Reliability Generalization of the Triarchic Psychopathy Measure

The extent to which psychopathy can be reliably assessed via self-report has been debated. One step in informing this debate is examining the internal consistency of self-report psychopathy measures, such as the Triarchic Psychopathy Measure (TriPM; Patrick, 2010). Reliability generalization (RG) studies apply a meta-analytic approach to examine the internal consistency of an instrument in a more robust manner by aggregating internal consistency statistics reported across the published literature. This study conducted an RG analysis to yield the average Cronbach's alpha among published studies (k = 219) that administered the TriPM. Meta-analytic alphas were high for TriPM Total (α = .88) Boldness (α = .81), Meanness (α = .87), and Disinhibition (α = .85). Moderator analyses indicated internal consistency differed minimally as a function of study characteristics, like gender, age, or the nature of the sample (i.e., forensic or community). Subsequent RG analyses were performed for McDonald's omega (k = 40), which yielded comparable internal consistency estimates. The results of this study provide strong evidence that the TriPM measures coherent, internally consistent constructs and thus could be a viable, cost-effective mechanism for measuring psychopathy across a broad range of samples.

Meanness and affective processing: A meta-analysis of EEG findings on emotional face processing in individuals with psychopathic traits

BACKGROUND

The triarchic model (Patrick et al., 2009) conceptualizes psychopathy as a multidimensional construct encompassing three biobehavioral dimensions: meanness, boldness, and disinhibition. Meanness entails low empathy, shallow affect, and lack of remorse, and is associated with poor facial emotion recognition; however, the mechanistic processes contributing to these deficits are unclear. Emotional face processing can be examined on a neurophysiological level using event-related potentials (ERPs) such as N170, P200, and LPP. No quantitative review to date has examined the extent to which amplitude of these ERP components may be modulated by psychopathic traits.

METHOD

The current study performed random-effects model meta-analyses of nine studies (N = 1131) which examined affective face processing ERPs in individuals with psychopathic traits to provide an overall effect size for the association between meanness, boldness, and disinhibition and N170, P200, and LPP amplitudes across studies. Analyses were also conducted examining potential moderators and publication bias.

RESULTS

N170 amplitudes were significantly smaller (r =.18) among individuals high in meanness when processing fearful faces. Significant effects were not found for N170 amplitude when processing angry or happy faces, nor for LPP and P200 amplitudes across stimulus types. Additionally, significant effects were not found for the association between N170 amplitude and other dimensions of psychopathy. Meta-regression analyses indicated the manipulation of facial stimuli was significant in explaining some between-study heterogeneity of the meanness N170-fear model. No evidence of publication bias was found.

CONCLUSIONS

Diminished amplitude of the N170 when viewing fear faces appears to be a neurophysiological marker of psychopathic meanness. Deficits in early encoding of faces may account for empathy deficits characteristic of psychopathy.

Assessing general versus specific liability for externalizing problems in adolescence: Concurrent and prospective prediction of symptoms of conduct disorder, ADHD, and substance use

This study explored the generality versus specificity of two trait-liability factors for externalizing problems-disinhibition and callousness-in the concurrent and prospective prediction of symptoms of conduct disorder, attention-deficit/hyperactivity disorder (ADHD), and substance use (i.e., alcohol use disorder and history of illicit substance use). Disinhibition involves an impulsive, unrestrained cognitive-behavioral style; callousness entails a dispositional lack of social-emotional sensitivity. Participants were European adolescents from the multisite IMAGEN project who completed questionnaires and clinical interviews at ages 14 (N = 1,504, Mage = 14.41, 51.13% female) and 16 (N = 1,407, Mage = 16.46, 51.88% female). Disinhibition was related concurrently and prospectively to greater symptoms of conduct disorder, ADHD, and alcohol use disorder; higher scores on a general externalizing factor; and greater likelihood of having tried an illicit substance. Callousness was selectively related to greater conduct disorder symptoms. These findings indicate disinhibition confers broad liability for externalizing spectrum disorders, perhaps due to its affiliated deficits in executive function. In contrast, callousness appears to represent more specific liability for antagonistic (aggressive/exploitative) forms of externalizing, as exemplified by antisocial behavior. Results support the utility of developmental-ontogenetic and hierarchical-dimensional models of psychopathology and have important implications for early assessment of risk for externalizing problems. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Latent variable model of triarchic psychopathy constructs in an incarcerated offender sample: Factor reliability and validity

The triarchic model of psychopathy posits that three distinct trait dispositions-disinhibition, meanness, and boldness-contribute to the interpersonal, affective, and impulsive-unrestrained features of this condition and is represented to varying degrees in all conceptualizations and measures of psychopathy. Using data for incarcerated males (n = 273) and females (n = 83) from 10 different prisons in Italy, we specified a latent variable model of the triarchic trait constructs in which scale measures of disinhibition, meanness, and boldness composed of items from the following inventories served as indicators: Triarchic Psychopathy Measure, Psychopathic Personality Inventory-Revised, Minnesota Multiphasic Personality Inventory-2 Restructured Form, and NEO Five Factor Inventory. A correlated three-factor solution evidenced adequate model fit, with individual triarchic trait scales loading strongly onto their target factors. The model exhibited comparable fit and factor loadings when specified using data for males only, and its factors showed expected relations with pertinent criterion variables, including measures of normative personality and clinical dysfunction along with staff ratings of prison behavior and release prognosis. Extending prior research with nonclinical participants from the U.S., present study results demonstrate the viability of a latent variable model of the triarchic traits in an incarcerated offender sample from a separate culture (Italy). The significance of this work lies in the potential of the triarchic traits to serve as conceptual-empirical points of reference for integrating findings across studies of psychopathy employing diverse samples and assessment measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Piloting a brief intervention plus mobile boosters for drug use among emerging adults receiving emergency department care

