A Rorschach investigation of incarcerated female offenders with antisocial personality disorder

Although male psychopathy has been linked to histrionic, narcissistic, and antisocial personality disorders (ASPD), less is known about female psychopathy. The Psychopathy Checklist-Revised (PCL-R) and the Rorschach were used to explore the personality functioning of 45 incarcerated female offenders with ASPD delineated by their psychopathy level. Psychopaths (PCL-R > or = 30) and nonpsychopaths (PCL-R < 24) were compared on Rorschach measures of self-perception, interpersonal relatedness, and reality testing. Compared to female offenders with ASPD who were nonpsychopathic, female offenders with ASPD who were psychopathic exhibited marked disturbances in self-perception, interpersonal relatedness, and reality testing. Our findings highlight the heterogeneity of the ASPD diagnosis in women, support the utility of the psychopathy construct with female offenders, and implicate important differences between men and women with ASPD. These gender differences have relevance to the evaluation (PCL-R scoring) and treatment of female offenders. Our findings are discussed within the context of the female psychopath's hypothesized hysterical character style.     

A preliminary study on findings of psychopathy and affective disorders in adult sex offenders

The construct of psychopathy has often been considered mutually exclusive to the presence of genuine depressive or anxiety symptomotology. This article addresses the hypothesized reasons for this dichotomous relationship. In this study, 68 civilly committed adult male sex offenders were evaluated using a variety of psychological measures to determine if psychopathic individuals in this group would demonstrate clinically significant affective symptoms. Results indicate that the men in this sample endorsed high rates of psychopathy on the PCL-R, with 42% of these expressing concurrent symptoms of depression and 26% manifesting symptoms of an anxiety disorder. Relationships between affective symptoms and PCL-R factor scores and qualitative differences between these constructs in child molesters and rapists are also discussed.     

Psychopathic traits in Finnish homicide offenders with schizophrenia

There is a paucity of studies examining psychopathy in comparable samples of violent individuals with and without psychotic illness. The main goal of the study was to assess the prevalence and nature of psychopathic traits as measured by PCL-R among Finnish homicide offenders with schizophrenia. Further, the impact of co-morbid psychopathy on the homicidal incidents, as well as the associations of psychopathy and offender background factors, among offenders with schizophrenia was investigated.A retrospective study was performed using extensive forensic psychiatric evaluation reports and crime reports as sources of information. The sample consisted of 72 homicide offenders with schizophrenia and 72 controls without psychotic illness.Psychopathic features were prevalent among Finnish homicide offenders with schizophrenia, although for the most parts to a lesser extent compared to other homicide offenders. Like non-mentally ill psychopathic offenders, offenders with schizophrenia and many psychopathic traits are likely to present early starting problems in many areas of life and they also commit homicides that resemble other psychopathic offenders' in their choice of victims, intoxication and post-offense behavior.The observed prevalence of psychopathic traits highlights the importance of psychopathy assessment among violence-prone individuals with schizophrenia. In most respects, offenders with schizophrenia and high levels of psychopathic traits seem to be similar to psychopathic offenders without psychotic illness, which has implications for early intervention and management.     

The PCL-R and violent recidivism in a prospective follow-up of a nationwide sample of female offenders

Psychopathy has been linked to violent reoffending in men, but the findings in women have been contradictory. The aim of this study was to examine the predictive validity of the Psychopathy Checklist-Revised (PCL-R) for violent recidivism in a nationwide sample of female violent offenders. The offenders (n = 48) had been assessed by the PCL-R and were followed after their release from prison or a psychiatric hospital. The average follow-up period was 8 years. Of the offenders, 16 (33%) had been reconvicted of a violent crime. Current findings of the performance indicators did not support the use of the PCL-R as a predictive instrument assessing risk of violent recidivism in females. The findings indicate that impulsivity plays a crucial role in female violent recidivism and that the PCL-R should be used with caution in risk assessment with female populations.     

Psychopathy, treatment change, and recidivism in high-risk, high-need sexual offenders

The present study investigated 154 consecutive admissions to the Regional Treatment Center (Ontario) Sex Offender Treatment Program with reference to psychopathy and outcome. Ratings of treatment behavior, as well as clinical judgments as to whether risk was reduced, were coded based on treatment reports. With reference to Psychopathy Checklist-revised (PCL-R) scores, survival analyses indicated that high scorers recidivated at significantly higher rates than low scorers. However, offenders who received high PCL-R scores and lower scores on measures of treatment behavior recidivated at the same rate as low scorers on the PCL-R. Furthermore, among high PCL-R offenders, those rated as lower risk at post treatment in fact reoffended at a lower rate than those whose risk was rated as unchanged, although this difference failed to reach significance. Findings are discussed in light of the clinical and research literature.     

