Psychopathy Checklist-Revised Facet Research Articles

The Effects of Psychopathy Facets on Treatment Involvement.

The current study explored the relations between patient characteristics and psychopathic traits in predicting treatment involvement. We rated treatment involvement using detailed archival clinical files of 218 individuals committed to the Massachusetts Treatment Center (MTC). Psychopathy Checklist-Revised (PCL-R) scores had been rated from a previous study on the same sample. Overall, PCL-R Facets 2 and 4 significantly predicted decreases in treatment involvement, suggesting the characteristics associated with these facets have the most disruptive effects on treatment involvement. Exploratory analyses were also conducted assessing the relations between the PCL-R facets and the individual treatment involvement components. Whereas Facet 2 significantly predicted lower levels in all three individual treatment involvement components, Facet 4 only significantly predicted lower levels in two, highlighting the differentiating effects of these facets. Identifying the components that have either positive or negative effects on treatment involvement can allow clinicians to tailor treatments to optimize treatment involvement and outcome.

Reduced structural integrity of the uncinate fasciculus in incarcerated women scoring high on psychopathy.

Both men and women scoring high on psychopathy exhibit similar structural and functional neural abnormalities, including reduced volume of the orbitofrontal cortex (OFC) and reduced hemodynamic activity in the amygdala during affective processing experimental paradigms. The uncinate fasciculus (UF) is a white matter (WM) tract that connects the amygdala to the OFC. Reduced structural integrity of the UF, measured via fractional anisotropy (FA), is commonly associated with men scoring high on psychopathy. However, only one study to date has investigated the relationship between psychopathic traits and UF structural integrity in women, recruiting participants from a community sample. Here, we investigated whether Hare Psychopathy Checklist-Revised (PCL-R) facet scores (measuring interpersonal, affective, lifestyle/behavioral, and antisocial psychopathic traits, respectively) were associated with reduced FA in the left and right UF in a sample of 254 incarcerated women characterized by a wide range of psychopathy scores. We observed that PCL-R Facet 3 scores, assessing lifestyle/behavioral psychopathic traits, were associated with reduced FA in the left and right UF, even when controlling for participant's age and history of previous substance use. The results obtained in the current study help improve our understanding of structural abnormalities associated with women scoring high on psychopathy. Specifically, reduced UF structural integrity may contribute to some of the deficits commonly associated with women scoring high on psychopathy, including emotion dysregulation.

PSYCHOPATHY AND RISKY SEXUAL BEHAVIOR IN INCARCERATED WOMEN.

To date, very few studies have explored the association between psychopathic traits and risky sexual behavior (RSB) among women. Here, we investigated this relationship in a sample of 137 incarcerated women. Psychopathic traits were assessed via the Hare Psychopathy Checklist-Revised (PCL-R) and lifetime RSB measures, including number of lifetime sexual partners, frequency of engaging in sexual intercourse while intoxicated, and frequency of forgoing protection (e.g., condom usage) during sexual intercourse, were assessed through self-report. PCL-R Facet 3 scores (assessing lifestyle psychopathic traits) were associated with an increased frequency of engaging in sexual intercourse while intoxicated. In addition, women scoring high on the PCL-R were more likely to engage in sexual intercourse while intoxicated compared with a previously collected sample of men scoring high on the PCL-R. The results obtained in the current study help improve our understanding of the association between psychopathic traits and RSB among women.

Rational, emotional, or both? Subcomponents of psychopathy predict opposing moral decisions.

Recent research has documented a small but significant correlation between psychopathic capacities and utilitarian moral judgment, although the findings are generally inconsistent and unclear. We propose that one way to make sense of mixed findings is to consider variation in perspective‐taking capacities of psychopathic individuals. With this in mind, we had criminal offenders (n = 60), who varied in their psychopathy levels according to the Psychopathy Checklist‐Revised (PCL‐R), respond to common sacrificial moral dilemmas (e.g., trolley dilemmas) under different conditions. In a baseline condition, participants simply responded to the sacrificial moral dilemmas as is typically done in previous research. In an “emotion‐salient” condition, participants had to reason about the emotions of another person after solving moral dilemmas (deliberative processing). In the “emotion‐ambiguous” condition, participants saw images of people in distress, after solving moral dilemmas, but did not have to explicitly reason about such emotions (spontaneous processing). The four PCL‐R facets predicted distinct interference effects depending on spontaneous versus deliberative processing of hypothetical victim's emotions. The findings suggest that the use of a multi‐faceted approach to account for cognitive and moral correlates of psychopathy may help address previously mixed results. Implications and future directions for theory and research are discussed.