PURPOSE

There are few efficacious prevention interventions for emerging adults (ages 18-25) drug use and concomitant risks (e.g., sexual risk behaviors). We developed and evaluated the feasibility and acceptability of an Emergency Department (ED)-initiated brief intervention (BI) combined with booster messaging as a clinician-extender primarily focusing on drug use, with a secondary focus on condomless sex. We examined descriptive outcomes of alcohol, drug use, and condomless sex.

PROCEDURES

We recruited N = 63 emerging adults who used drugs (primarily cannabis) from an ED (72.4 % participation rate). Their mean age was 21.7 years (SD = 2.3); 67 % were female and 52.4 % were Black/African American. Participants randomized to the intervention (N = 31) received a BI and 28 days of tailored booster messaging (based on drug use motives) daily, and the control condition received a community resource brochure. A post-test occurred at 1-month with a follow-up at 2-months.

RESULTS

The intervention was well-received (83.9 % allocated completed the BI) with 79 % overall liking the BI and 71 % finding it helpful to discuss substances. Mean ratings of booster messages were >4.0 (5-point scale); 77 % liked the daily messages and 91 % found them helpful. Descriptively, the intervention group evidenced absolute reductions over time on alcohol outcomes, cannabis use, and condomless sex.

CONCLUSIONS

This BI with booster messages was feasible and acceptable in the target population of emerging adults who use drugs (i.e., mostly cannabis). This intervention model, initiated during a healthcare visit and accompanied by a clinician-extender, should be tested in a future fully-powered trial.

Operationalizing the triarchic model of psychopathy in adolescents using the MMPI-A-RF (Restructured Form)

The triarchic model is an increasingly influential multidimensional model of psychopathy that focuses on three distinct phenotypic domains of boldness, meanness, and disinhibition. Although originally operationalized through the Triarchic Psychopathy Measure (TriPM), the triarchic model has also been operationalized through items of existing psychopathy and personality measures that provide sufficient content coverage of the triarchic dimensions. The current study aimed to provide a means for enhancing understanding of psychopathic features in adolescents through the development and validation of triarchic scales using items from the Minnesota Multiphasic Personality Inventory-Adolescent-Restructured Form (MMPI-A-RF). The MMPI-A-RF normative sample and a large sample of juveniles undergoing court-ordered evaluations were used for formal scale development and the juvenile-court sample was also used for validation analyses. The MMPI-A-RF triarchic scales demonstrated adequate internal consistency in both the normative and juvenile offender samples, and were largely related to criterion variables, including measures of personality, psychopathology, interpersonal functioning, and adolescent concerns as predicted based on the triarchic model. Canonical correlation analyses revealed unexpected and novel findings of (variable-centered) patterns of associations between our predictor triarchic scales and criterion variables that resemble "primary" and "secondary" psychopathy variants or subtypes. Overall, findings suggest that the triarchic model as indexed by the MMPI-A-RF scales can be useful for understanding how psychopathy may manifest in youth and for identifying youth at risk for severe and persistent antisocial behavior. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Les progrès dans la réalisation de la classification quantitative de la psychopathologie☆

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.

Latent variable modeling of item-based factor scales: Comment on Triarchic or septarchic?-Uncovering the Triarchic Psychopathy Measure's (TriPM) Structure, by Roy et al

We critique Roy et al.'s (2020; this issue) approach to characterizing the item-level factor structure of the three scales of the Triarchic Psychopathy Measure (TriPM), in light of the manner in which the TriPM scales were developed, the purposes they were designed to serve, and the growing body of evidence supporting their construct validity. We focus on three major points: (1) The TriPM scales are item-based factor scales - i.e., item sets designed to index broad factors of larger multi-scale (parent) inventories; (2) item-level structural analysis can be useful for representing broad dimensions tapped by such scales, but it cannot be expected to provide an accurate picture of narrower subdimensions (facets) assessed by their parent inventories; and (3) it is critical to consider the nomological networks of the TriPM scales (and other triarchic scale measures) in appraising their effectiveness as operationalizations of the triarchic model constructs. We illustrate the first and second of these points by applying Roy et al.'s analytic approach to the trait scales of the NEO-FFI, which were developed to index broad personality dimensions of the multi-scale NEO-PI-R. We address the third point with reference to the growing body of literature supporting the construct validity of the TriPM scales and demonstrating their utility for advancing an integrative understanding of psychopathy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Therapist and computer-based brief interventions for drug use within a randomized controlled trial: effects on parallel trajectories of alcohol use, cannabis use and anxiety symptoms

BACKGROUND AND AIMS

Despite their high comorbidity, the effects of brief interventions (BI) to reduce cannabis use, alcohol use and anxiety symptoms have received little empirical attention. The aims of this study were to examine whether a therapist-delivered BI (TBI) or computer-guided BI (CBI) to address drug use, alcohol consumption (when relevant) and HIV risk behaviors, relative to enhanced usual care (EUC), was associated with reductions in parallel trajectories of alcohol use, cannabis use and anxiety symptoms, and whether demographic characteristics moderated reductions over time.

