Testing a Four-Factor Model of Psychopathy and Its Association With Ethnicity, Gender, Intelligence, and Violence

Response inhibition in the parametric Go/No-Go task in psychopathic offenders

Previous research on response inhibition in psychopaths has failed to find consistent evidence for aberrant inhibitory ability, despite strong expectations to the contrary. However, previous examinations have utilised inhibition paradigms that suffer from critical shortcomings, such as a lack of ecological validity and overly simplistic response criteria. To assess inhibition under conditions close to the demands of everyday settings, the current study employs a parametric Go/No-go task in male offenders (n77). Additionally, rather than treating psychopathy as a categorical descriptor, a dimensional approach is taken to assess the relationship between individual psychopathic traits and response inhibition performance. Results indicate significant relationships between response inhibition and individual facets of psychopathy as measured by the Psychopathy Checklist: Screening Version. A positive relationship was found between inhibitory ability and interpersonal aspects of psychopathy, reflecting an enhancement of inhibitory functioning for those scoring high on this facet. In addition, a negative association was found between psychopathic lifestyle characteristics and response inhibition. Whereas the negative association mirrors the conceptualisation of the lifestyle facet, the positive association between interpersonal psychopathic aspects and response inhibition might reflect a propensity for adaptive behaviour that enables psychopaths to adequately manipulate their victims and mask their true nature.

A Statistical Consideration Regarding the Threshold of the Psychopathy Checklist-Revised

The Psychopathy Checklist-Revised (PCL-R; Hare, 2003 ) is one of the most commonly used measures of psychopathy. Scores range from 0 to 40, and legal and mental health professionals sometimes rely on a cut score or threshold to classify individuals as psychopaths. This practice, among other things, assumes that all items contribute equally to the overall raw score. Results from an item response theory analysis (Bolt, Hare, Vitale, & Newman, 2004 ), however, indicate that PCL-R items differ in the amount of information they can provide about psychopathy. We examined the consequences of these item differences for using a cut score, detailing the consequences for a previously applied cut score of 30 as an example. Results indicated that there were more than 8.5 million different response combinations that equaled 30 and more than 14.2 million that equaled 30 or more. This raw score, like others, corresponded to a broad range of PCL-R-defined psychopathy, indicating that applying cut scores on this measure results in imprecise quantifications of psychopathy. We show that by using the item parameters along with an individual's particular scores on the PCL-R items, it is possible to arrive at a more precise understanding of an individual's level of psychopathy on this instrument.

Psychopathic Personality in the General Population: Differences and Similarities Across Gender

This study aimed to identify distinct subgroups of adults in a general population sample (N = 2,500; 52.6% females) based on their scores on three psychopathy dimensions. Using latent profile analysis, five groups were identified among males and females separately, including a psychopathic personality group. Multivariate analyses of variance showed that this latter group had higher levels of aggression, offending, substance use, attention-deficit/hyperactivity symptoms, internalizing problems, and maltreatment than most of the other groups. Associated features of males and females with a psychopathic personality were very similar; however, salient gender differences did emerge. Specifically, females with a psychopathic personality were more frequently exposed to sexual abuse, expressed more emotional difficulties, and engaged in higher levels of relational aggression. In conclusion, person-oriented analyses identified adults with a personality that looks like psychopathy, and furthered our understanding of gender similarities and differences in these adults.

Association of Fluid Intelligence and Psychiatric Disorders in a Population-Representative Sample of US Adolescents

IMPORTANCE

Despite long-standing interest in the association of psychiatric disorders with intelligence, few population-based studies of psychiatric disorders have assessed intelligence.

OBJECTIVE

To investigate the association of fluid intelligence with past-year and lifetime psychiatric disorders, disorder age at onset, and disorder severity in a nationally representative sample of US adolescents.

DESIGN, SETTING, AND PARTICIPANTS

National sample of adolescents ascertained from schools and households from the National Comorbidity Survey Replication-Adolescent Supplement, collected 2001 through 2004. Face-to-face household interviews with adolescents and questionnaires from parents were obtained. The data were analyzed from February to December 2016. DSM-IV mental disorders were assessed with the World Health Organization Composite International Diagnostic Interview, and included a broad range of fear, distress, behavior, substance use, and other disorders. Disorder severity was measured with the Sheehan Disability Scale.

MAIN OUTCOMES AND MEASURES

Fluid IQ measured with the Kaufman Brief Intelligence Test, normed within the sample by 6-month age groups.