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.

Drug Abuse and Behavioral Transgressions during Methadone Maintenance Treatment (MMT) are Related to High Psychopathy Levels

Introduction: Studies which used the Psychopathy Checklist-Revised (PCL-R) among methadone maintenance treatment (MMT) patients focused mostly on methodological issues, without addressing its relationship to patients' misconduct during treatment. This paper tests the hypothesis that high PCL-R scores are related to high rates of drug abuse, and high numbers of behavioral transgressions in MMT during a 7-year period. Material and Methods: 107 MMT patients were recruited from a MMT clinic in Israel, and were administered the PCL-R. The questionnaires results as well as routine drug test findings were recorded between 7/2007 and 11/2007. Seven years later (7/2014), repeated drug test results were analyzed, and the number of behavioral transgressions during the entire period was computed. Results: High levels of psychopathy were related to drug test results indicating any illicit drug use, cocaine use and benzodiazepines misuse at the beginning of study, and limited to benzodiazepines misuse among patients who stayed in treatment at the 7-year follow-up. However, higher scores on different PCL-R facets were significantly associated with different types of drugs. The PCL-R's total score and all but the antisociality facet were positively correlated with a higher number of behavioral transgressions (such as, threats and/or verbal and physical aggression). Conclusions: Administration of the PCL-R during MMT may help identify patients with high illicit drug use levels and a higher chance of committing behavioral transgressions during treatment.

Facets of Psychopathy, Intelligence, and Aggressive Antisocial Behaviors in Young Violent Offenders.

Psychopathy continues to be a challenge in forensic contexts, and evidence of its association with destructive behaviors, such as aggressive antisocial behaviors, is extensive. However, the potential role of intelligence as moderator of the well-established association between psychopathy and aggressive antisocial behaviors has largely been neglected, despite intelligence having been independently related to both concepts. Increased knowledge of whether intelligence is relevant to this association is needed because of its possible implications on the assessment and treatment of individuals with psychopathic traits and aggressive antisocial behaviors. This study aimed to investigate the association between psychopathic traits, aggressive antisocial behaviors, and intelligence in young violent offenders and to test whether intelligence moderates the relationship between psychopathic traits and aggressive antisocial behaviors. Participants were 269 male violent offenders aged 18–25 years, assessed on the Psychopathy Checklist-Revised (PCL-R), the Life History of Aggression (LHA), and the General Ability Index from the Wechsler Adult Intelligence Scale, 3rd edition. Associations were tested with Spearman’s rho, and moderation analysis was performed through ordinary least squares regressions. The PCL-R four-facet structure was used for the analyses. We found a positive association between psychopathic traits and aggressive antisocial behaviors, and a small negative association between the Affective PCL-R facet and intelligence. In the moderation analyses, a small yet statistically significant moderation effect of intelligence on the association between the Interpersonal facet and LHA total scores was demonstrated. However, the amount of variance in the LHA total score explained by the model was very small: 2.9%. We suggest that intelligence, however, important for rehabilitation strategies and everyday functioning, is not necessarily pertinent to understanding aggressive antisocial behaviors in young offenders with psychopathic traits.

Sexual offender treatment outcomes among psychopathy subtypes

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.

Affective traits of psychopathy are linked to white-matter abnormalities in impulsive male offenders.

Psychopathy is a personality disorder typified by lack of empathy and impulsive antisocial behavior. Psychopathic traits may partly relate to disrupted connections between brain regions. The aim of the present study was to link abnormalities in microstructural integrity of white-matter tracts to the severity of different psychopathic traits in 15 male offenders with impulse control problems and 10 without impulse control problems. Psychopathic traits were assessed using the Psychopathy Checklist-revised (PCL-R). Diffusion-weighted MRI was used to examine white-matter tracts. Fractional anisotropy (FA), an index of white-matter integrity, was calculated for each voxel. Clusters of voxels showing a significant relationship with psychopathy severity were submitted to probabilistic tractography. No significant correlations between psychopathy severity and FA were present in the whole group of impulsive and nonimpulsive offenders. In impulsive offenders, interpersonal-affective traits (PCL-R Factor 1) were negatively correlated with FA in the anterior and posterior temporal lobe and orbitofrontal area. Further analyses indicated that elevated affective traits (PCL-R Facet 2) were specifically related to reduced FA in the right temporal lobe. Our findings suggest that white-matter abnormalities in temporal and frontotemporal tracts may be linked to the interpersonal-affective deficits of psychopathy in offenders with relatively severe impulse control problems. Our study offers novel insights into the relationships between the four facets of psychopathy and disrupted structural connectivity, and may provide new leads for further characterization of different subtypes of antisocial populations. (PsycINFO Database Record