DESIGN

Latent growth curve modeling was used to examine joint trajectories of alcohol use, cannabis use and anxiety symptoms assessed at 3, 6 and 12 months after baseline enrollment.

SETTING

Hurley Medical Center Emergency Department (ED) in Flint, MI, USA.

PARTICIPANTS

The sample was 780 drug-using adults (aged 18-60 years; 44% male; 52% black) randomly assigned to receive either a TBI, CBI or EUC through the HealthiER You study.

INTERVENTIONS AND COMPARATOR

ED-delivered TBI and CBIs involved touchscreen-delivered and audio-assisted content. The TBI was administered by a Master's-level therapist, whereas the CBI was self-administered using a virtual health counselor. EUC included a review of health resources brochures in the ED.

MEASUREMENTS

Assessments of alcohol use (10-item Alcohol Use Disorders Identification Test), cannabis use (past 30-day frequency) and anxiety symptoms (Brief Symptom Inventory-18) occurred at baseline and 3-, 6- and 12-month follow-up.

FINDINGS

TBI, relative to EUC, was associated with significant reductions in cannabis use [B = -0.49, standard error (SE) = 0.20, P < 0.05) and anxiety (B = -0.04, SE = 0.02, P < 0.05), but no main effect for alcohol use. Two of 18 moderation tests were significant: TBI significantly reduced alcohol use among males (B = -0.60, SE = 0.19, P < 0.01) and patients aged 18-25 years in the TBI condition showed significantly greater reductions in cannabis use relative to older patients (B = -0.78, SE = 0.31, P < 0.05). Results for CBI were non-significant.

CONCLUSIONS

Emergency department-based therapist-delivered brief interventions to address drug use, alcohol consumption (when relevant) and HIV risk behaviors may also reduce alcohol use, cannabis use and anxiety over time, accounting for the overlap of these processes.

Comparing the Triarchic and Five-Factor Trait Models: Relations With Psychopathy and Other Clinical Criteria in an Incarcerated Offender Sample

This study compared how normative personality dimensions of the Five-Factor Model (FFM) and neurobehavioral traits of the triarchic model relate to psychopathic tendencies and clinical outcomes in an incarcerated sample of 277 Italian male offenders. Associations between triarchic model traits, measured using the TriPM and the FFM dimensions, measured using the NEO-FFI, were consistent with prior studies. Scores on the TriPM, particularly the Disinhibition scale, were associated with substance abuse and self-harm behavior over and above the presence of psychopathy, and beyond the personality dimensions indexed by the NEO-FFI. By contrast, the Neuroticism and Extraversion scales showed incremental validity, over and above psychopathy and TriPM scores, in predicting depressive tendencies. Lastly, both NEO-FFI and TriPM scales contributed to prediction of staff ratings of behavior in prison and prognosis for release, above and beyond psychopathy. These findings highlight potential advantages of the FFM and triarchic trait models for predicting clinical outcomes.

Modeling Relations Between Triarchic Biobehavioral Traits and DSM Internalizing Disorder Dimensions

The biobehavioral traits of the triarchic model of psychopathy have well-known correlates with externalizing psychopathology. Although evidence also suggests associations with internalizing disorders, research has yet to formally model relationships between dimensions of internalizing psychopathology and triarchic traits. Employing a sample of 218 adults (50.2% female), the current study used confirmatory factor analysis to characterize how triarchic trait dimensions-delineated using different scale operationalizations-relate to internalizing when modeled as a single broad factor, and as distinct fear and distress subfactors. Findings demonstrated (a) robust opposing relations for triarchic boldness (+) and disinhibition (-), and an interactive association for the two, with general internalizing, along with a modest negative relationship for meanness; and (b) distinct associations for the three triarchic trait dimensions with fear and distress subfactors of internalizing. This work clarifies how facets of psychopathy relate to the internalizing psychopathology spectrum and provides a means for interfacing this spectrum with biological variables.

Modeling the Structure of the Triarchic Psychopathy Measure: Conceptual, Empirical, and Analytic Considerations

This study sought to characterize the factor structure of the Triarchic Psychopathy Measure (TriPM) using data from a sample of 1,082 community-dwelling Italian adults. Exploratory structural equation modeling (ESEM) was used to compare the fit of a bifactor model for each TriPM scale, in which specific-content factors were specified along with a general factor, with the fit of a single, general-factor model. Robust weighted least square (WLSMV) ESEM supported a bifactor latent structure of the TriPM items for all individual scales. When we jointly factor analyzed the 58 TriPM items, a WLSMV ESEM three-factor structure showed adequate fit; the three ESEM factors were akin to TriPM Boldness, Meanness, and Disinhibition theoretical dimensions, respectively, and could be effectively replicated across gender subgroups. Our findings support the three-factor structure of TriPM items, at least in Italian community-dwelling adults, and provide further evidence for the construct validity of the TriPM.