RESULTS

The sample included 10 073 adolescents (mean [SD] age, 15.2 [1.50] years; 49.0% female) with valid data on fluid intelligence. Lower mean (SE) IQ was observed among adolescents with past-year bipolar disorder (94.2 [1.69]; P = .004), attention-deficit/hyperactivity disorder (96.3 [0.91]; P = .002), oppositional defiant disorder (97.3 [0.66]; P = .007), conduct disorder (97.1 [0.82]; P = .02), substance use disorders (alcohol abuse, 96.5 [0.67]; P < .001; drug abuse, 97.6 [0.64]; P = .02), and specific phobia (97.1 [0.39]; P = .001) after adjustment for a wide range of potential confounders. Intelligence was not associated with posttraumatic stress disorder, eating disorders, and anxiety disorders other than specific phobia, and was positively associated with past-year major depression (mean [SE], 100 [0.5]; P = .01). Associations of fluid intelligence with lifetime disorders that had remitted were attenuated compared with past-year disorders, with the exception of separation anxiety disorder. Multiple past-year disorders had a larger proportion of adolescents less than 1 SD below the mean IQ range than those without a disorder. Across disorders, higher disorder severity was associated with lower fluid intelligence. For example, among adolescents with specific phobia, those with severe disorder had a mean (SE) of 4.4 (0.72) points lower IQ than those without severe disorder (P < .001), and those with alcohol abuse had a mean (SE) of 5.6 (1.2) points lower IQ than those without severe disorder (P < .001).

CONCLUSIONS AND RELEVANCE

Numerous psychiatric disorders were associated with reductions in fluid intelligence; associations were generally small in magnitude. Stronger associations of current than past disorders with intelligence suggest that active symptoms of psychiatric disorders interfere with cognitive functioning. Early identification and treatment of children with mental disorders in school settings is critical to promote academic achievement and long-term success.

Developmental Antecedents of the Facets of Psychopathy: The Role of Multiple Abuse Experiences

The etiology of psychopathy remains poorly understood, despite the wealth of studies focused on examining this serious and complex personality disorder. The present study explored the contribution of psychological, physical, and sexual abuse in predicting PCL-R facet and total scores. The study was conducted on a sample of 397 adult male sexual offenders, using archival ratings and developmental data gathered with a self-report inventory, the Multidimensional Assessment of Sex and Aggression (the MASA). All types of abuse covaried with the total PCL-R score, but the kinds of abuse were differentially associated with the facet scores. Sexual abuse was positively associated with Interpersonal and Lifestyle facet scores, whereas physical abuse was associated with Lifestyle and Antisocial facets. Psychological abuse covaried with the Affective facet, but the relation was negative. The results of the structural equation model underscored the significance of physical abuse, above and beyond psychological and sexual abuse.

Score Metric Equivalence of the Psychopathy Checklist–Revised (PCL-R) Across Criminal Offenders in North America and the United Kingdom

David Cooke and colleagues have published a series of item response theory (IRT) studies investigating the equivalence of the Psychopathy Checklist-Revised (PCL-R) for European versus North American (NA) male criminal offenders. They have consistently concluded that PCL-R scores are not equivalent, with European offenders receiving scores up to five points lower than those in NA when matched according to the latent trait. In this article, the authors critique the Cooke et al. analyses and demonstrate how their anchor item selection method is responsible for their final conclusions concerning the apparent lack of equivalence. The authors provide a competing IRT analysis using an iterative purification strategy for anchor item selection and show how this more justifiable approach leads to very different conclusions regarding the equivalence of the PCL-R. More generally, it is argued that strong interpretations of IRT analyses in the presence of uncorroborated anchor items can be highly misleading when evaluating score metric equivalence.

Initial development of an implicit and explicit approach to assess psychopathy

Four studies outline the ACL (Affective, Cognitive and Lifestyle) assessment, a new means of assessing psychopathy capturing implicit and explicit functioning. Studies 1 and 2 comprised students (Study 1, n=42, 14 men, 28 women; Study 2, n=50 men), Study 3 comprised 80 young prisoners (men) and Study 4, 40 forensic psychiatric patients (men). It was predicted that the ACL affective, cognitive and interpersonal components would positively correlate with the interpersonal factor of another measure of psychopathy (PCL-SV), whereas the ACL Lifestyle component would correlate with the criminal history/lifestyle component of the PCL-SV. Evidence for internal reliability for the ACL was noted. The ACL correlated as expected with the PCL-SV although variation across samples was noted. Implicit affect and specific aspects of cognition positively correlated with increased psychopathy on the PCL-SV. Implicit affect correlated differently across samples. Findings are discussed regarding implications. Directions for future research are indicated.

Examining the Factor Structure of the Self-Report of Psychopathy Short-Form Across Four Young Adult Samples

Psychopathy refers to a range of complex behaviors and personality traits, including callousness and antisocial behavior, typically studied in criminal populations. Recent studies have used self-reports to examine psychopathic traits among noncriminal samples. The goal of the current study was to examine the underlying factor structure of the Self-Report of Psychopathy Scale-Short Form (SRP-SF) across complementary samples and examine the impact of gender on factor structure. We examined the structure of the SRP-SF among 2,554 young adults from three undergraduate samples and a high-risk young adult sample. Using confirmatory factor analysis, a four-correlated factor model and a four-bifactor model showed good fit to the data. Evidence of weak invariance was found for both models across gender. These findings highlight that the SRP-SF is a useful measure of low-level psychopathic traits in noncriminal samples, although the underlying factor structure may not fully translate across men and women.