A multidimensional scaling analysis of the Hare PCL-R: Unfolding the structure of psychopathy

Abstract

Recent studies examining the Psychopathy Checklist – Revised (PCL-R) have argued for a range of factorial solutions to describe and explain the dimensions of psychopathy. This study details an empirical analysis of North American PCL-R data for 4630 male offenders, using multidimensional scaling (MDS) as a non-linear alternative to factor analysis. The emergent structure of Hare's psychopathy psychometric can be interpreted in more than one way and at different levels of specificity. The multidimensional scalograms reveal a set of facets consistent with the two- and four-factor solutions that emerge from the same data. Equally the structure of the PCL-R can be interpreted through personality theory as a set of core traits and behavioural manifestations, consistent with an evolutionary basis for psychopathic tendencies. These analyses provide support for a multidimensional structure within the PCL-R, and suggest that psychopathy can be viewed as an extreme variant of multiple dimensions of personality.     

Psychopathy,intelligence, and impulsivity in German violent offenders

Previous studies have reported numerous correlations between psychopathy and various personality traits, behavioural tendencies or clinical characteristics. The present study examined in greater depth the relationships between the components of psychopathy as measured by the Psychopathy Checklist—Revised (PCL-R) and intelligence as well as impulsivity. A total of ninety male violent offenders were recruited from a prison and a forensic–psychiatric hospital in Germany. All of the subjects were assessed using the PCL-R, the Barratt Impulsiveness Scale (BIS-11), and a short version of the German Wechsler Adult Intelligence Scale (WIP). As expected, a canonical correlation analysis showed a negative association between spatial intelligence and the Factor 2 subtotal on the PCL-R (reckless lifestyle/antisociality). In addition, our results agreed with the assumption of an association between impulsivity and the subtotal for PCL-R Factor 2. The positive relationship between verbal intelligence and the subtotal for Factor 1 of the PCL-R (insincere, manipulative conduct/affective deficits) vanished after controlling for educational level. The results indicate that there is a relationship between the spatial components of intelligence and the concept of psychopathy as described by Hare. This result supports the spatial impairment aetiological model of antisocial behaviour.     

The Evidentiary Introduction of Psychopathy Checklist-Revised Assessed Psychopathy in U.S. Courts: Extent and Appropriateness*

We examine the application of Psychopathy Checklist Revised (PCL-R) assessed psychopathy in U.S. courts from the time of the introduction of the PCL-R in 1991, through the end of 2004, and consider the PCL-R in light of relevant evidentiary standards and the empirical support for the construct of psychopathy. Our review of the Westlaw legal database indicates that the evidentiary introduction of PCL-R assessed psychopathy extends across state and federal jurisdictions, and has increased considerably in recent years. We identify nine contexts in which PCL-R evidence has been introduced and examine the appropriateness of such introduction. In most contexts the PCL-R was considered with regard to the prediction of violence in the community, and in such context the introduction of PCL-R scores appears appropriate, at least with regard to European American male offenders. However, PCL-R assessments may not meet relevant evidentiary standards with regard to the prediction of institutional violence and violence among females, adolescents and ethnic minorities.     

Psychopathy (PCL-R) in a forensic psychiatric sample of homicide offenders: some reliability issues

Several studies have shown that psychopathy is overrepresented among homicide offenders. There is a consensus that Hare's Psychopathy Checklist-Revised PCL-R is currently the most valid and useful tool for rating psychopathy (e.g., [Fulero, S. M. (1995). Review of the Hare Psychopathy Checklist-Revised. In J. C. Conoley & J. C. Impara (Eds.), Twelfth Mental Measurements Yearbook (pp. 453-454). Lincoln, NE: Buros Institute]). Usually, when making a rating of psychopathy, both an interview and an examination of the subject's files are used. However, it has been discussed what is really required to be able to rate psychopathy in a reliable manner. The aim of the present study was to retrospectively rate the degree of psychopathy in 35 homicide offenders being subjected to forensic psychiatric assessment. These ratings of psychopathy were carried out using forensic psychiatric files and courts'; verdicts only. Another aim was to examine the reliability of PCL-R in this specific Swedish sample of homicide offenders. There was a good agreement between the two raters with respect to the categorical diagnosis of psychopathy (Cohen's kappa=.81, p<.001), which indicates that retrospective ratings of psychopathy are well suited for research purposes. The prevalence of psychopathy among the homicide offenders was 31.4% (using a cut-off score of 30), which means that the construct of psychopathy may contribute to the understanding of the phenomenon of homicide. In the planning of treatment for homicide offenders, a consideration of possible psychopathy is necessary. As criminal psychopaths are known to relapse into violent criminality, it is very important that they are given efficient treatment, placement and management.     

