Psychopathy,Conduct Disorder,and Stigma: Does Diagnostic Labeling Influence Juvenile Probation Officer Recommendations?

This study investigated the potential influence of labeling a juvenile as psychopathic. Juvenile probation officers (JPOs; N = 260) rendered hypothetical recommendations based on eight mock psychological evaluations. The evaluations varied the presence of two diagnostic criteria (antisocial behavioral history and psychopathic personality traits) and diagnostic labels (psychopathy, conduct disorder, no diagnosis) in order to distinguish criterion effects from labeling effects. The diagnostic criteria of antisocial behavior had a substantial effect on JPO recommendations (effect sizes .50–.79), while the diagnostic criteria of psychopathic personality traits had a more limited effect. Surprisingly, diagnostic labels had little effect, and there were no appreciable differences between conduct disorder and psychopathy diagnoses. These findings illustrate the importance of distinguishing diagnostic criterion effects from diagnostic labeling effects.     

Is PCL-R psychopathy associated with either type or severity of personality disorder?

The extent to which assessment of personality disorders (PDs), and trans-diagnostic measures of PD severity, can capture the variance in psychopathy measured by the Psychopathy Checklist-Revised (PCL-R) was examined in 100 forensic patients with a history of violent offending. Correlational and linear regression analyses were carried out to establish whether (i) combinations of PDs would predict PCL-R scores for each of its two factors, interpersonal–affective (F1) and antisocial deviance (F2); (ii) ‘acting out’, a putative measure of externalising maladjustment that transcends PD categories, would predict PCL-R scores. Results showed that narcissistic and avoidant PDs contributed significantly to the prediction of F1, but only antisocial PD contributed to the prediction of F2. ‘Acting out’ predicted both F1 and F2, suggesting that core features of PCL-R psychopathy are embedded within and across different PD diagnoses. Results are discussed in relation to different sub-types of psychopathy described in the literature.     

Psychopathy, intelligence and conviction history

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

Are There Ethnic Differences in Levels of Psychopathy? A Meta-Analysis

Although considerable research on psychopathy has been conducted over the past 30 years, relatively few studies have examined key issues related to potential ethnic differences in this constellation of socially maladaptive personality traits. Given recent sociopolitical and scientific developments, an issue of considerable debate is whether Black individuals possess "more" traits of psychopathy than do Whites. To address this issue, a meta-analysis of differences between these groups' scores on the Psychopathy Checklist--Revised (PCL-R; Hare, 1991) was performed, using 21 studies (N = 8,890) of correctional, substance abuse, and psychiatric samples. Blacks exceeded Whites by an average of less than 1 point on the PCL-R total score. Effect sizes for core interpersonal and affective traits of psychopathy (Factor 1) were sufficiently homogeneous to clearly interpret, although other features manifested statistically significant heterogeneity. Our finding that Blacks and Whites do not meaningfully differ in their levels of core psychopathic traits is consistent with community-based findings for self-report measures of psychopathy and clinical diagnoses of antisocial personality disorder.     

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.     

Women and Men who Committed Murder: Male/Female Psychopathic Homicides

The present study was designed to compare gender differences in psychiatric diagnosis with the dimension of psychopathy in women and men who had attempted or committed homicide. The study samples consisted of 39 homicidal females and 48 homicidal males who were confined in one of Italy’s REMS or prison facilities in two southern provinces of Italy (Puglia and Basilicata). Assessment instruments included the SCID-5, the PID-5 IRF, and the PCL-R. Each gender group was stratified according to the level of criminal responsibility for the homicidal offense (full, partial, absent), and after assessments, according to the degree of the psychopathic dimension. There were clear gender differences in homicidal individuals. Female offenders were less likely to have had a record of criminal charges/convictions or imprisonment, and their homicides were more often intrafamilial, victimizing especially of their children, whereas males targeted intimate partners and extrafamilial victims. In the entire group, there was an inverse relationship between the level of psychopathy and the personality disorder on one side, and the psychotic disturbance on the other. Factor 2 (lifestyle/antisocial dimension) of the PCL-R was higher among the homicidal males, whereas females tended to score higher on Factor 1 (the interpersonal/affective dimension). Finally, if the psychopathic dimension is a qualifier for antisocial personality disorder, as indicated in DSM-5, this appears to be less true for females who tend to have other personality disorders.     

Youth Psychopathy and Criminal Recidivism: A Meta-Analysis of the Psychopathy Checklist Measures

Although narrative reviews have suggested that "youth psychopathy" is a strong predictor of future crime and violence, to date no quantitative summaries of this literature have been conducted. We meta-analyzed recidivism data for the Psychopathy Checklist measures across 21 non-overlapping samples of male and female juvenile offenders. After removing outliers, psychopathy was significantly associated with general and violent recidivism (r (w)'s of .24 and .25, respectively), but negligibly related to sexual recidivism in the few studies examining this low base rate outcome. Even after eliminating outliers, however, considerable heterogeneity was noted among the effects, with some of this variability being explained by the gender and ethnic composition of the samples. Effect sizes for the small number of female samples available for analysis were mostly small and nonsignificant, and psychopathy was a weaker predictor of violent recidivism among more ethnically heterogeneous samples. In relation to predicting both general and violent recidivism, psychopathy performed comparably to an instrument designed specifically to assess risk, the Youth Level of Service/Case Management Inventory (Hoge & Andrews, 2002).     