Psychopathy in a Multiethnic World: Investigating Multiple Measures of Psychopathy in Hispanic, African American, and Caucasian Offenders

Despite the forensic relevance of psychopathy and the overrepresentation of Hispanics in the United States’ criminal justice system, these two issues remain underexplored, particularly with self-report measures of psychopathy. We investigated the criterion validity of three psychopathy measures among African Americans, Caucasians, and Hispanics in a sample of 1,742 offenders. More similarity than dissimilarity emerged across groups. The factor structures of psychopathy measures among Hispanic offenders were consistent with previous findings. Few significant differences emerged between Hispanic and Caucasian offenders, with most differences emerging between African Americans and the other ethnic groups. In such instances, the correlates of psychopathy were typically weaker for African Americans. The Psychopathy Checklist–Revised yielded fewer psychopathy × ethnicity interactions than the Psychopathic Personality Inventory and Levenson Primary and Secondary Psychopathy Scales. Overall, these psychopathy measures showed reasonable validity across these cultural groups.

Validity of the Self-Report Psychopathy Scales (SRP-III Full and Short Versions) in a Community Sample

The psychometric properties of the 64-item Self-Report Psychopathy Scale-III (SRP-III) and its abbreviated 28-item SRP-Short Form (SRP-SF) seem promising. Still, cross-cultural evidence for its construct validity in heterogeneous community samples remains relatively scarce. Moreover, little is known about the interchangeability of both instruments. The present study addresses these research gaps by comparing the SRP-III and SRP-SF factorial construct validity and nomological network in a Belgian community sample. The four-factor model of psychopathy was evaluated ( N = 1,510) and the SRP scales' relationship with various external correlates (i.e., attachment, bullying and victimization, right-wing attitudes, right-wing authoritarianism, and response styles) was examined ( n = 210). Both SRP versions demonstrated a good fit for the four-factor model and a considerable overlap with the nomological network of psychopathy. The results suggested that the SRP-SF provides a viable alternative to the SRP-III for assessment in the community. Theoretical and practical implications are discussed.

Mapping the association of global executive functioning onto diverse measures of psychopathic traits

Psychopathic individuals display a callous-coldhearted approach to interpersonal and affective situations and engage in impulsive and antisocial behaviors. Despite early conceptualizations suggesting that psychopathy is related to enhanced cognitive functioning, research examining executive functioning (EF) in psychopathy has yielded few such findings. It is possible that some psychopathic trait dimensions are more related to EF than others. Research using a 2-factor or 4-facet model of psychopathy highlights some dimension-specific differences in EF, but this research is limited in scope. Another complicating factor in teasing apart the EF-psychopathy relationship is the tendency to use different psychopathy assessments for incarcerated versus community samples. In this study, an EF battery and multiple measures of psychopathic dimensions were administered to a sample of male prisoners (N = 377). Results indicate that using the Psychopathy Checklist-Revised (PCL-R), the independent effect of Factor 2 was related to worse EF, but neither the independent effect of Factor 1 nor the unique variance of the Factors (1 or 2) were related to EF. Using a 4-facet model, the independent effects of Facet2 (Affect) and Facet4 (Antisocial) were related to worse EF, but when examining the unique effects, only Facet2 remained significant. Finally, the questionnaire-based measure, Multidimensional Personality Questionnaire-Brief, of Fearless Dominance was related to better EF performance, whereas PCL-R Factor 1 was unrelated to EF. Overall, the results reveal the complex relationship among EF and behaviors characteristic of psychopathy-related dimensions. Moreover, they demonstrate the interpersonal and affective traits measured by these distinct assessments are differentially related to EF.

The four-factor model of the Psychopathy Checklist--Revised: validation in a Dutch forensic inpatient sample

In The Netherlands, the Ministry of Security and Justice requires the assessment of the Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Hare, 2003) in all forensic psychiatric inpatients. To examine the four-factor structure of the Psychopathy Checklist-Revised, confirmatory factor analysis (CFA) was conducted using a Dutch sample of forensic psychiatric inpatients (N=411) and the results indicated acceptable fit. Also, using multiple group CFA, the four-factor model provided an acceptable fit in both patients with a personality disorder and patients with a psychotic disorder, and there was reasonably good evidence of measurement invariance between these two subgroups. Furthermore, correlations with external measures of aggression and personality traits provided additional support for the validity of the four-factor model in patients with a personality disorder. In patients with a psychotic disorder fewer significant correlations with external measures were found. Taken together, the results support the use of the four-factor structure in Dutch offenders who are detained under hospital order.