Improving characterization of psychopathy within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), alternative model for personality disorders: Creation and validation of Personality Inventory for DSM-5 Triarchic scales

The latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) bridges a significant gap in psychiatric nosology by providing trait-based characterizations of psychopathy along with antisocial personality disorder within the Section III alternative model for personality disorders (AMPD). However, the representation of psychopathy in the AMPD has met with some criticisms (Crego & Widiger, 2014; Few, Lynam, Maples, MacKillop, & Miller, 2015). The current study was undertaken to establish an improved means for characterizing psychopathy in DSM-5 Section III terms, by creating scale measures of triarchic psychopathy dimensions using items from the best-established assessment instrument for the AMPD, the Personality Inventory for DSM-5 (PID-5). Using data from a sample of community adults (N = 210), we employed a construct rating and psychometric refinement approach to develop item-based PID-5 Triarchic scales for measuring psychopathy dimensions of boldness, meanness, and disinhibition. The validity of the PID-5 Triarchic scales was then evaluated in relation to criteria including other scale measures of the triarchic constructs and psychopathy, self-reported antisocial behavior and substance use, empathy, internalizing and other clinical problems, and personality within the development sample and a separate independent sample of adults (N = 240) recruited to have elevated psychopathic traits. Results of this work provide a foundation for improved characterization of psychopathy in terms of the AMPD trait system and provide a mechanism for future research oriented toward clarifying the developmental interface between childhood conduct disorder and psychopathy, as well as identifying neurobiological correlates of dimensions of psychopathy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Progress in achieving quantitative classification of psychopathology

Shortcomings of approaches to classifying psychopathology based on expert consensus have given rise to contemporary efforts to classify psychopathology quantitatively. In this paper, we review progress in achieving a quantitative and empirical classification of psychopathology. A substantial empirical literature indicates that psychopathology is generally more dimensional than categorical. When the discreteness versus continuity of psychopathology is treated as a research question, as opposed to being decided as a matter of tradition, the evidence clearly supports the hypothesis of continuity. In addition, a related body of literature shows how psychopathology dimensions can be arranged in a hierarchy, ranging from very broad "spectrum level" dimensions, to specific and narrow clusters of symptoms. In this way, a quantitative approach solves the "problem of comorbidity" by explicitly modeling patterns of co-occurrence among signs and symptoms within a detailed and variegated hierarchy of dimensional concepts with direct clinical utility. Indeed, extensive evidence pertaining to the dimensional and hierarchical structure of psychopathology has led to the formation of the Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium. This is a group of 70 investigators working together to study empirical classification of psychopathology. In this paper, we describe the aims and current foci of the HiTOP Consortium. These aims pertain to continued research on the empirical organization of psychopathology; the connection between personality and psychopathology; the utility of empirically based psychopathology constructs in both research and the clinic; and the development of novel and comprehensive models and corresponding assessment instruments for psychopathology constructs derived from an empirical approach.

Extending the Construct Network of Trait Disinhibition to the Neuroimaging Domain: Validation of a Bridging Scale for Use in the European IMAGEN Project

Trait disinhibition, a clinical-liability construct, has well-established correlates in the diagnostic, self-rating, task-behavioral, and brain potential response domains. Recently, studies have begun to test for neuroimaging correlates of this liability factor, but more work of this type using larger data sets is needed to clarify its brain bases. The current study details the development and validation of a scale measure of trait disinhibition composed of questionnaire items available in the IMAGEN project, a large-scale longitudinal study of factors contributing to substance abuse that includes clinical interview, self-report personality, task-behavioral, neuroimaging, and genomic measures. Using a construct-rating and psychometric refinement approach, a scale was developed that evidenced: (a) positive relations with interview-assessed psychopathology in the IMAGEN sample, both concurrently and prospectively and (b) positive associations with scale measures of disinhibition and reported psychopathology, and a robust negative correlation with P3 brain response, in a separate adult sample ( M_age = 19.5). These findings demonstrate that a common scale measure can index this construct from adolescence through to early adulthood, and set the stage for systematic work directed at identifying neural and genetic biomarkers of this key liability construct using existing and future data from the IMAGEN project.

Callousness and affective face processing in adults: Behavioral and brain-potential indicators

The investigation of callous-unemotional (CU) traits has been central to contemporary research on child behavior problems, and served as the impetus for inclusion of a specifier for conduct disorder in the latest edition of the official psychiatric diagnostic system. Here, we report results from 2 studies that evaluated the construct validity of callousness as assessed in adults, by testing for affiliated deficits in behavioral and neural processing of fearful faces, as have been shown in youthful samples. We hypothesized that scores on an established measure of callousness would predict reduced recognition accuracy and diminished electocortical reactivity for fearful faces in adult participants. In Study 1, 66 undergraduate participants performed an emotion recognition task in which they viewed affective faces of different types and indicated the emotion expressed by each. In Study 2, electrocortical data were collected from 254 adult twins during viewing of fearful and neutral face stimuli, and scored for event-related response components. Analyses of Study 1 data revealed that higher callousness was associated with decreased recognition accuracy for fearful faces specifically. In Study 2, callousness was associated with reduced amplitude of both N170 and P200 responses to fearful faces. Current findings demonstrate for the first time that callousness in adults is associated with both behavioral and physiological deficits in the processing of fearful faces. These findings support the validity of the CU construct with adults and highlight the possibility of a multidomain measurement framework for continued study of this important clinical construct. (PsycINFO Database Record

