Psychopathy and instrumental violence: facet level relationships

Psychopathy traits explain variance shared between features of substance use disorders and violence

BACKGROUND

There is a substantial research literature on identifying risk and protective factors for violence perpetration. Substance use disorders have long been identified as constituting a significant predictor of violent behaviour. Psychopathy traits have also been similarly recognised, but inter-relationships between psychopathy traits, features of substance use disorders and violence have been little explored.

AIMS

To determine the degree to which shared variance between substance dependence symptoms and violence, as indicated by criminal charges for violent offences, among jailed men can be explained by psychopathy traits.

METHODS

Features of dependence on substances in three drug classes (alcohol, cannabis and cocaine) were assessed in a sample of 682 men in a county jail awaiting trial on criminal charges, many for violent offences. Statistical comparisons of zero-order and partial correlations tested whether accounting for psychopathy total and facet scores, assessed by the Psychopathy Checklist-Revised (PCL-R), affected associations between substance dependence symptoms and violent charges.

RESULTS

Total PCL-R scores accounted for a significant proportion of the shared variance between the history of criminal charges for violence offences and lifetime substance dependence symptoms in all three drug classes. At the facet level, controlling for ratings on the interpersonal and modified antisocial facets reduced the association between criminal charges for violent offences and symptoms of cocaine dependence; controlling for ratings on a modified antisocial facet also attenuated links between alcohol and cannabis dependence symptoms and history of charges for violent offences.

CONCLUSION

These findings build on the sparse literature to date on the role of psychopathy traits on relationships between features of substance use disorders and violence. Given that the observed connection between substance dependence symptoms and charges for violent offences is partly accounted for by individual differences in psychopathy traits, it follows that effective treatment for those traits may be useful, perhaps essential to reducing links between features of some substance use disorders and violent offending.

Mentalizing mediates the relationship between psychopathy and premeditated criminal offending in schizophrenia: a 6-year follow-up study

PURPOSE

Research has shown that schizophrenia augments the risk for criminal behaviour and variables both defining- and related to schizophrenia, increase criminal offending. Premeditated criminal offending is considered a severe form of criminal offending, however, very little is known about what predicts future premeditated criminal offending in schizophrenia.

METHOD AND MATERIALS

In this 6-year follow-up study we explored which factors underlie future premeditated criminal behaviour in a sample of patients diagnosed with schizophrenia (N = 116). We also investigated if a specific mentalizing profile underlie part of the variance of premeditated criminal offending.

RESULTS

Results showed that psychopathy underlie future premeditated crime in schizophrenia, and that a specific mentalizing profile, comprised of a dysfunctional emotional and intact cognitive mentalizing profile in relation to others, mediated parts of the relation between psychopathy and premeditated criminal offending. Finally, our results indicated that patients with schizophrenia with a specific mentalizing profile (see above) engaged in premeditated criminal behaviour earlier during the 6-year follow-up period compared to patients with other mentalizing profiles.

CONCLUSIONS

Our findings suggest that mentalization should carefully be inspected in patients with schizophrenia in relation to future premeditated offending.

Gun Violence and Psychopathy Among Female Offenders

Research exploring risk factors of gun violence is limited, especially research involving women as perpetrators of violence. Yet, women account for 18-21% of convicted violent crime. The present study aimed to test if psychopathy, a notable risk factor for violence, was related to past convictions of gun violence, general forms of violence, and non-violent crime. In a sample of 206 female offenders, multinomial logistic regressions assessed how interpersonal, affective, and behavioral psychopathic traits increased the likelihood of women belonging to the gun violence group, a violent crime group, and a non-violent crime group. Results showed the interpersonal and affective facets increased the likelihood of women belonging to the gun violence group compared to both the violent and non-violent crime groups. The behavioral facet increased the likelihood of women belonging to the violent crime group when compared to the gun violence and non-violent crime groups. These results suggest that gun violence has different risk factors than violent and non-violent crime. This line of inquiry indicates that existing violence prevention strategies may need to be modified to address gun violence.