Executive function in psychopathy: the Tower of London, Brixton Spatial Anticipation and the Hayling Sentence Completion Tests

Executive dysfunction in those high on traits of psychopathy has often been reported, with many disagreements as to the nature of the dysfunction. We aimed to see if tests of planning and rule acquisition/adherence would discriminate those high on psychopathic traits. A battery of executive function tests (Tower of London, Brixton Spatial Anticipation, and Hayling Sentence Completion Tasks) was given to 28 British male prisoners. Psychopathy was measured using the Psychopathy Checklist-Revised. High psychopathy was related to reduced planning in the Tower of London Test and poor rule-adherence on the Brixton Test. Other tests of executive function were not related to psychopathy. The results appear supportive of the notion that function of the orbitofrontal cortex (OFC) is dysfunctional in psychopathy whilst that of the dorsolateral prefrontal cortex (DLPFC) is normal and suggest that impulsivity in those high on psychopathy traits impedes planning and rule following. We suggest the adapted Tower of London Test and the Brixton Test could be useful objective measures of this type of impulsivity in offenders which could help identify key treatment goals.

Psychopathy, intelligence and emotional responding in a non-forensic sample: an experimental investigation

This study examined the relationships between psychopathy (primary and secondary), intelligence and emotional responding in a sample of 50 university students, using a task measuring autonomic responses to 40 pictorial stimuli (20 neutral and 20 emotionally provoking). Results indicated no significant direct relationship between primary or secondary psychopathy and emotional response, or primary or secondary psychopathy and intelligence. However, a significant moderating effect of intelligence on the association between both psychopathy factors and emotional response was observed, indicating those scoring higher on psychopathy but with lower intelligence portray the expected emotional responses to the affective stimuli (primary: β = -.56, p < .05; secondary: β = .80, p < .001). These findings indicate abnormal reactivity to emotional stimuli in lower intelligence, higher psychopathic individuals, and suggest differing roles for the two facets of psychopathy in affective responsiveness deviations.

Psychopathy in Bulgaria: The cross-cultural generalizability of the Hare Psychopathy Checklist

The generalizability of the psychopathy construct to Eastern European cultures has not been well-studied, and no prior studies have evaluated psychopathy in non-offender samples from this population. The current validation study examines the factor structure, internal consistency, and external validity of the Bulgarian translation of the Hare Psychopathy Checklist: Screening Version. Two hundred sixty-two Bulgarian adults from the general community were assessed, of which 185 had a history of substance dependence. Confirmatory factor analysis indicated good fit for the two-, three-, and four-factor models of psychopathy. Zero-order and partial correlation analyses were conducted between the two factors of psychopathy and criterion measures of antisocial behavior, internalizing and externalizing psychopathology, personality traits, addictive disorders and demographic characteristics. Relationships to external variables provided evidence for the convergent and discriminant validity of the psychopathy construct in a Bulgarian community sample.

Response monitoring and adjustment: differential relations with psychopathic traits

Studies on the relation between psychopathy and cognitive functioning often show mixed results, partially because different factors of psychopathy have not been considered fully. Based on previous research, we predicted divergent results based on a 2-factor model of psychopathy (interpersonal-affective traits and impulsive-antisocial traits). Specifically, we predicted that the unique variance of interpersonal-affective traits would be related to increased monitoring (i.e., error-related negativity) and adjusting to errors (i.e., posterror slowing), whereas impulsive-antisocial traits would be related to reductions in these processes. Three studies using a diverse selection of assessment tools, samples, and methods are presented to identify response monitoring correlates of the 2 main factors of psychopathy. In Studies 1 (undergraduates), 2 (adolescents), and 3 (offenders), interpersonal-affective traits were related to increased adjustment following errors and, in Study 3, to enhanced monitoring of errors. Impulsive-antisocial traits were not consistently related to error adjustment across the studies, although these traits were related to a deficient monitoring of errors in Study 3. The results may help explain previous mixed findings and advance implications for etiological models of psychopathy.

Factor structure and construct validity of the Self-Report Psychopathy (SRP) scale and the Youth Psychopathic Traits Inventory (YPI) in young men

A large sample (N = 425) of young adult males from the Pittsburg Youth Study (PYS; Loeber, Farrington, Stouthamer-Loeber, & Van Kammen, 1998) was used to test the item-level structure of the short-form version of the Self-Report Psychopathy Scale (SRP; Paulhus, Neumann, & Hare, in press) and the standard version of the Youth Psychopathic Traits Inventory (YPI; Andershed, Kerr, Stattin, & Levander, 2002). Also, structural equation modeling analyses examined how the SRP and YPI factors were linked to external correlates involving criminal offenses and internalizing and externalizing psychopathology. The modeling results indicated acceptable fit for the latent structure of both instruments and the SRP and YPI factor correlations were strong, particularly for conceptually-related scales. Finally, both instruments showed similar patterns in predicting externalizing and internalizing psychopathology, as well as criminal offenses. Taken together, the results provide evidence of convergent and construct validity across the two instruments. New insights into the link between psychopathy and the external correlates in young adult males are discussed.