Psychopathy and intelligence in high-risk violent women

There has been a longstanding debate and mixed evidence on the link between psychopathy and intelligence. Most of the existing research comes from male prisoners, with the literature on female psychopathy and intelligence remaining sparse. Thus, the current study explored the correlational association between psychopathy and intelligence in a sample of high-risk violent female offenders. This is the first study of its kind from the Offender Personality Disorder (OPD) pathway for women in the United Kingdom (UK). The sample includes high-risk violent women presenting with severe personality disorder. In the present study, we conducted a correlational examination between total scores, and the 2-factor and 4-facet structure of the Psychopathy Checklist-Revised (PCL-R) with intelligence using the Wechsler Adult Intelligence Scale (WAIS). No significant associations were found between total PCL-R scores, or factor 2, and intelligence. Positive associations were found between verbal comprehension and factor 1 and the interpersonal facet. Thus, the results suggest high-risk violent female offenders with interpersonal psychopathic traits demonstrate higher levels of verbal comprehension skills. This finding may help explain why psychopathic female offenders, who can be characterized by deceitful and egocentric behaviours, may be able to successfully charm and con others for their own personal gain.     

Psychopathy and Recidivism Among Female Inmates

Despite a plethora of studies investigating psychopathy among male offenders, little is known about the applicability of this construct to female populations. Research has shown that prevalence rate, symptom presentation, and diagnostic comorbidity differ for females as compared to males. The current study is the first to examine the relationship between psychopathy and recidivism among women. Recidivism data on a sample of 78 female inmates were examined at a 1-year interval in relation to the Psychopathy Checklist-Revised (PCL-R), inclusion criteria for the Antisocial Personality Disorder Diagnosis from the Personality Disorder Examination (PDE), and selected scales from the Personality Assessment Inventory (PAI; Antisocial and Aggression scales). The egocentricity subscale of the PAI, Factor 1 of the PCL-R, and the verbal aggression subscale of the PAI were the best predictors of future recidivism. Specific differences emerged between male and female offenders when comparing the present data with previous studies of male psychopaths.     

Psychopathy (PCL-R) as a Predictor of Violent Recidivism Among Criminal Offenders with Schizophrenia

Hare's Psychopathy Checklist-Revised (PCL-R) was used to test the hypothesis that psychopathy predicts violent recidivism in a cohort subjected to forensic psychiatric investigation and consisting of male violent offenders with schizophrenia (N = 202). Psychopathy was assessed with retrospective file-based ratings. Mean follow-up time after detainment was 51 months. Twenty-two percent of the offenders had a PCL-R score 26 (cutoff), and the base rate for violent recidivism (reconvictions) during follow-up was 21%. Survival analysis revealed that psychopathy was strongly associated to violent recidivism (log-rank = 17.71, df = 1, p < 0.0001). The area under the curve (AUC) of the receiver operating characteristics (ROC) of PCL-R total score to predict violent recidivism varied between different time frames from .64 to .75. Cox regression analyses revealed that other potential risk factors could not equally well or better explain violent recidivism in the cohort than psychopathy as measured by PCL-R.     

Predictors of sex offender treatment dropout: psychopathy,sex offender risk,and responsivity implications

Abstract

We examined sex offender treatment dropout predictors, in particular, the relationship of psychopathy and sex offender risk to treatment dropout in a sample of 154 federally incarcerated sex offenders treated in a high intensity sex offender treatment program. Demographic, criminal history, mental health and treatment-related data as well as data on risk assessment measures including the Static 99, Violence Risk Scale – Sexual Offender version (VRS-SO), and Psychopathy Checklist – Revised (PCL-R) were collected. Logistic regression and discriminant function analyses were used to identify predictors that made significant and unique contributions to dropout among all the variables under study. The Emotional facet of Factor 1 of the PCL-R and never being married were found to be the most salient predictors of treatment dropout and correctly identified about 70% of the cases. The implications of the findings for managing treatment dropout and for the treatment of psychopathic offenders are discussed.     

Empathy in sexually sadistic offenders: an experimental comparison with non-sadistic sexual offenders

Previous studies suggest that severe sexual sadism and psychopathy are phenotypically different, although both are characterized by deficits in emotional processing. We assessed empathic capacity in a sample of 12 sexual sadists in comparison with 23 non-sadistic offenders using the Multifaceted Empathy Test (MET). All participants were forensic patients under mandatory treatment orders who had committed sexual offenses. The MET is a computerized rating task that differentiates and measures cognitive and emotional components of empathy, or perspective-taking versus compassionate components. To identify the effects of possible empathy deficits caused by psychopathic traits, we controlled both samples for psychopathy as a covariate, measured by the Psychopathy Checklist-Revised (PCL-R). According to our results, sexual sadists did not differ from non-sadistic sexual offenders with regard to emotional empathy for either positive or negative stimuli. The results suggest that severe sexual sadism is a distinct, pathological sexual arousal response, not a deficit in emotional processing.     