The Dark Tetrad, Intimate Partner Violence and the Mediating Role of Moral Disengagement

PURPOSE

Research suggests that physical, psychological, and/or sexual focussed Intimate Partner Violence (IPV) is related to the dark triad (DT) traits of Machiavellianism, psychopathy, and narcissism. This study extends these findings by considering the addition of everyday sadism into the four-dimension dark tetrad (DTET), testing the possibility that moral disengagement (MD) mediates the relationship between these variables. It was also examined whether the DTET provided incremental validity to the more general personality traits Honesty-Humility, Emotionality, Extraversion, Agreeableness, Conscientiousness, Openness (HEXACO) to predict IPV.

METHOD

Males and females (N = 416) from the general population completed five questionnaires in an online survey (HEXACO-60, MMEA, PMDS, CTS2S, SD4).

RESULTS

A principal component factor-analysis found that sexual IPV did not load as an individual factor and distinct form of violence on the CTS2S scale so was excluded from this study. Four hierarchical multiple regressions were conducted, using the demographics, HEXACO and either the DTET traits or an overall DTET variable as predictor variables, and either physical or psychological IPV as the dependent variables. Only psychopathy predicted physical and psychological IPV; MD mediated the relationship between psychopathy and psychological IPV. Although the DTET added incremental validity over HEXACO to predict physical IPV, HEXACO low Agreeableness was the strongest predictor of psychological IPV.

CONCLUSIONS

Those higher in psychopathy may show different offending trajectories for physical and psychological IPV dependent upon the use of MD processes. Despite the DTET adding incremental validity over the HEXACO dimensions, some HEXACO elements better explain the relationship between personality and psychological IPV than the DTET.

Prevalence and correlates of aggressive behavior in psychiatric inpatient populations

Aggressive behavior in patients with psychiatric disorders is attracting increasing research interest. One reason for this is that psychiatric patients are generally considered more likely to be aggressive, which raises a related question of whether diagnoses of psychiatric disorders predict the prevalence of aggressive behavior. Predicting aggression in psychiatric wards is crucial, because aggressive behavior not only endangers the safety of both patients and staff, but it also extends the hospitalization times. Predictions of aggressive behavior also need careful attention to ensure effective treatment planning. This literature review explores the relationship between aggressive behavior and psychiatric disorders and syndromes (dementia, psychoactive substance use, acute psychotic disorder, schizophrenia, bipolar affective disorder, major depressive disorder, obsessive-compulsive disorder, personality disorders and intellectual disability). The prevalence of aggressive behavior and its underlying risk factors, such as sex, age, comorbid psychiatric disorders, socioeconomic status, and history of aggressive behavior are discussed as these are the components that mostly contribute to the increased risk of aggressive behavior. Measurement tools commonly used to predict and detect aggressive behavior and to differentiate between different forms of aggressive behavior in both research and clinical practice are also reviewed. Successful aggression prevention programs can be developed based on the current findings of the correlates of aggressive behavior in psychiatric patients.

Emotional intelligence in incarcerated sexual offenders with sexual sadism

Emotional intelligence (EI) is defined by the ability to perceive, manage, and reason about emotions in oneself and others. Studies have reported deficits in EI abilities among certain antisocial populations such as individuals with psychopathy, and enhanced performance among sexual offenders. Despite EI's relevance to offending behaviour, the association between EI and paraphilic offending has been under-studied. We examined the association between EI, sexual offending, and sexual sadism in 80 incarcerated men with sexual offenses and 207 incarcerated men with non-sexual offences. EI was assessed using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT). Sadism was measured using the Severe Sexual Sadism Scale (SeSaS). Results showed that SeSaS scores were positively associated with Strategic EI (the ability to understand and manage emotions), but were not significantly related to Experiential EI. This may reflect core characteristics of sexual sadism including domination and manipulation, challenging the prevalent notion that higher EI is invariably positive.