Psychopathy and Violent Reoffending in German-Speaking Countries

The Psychopathy Checklist-Revised (PCL-R) and its screening version, the PCL:SV, are clinical assessment instruments for the observer rating of psychopathic personality in offenders. Given the link between PCL-R/SV total scores and violent offending, these instruments have been incorporated into various risk assessment protocols in forensic psychology. The purpose of the present study was to examine the predictive validity of the PCL-R/SV instruments in German-speaking countries. We collated data from 11 published studies (total-N = 2,412 offenders). Based on suitable diagnostic cutscores for prototypical psychopathy, the proportions of true-positive and false-positive cases with respect to violent reoffending were compared. Overall, sensitivity was estimated at 27% and specificity at 88% for the PCL-R (or at 28% and 90% for the PCL:SV, respectively). At critical score levels, the odds for violent offense recidivism were more than two times higher than at subcritical levels for both instruments. A decision-theory analysis suggested that the implicit utility of false-positive risk assessments was about halfway between the minimal utility of false-negative assessments and the maximal utility of correct assessments. Both the PCL-R and its screening version are viable instruments for the prediction of violent offense recidivism in German-speaking countries.

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.

Assessment of Psychopathy in Austria

The Psychopathy Checklist-Revised (PCL-R) is a clinician rating instrument for psychopathic personality disorder. Although the instrument is routinely used in forensic assessment in Austria, Germany, and Switzerland, data on its psychometric properties in German-speaking countries are lacking. Based on a national sample of adult male sexual offenders assessed at a federal evaluation unit in Austria (N = 1,046), reliability and factor structure were estimated. More specifically, measurement invariance was assessed with respect to the North American normative data of male offenders. In the sample, the PCL-R achieved similar levels of reliability as those reported in the manual for North American male offenders. According to confirmatory factor analysis, a four-factor model of psychopathy described the data well. More specifically, weak measurement invariance (i.e., equivalence of loadings, not of thresholds) held in comparison with the North American data. The present findings support the suitability of the PCL-R for assessment purposes in German-speaking countries. However, the total score is not directly comparable to North American data given that only weak measurement invariance was observed.

No clear evidence for a positive association between the interpersonal-affective aspects of psychopathy and executive functioning

Common psychopathy rating instruments distinguish between an interpersonal-affective and an antisocial dimension. The suggestion that the interpersonal-affective dimension, often considered to be the core feature of psychopathy, is positively associated with executive functioning is occasionally made in the literature, without reporting objective empirical data. The primary aim of the present paper was to search for empirical studies reporting relevant data, focussing on four aspects of 'cold' executive functioning: inhibition, attentional shifting, working memory, and planning. Eleven published articles were identified, reporting data of 721 individuals from incarcerated and non-incarcerated, male and female, and adult and non-adult samples. Using a heterogeneous set of tests and dependent measures across studies, the inhibition and attentional shifting components were assessed in eight and five studies, respectively; the working memory and planning components each in two studies. A small majority of the studies found positive associations with the different executive functions, although the associations were mostly non-significant. Given the scarcity of studies and the use of heterogeneous populations, tests and statistical analyses, no robust conclusions can be drawn at this stage. Therefore, caution is needed when claiming a positive association between the interpersonal-affective features of psychopathy and executive functioning. Clearly more research is needed to further validate and specify the suggested association.

Heartless and cunning? Intelligence in adolescents with antisocial behavior and psychopathic traits

Clinical theory predicts that individuals high in psychopathic traits possess average or above average intelligence; however findings in adult and child samples have been mixed. The present study aimed to investigate (1) the relationship between verbal and nonverbal intelligence and the three dimensions of psychopathy (callous-unemotional (CU) traits, narcissism, impulsivity); and (2) whether these dimensions moderate the association between verbal and nonverbal intelligence and the severity of antisocial behavior. Participants were 361 adolescents aged 9-18 years (68% boys) and their parents, drawn from four samples with different levels of risk for antisocial behavior. Families were disadvantaged and 25% were from an ethnic minority. Verbal intelligence was unrelated to parent-reported CU traits, narcissism or impulsivity after controlling for gender, sociodemographic disadvantage, sample, antisocial behavior and hyperactivity. Narcissism, but not CU traits or impulsivity, was significantly related to lower nonverbal IQ. None of the three psychopathic trait dimensions moderated the relationship between verbal or nonverbal IQ and antisocial behavior. CU traits, narcissism, hyperactivity and inclusion in the very high or high risk samples were significantly related to more severe antisocial behavior. Results contradict the widely held view that psychopathic traits are associated with better than average verbal or nonverbal intelligence.

Impulsivity, Aggression, and Suicide Risk in Patients with Schizophrenia

CME Educational Objectives

1.

Recognize the threat for impulsivity, aggression and suicide in patients with schizophrenia.

2.

Assess the risk for aggressive and suicidal behaviors in patients with schizophrenia with detailed anamnestic assessment and self-report questionnaires or specific psychometric instruments.

3.