Interfacing five-factor model and triarchic conceptualizations of psychopathy

The lexically based five-factor model (FFM) of personality has been a highly influential research framework for characterizing clinical-psychological conditions, including psychopathy, in lexical-trait terms. An alternative trait-descriptive framework, the triarchic model was formulated to characterize psychopathy in neurobehavioral-trait terms, in order to facilitate linkages with variables in the domain of neurobiology. The current study used data from a mixed-gender sample (N = 769; M age = 19.3) to establish an interface between the FFM and triarchic frameworks by identifying subsets of items from a widely used five-factor personality inventory, the NEO Personality Inventory-Revised (NEO-PI-R), that effectively index the dimensional constructs of the triarchic model (boldness, meanness, and disinhibition). A consensus rating and psychometric refinement approach was used to select NEO-PI-R items for assessing each triarchic dimension, and the resulting NEO-Tri item-sets ("scales") were evaluated in relation to criteria including other scale measures of the triarchic constructs, reported antisocial behavior and drug/alcohol use, and an FFM-generated omnibus psychopathy measure, the Psychopathy Resemblance Index. The NEO-Tri scales were also evaluated for effectiveness as indicators of latent triarchic dimensions within a confirmatory factor analysis anchored by previously validated triarchic scale measures. Results of this work have implications for clarifying how the triarchic model dimensions relate to normal-range personality traits and FFM-based conceptions of psychopathy, and provide a foundation for further examining neurobiological correlates of the triarchic model dimensions using existing multidomain data-sets that include the NEO-PI-R. (PsycINFO Database Record

Integrating Alternative Conceptions of Psychopathic Personality: A Latent Variable Model of Triarchic Psychopathy Constructs

This study undertook confirmatory factor analyses (CFAs) of data from 567 participants to quantify constructs specified by the triarchic model of psychopathy (Patrick, Fowles, & Krueger, 2009)-boldness, meanness, and disinhibition-as latent variables. Indicators for the CFAs consisted of subscales of the Triarchic Psychopathy Measure along with triarchic scales derived from items of the Psychopathic Personality Inventory, Youth Psychopathic Traits Inventory, and Multidimensional Personality Questionnaire. A modified three-factor model provided good fit to the data and outperformed alternative two- and one-factor models. Multiple-group CFAs demonstrated gender differences (male > female) in factor means and covariances, but not in factor loadings or intercepts. These findings support the idea that the triarchic model dimensions are embedded in differing models and measures of psychopathy and comprise essential building blocks for this clinical condition. Implications for understanding the structure of psychopathy, gender differences in psychopathic traits, and applications of latent variable modeling in future research are discussed.

Methodological issues in the use of individual brain measures to index trait liabilities: The example of noise-probe P3

Recent research initiatives have called for an increased use of biological concepts and measures in defining and studying mental health problems, but important measurement-related challenges confront efforts in this direction. This article highlights some of these challenges with reference to an intriguing measure of neural reactivity: the probe P3 response, a mid-latency brain potential evoked by an intense, unexpected acoustic-probe stimulus. Using data for a large adult sample (N=418), we report evidence that amplitude of probe P3 response to unwarned noise bursts occurring in a picture-viewing task exhibits robust, independent associations with two distinct trait constructs: weak inhibitory control (or disinhibition; DIS) and threat sensitivity (THT). Additionally, we report a selective association for THT with attentional suppression of probe P3 response during viewing of aversive pictures compared to neutral. These results point to separable elements of variance underlying the probe P3 response, including one element reflecting DIS-related variations in cognitive-elaborative processing, and others reflecting THT-related variations in aversive foreground engagement and abrupt defensive reorientation. Key measurement issues are considered in relation to these specific findings, and methodological and statistical approaches for addressing these issues are discussed in relation to advancement of a quantitatively sound, biologically informed science of psychopathology.

Further Evidence for Reliability and Validity of the Triarchic Psychopathy Measure in a Forensic Sample and a Community Sample

Psychopathy is often described as a constellation of personality characteristics encompassing features such as impulsivity and antisociality, and a lack of empathy and guilt. Although the use of self-reports to assess psychopathy is still debated, there are distinct advantages to such measures and recent research suggests that they may not be as problematic as previously thought. This study further examined the reliability and validity of the Triarchic Psychopathy Measure (TriPM) in a community sample (N = 496) and forensic psychiatric patient sample (N = 217). Results indicated excellent internal consistencies. Additionally, the TriPM total and subscale scores related as expected to different subscales of the Psychopathic Personality Inventory -Revised (PPI-R) and to the Reactive and Proactive Aggression Questionnaire, reflecting good construct validity. Most importantly, ROC curve analyses showed that the TriPM evidenced better discrimination between the community sample and forensic psychiatric patients than the PPI-R. The current study extends the existent evidence demonstrating that the TriPM can be used as an efficient self-report instrument.

Development and Validation of MMPI-2-RF Scales for Indexing Triarchic Psychopathy Constructs

The triarchic model characterizes psychopathy in terms of three distinct dispositional constructs of boldness, meanness, and disinhibition. The model can be operationalized through scales designed specifically to index these domains or by using items from other inventories that provide coverage of related constructs. The present study sought to develop and validate scales for assessing the triarchic model domains using items from the Minnesota Multiphasic Personality Inventory–2–Restructured Form (MMPI-2-RF). A consensus rating approach was used to identify items relevant to each triarchic domain, and following psychometric refinement, the resulting MMPI-2-RF-based triarchic scales were evaluated for convergent and discriminant validity in relation to multiple psychopathy-relevant criterion variables in offender and nonoffender samples. Expected convergent and discriminant associations were evident very clearly for the Boldness and Disinhibition scales and somewhat less clearly for the Meanness scale. Moreover, hierarchical regression analyses indicated that all MMPI-2-RF triarchic scales incremented standard MMPI-2-RF scale scores in predicting extant triarchic model scale scores. The widespread use of MMPI-2-RF in clinical and forensic settings provides avenues for both clinical and research applications in contexts where traditional psychopathy measures are less likely to be administered.