Novel validity evidence of the Psychopathy Checklist- Revised (PCL-R) in a representative sample of Spanish inmates

Psychopathy Checklist-Revised (PCL-R) validation studies have been conducted mainly in non representative samples of North American adult male serious offenders. Research in other samples is needed to test the generalizability of PCL-R construct validity.PCL-R psychometric properties and construct validity were evaluated in a representative sample of 204 Spanish sentenced inmates. These inmates had served at least 6 months of their sentence at Pereiro de Aguiar prison. This sample was heterogeneous with respect to type of official charges and was representative, as all offenders who met the inclusion and exclusion criteria were invited to participate.Classical test theory indexes of reliability, correlations between PCL-R items, factors and facets, external correlations, and factor structure analysis demonstrated that PCL-R affective, interpersonal and lifestyle dimensions were more reliable and valid for the psychopathy than the antisocial construct in this Southern European sample.

The mediating role of emotional intelligence on the autonomic functioning – Psychopathy relationship

Reduced autonomic activity is a risk factor for psychopathy, but the mechanisms underlying this association are under-researched. We hypothesize that emotional intelligence mediates this relationship. Emotional intelligence, cognitive intelligence, scores on the Psychopathy Checklist- Revised (PCL-R), skin conductance, and heart rate were assessed in 156 men from communities in Los Angeles. Emotional intelligence fully mediated the relationship between autonomic functioning and total psychopathy after controlling for cognitive intelligence for both autonomic measures. Full mediation was also found when using PCL-R factors and facets as outcome variables, with the exception of a partial mediation of the heart rate – Antisocial facet relationship. These findings are the first to document emotional intelligence as a mediator of the blunted physiological stress activity – psychopathy relationship, and are interpreted within the framework of the somatic marker and somatic aphasia theories of psychopathy. Possible implications for treatment interventions are also discussed.

The relationship between cavum septum pellucidum and psychopathic traits in a large forensic sample

Cavum septum pellucidum (CSP) is a neuroanatomical variant of the septum pellucidum that is considered a marker for disrupted brain development. Several small sample studies have reported CSP to be related to disruptive behavior, persistent antisocial traits, and even psychopathy. However, no large-scale samples have comprehensively examined the relationship between CSP, psychopathic traits, and antisocial behavior in forensic samples. Here we test hypotheses about the presence of CSP and its relationship to psychopathic traits in incarcerated males (N = 1432). We also examined the incidence of CSP in two non-incarcerated male control samples for comparison (N = 208 and 125). Ethnic and racial composition was varied with a mean age of 33.1, and an average IQ of 96.96. CSP was evaluated via structural magnetic resonance imaging. CSP was measured by length (number of 1.0 mm slices) in continuous analyses, and classified as absent (0) or present (1+ mm), as well as by size (absent (0), small (1–3), medium (4–5), or large (6+ mm)) for comparison with prior work. The Wechsler Adult Intelligence Scale (WAIS-III), Structured Clinical Interview (SCID-I/P), and Hare Psychopathy Checklist-Revised (PCL-R) were used to assess IQ, substance dependence, and psychopathy, respectively. CSP length was positively associated with PCL-R total, Factor 1 (interpersonal/affective) and Facets 1 (interpersonal) and 2 (affective). CSP was no more prevalent among inmates than among non-incarcerated controls, with similar distributions of size. These results support the hypotheses that abnormal septal/limbic development may contribute to dimensional affective/interpersonal traits of psychopathy, but CSP is not closely associated with antisocial behavior, per se.

Childhood predictors of adult psychopathy scores among males followed from age 6 to 33

PurposePsychopathic traits are associated with multiple negative outcomes. The present prospective, longitudinal study identified associations of childhood factors with adult psychopathy scores. Methods311 men, aged, on average, 33years, were assessed using the Psychopathy Checklist-Revised (PCL-R). Predictors included neighbourhood deprivation, parents' characteristics, teacher ratings of behaviour at ages 6, 10 and 12, and academic performance at age 12. Hierarchical linear regression models were computed to identify predictors at different ages of PCL-R total and facet scores. ResultsAge 33 PCL-R total and facet scores were significantly, and independently, associated with father's and mother's criminality and mother's age at participant's birth when teacher ratings of childhood behaviours and mathematics marks were included in the models. Anxiety was negatively associated with facet 1 scores at age 6. At age 12, 22% of the variance in facet 2 scores was predicted by father's violent convictions, mother's age and criminal charges, and reactive aggression. Facet 3 scores were associated with mother's age (marginally), inattention, and reactive aggression. Facet 4 scores were associated with father's violent criminality, mother's age, conduct problems, inattention, and reactive aggression. ConclusionEtiological research and prevention programs should focus on antecedents of psychopathic traits present in early childhood.