Incorporate targeted and evidence-based therapies into treatment of patients with schizophrenia.

The relationship between the Psychopathy Checklist-Revised and the MMPI-2: a pilot study

The goal of the study was to investigate the relationship between Hare's four-facet model of psychopathy and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in a forensic, culturally homogenous sample. 22 male prisoners from Bergen Prison participated. There was only a statistically significant negative zero-order correlation between the total PCL-R score and the score on the Depression scale of the MMPI-2. However, the results revealed that the four facets had different underlying correlates with negative affectivity. Overall, Facets 1 and 2 showed a tendency toward a negative relationship with the clinical scales on the MMPI-2, while Facets 3 and 4 had a positive relationship. Interestingly, partial correlations showed that Facet 4 of PCL-R was the only facet that correlated statistically significantly with the scores on the Psychopathic Deviate scale of the MMPI-2.

Social cognition deficits and psychopathic traits in young people seeking mental health treatment

Antisocial behaviours and psychopathic traits place an individual at risk for criminality, mental illness, substance dependence, and psychosocial dysfunction. Social cognition deficits appear to be associated with psychopathic traits and are believed to contribute to interpersonal dysfunction. Most research investigating the relationship of these traits with social cognition has been conducted either in children or adult forensic settings. We investigated whether psychopathic traits were associated with social cognition in 91 young people presenting for mental healthcare (aged between 15 and 25 years). Participants completed symptom severity measures, neuropsychological tests, the Reading the Mind in the Eyes Test of social cognition (RMET), and the Antisocial Process Screening Device (APSD) to assess psychopathic personality traits. Correlation analyses showed poorer social cognition was associated with greater psychopathic traits (r = −.36, p = .01). Interestingly, social cognition performance predicted unique variance in concurrent psychopathic personality traits above gender, IQ sustained attention, and working memory performance. These findings suggest that social cognitive impairments are associated with psychopathic tendencies in young people presenting for community mental healthcare. Research is needed to establish the directionality of this relationship and to determine whether social cognition training is an effective treatment amongst young people with psychopathic tendencies.

Fearless Dominance and reduced feedback-related negativity amplitudes in a time-estimation task - further neuroscientific evidence for dual-process models of psychopathy

Dual-process models of psychopathy postulate two etiologically relevant processes. Their involvement in feedback processing and its neural correlates has not been investigated so far. Multi-channel EEG was collected while healthy female volunteers performed a time-estimation task and received negative or positive feedback in form of signs or emotional faces. The affective-interpersonal factor Fearless Dominance, but not Self-Centered Impulsivity, was associated with reduced feedback-related negativity (FRN) amplitudes. This neural dissociation extends previous findings on the impact of psychopathy on feedback processing and further highlights the importance of distinguishing psychopathic traits and extending previous (neuroscientific) models of psychopathy.

Callous-unemotional traits robustly predict future criminal offending in young men

Callous-unemotional (CU) traits (e.g., lack of empathy, deficient guilt/remorse, and shallow affect) are a circumscribed facet of the adult psychopathic personality. Although several studies have found that adult psychopathy is a robust predictor of future criminal offending, research exploring the predictive utility of CU traits and future offending are lacking. Moreover, empirical studies examining the predictive utility of psychopathic features often neglect to account for other well-documented risk factors (e.g., prior offending, delinquent peers, marital status), and thus the incremental predictive utility of CU traits remains uncertain. To address these limitations, the current study examined the unique contribution of CU traits in the prediction of future criminal offending in a large ethnically diverse community sample of young adult males (Mean Age = 25.76, SD = .95). Official criminal record information was collected approximately 3.5 years later using multiple sources. Results indicated that after controlling for several other well-established predictors of future offending, men with elevated CU traits had a greater number of arrests and criminal charges and were more likely to be charged with a serious offense and obstruction of justice. CU traits also predicted future theft for Caucasian men, but not African American men. Overall, the results support the notion that CU traits significantly add to the prediction of future offending, even after controlling for several other risk factors.

Evaluating the relation between psychopathy and affective empathy: two preliminary studies

It is widely believed that impairment in an ability to experience affective empathy for others is a central feature of psychopathy. The authors tested this assumption by covertly manipulating and measuring state experiences of emotional contagion and empathic concern in college undergraduates and male forensic inpatients. Surprisingly, they found little evidence of a negative association between psychopathy and affective empathy in either sample. In those instances in which associations were found, they tended to indicate that higher psychopathy was associated with increased affective empathy. Follow-up analyses also revealed that psychopathy was positively associated with pervasive experiences of sadness, anger, and fear, and negatively associated with pervasive experiences of happiness among nonforensic individuals. This research raises questions about existing conceptualizations of interpersonal affect in psychopathy and offers suggestions for advancing future understanding of the role-played by emotional processes in psychopathy.