A Chimpanzee (Pan troglodytes) Model of Triarchic Psychopathy Constructs: Development and Initial Validation

The current work sought to operationalize constructs of the triarchic model of psychopathy in chimpanzees (Pan troglodytes), a species well-suited for investigations of basic biobehavioral dispositions relevant to psychopathology. Across three studies, we generated validity evidence for scale measures of the triarchic model constructs in a large sample (N=238) of socially-housed chimpanzees. Using a consensus-based rating approach, we first identified candidate items for the chimpanzee triarchic (CHMP-Tri) scales from an existing primate personality instrument and refined these into scales. In Study 2, we collected data for these scales from human informants (N=301), and examined their convergent and divergent relations with scales from another triarchic inventory developed for human use. In Study 3, we undertook validation work examining associations between CHMP-Tri scales and task measures of approach-avoidance behavior (N=73) and ability to delay gratification (N=55). Current findings provide support for a chimpanzee model of core dispositions relevant to psychopathy and other forms of psychopathology.

Further Validation of Triarchic Psychopathy Scales From the Multidimensional Personality Questionnaire: Setting the Stage for Large-Sample Etiological Studies

Psychopathy as conceptualized by the triarchic model encompasses three distinct dispositional constructs: boldness, meanness, and disinhibition. The current study sought to further validate triarchic (Tri) construct scales composed of items from the Multidimensional Personality Questionnaire (MPQ) as a foundation for advancing research on the etiology of psychopathy using existing large-scale longitudinal studies. MPQ-Tri scales were examined in three samples: mixed-gender undergraduate students ( N = 346), male offenders from a residential substance abuse treatment facility ( N = 190), and incarcerated female offenders ( N = 216). Across these three samples, the MPQ-Tri scales demonstrated high internal consistency and clear convergent and discriminant associations with criterion measures of psychopathy and other psychopathology outcomes. Gender comparisons revealed relatively few differences in relationships with criterion measures. Findings are discussed in terms of their implications for further investigation of the causal bases of psychopathy and other forms of psychopathology utilizing data from large etiologically informative studies.

Assessing the triarchic model of psychopathy in adolescence: Reliability and validity of the Triarchic Psychopathy Measure (TriPM) in three samples of Italian community-dwelling adolescents

To assess the psychometric properties and construct validity of the Italian translation of the Triarchic Psychopathy Measure (TriPM) in adolescents, we administered the inventory to 3 independent samples of Italian high school students (Ns = 609, 618, and 1,142). Cronbach's alpha values greater than .80 were observed for the TriPM scale scores in all samples. In Sample 1, overall scores on the Youth Psychopathic Traits Inventory correlated substantially with TriPM total scores, r = .77, p < .001. Data from Study 1 also demonstrated adequate 3-month test-retest reliabilities for the 3 TriPM subscales. In Study 2, TriPM scores significantly predicted scores on a self-report measure of delinquent behaviors, Radjusted2 = .25, p < .001. In Study 3, five-factor domain scores showed significant relations with TriPM scale scores consistent with results reported for adults. Consistent with a hypothesized role of fearlessness in psychopathy, adolescents at high psychopathy risk (i.e., >97th percentile on the TriPM) reported lower fear in response to emotion-eliciting movie clips than low-psychopathy participants. In addition, scores on a measure of hedonistic moral tendencies discriminated between adolescents at high as opposed to low psychopathy. Similarly, scores on the Reflective Function Questionnaire for Youths were negatively correlated with TriPM scores. As a whole, our findings provide further support for the reliability and validity of the TriPM and its cross-cultural utility, and provide initial evidence of its effectiveness with community-dwelling adolescents.

Separate and interactive contributions of weak inhibitory control and threat sensitivity to prediction of suicide risk

Biobehavioral dispositions can serve as valuable referents for biologically oriented research on core processes with relevance to many psychiatric conditions. The present study examined two such dispositional variables-weak response inhibition (or disinhibition; INH-) and threat sensitivity (or fearfulness; THT+)-as predictors of the serious transdiagnostic problem of suicide risk in two samples: male and female outpatients from a U.S. clinic (N=1078), and a population-based male military cohort from Finland (N=3855). INH- and THT+ were operationalized through scores on scale measures of disinhibition and fear/fearlessness, known to be related to DSM-defined clinical conditions and brain biomarkers. Suicide risk was assessed by clinician ratings (clinic sample) and questionnaires (both samples). Across samples and alternative suicide indices, INH- and THT+ each contributed uniquely to prediction of suicide risk-beyond internalizing and externalizing problems in the case of the clinic sample where diagnostic data were available. Further, in both samples, INH- and THT+ interactively predicted suicide risk, with individuals scoring concurrently high on both dispositions exhibiting markedly augmented risk. Findings demonstrate that dispositional constructs of INH- and THT+ are predictive of suicide risk, and hold potential as referents for biological research on suicidal behavior.