Working Alliance and Psychopathy: Linkages to Treatment Outcome in a Sample of Treated Sexual Offenders.

The present study examined the working alliance, as measured by the full-length Working Alliance Inventory (WAI), and its association with psychopathy, treatment completion, and recidivism in a sample of 111 incarcerated adult male sexual offenders. The men completed the WAI 3 months into their treatment program, while psychopathy was measured via file-based ratings of the Hare's Psychopathy Checklist-Revised (PCL-R), and outcome data were collected via the Canadian Police Information Centre. The majority (85%) of high PCL-R scoring men (PCL-R 25+) successfully completed their treatment program, and by and large, the men demonstrated strong working alliances with their primary therapists. The WAI scale components showed differential associations with the structural features of psychopathy. Specifically, the Affective facet was significantly associated with weaker Bond scores, while the Lifestyle facet was associated with lower Task scores; these results were upheld after controlling for scores on the other PCL-R facets. Strength of alliance, however, was not significantly associated with any recidivism outcomes, irrespective of controls for psychopathy. Implications for the treatment of offenders with high levels of psychopathic traits are discussed in light of extant findings and unique features of the therapeutic alliance.

Error-related processing in adult males with elevated psychopathic traits.

Psychopathy is a serious personality disorder characterized by dysfunctional affective and behavioral symptoms. In incarcerated populations, elevated psychopathic traits have been linked to increased rates of violent recidivism. Cognitive processes related to error processing have been shown to differentiate individuals with high and low psychopathic traits and may contribute to poor decision making that increases the risk of recidivism. Error processing abnormalities related to psychopathy may be attributable to error-monitoring (error detection) or posterror processing (error evaluation). A recent 'bottleneck' theory predicts deficiencies in posterror processing in individuals with high psychopathic traits. In the current study, incarcerated males (n = 93) performed a Go/NoGo response inhibition task while event-related potentials (ERPs) were recorded. Classic time-domain windowed component and principal component analyses were used to measure error-monitoring (as measured with the error-related negativity [ERN/Ne]) and posterror processing (as measured with the error positivity [Pe]). Psychopathic traits were assessed using Hare's Psychopathy Checklist-Revised (PCL-R). PCL-R Total score, Factor 1 (interpersonal-affective traits), and Facet 3 (lifestyle traits) scores were positively related to posterror processes (i.e., increased Pe amplitude) but unrelated to error-monitoring processes (i.e., ERN/Ne). These results support the attentional bottleneck theory and further describe deficiencies related to elevated psychopathic traits that could be beneficial for new treatment strategies for psychopathy.

Psychopathy, attention, and oddball target detection: New insights from PCL-R facet scores.

Psychopathy is a disorder accompanied by cognitive deficits including abnormalities in attention. Prior studies examining cognitive features of psychopaths using ERPs have produced some inconsistent results. We examined psychopathy-related differences in ERPs during an auditory oddball task in a sample of incarcerated adult males. We extend previous work by deriving ERPs with principal component analysis (PCA) and relate these to the four facets of Hare's Psychopathy Checklist Revised (PCL-R). Features of psychopathy were associated with increased target N1 amplitude (facets 1, 4), decreased target P3 amplitude (facet 1), and reduced slow wave amplitude for frequent standard stimuli (facets 1, 3, 4). We conclude that employing PCA and examining PCL-R facets improve sensitivity and help clarify previously reported associations. Furthermore, attenuated slow wave during standards may be a novel marker for psychopaths' abnormalities in attention.

Risk assessments and recidivism among a population-based group of Swedish offenders sentenced to life in prison.

