' results, in conjunction with previous evidence indicating perseverative deficits in several impulse control disorders, suggest that response perseveration may not be specific to psychopathy but rather is associated more generally with the externalizing dimension of psychopathology.

Tridimensional Personality Questionnaire data on alcoholic violent offenders: specific connections to severe impulsive cluster B personality disorders and violent criminality

BackgroundThe validity of traditional categorical personality disorder diagnoses is currently re-evaluated from a continuous perspective, and the evolving DSM-V classification may describe personality disorders dimensionally. The utility of dimensional personality assessment, however, is unclear in violent offenders with severe personality pathology.MethodsThe temperament structure of 114 alcoholic violent offenders with antisocial personality disorder (ASPD) was compared to 84 offenders without ASPD, and 170 healthy controls. Inclusion occurred during a court-ordered mental examination preceded by homicide, assault, battery, rape or arson. Participants underwent assessment of temperament with the Tridimensional Personality Questionnaire (TPQ) and were diagnosed with DSM-III-R criteria.ResultsThe typical temperament profile in violent offender having ASPD comprised high novelty seeking, high harm avoidance, and low reward dependence. A 21% minority scored low in trait harm avoidance. Results, including the polarized harm avoidance dimension, are in accordance with Cloninger's hypothesis of dimensional description of ASPD. The low harm avoidance offenders committed less impulsive violence than high harm avoidance offenders. High harm avoidance was associated with comorbid antisocial personality disorder and borderline personality disorder.ConclusionResults indicate that the DSM based ASPD diagnosis in alcoholic violent offenders associates with impulsiveness and high novelty seeking but comprises two different types of ASPD associated with distinct second-order traits that possibly explain differences in type of violent criminality. Low harm avoidance offenders have many traits in common with high scorers on the Hare Psychopathy Checklist-Revised (PCL-R). Results link high harm avoidance with broad personality pathology and argue for the usefulness of self-report questionnaires in clinical praxis.

Review of The psychopath: Theory, research and practice.

HUGUES HERVE and JOHN C. YUILLE The Psychopath: Theory, Research and Practice New Jersey: Lawrence Erlbaum Associates, 2007, 592 Pages (ISBN: 0-8058-5053-8, C$135.00, Cloth) Reviewed by MARC NESCA The Psychopath: Theory, Research, ana Practice is an edited text that grew out of a 2000 Festschrift celebrating Dr. Hare's retirement from academia. The identified audience for this book includes both lay (e.g., judges) and professional (e.g., forensic practitioners) consumers, as well as students and researchers. The book begins with an historical overview of the construct of psychopathy and then works its way through a variety of important issues, including measurement, etiology, behavioural manifestations of the disorder, typologies, and practice considerations. The first section opens with a balanced and informative overview of the psychopathy literature written by Dr. Hare. This overview highlights progress made since the emergence of the Hare Psychopathy Checklist-Revised (PCL-R) as the gold standard diagnostic instrument for psychopathy, with links drawn to the diverse areas of inquiry that have been impacted by Dr. Hare's work. The main theme of this chapter is that our understanding of psychopathy has increased significantly as a result of the development of a valid and reliable diagnostic instrument. Indeed, Dr. Hare explicitly warns that loosening of the operational definition of psychopathy may ... result in a partial return to the conceptual and measurement confusion JA that held sway some 20 years ago (p. 7). Among the high points of this book are chapters examining the affective-interpersonal features of psychopathy, the link between psychopathy and crime scene analysis, psychopathy in women, psychopathy in youth, and the role of psychopathy in domestic violence. The latter includes a very interesting, albeit quite brief, discussion of treatment issues for psychopathic batterers. The chapter on psychopathy in women is also very well written and includes a clear synthesis of current knowledge about psychopathic women. Measurement issues in the study of psychopathic youths, as well as the conceptual underpinnings of the PCL-YV, also receive solid reviews. Similarly, Dr. O'Toole's chapter on crime scene analysis is quite interesting and informative. The proposed typology (based on the work of the first editor) is consistent with the four-factor model of psychopathy preferred by Dr. Hare and promises to have more clinical relevance than other existing typologies. To my mind, however, the chapter examining the affective-interpersonal features of psychopathy is the true highlight of this book. Dr. Patrick's writing style is pleasant and engaging while maintaining scientific integrity, and his review of findings from such diverse fields of inquiry as neuroscience and social psychology is outstanding. Finally, the proposed dual-process model of psychopathy is elegant, parsimonious, and both clinically and scientifically compelling. In fact, the only obvious flaw in this chapter is the poor quality of the figures. Parenthetically, with very few exceptions, this problem mars the entire book, with most figures appearing to be little more than simple photocopies of presentation overheads or slides. In fact, the quality of some figures is sufficiently poor to render them useless. The remaining chapters in this book are unfortunately of lesser quality: Some provide little beyond superficial reviews of well-known bodies of work (e.g., psychopathy and violent crime), while others stray off topic to the point that psychopathy becomes secondary to some other issue. Chapter three, for example, often strays into discussions and opinions regarding general risk assessment and, in this reviewer's opinion, includes far too much discussion of the VRAG (a risk assessment instrument developed by the authors of the chapter) for a text on psychopathy. Chapters four and five overlap considerably and focus on statistical issues to a degree that is more appropriate for a textbook on statistics than a reference book on psychopathy. …

Using a General Model of Personality to Identify the Basic Elements of Psychopathy

In the present paper, we outline why we believe that factor analyses of the Hare Psychopathy Checklist Revised (Hare, 2003) are unlikely to yield the basic elements of psychopathy. As an alternative approach, we suggest embedding psychopathy within a broad model of general personality functioning, namely the five factor model (McCrae & Costa, 1990). Drawing on our previous work in the area using expert ratings, correlational approaches, and a "translation" of the PCL-R, we provide a consensus description of the core elements of psychopathy: extremely high interpersonal antagonism, pan-impulsivity, the absence of negative self-directed affect, the presence of angry hostility, and interpersonal assertiveness. We end with a discussion of the implications of this analysis for understanding, researching, and measuring psychopathy.

Hare Psychopathy Checklist Revised profiles of male patients with Asperger's syndrome detained in high security psychiatric care

‘Asperger's syndrome’ (AS) is a pervasive developmental disorder falling at the high end of functioning along the autistic spectrum. It is characterized by significant impairments in social communi...