The Triarchic Model of Psychopathy and Antisocial Behavior: Results From an Offender Population With Personality Disorder

The triarchic model posits that psychopathy is a combination of phenotypes related to boldness, meanness, and disinhibition. We examined how each of these phenotypes of psychopathy related to past violence and antisocial behavior and to behavior within the prison. The sample consisted of men (n = 108) with a history of serious offending and a diagnosis of personality disorder at the point of admission to a prison serving as a therapeutic community. We took four indices of violence and antisocial behavior, (a) self-report of lifetime proactive and reaction aggression, (b) criminal convictions prior to admission to the prison, (c) exclusion from the prison within 12 months due to rule breaking, and (d) behavior within the first 12 months of admission to the unit. The constructs of the triarchic model, as assessed by the triarchic psychopathy measure (TriPM), were strong predictors of self-reported aggression, with disinhibition being related to both proactive and reactive aggression, whereas boldness was related to proactive aggression alone. Past criminal convictions were also associated with disinhibition, except for convictions for violent behavior. Both meanness and disinhibition were predictive of exclusion from the prison within 12 months for rule-breaking behavior and of aggressive behavior within the prison. The triarchic model of psychopathy is associated with past antisocial behavior and is predictive of antisocial behaviors within the prison, and the different constructs of the triarchic model are associated with different manifestations of antisocial behavior. The TriPM holds great promise for improved assessment and enhanced understanding of psychopathic personality within institutions and can facilitate offender management via improved phenotypic analysis of boldness, meanness, and disinhibition.

Psychopathic Traits and Sexual Coercion Against Relationship Partners in Men and Women

The present study examined the relationships between psychopathic traits, gender, and sexual coercion perpetration in the specific context of intimate partner relationships. Community-dwelling adult men and women with recent criminal or substance-use histories (N = 300) completed self-report measures of psychopathic personality traits (interpersonal, affective, lifestyle, and antisocial facets), sexual coercion perpetrated within their most recent relationship, and other relevant behaviors including physical intimate partner violence perpetration and sexual coercion victimization. Results of regression analyses showed that the relationship between psychopathic trait facets and sexual coercion was moderated by gender, with effects varying based on level of coercion severity. Specifically, women who showed high levels of interpersonal psychopathic traits (superficial charm, social dominance) were more likely to engage in any sexual coercion and minor severity sexual coercion than women with low levels of interpersonal traits. For severe coercion, women who showed low levels of affective psychopathic traits (coldness, lack of empathy) or high levels of antisocial psychopathic traits (aggressiveness, criminality) were more likely to be sexually coercive than other women. Relationships between the four psychopathic trait facets and sexual coercion were more modest and nonsignificant for men at any level of coercion severity. Results are discussed in the context of sociocultural factors that may influence the role of psychopathic traits on sexual coercion as a function of gender and relationship contexts, including traditional sexual scripts, the cultural role of women as sexual gatekeepers, and beliefs about token resistance.

Prediction of Trolling behavior from sadism and Internet addiction in young adults of Buenos Aires

Background: Trolling is a very topical phenomenon, but much less studied unlike other problems related to new technologies. The present study evaluated the levels of trolling in adults from sadism and internet addiction. Method: For this purpose, an intentional sample of 708 adults of both genders (56% women, age M = 25 years SD = 8.7), from the Autonomous City of Buenos Aires (CABA) and Greater Buenos Aires (GBA), Argentina is selected. Participants answered the Trolling Questionnaire by Buckels et al., On Sadistic Tendencies by Paulhus et al., On Internet Addiction by Lam-Figueroa et al. and a demographic questionnaire. The data indicated that both vicarious sadism, outright sadism, and dysfunctionality in Internet use were predictors of trolling. Results: The results suggested an association of trolling with age and differences according to gender. A structural model to predict trolling based on sadism as a latent variable and internet addiction shows an adequate fit CFI = .99, TLI = .98, RMSEA = .04, indicating that sadism predicted trolling and internet addiction. Conclusion: Sadism is an important predictor for trolling behavior over the internet, where individuals with these characteristics take advantage of anonymity to carry out their aggressive behaviors.

High levels of psychopathic traits increase the risk of transferring reactive aggression to innocent people after provocation: Evidence from an ERP study

This study investigated the neuropsychological underpinnings of reactive aggression toward innocent people in a student population with different levels of psychopathic traits. While recording event-related potentials, participants (divided into high/low psychopathic [HP/LP] traits groups) competed against two fictitious opponents in a modified Taylor Aggression Paradigm. We found that the HP group compared to the LP group selected more often high-intensity punishment for the second innocent opponent after being provoked by the first opponent. Further, a more negative N2 and a smaller P3 was found in the HP group while punishing the innocents-reflecting a tendency on antisocial-aggressive behavior. Finally, both groups showed a more negative FRN for losing than winning trials when seeing the outcome of the game. Our results suggest that high psychopathic traits increase the risk of transferring provoked aggression to innocent people-offering a psychophysiological perspective for explaining and predicting aggression against the innocents in social interactions.