In Sweden, the number of people serving life sentences has steadily increased. To date, few studies have examined the recidivism rate or the predictive validity of different risk assessment instruments in this group. Our aim was to test the predictive validity among inmates serving life sentences of two different instruments used for assessing risk--the Historical, Clinical and Risk Management-20 (HCR-20), most widely used in clinical populations, and the Psychopathy Checklist-Revised (PCL-R), commonly applied in both penal and clinical settings. Ninety-eight life-sentenced prisoners were included, 26 of whom were released during the study period. Data on risk assessments and dates for release were collected from administrative records, while recidivism data were retrieved from a national database on criminal convictions. Sex offenders obtained the highest scores and inmates charged with domestic violent offences obtained the lowest scores on both instruments. The released prisoners were followed for a mean period of 33 months. During this time five prisoners (19%) reoffended, four of them violently, with an average time to recidivism of 10 months. Only PCL-R Facet 4, which reflects antisocial features, was significantly associated with recidivism. This small, but population-based, study demonstrates that antisocial behaviour shows incremental predictive validity for reoffending among life-sentenced offenders, but other measures have little to add for this specific task. The fact that those life sentenced prisoners who reoffended did so so soon after release should prompt allocation of earlier interventions towards preventing this.

Evaluator differences in Psychopathy Checklist-Revised factor and facet scores.

Recent research suggests that the reliability of some measures used in forensic assessments--such as Hare's (2003) Psychopathy Checklist-Revised (PCL-R)--tends to be weaker when applied in the field, as compared with formal research studies. Specifically, some of the score variability in the field is attributable to evaluators themselves, rather than the offenders they evaluate. We studied evaluator differences in PCL-R scoring among 558 offenders (14 evaluators) and found evidence of large evaluator differences in scoring for each PCL-R factor and facet, even after controlling for offenders' self-reported antisocial traits. There was less evidence of evaluator differences when we limited analyses to the 11 evaluators who reported having completed a PCL-R training workshop. Findings provide indirect but positive support for the benefits of PCL-R training, but also suggest that evaluator differences may be evident to some extent in many field settings, even among trained evaluators.

Relating sexual sadism and psychopathy to one another, non‐sexual violence, and sexual crime behaviors

Sexual sadism and psychopathy have been theoretically, clinically, and empirically linked to violence. Although both constructs are linked to predatory violence, few studies have sought to explore the covariation of the two constructs, and even fewer have sought to conceptualize the similarities of violence prediction in each. The current study considered all four Psychopathy Checklist-Revised (PCL-R) facets and employed well-defined, validated measures of sadism to elucidate the relation between sadism and psychopathy, as well as to determine the role of each in the prediction of non-sexual violence and sexual crime behaviors. Study 1 assessed 314 adult, male sex offenders using archival ratings, as well as the self-report Multidimensional Inventory of Development, Sex, and Aggression (the MIDSA). Study 2 used archival ratings to assess 599 adult, male sex offenders. Exploratory and confirmatory factor analyses of crime scene descriptions yielded four sexual crime behavior factors: Violence, Physical Control, Sexual Behavior, and Paraphilic. Sadism and psychopathy covaried, but were not coextensive; sadism correlated with Total PCL-R, Facet 1, and Facet 4 scores. The constructs predicted all non-sexual violence measures, but predicted different sexual crime behavior factors. The PCL-R facets collectively predicted the Violence and Paraphilic factors, whereas sadism only predicted the Violence factor.

Psychopathy and the combination of psychopathy and sexual deviance as predictors of sexual recidivism: Meta-analytic findings using the Psychopathy Checklist—Revised.

Clinicians routinely administer Hare's (2003) Psychopathy Checklist-Revised (PCL-R) to sex offenders and report PCL-R scores as meaningful predictors of recidivism risk. Although a 2005 meta-analysis reported a small (d=0.29) association between PCL-R scores and sexual recidivism (Hanson & Morton-Bourgon, 2005), no meta-analysis has examined effects for PCL-R factors and facets, the widely cited combination of high PCL-R and high sexual deviance scores, or potential moderators of the PCL-R/recidivism relation. We conducted a meta-analysis of effects from all available studies examining the relation between PCL-R scores and sexual recidivism (k=20, N=5,239). The effect for PCL-R Total scores predicting sexual recidivism was d=0.40, which falls beyond the upper end of the 2005 confidence interval [.20, .38]. Effects were stronger for Factor 2 (d=0.44) and Facet 4 (d=0.40) scores than other factor or facet scores (ds=0.01 to 0.17). Effects tended to be stronger for scores calculated for research (d=0.44) compared to those calculated for clinical use (d=0.28). Offenders who scored high on both the PCL-R and a measure of sexual deviance were more likely to reoffend sexually than other offenders (odds ratio=2.80 to 3.21, k=6). Results indicate that PCL-R scores, particularly combined with a measure of sexual deviance, are potentially relevant to sex offender risk. But results also underscore several practical challenges to implementing these findings in routine clinical practice.