Development and validation of triarchic psychopathy scales from the Multidimensional Personality Questionnaire

Psychopathy is conceptualized by the triarchic model as encompassing 3 distinct phenotypic constructs: boldness, meanness, and disinhibition. In the current study, the Multidimensional Personality Questionnaire (MPQ), a normal-range personality measure, was evaluated for representation of these 3 constructs. Consensus ratings were used to identify MPQ items most related to each triarchic (Tri) construct. Scale measures were developed from items indicative of each construct, and scores for these scales were evaluated for convergent and discriminant validity in community (N = 176) and incarcerated samples (N = 240). Across the 2 samples, MPQ-Tri scale scores demonstrated good internal consistencies and relationships with criterion measures of various types consistent with predictions based on the triarchic model. Findings are discussed in terms of their implications for further investigation of the triarchic model constructs in preexisting datasets that include the MPQ, in particular longitudinal and genetically informative datasets.

A triarchic model analysis of the youth psychopathic traits inventory

The Triarchic model of psychopathy characterizes this complex condition in terms of distinct phenotypic constructs of boldness, meanness, and disinhibition. The current study evaluated the coverage of these constructs provided by a well-established inventory for assessing psychopathy in adolescents, the Youth Psychopathic Traits Inventory (YPI). A consensus rating approach was used to identify YPI items relevant to each Triarchic model construct, and convergent and discriminant validity of the resulting YPI-Triarchic scales were examined in relation to criterion measures consisting of scores on other psychopathy measures and relevant personality trait variables (N = 618, M age = 18.8). The YPI-Triarchic scales showed good internal consistency and exhibited properties largely consistent with predictions based on the Triarchic model, aside from somewhat greater than expected covariance between boldness and other facet scales. Findings are discussed in terms of their implications for interpreting scores on the YPI and for investigating distinctive components of psychopathy in youth.

Elucidating the Construct Validity of the Psychopathic Personality Inventory Triarchic Scales

This study sought to replicate and extend Hall and colleagues' (2014) work on developing and validating scales from the Psychopathic Personality Inventory (PPI) to index the triarchic psychopathy constructs of boldness, meanness, and disinhibition. This study also extended Hall et al.'s initial findings by including the PPI Revised (PPI-R). A community sample (n = 240) weighted toward subclinical psychopathy traits and a male prison sample (n = 160) were used for this study. Results indicated that PPI-Boldness, PPI-Meanness, and PPI-Disinhibition converged with other psychopathy, personality, and behavioral criteria in ways conceptually expected from the perspective of the triarchic psychopathy model, including showing very strong convergent and discriminant validity with their Triarchic Psychopathy Measure counterparts. These findings further enhance the utility of the PPI and PPI-R in measuring these constructs.

Triarchic Model of Psychopathy: Origins, Operationalizations, and Observed Linkages with Personality and General Psychopathology

The triarchic model (Patrick, Fowles, & Krueger, 2009) was formulated to reconcile contrasting conceptions of psychopathy reflected in historic writings and contemporary assessment instruments, and to address persisting unresolved issues in the field. The model conceives of psychopathy as encompassing three distinct but interrelated phenotypic dispositions--disinhibition, boldness, and meanness--with biological referents. These dispositional constructs can be viewed as building blocks for alternative conceptions of psychopathy, and various existing psychopathy measures are presumed to index these constructs to differing degrees. This article summarizes the bases of the triarchic model in the conceptual and empirical literatures on psychopathy, and it describes linkages between the constructs of the model and established structural frameworks for personality and psychological disorders. Alternative methods for indexing the constructs of the model are described, and evidence regarding their interrelations and criterion-related validity is reviewed. Promising aspects of the model for ongoing research on psychopathy are discussed, along with current gaps in knowledge/methods and recommended avenues for future research.

Triarchic Model of Psychopathy: Origins, Operationalizations, and Observed Linkages with Personality and General Psychopathology

The triarchic model (Patrick, Fowles, & Krueger, 2009) was formulated to reconcile contrasting conceptions of psychopathy reflected in historic writings and contemporary assessment instruments, and to address persisting unresolved issues in the field. The model conceives of psychopathy as encompassing three distinct but interrelated phenotypic dispositions--disinhibition, boldness, and meanness--with biological referents. These dispositional constructs can be viewed as building blocks for alternative conceptions of psychopathy, and various existing psychopathy measures are presumed to index these constructs to differing degrees. This article summarizes the bases of the triarchic model in the conceptual and empirical literatures on psychopathy, and it describes linkages between the constructs of the model and established structural frameworks for personality and psychological disorders. Alternative methods for indexing the constructs of the model are described, and evidence regarding their interrelations and criterion-related validity is reviewed. Promising aspects of the model for ongoing research on psychopathy are discussed, along with current gaps in knowledge/methods and recommended avenues for future research.

Development and validation of Triarchic construct scales from the psychopathic personality inventory

The Triarchic model of psychopathy describes this complex condition in terms of distinct phenotypic components of boldness, meanness, and disinhibition. Brief self-report scales designed specifically to index these psychopathy facets have thus far demonstrated promising construct validity. The present study sought to develop and validate scales for assessing facets of the Triarchic model using items from a well-validated existing measure of psychopathy-the Psychopathic Personality Inventory (PPI). A consensus-rating approach was used to identify PPI items relevant to each Triarchic facet, and the convergent and discriminant validity of the resulting PPI-based Triarchic scales were evaluated in relation to multiple criterion variables (i.e., other psychopathy inventories, antisocial personality disorder features, personality traits, psychosocial functioning) in offender and nonoffender samples. The PPI-based Triarchic scales showed good internal consistency and related to criterion variables in ways consistent with predictions based on the Triarchic model. Findings are discussed in terms of implications for conceptualization and assessment of psychopathy.