Impulsive and premeditated aggression in male offenders with antisocial personality disorder

INTRODUCTION

Aggression is a clinical symptom of various psychiatric disorders that can be conceptualised as a physical act towards another person with the intent to cause harm. In antisocial personality disorder (ASPD), aggression is a frequent manifestation that differently compromise therapeutic and prognostic goals according to its impulsive or premeditated categorisation. ASPD is characterised by high levels of impulsivity, psychopathic traits, and a high prevalence of co-morbid substance use disorders (SUDs). Aggression in ASPD patients may determine long and recurrent imprisonment thus representing a challenge clinicians and legal experts face.

OBJECTIVES

Our aims were to characterise impulsive and premeditated aggression in male ASPD offenders as well as to determine the potential role of SUDs, impulsivity, and psychopathic traits as predictors.

MATERIALS AND METHODS

In this cross-sectional study we evaluated a sample of ASPD offenders with a battery of clinical and psychometric, standardised instruments: the Psychopathy Checklist-Revised (PCL-R), the European Version of the Addiction Severity Index (EuropASI), the Barratt Impulsivity Scale Version 11 (BIS-11), and the Impulsive/Premeditated Aggression Scale (IPAS).

RESULTS

We used a total sample of 134 offenders, all of whom were male. ASPD patients (n = 96) had a 71.9% prevalence of impulsive aggression and a 28.1% prevalence of premeditated aggression. ASPD patients with impulsive aggression had significantly lower scores of total PCL-R (p<0.01) factor 1 and interpersonal facet 1 (p<0.05), compared with ASPD patients with premeditated aggression. ASPD patients with impulsive aggression and ASPD patients with premeditated aggression had comparable BIS-11 mean scores, and exhibited an equal prevalence of SUDs. The interpersonal facet 1of the PCL-R predicted the aggression type (p<0.05) in ASPD patients, and the exponential beta value for facet 1 was 1.42 (CI = 1.03; 1.95).

CONCLUSIONS

The aggression type that is associated with ASPD is mainly impulsive in nature. ASPD patients who have higher scores of psychopathic traits have a lower probability of exhibiting impulsive aggression and a higher probability of exhibiting premeditated aggression. Although ASPD patients have high levels of impulsivity and a high frequency of SUDs, these two variables were not predictors of the aggression type.

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.

Three Central Dimensions of Sexual Recidivism Risk: Understanding the Latent Constructs of Static-99R and Static-2002R

The most commonly used risk assessment tools for predicting sexual violence focus almost exclusively on static, historical factors. Consequently, they are assumed to be unable to directly inform the selection of treatment targets, or evaluate change. However, researchers using latent variable models have identified three dimensions in static actuarial scales for sexual offenders: Sexual Criminality, General Criminality, and a third dimension centered on young age and aggression to strangers. In the current study, we examined the convergent and predictive validity of these dimensions, using psychological features of the offender (e.g., antisocial traits, hypersexuality) and recidivism outcomes. Results indicated that (a) Sexual Criminality was related to dysregulation of sexuality toward atypical objects, without intent to harm; (b) General Criminality was related to antisocial traits; and (c) Youthful Stranger Aggression was related to a clear intent to harm the victim. All three dimensions predicted sexual recidivism, although only General Criminality and Youthful Stranger Aggression predicted nonsexual recidivism. These results indicate that risk tools for sexual violence are multidimensional, and support a shift from an exclusive focus on total scores to consideration of subscales measuring psychologically meaningful constructs.