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

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

The relationship between psychopathy and moral development in young sex offenders

Abstract

This study examined the relationship between psychopathic traits and moral development (moral judgement and empathy) in 85 Dutch male sex offenders between 13 and 23 years of age. Questions were asked about general life situations, sexual situations with morally relevant features, and questions about the offender's own abuse victim. A weak negative association was found between psychopathy and mature moral judgement, but only when questions involved the offender's own abuse victim. Weak to moderate negative associations were found between psychopathy and cognitive and affective empathy in general and sexual situations, but not in the own abuse victim situations. Further analysis revealed moderate negative associations between psychopathy and affective empathy in the own abuse victim situations, but only when an unfamiliar victim was involved. This is the first study, to our knowledge, showing that juvenile sex offenders with high levels of psychopathy have context-specific moral deficits, and that in this group both cognitive and affective empathy are related to psychopathy.     

Sexual fantasies and sensation seeking among psychopathic sexual offenders

Abstract

This study investigated the relationship between psychopathy, sensation seeking behavior and sexual fantasies in a sample of 199 participants from a maximum security forensic hospital. Psychopathy, measured by the Psychopathy Checklist – Revised (PCL-R), and several sensation seeking and sexual fantasy measures were utilized. Results indicated that, in agreement with previous research, sexually deviant psychopaths are more likely to offend against adults than children. Likewise, psychopaths showed some tendency to score significantly higher on sexual sensation seeking measures than nonpsychopathic sexual offenders. Furthermore, a relationship between psychopathy and overall sexual fantasies existed but there were not specific patterns among psychopaths and nonpsychopaths with regard to specific categories of sexual fantasies.     

Assessing measurement invariance of PCL-R assessments from file reviews of North American and German offenders

Cross-cultural research on psychopathy necessitates assessment methods that are generalizable across linguistic and cultural differences. Multiple-group confirmatory factor analysis was used to compare the factorial structure of Psychopathy Checklist-Revised (PCL-R) assessments obtained from file reviews of North-American (N = 2622) and German (N = 443) male offenders. The analyses indicated that the 18 item, 4-factor model of the PCL-R obtained with the standard PCL-R protocol (interview and file review) also holds for file review data. On a factor-by-factor level, the data are commensurate with strong factorial invariance of factor loadings and item thresholds for the Interpersonal and Lifestyle factors, and with likely metric invariance for the Affective factor. The Antisocial factor showed structural differences between the two samples. The results imply that cultural or environmental factors more strongly influence the judgment and/or expression of antisociality. Based on the results, cross-cultural comparisons between North-American and German offenders in terms of PCL-R psychopathy should be limited to the Interpersonal and Lifestyle factors. Further research using data obtained through the standard protocol (i.e., interview plus file information) is encouraged.     

Characterising the psychiatric comorbidities among adults with ADHD who have a history of offending

The prevalence of attention deficit hyperactivity disorder (ADHD) among adult offenders is significantly higher than in the general population. Adults with ADHD often present with multiple psychiatric comorbidities. This study aims to characterise the comorbidities presented by adults with ADHD who have offended and also to investigate predictors of offending among this population. Seventy-three participants with a diagnosis of adult ADHD were divided into a group with a history of offending behaviour (n = 30) and a group of non-offenders (n = 43). Groups were compared on measures of ADHD symptoms, substance use and DSM-IV Axis I and Axis II disorders using the Millon Clinical Multiaxial Inventory – 3rd Edition. Major depression, cannabis use and childhood hyperactivity-impulsivity symptoms predicted offending. These findings indicate that adults with ADHD who have a history of offending behaviour are more likely to present with complex psychiatric needs.     

Psychopathy among condemned capital murderers

Psychopathy is an important forensic mental health construct. Despite this importance, the research base of psychopathy among individuals convicted of capital murder is limited. Archival data were collected from a sample of 636 persons convicted of capital murder and sentenced to death in the State of California. Psychopathy was assessed using the Psychopathy Checklist – Revised (PCL-R) instrument. Data on criminal careers and other behavioral disorders were also extracted. The sample mean PCL-R total score was 23.31 (SD = 9.92) and one-third of individuals in this sample were considered clinically psychopathic with PCL-R total scores of 30 or greater. Factor analytic examination yielded support for four facets: affective, interpersonal, lifestyle, and antisocial. Criterion validity findings revealed positive correlations of psychopathy scores with Antisocial Personality Disorder (ρ = 0.72), Conduct Disorder (ρ = 0.46), sexual sadism (ρ = 0.24), Oppositional Defiant Disorder (ρ = 0.20), ADHD (ρ = 0.15), arrest charges (r = 0.56), prison sentences (r = 0.53), and age of arrest onset (r = −0.57). Individuals convicted of capital murder and sentenced to death reflect heterogeneity in psychopathy with some individuals exhibiting pronounced psychopathic features.