Distinct variants of extreme psychopathic individuals in society at large: evidence from a population-based sample

This study used model-based cluster analysis to identify subtypes of men who scored high in overall psychopathy (i.e., ≥ 95th percentile on the Triarchic Psychopathy Measure; n = 193) from a larger sample evaluated for service in the Finnish military (N = 4043). Cluster variates consisted of scores on distinct facets of psychopathy together with a measure of negative affectivity. The best-fitting model specified 2 clusters, representing "primary" (n = 110) and "secondary" psychopathy (n = 83) groups. Compared to a low-psychopathy comparison group (n = 1878), both psychopathy subgroups showed markedly elevated levels of externalizing symptoms and criminal behavior. Secondary psychopathic participants also reported high levels of internalizing problems including anxiousness, depression, and somatization, and scored higher on the disinhibition facet of psychopathy relative to the primary group. By contrast, primary psychopathic individuals reported fewer internalizing problems than either the secondary psychopathy or comparison groups and scored higher on the boldness facet of psychopathy. Primary psychopathic participants also had higher rates of violent crimes than the secondary psychopaths. Implications for conceptualizing and studying psychopathy in nonforensic populations are discussed.

Clarifying the content coverage of differing psychopathy inventories through reference to the triarchic psychopathy measure

The triarchic model of psychopathy (Patrick, Fowles, & Krueger, 2009) was formulated as an integrative framework for reconciling differing conceptions of psychopathy. The model characterizes psychopathy in terms of 3 distinguishable phenotypic components: boldness, meanness, and disinhibition. Data from a large mixed-gender undergraduate sample (N = 618) were used to examine relations of several of the best known measures for assessing psychopathic traits with scores on the Triarchic Psychopathy Measure (TriPM), an inventory developed to operationalize the triarchic model through separate facet scales. Analyses revealed that established inventories of psychopathy index components of the model as indexed by the TriPM to varying degrees. Although each inventory provided effective coverage of meanness and disinhibition components, instruments differed in their representation of boldness. Present results demonstrate the heuristic value of the triarchic model for delineating commonalities and differences among alternative measures of psychopathy and provide support for the utility of the triarchic model as a framework for reconciling alternative conceptions of psychopathy.

The role of fearless dominance in differentiating psychopathy from antisocial personality disorder: comment on Marcus, Fulton, and Edens

Comments on the original article by Marcus et al. (see record 2011-23134-001). Based on their meta-analytic review of the correlates of the two factors of the Psychopathic Personality Inventory (PPI), Fearless Dominance (FD) and Self-Centered Impulsivity (SCI), Marcus, Fulton, and Edens (this issue, pp. 70-79) raise important questions about the role of FD in diagnostic conceptualizations of psychopathy. In considering their findings, general limitations of metaanalyses (e.g., Ioannidis & Lau, 1999) should be borne in mind, along with specific limitations of their analysis. These limitations are discussed here.

Characterizing Psychopathy Using DSM-5 Personality Traits

Despite its importance historically and contemporarily, psychopathy is not recognized in the current Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revised ( DSM-IV-TR). Its closest counterpart, antisocial personality disorder, includes strong representation of behavioral deviance symptoms but weak representation of affective-interpersonal features considered central to psychopathy. The current study evaluated the extent to which psychopathy and its distinctive facets, indexed by the Triarchic Psychopathy Measure, can be assessed effectively using traits from the dimensional model of personality pathology developed for DSM-5, operationalized by the Personality Inventory for DSM-5 (PID-5). Results indicate that (a) facets of psychopathy entailing impulsive externalization and callous aggression are well-represented by traits from the PID-5 considered relevant to antisocial personality disorder, and (b) the boldness facet of psychopathy can be effectively captured using additional PID-5 traits. These findings provide evidence that the dimensional model of personality pathology embodied in the PID-5 provides effective trait-based coverage of psychopathy and its facets.

Reduced cortical call to arms differentiates psychopathy from antisocial personality disorder

BACKGROUND

Psychopathy and antisocial personality disorder (ASPD) are both characterized by impulsive, externalizing behaviors. Researchers have argued, however, that psychopathy is distinguished from ASPD by the presence of interpersonal-affective features that reflect an underlying deficit in emotional sensitivity. No study to date has tested for differential relations of these disorders with the brain's natural orienting response to sudden aversive events. Method Electroencephalography was used to assess cortical reactivity to abrupt noise probes presented during the viewing of pleasant, neutral and unpleasant pictures in 140 incarcerated males diagnosed using the Psychopathy Checklist - Revised and DSM-IV criteria for ASPD. The primary dependent measure was the P3 event-related potential response to the noise probes.

RESULTS

Psychopaths showed significantly smaller amplitude of P3 response to noise probes across trials of all types compared with non-psychopaths. Follow-up analyses revealed that this overall reduction was attributable specifically to the affective-interpersonal features of psychopathy. By contrast, no group difference in general amplitude of probe P3 was evident for ASPD versus non-ASPD participants.

CONCLUSIONS

The findings demonstrate a reduced cortical orienting response to abrupt aversive stimuli in participants exhibiting features of psychopathy that are distinct from ASPD. The specificity of the observed effect fits with the idea that these distinctive features of psychopathy reflect a deficit in defensive reactivity, or mobilization of the brain's defensive system, in the context of threat cues.