Validation of the Portuguese Version of Impulsive-Premeditated Aggression Scale in an Inmate Population

Aggression is one of the core symptoms of antisocial personality disorder (ASPD) with therapeutic and prognostic relevance. ASPD is highly prevalent among inmates, being responsible for adverse events and elevated direct and indirect economic costs for the criminal justice system. The Impulsive/Premeditated Aggression Scale (IPAS) is a self-report instrument that characterizes aggression as either predominately impulsive or premeditated. This study aims to determine the validity and reliability of the IPAS in a sample of Portuguese inmates. A total of 240 inmates were included in the study. A principal component factor analysis was performed so as to obtain the construct validity of the IPAS impulsive aggression (IA) and premeditated aggression (PM) subscales; internal consistency was determined by Cronbach's alpha coefficient; convergent and divergent validity of the subscales were determined analyzing correlations with the Barratt Impulsiveness scale, 11th version (BIS-11), and the Psychopathic Checklist Revised (PCL-R). The rotated matrix with two factors accounted for 49.9% of total variance. IA subscale had 11 items and PM subscale had 10 items. The IA and PM subscales had a good Cronbach's alpha values of 0.89 and 0.88, respectively. The IA subscale is correlated with BIS-11 attentional, motor, and non-planning impulsiveness dimensions (p < 0.05). The PM subscale is correlated with BIS-11 attentional, motor impulsiveness dimensions (p < 0.05). The PM subscale is correlated with PCL-R interpersonal, lifestyle, and antisocial dimensions (p < 0.05). The IA subscale is not correlated with PCL-R. The Portuguese translated version of IPAS has adequate psychometric properties, allowing the measurement of impulsive and premeditated dimensions of aggression.

Clarifying Associations between Psychopathy Facets and Personality Disorders among Offenders

PURPOSE

This study examined bivariate, unique, and multivariate associations between psychopathy facets and other Personality Disorders (PDs).

METHOD

76 incarcerated males were assessed with clinical interviews assessing psychopathy and DSM-5 PDs. Canonical Correlation Analysis (CCA) was used to examine multivariate associations between dimensional scores of psychopathy facets and other PDs.

RESULTS

Preliminary analyses of bivariate and partial associations revealed that much of the covariation between psychopathy and PD traits reflected shared variance among psychopathy facets and among PD traits. After controlling for the shared variance, unique relationships were limited to positive relationships between Narcissistic PD and interpersonal facet and between Paranoid PD and antisocial facet ratings. Canonical Correlation Analysis results yielded two pairs of functions that explained the shared variance between psychopathy and PDs. In the first pair of functions, elevations on the interpersonal and antisocial facets were associated with symptoms of Paranoid, Narcissistic, Histrionic, and Antisocial PDs. In the second pair of functions, high levels of the antisocial facet and low levels of the interpersonal facet were related to Borderline PD.

CONCLUSION

Results suggest that associations between psychopathy and DSM-5 PDs go beyond established links with Antisocial and Narcissistic PDs to include associations with Histrionic, Borderline, and Paranoid PDs.

Impulsive versus premeditated aggression in the prediction of violent criminal recidivism

Past aggression is a potent predictor of future aggression and informs the prediction of violent criminal recidivism. However, aggression is a heterogeneous construct and different types of aggression may confer different levels of risk for future violence. In this prospective study of 91 adults in a pretrial diversion program, we examined (a) premeditated versus impulsive aggression in the prediction of violent recidivism during a one-year follow-up period, and (b) whether either type of aggression would have incremental validity in the prediction of violent recidivism after taking into account frequency of past general aggression. Findings indicate that premeditated, but not impulsive, aggression predicts violent recidivism. Moreover, premeditated aggression remained a predictor of recidivism even with general aggression frequency in the model. Results provide preliminary evidence that the assessment of premeditated aggression provides relevant information for the management of violent offenders.

Psychopathic personality traits and their influence on parenting quality: results from a nationally representative sample of Americans

Psychopathic personality traits have consistently been found to predict a range of negative and dysfunctional outcomes. As a result, it is somewhat surprising that the research to date has failed to empirically examine the potential association between psychopathic personality traits and parenting quality. The current study addressed this omission in the literature by analyzing a community sample of adults. The results revealed that respondents scoring higher on psychopathic personality traits tended to report more negative parenting quality. These results were detected for both males and females and remained significant even after controlling for the effects of parental transmission and child-effects. To our knowledge, this is the first study to show a statistically significant association between psychopathic personality traits and parenting quality. We conclude with a discussion of what these findings mean for psychopathy research and the parenting the literature.