A Validation of the Inventory of Callous-Unemotional Traits in a Community Sample of Young Adult Males

Callous-unemotional (CU) traits have been shown to delineate a subgroup of individuals at high risk for exhibiting severe and persistent criminal behavior. The Inventory of Callous-Unemotional Traits (ICU; Frick 2004) was recently developed as a comprehensive rating scale designed to measure multiple facets of CU traits. However, validation of this measure has been limited to youth in adolescence and emerging adulthood (age range=12-20), leaving questions about the utility of this measure in early adulthood unanswered. The current study evaluated the factor structure of the ICU within a racially diverse and well characterized community sample of adult males (n=425) using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). While results found the best fitting model to be the three-bifactor structure that has been previously reported in adolescent samples, the fit indices were only marginally acceptable and suggest the need for scale refinement. Total and subscales scores demonstrated significant and distinct associations with relevant external criteria (e.g., delinquency, psychopathy, psychopathology, psychosocial functioning). Implications and directions for future research are discussed.

Psychopathic traits in females and males across the globe

The current study examined the prevalence and structure of psychopathic traits in females and males using a very large world sample (N = 33,016, females = 19,183). Psychopathic traits were assessed with the Self-Report Psychopathy (SRP) scale, and structural equation modeling (SEM) was used to test the four-factor model of psychopathy (interpersonal, affective, lifestyle, antisocial) both in the total sample and in the separate samples of females and males. Multi-sample confirmatory factor analysis was used to test for invariance of model parameters across sex as well as across females from different world regions. Inferential statistics were used to examine how the mean-level average of the four SRP facets varied as a function of culture and sex. Finally, the SRP data were linked to objective world health data (e.g., mortality, fertility, gross domestic product) from relevant world regions. The results indicated good support for the four-factor model, as well as invariance across sex and reasonably good evidence of invariance across females from different world regions. Variation in the elevation of SRP facet scores across major world regions suggested that cultural factors moderated the expression of the level of psychopathic propensities and that these traits were strongly correlated with the world health data.

Factor structure of the Hare Psychopathy Checklist: Youth Version (PCL:YV) in adolescent females

Despite substantial evidence for the fit of the 3- and 4-factor models of Psychopathy Checklist-based ratings of psychopathy in adult males and adolescents, evidence is less consistent in adolescent females. However, prior studies used samples much smaller than recommended for examining model fit. To address this issue, we conducted a confirmatory factor analysis of 646 adolescent females to test the fit of the 3- and 4-factor models. We also investigated the fit of these models in more homogeneous subsets of the full sample to examine whether fit was invariant across geographical region and setting. Analyses indicated adequate fit for both models in the full sample and was generally acceptable for both models in North American and European subsamples and for participants in less restrictive (probation/detention/clinic) settings. However, in the incarcerated subsample, the 4-factor model achieved acceptable fit on only two of four indices. Although model fit was not invariant across continent or setting, invariance could be achieved in most cases by simply allowing factor loadings on a single Psychopathy Checklist: Youth Version (Forth, Kosson, & Hare, 2003) item to vary across groups. In summary, in contrast to prior studies with small samples, current findings show that both the 3- and 4-factor models fit adequately in a large sample of adolescent females, and the factor loadings are largely similar for North American and European samples and for long-term incarcerated and shorter-term incarcerated/probation/clinic samples.

A prospective study of the Acquired Preparedness Model: the effects of impulsivity and expectancies on smoking initiation in college students

This study reports on a prospective test of the Acquired Preparedness Model, which posits that impulsivity influences cigarette smoking through the formation of more positive and fewer negative expectancies about smoking effects. College freshman never-smokers (n = 400; 45% male) completed a baseline interview and quarterly online follow-up assessments for 15 months after baseline. Structural equation modeling indicated that the effects of the impulsivity components of sensation seeking and negative urgency on risk of smoking initiation were mediated by expectancies for positive and negative reinforcement from smoking, respectively. Expectancies about negative consequences from smoking predicted initiation but did not mediate the effects of sensation seeking or negative urgency. Findings are consistent with the Acquired Preparedness Model and suggest that heightened impulsivity is associated with heightened expectancies for reinforcement from smoking, and thus with greater risk for smoking initiation.

Aggressive behavior and measurement of psychopathy in female inmates of German prisons--a preliminary study

Studies concerning inmate psychopathy (as measured by Psychopathy-Checklist-Revised, PCL-R; Hare, 1991) have predominantly been concerned with male inmates. This study was the first to look into psychopathy using the PCL-R with the whole required procedure in German prisons with female inmates. The aims of the present study were to gain data about the prevalence of psychopathy in this sample and to examine potential relations between the types and motive of aggression, prosocial behavior and scores on the PCL-R. Sixty female inmates were examined. We obtained a prevalence rate of psychopathy of 17% (N=10, with a cut-off score of 25). Considering a wide range of subtypes of aggressive behaviors, we found that physical proactive, and relational reactive aggression as well as age predicted high scores of psychopathy. However, prosocial or helping behavior was not associated with psychopathy. Implications for diagnostic issues in forensics concerning female prisoners are discussed.