Personality traits and violent behavior: a comparison between psychopathic and non-psychopathic male murderers

The relationship between psychopathy and traits of temperament and character in a specific population of criminals, such as murderers, has not been sufficiently investigated. This study assesses the relationship between psychopathy and temperament and character traits in murderers. The sample consisted of 118 men divided into three groups: psychopathic murderers (N=40), non-psychopathic murderers (N=40) and 38 non-psychopathic non-criminals (controls). All individuals were evaluated by Psychopathy Checklist Revised (PCL-R) and The Temperament and Character Inventory (TCI). Psychopathic murderers presented higher scores than the other two groups in PCL-R; both criminal groups presented higher scores than non-psychopathic non-criminals. Psychopathic murderers showed lower scores than non-psychopathic murderers on Harm Avoidance, Reward Dependence, Persistence, Self-Directness and Cooperativeness. There was no difference between murderers groups regarding Novelty Seeking and Self-transcendence. In all TCI personality traits psychopathic and non-psychopathic murderers showed scores lower than controls, except Harm Avoidance for non-psychopathic murderers. In conclusion, most personality traits assessed by TCI were associated with psychopathy, while Novelty Seeking and Self-transcendence were associated with homicidal behavior independently of the psychopathy.

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.

Psychological vulnerabilities and propensities for involvement in violent extremism

Research on the psychology of terrorism has argued against the idea that most terrorist behavior is caused by mental illness or by a terrorist personality. This article suggests an alternative line of inquiry - an individual psychology of terrorism that explores how otherwise normal mental states and processes, built on characteristic attitudes, dispositions, inclinations, and intentions, might affect a person's propensity for involvement with violent extremist groups and actions. It uses the concepts of "mindset" - a relatively enduring set of attitudes, dispositions, and inclinations - and worldview as the basis of a psychological "climate," within which various vulnerabilities and propensities shape ideas and behaviors in ways that can increase the person's risk or likelihood of involvement in violent extremism.

Don't stand so close to me: psychopathy and the regulation of interpersonal distance

Psychopathy is characterized by callous and unemotional personality traits, such as reduced empathy and remorse, and a tendency toward deviant interpersonal behaviors. It has been suggested that subtle behavioral cues in individuals with high levels of psychopathic traits may betray their personality during interpersonal interactions, but little research has addressed what these clues might be. In this study, we investigated whether psychopathic traits predict interpersonal distance preferences, which have been previously linked to amygdala functioning. 46 healthy participants performed a behavioral task in which the distance they preferred to maintain between themselves and an experimenter was measured across a series of trials. Psychopathic traits, including Coldheartedness, Fearless Dominance, and Self-centered Impulsivity were assessed using the Psychopathic Personality Inventory-Revised (Lilienfeld and Widows, 2005). Results demonstrated that Coldheartedness predicted preferred interpersonal distance, with more coldhearted participants preferring shorter distances. These findings suggest that interpersonal distance preferences may signal psychopathic traits, particularly callousness, supporting accounts of amygdala dysfunction in psychopathy.

Violent female youth: an examination of instrumental violence, psychopathy, and offense characteristics

Female youth are a strikingly under-studied population within the accumulated forensic literature, yet they represent a significant and growing population within forensic contexts. Despite research demonstrating a relationship between the presence of psychopathic traits and instrumental violence among adult offenders, researchers have only recently begun to examine this relationship among juvenile offenders. Our investigation of this potential relationship among a large sample of female offenders (N = 145) who had committed a violent offense revealed that youths with more psychopathic traits were not significantly more likely to use instrumental violence in the commission of their crimes than those with less psychopathic traits. The findings are discussed in terms of offense severity, and a comprehensive overview of female youths' specific motivations and offense characteristics are provided. Research directions and clinical implications are discussed.

Childhood maltreatment and aggressive behaviour in violent offenders with psychopathy

OBJECTIVE

To document experiences of childhood maltreatment among violent offenders with antisocial personality disorder (ASPD) distinguishing between those with and without the syndrome of psychopathy (+P and -P), and to determine whether maltreatment is associated with proactive and reactive aggression.

METHOD

The sample included 10 violent offenders with ASPD+P, 15 violent offenders with ASPD-P, and 15 non offenders. All participants completed interviews with the same forensic psychiatrist focusing on physical, sexual, and emotional abuse prior to age 18 using the Early Trauma Inventory. Aggression was assessed using the Reactive-Proactive Questionnaire.