Schizophrenia spectrum disorders, substance misuse, and the four-facet model of psychopathy: the relationship to violence

OBJECTIVE

To investigate the relationship between the four-facet model of PCL-R psychopathy and violence in a community-based sample of Australian men with schizophrenia-spectrum disorders.

METHOD

A community sample of 94 males with schizophrenia-spectrum disorders was recruited from mental health services within Victoria, Australia. Psychopathy was measured using the PCL-R. Measures of substance misuse and lifetime violence were also administered.

RESULTS

PCL-R-total, Facets 2, 3, and 4 scores and substance misuse (DAST) scores were predictive of Violent versus Non-Violent group membership. The regression equation indicated that the predictive validity of PCL-R scores remained significant after controlling for substance misuse. An additional regression indicated that only Facets 3 and 4 were significant in predicting violence group membership.

CONCLUSION

Psychopathy (particularly the antisocial and behavioural components) was associated with lifetime violence, even after controlling for substance misuse. These findings have implications for the assessment, treatment, and management of health clients with schizophrenia-spectrum disorders.

Differential associations between psychopathy dimensions, types of aggression, and response inhibition

Findings on executive functioning in psychopathy are inconsistent. Different associations between psychopathy dimensions and executive functioning might explain contradicting findings. This study examined the role of psychopathy dimensions and types of aggression in response inhibition among 117 male adolescents (53 antisocial delinquents and 64 controls). Participants completed a self-report measure of aggression and a GoNoGo task. Psychopathy dimensions were assessed using the Psychopathy Checklist: Youth Version. Although high scores on the antisocial dimension and reactive aggression were associated with poor response inhibition, the affective-interpersonal dimension, proactive aggression, and verbal intelligence (IQ) were related to better response inhibition (two-factor model). Associations with the affective-interpersonal dimensions did not reach significance. Exploratory analyses showed that affective and antisocial facets accounted for the obtained opposing associations of the affective-interpersonal and antisocial psychopathy dimensions with response inhibition. The interpersonal and lifestyle facets (four-facet model) were unrelated to response inhibition. Results could not be explained by Attention Deficit Hyperactivity Disorder (ADHD). Findings suggest differential associations between the psychopathy dimensions, types of aggression, and response inhibition. Therefore, a dimensional approach to psychopathy and related concepts, such as aggression, might strongly improve diagnostic procedures. Global scores could mask important differential associations.

Attention network performance and psychopathic symptoms in early adolescence: an ERP study

Reaction time (RT) and event-related potential (ERP) measures were used to examine the relationships between psychopathic symptoms and three major attention networks (alerting, orienting, and executive attention) among a community sample of youth. Antisocial Process Screening Device (APSD; Frick and Hare 2001) total and subscale scores were negatively correlated with ERP measures of attentional alerting, indicating that youth with psychopathic symptoms had difficulty using warning cues to prepare for upcoming targets. APSD total scores were not related to performance on measures of orienting or executive attention, although weaker executive attention was found among youth with higher scores on the Impulsivity subscale. These findings support attention-based models of psychopathy and provide evidence of specific deficits in attentional alerting among youth with psychopathic traits. Deficiencies in attentional alerting may be related to noradrenergic functioning and may have cascading effects on higher order cognitive and affective processing.

Psychopharmacology of aggression in schizophrenia

The management of aggression in patients with schizophrenia is a complex and challenging clinical dilemma. It also is greatly influenced by prevailing societal and medicolegal considerations regarding the perceived associations between violence and mental illness. This article provides a succinct account of a complex area and offers evidence for available treatments to reduce the occurrence of violent behavior among patients with schizophrenia.

Psychopathy, intelligence and conviction history

The current study examined the relationship between psychopathy, intelligence and two variables describing the conviction history (length of conviction and number of prior convictions). It was hypothesized that psychopathy factors (interpersonal and antisocial factors assuming a 2-factor model or interpersonal, affective, lifestyle and antisocial factors assuming a 4-factor model) would be related in different ways to IQ scores, length of conviction and number of prior convictions. Psychopathy and IQ were assessed using the PCL:SV and the CFT 20-R respectively. Results indicated no association between interpersonal psychopathy features (Factor 1, two-factor model), IQ and the number of prior convictions but a positive association between Factor 1 and the length of conviction. Antisocial features (Factor 2, two-factor model) were negatively related to IQ and the length of conviction and positively related to the number of prior convictions. Results were further differentiated for the four-factor model of psychopathy. The relationship between IQ and psychopathy features was further assessed by statistically isolating the effects of the two factors of psychopathy. It was found that individuals scoring high on interpersonal features of psychopathy are more intelligent than those scoring high on antisocial features, but less intelligent than those scoring low on both psychopathy features. The results underpin the importance of allocating psychopathic individuals to subgroups on the basis of personality characteristics and criminological features. These subgroups may identify different types of offenders and may be highly valuable for defining treatment needs and risk of future violence.