RESULTS

Violent offenders with ASPD+P reported significantly more severe childhood physical abuse, but not more sexual or emotional abuse, than violent offenders with ASPD-P and non offenders. Psychopathy Checklist-Revised (PCL-R) scores, but not childhood physical abuse, were associated with proactive aggression. Childhood physical abuse was associated with reactive aggression, as was an interaction term indicating that when both PCL-R scores and childhood physical abuse were high, so was reactive aggression.

CONCLUSIONS

Among violent offenders, PCL-R scores were positively associated with proactive aggression, while experiences of childhood maltreatment were not. This finding concurs with previous studies of children and adults and suggests that proactive aggression may be a behavioural marker of psychopathic traits. By contrast, childhood physical abuse was associated with reactive aggression, even among violent offenders with high PCL-R scores. This latter finding suggests a strong influence of childhood physical abuse on the development of reactive aggression that persists over the lifespan.

Emotion processing in Psychopathy Checklist-assessed psychopathy: a review of the literature

Deficient emotional experience is recognized as one of the central features of psychopathy and an impressive body of empirical findings regarding emotion processing in psychopathy has amassed over the past several decades, resulting in two broad theoretical perspectives. The general emotional deficit perspective postulates a globally reduced capacity for emotional experience and processing across the emotional spectrum. In contrast, according to the specific emotional deficit perspective, psychopathy is associated with abnormal experience of only specific types of emotion; several distinct hypotheses have been proposed under this latter perspective. We systematically and critically review findings from peer-reviewed research of emotion processing in psychopathy in relation to the two theoretical perspectives. In general, findings suggest that, compared to controls, psychopaths exhibit behavioral, psychophysiologic, and regional brain activation anomalies when processing emotion, but their ratings of self-arousal and stimulus valence/intensity do not differ from controls. However, when behavioral findings are examined separately by emotion type, the overall pattern of findings is not clearly consistent with any of the dominant theoretical perspectives of emotion processing in psychopathy. We summarize the current state of the field, including consistencies and inconsistencies in the literature, offer alternative explanations for the findings, and outline directions for future research.

Neuroimaging and neurocognitive correlates of aggression and violence in schizophrenia

Individuals diagnosed with major mental disorders such as schizophrenia are more likely to have engaged in violent behavior than mentally healthy members of the same communities. Although aggressive acts can have numerous causes, research about the underlying neurobiology of violence and aggression in schizophrenia can lead to a better understanding of the heterogeneous nature of that behavior and can assist in developing new treatment strategies. The purpose of this paper is to review the recent literature and discuss some of the neurobiological correlates of aggression and violence. The focus will be on schizophrenia, and the results of neuroimaging and neuropsychological studies that have directly investigated brain functioning and/or structure in aggressive and violent samples will be discussed as well as other domains that might predispose to aggression and violence such as deficits in responding to the emotional expressions of others, impulsivity, and psychopathological symptoms. Finally gender differences regarding aggression and violence are discussed. In this context several methodological and conceptional issues that limited the comparison of these studies will be addressed.

Criminal recidivism and mortality among patients discharged from a forensic medium secure hospital

BACKGROUND

One of the goals in forensic psychiatric care is to reduce the risk of recidivism, but current knowledge about the general outcome of forensic psychiatric treatment is limited.

AIMS

To analyse the rate of criminal recidivism and mortality after discharge in a sample of patients sentenced to forensic psychiatric treatment in a Swedish county.

METHODS

All offenders in Örebro County, Sweden, sentenced to forensic psychiatric treatment and discharged during 1992-2007 were included: 80 males and eight females. Follow-up data was retrieved from the Swedish National Council for Crime Prevention, the National Cause-of-Death register and clinical files. Mean follow-up time was 9.4 years.

RESULTS

The mean age at discharge was 40 years. Schizophrenia, other psychoses and personality disorders were the most prevalent diagnoses. Thirty-eight percent of those still alive and still living in the country re-offended and were sentenced to a new period of forensic psychiatric treatment or incarceration during follow-up. Four male re-offenders committed serious violent crimes. Substance-related diagnosis was significantly associated with risk of recidivism and after adjustment for diagnoses, age and history of serious violent crime, the Hazard Ratio was 4.04 (95% CI 1.51-10.86, P = 0.006). Of all included patients, 23% had died at the end of follow-up (standardized mortality rate 10.4).

CONCLUSIONS

Since repetition of serious violent crimes was unusual, results indicate a positive development subsequent to treatment for those alive at follow-up.

CLINICAL IMPLICATIONS

The high mortality rate suggests that more attention should be paid in evaluation of the patients' somatic and psychiatric health during and after care in order to prevent premature death.

Predicting self- and other-directed violence among discharged psychiatric patients: the roles of anger and psychopathic traits

BACKGROUND

We examined the extent to which trait anger and psychopathic traits predicted post-discharge self-directed violence (SDV) and other-directed violence (ODV) among psychiatric patients.

METHOD

Participants were 851 psychiatric patients sampled from in-patient hospitals for the MacArthur Violence Risk Assessment Study (MVRAS). Participants were administered baseline interviews at the hospital and five follow-up interviews in the community at approximately 10-week intervals. Psychopathy and trait anger were assessed with the Psychopathy Checklist: Screening Version (PSC:SV) and the Novaco Anger Scale (NAS) respectively. SDV was assessed during follow-ups with participants and ODV was assessed during interviews with participants and collateral informants. Psychopathy facets and anger were entered in logistic regression models to predict membership in one of four groups indicating violence status during follow-up: (1) SDV, (2) ODV, (3) co-occurring violence (COV), and (4) no violence.

RESULTS

Anger predicted membership in all three violence groups relative to a non-violent reference group. In unadjusted models, all psychopathy facets predicted ODV and COV during follow-up. In adjusted models, interpersonal and antisocial traits of psychopathy predicted membership in the ODV group whereas only antisocial traits predicted membership in the COV group.

CONCLUSIONS

Although our results provide evidence for a broad role for trait anger in predicting SDV and ODV among discharged psychiatric patients, they suggest that unique patterns of psychopathic traits differentially predict violence toward self and others. The measurement of anger and facets of psychopathy during discharge planning for psychiatric patients may provide clinicians with information regarding risk for specific types of violence.

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.

Understanding psychopathy through an evaluation of interpersonal behavior: testing the factor structure of the interpersonal measure of psychopathy in a large sample of jail detainees

Interpersonal characteristics are core features of the psychopathy construct which have a unique pattern of correlations with a variety of external correlates. To improve the assessment of interpersonal traits, the current study evaluated the internal structure of the Interpersonal Measure of Psychopathy (IM-P) through exploratory and confirmatory factor analyses (CFA) in a large sample of jail inmates. A 17-item, 3-factor (Dominance, Grandiosity, and Boundary Violations) structure evidenced good fit in European American inmates. A second CFA demonstrated good fit for this structure in a sample of African American inmates. Moreover, a multigroup CFA indicated structural invariance between European and African American inmates. External validity was tested and demonstrated through positive correlations between IM-P factor scores and Psychopathy Checklist--Revised total and facet scores (R. D. Hare, 2003) and antisocial personality disorder symptoms and diagnoses. Modest correlations between Grandiosity scores and scores on the Shipley Institute of Living Scale--Revised (R. A. Zachary, 1994) were also observed. Finally, a step-down hierarchical regression was conducted to test for racial bias of the IM-P factor scores in relation to external correlates. Little evidence was found for slope bias, but there was evidence of intercept bias for some analyses. Implications and advantages of assessing psychopathy through a comprehensive evaluation of interpersonal traits are discussed.

Psychopathy and axis I psychiatric disorders among criminal offenders: relationships to impulsive and proactive aggression

Both psychopathology and aggression are heterogeneous constructs. Determining which forms of psychopathology relate to risk for different classes of aggressive behavior has implications for risk recognition and management. This study examined the relationships of impulsive aggression (IA) and proactive aggression (PA) to psychopathy and symptoms of several Diagnostic and Statistical Manual Axis I disorders in a sample of criminal offenders. Results replicated prior findings from community samples of a broad relationship between psychopathology and IA. PA was related only to psychopathy. An interaction was found whereby IA was associated with impulsive-antisocial traits of psychopathy only for individuals with moderate to high levels of generalized anxiety. Results indicate that assessing and treating several Axis I disorders in offenders may decrease risk for IA. Moreover, current findings raise the possibility that generalized anxiety is a key, modifiable component of the relationship between IA and impulsive-antisocial traits.