NEUROPSYCHOLOGICAL MEASURES OF EXECUTIVE FUNCTION AND ANTISOCIAL BEHAVIOR: A META‐ANALYSIS*

A meta‐analysis was performed to quantify the association between antisocial behavior (ASB) and performance on neuropsychological executive functioning (EF) measures. This meta‐analysis built on Morgan and Lilienfeld's (2000) meta‐analysis of the same topic by including recently published studies and by examining a wider range of EF measures. A total of 126 studies involving 14,786 participants were included in the analyses. Antisocial groups performed significantly worse on measures of EF compared with controls, with a grand mean effect size of d= .44. Significant variation occurred in the magnitude of effect sizes calculated across studies. The largest effect sizes were found for criminality (d= .61) and externalizing behavior disorder (d= .54) ASB groups, whereas the smallest effect sizes were found for antisocial personality disorder (d= .19) groups. Larger differences in EF performance were observed across studies involving participants from correctional settings and with comorbid attention deficit and hyperactivity problems. Overall, the results indicated that a robust association exists between ASB and poor EF that held across studies with varied methodological approaches. The methodological issues in the research literature and the implications of the meta‐analysis results are discussed, and the directions for future research are proposed.     

Antisocial personality disorder comorbid with borderline pathology and psychopathy is associated with severe violence in a forensic sample

Background: Evidence suggests the relationship between personality disorder (PD) and violence in offenders might be clarified by considering sub-groups of PD offenders defined by patterns of PD comorbidity. Aim: to identify patterns of PD comorbidity associated with severe violence, defined by its severity, quantity and age of onset (Violence Index: VI) in a forensic sample of 100 PD offenders. Methods: Correlations were first computed between VI and a range of personality and criminological variables; next, patients with antisocial/borderline comorbidity were compared with other PD patients; finally, regression analysis was conducted to identify unique predictors of VI. Results: The antisocial deviance factor of psychopathy and antisocial/borderline comorbidity were each significantly and independently associated with severe violence. Patients showing both a high psychopathy score and antisocial/borderline comorbidity had a significantly greater VI than those without these characteristics. Conclusion: PD patients with high psychopathy co-occurring with borderline and antisocial PDs show a criminal profile characterised by a high degree of serious violence.     

Preliminary Study of Testosterone and Empathy in Determining Recidivism and Antisocial Behavior

Recidivism, repeated criminal behavior after conviction and correction of prior offenses, is a costly problem across the nation. However, the contribution of empathy in determining the risk of recidivism has received limited attention, although lack of empathy has been related to antisocial personality disorder in various studies. Studies linked testosterone to aggression, antisocial behavior, and criminality, and evidence support hormonal connections between empathy and aggression. Adult male prison inmates convicted of violent or nonviolent offenses were included in a cross‐sectional study of empathy, antisocial behavior, salivary testosterone, and recidivism. Subjects underwent criminal history, Empathy Quotient, Levenson Self‐Report Psychopathy Scale, Beck Depression Inventory, Spielberger State‐Trait Anxiety Inventory, and salivary testosterone assays. Bivariate analyses indicated multiple correlations between variables. Multivariate modeling analyses found a significant relationship between self‐reported conviction number and psychopathy scale score (p = 0.013). These preliminary results suggest avenues of investigation of factors contributing to recidivism risk.     

The relation of ADHD and violent aggression: What can we learn from epidemiological and genetic studies?

Disruptive behavior includes psychopathological and behavioral constructs like aggression, impulsivity, violence, antisociality and psychopathy and is often closely related with diagnostic categories like conduct disorder (CD), attention deficit disorder (ADHD) and antisocial personality disorder (ASP). There is now clear evidence that neurobiological and environmental factors contribute to these phenotypes. A mounting body of evidence also suggests interactive effects of genetic and environmental risks.In this selective review we give an overview over epidemiological aspects of the relation between ADHD and antisocial behavior, including violent aggression and psychopathy. Moreover, we summarize recent findings from molecular genetic studies and particularly discuss pleiotropic effects of a functional polymorphism of the serotonin transporter promoter gene (5HTTLPR) and childhood adversity on ADHD and violent behavior. The reported gene–environment interactions are not only informative for understanding the neurobiological underpinnings of disruptive behavior, but also throw some light on the relation between ADHD and violent behavior from a genetic perspective. The impact of genetic research on forensic psychiatry and future directions of neurobiological research are discussed.     

Continuity of aggressive antisocial behavior from childhood to adulthood: The question of phenotype definition

Aiming to clarify the adult phenotype of antisocial personality disorder (ASPD), the empirical literature on its childhood background among the disruptive behaviour disorders, such as attention deficit/hyperactivity disorder (AD/HD), oppositional defiant disorder (ODD), conduct disorder (CD), or hyperkinetic conduct disorder (HKCD), was reviewed according to the Robins and Guze criteria for nosological validity. At least half of hyperactive children develop ODD and about a third CD (i.e. AD/HD + CD or HKCD) before puberty. About half of children with this combined problem constellation develop antisocial personality disorder (ASPD) in adulthood. Family and adoption/twin studies indicate that AD/HD and CD share a high heritability and that, in addition, there may be specific environmental effects for criminal behaviours. “Zones of rarity” delineating the disorders from each other, or from the normal variation, have not been identified. Neurophysiology, brain imaging, neurochemistry, neurocognition, or molecular genetics have not provided “external validity” for any of the diagnostic categories used today. Deficient mental functions, such as inattention, poor executive functions, poor verbal learning, and impaired social interaction (empathy), seem to form unspecific susceptibility factors. As none of today's proposed syndromes (e.g. AD/HD or psychopathy) seems to describe a natural category, a dimensional behavioural phenotype reflecting aggressive antisocial behaviours assessed by numbers of behaviours, the severity of their consequences and how early is their age at onset, which will be closely related to childhood hyperactivity, would bring conceptual clarity, and may form the basis for further probing into mental, cognitive, biological and treatment-related co-varying features.     

Psychopathy versus psychopathies in classifying criminal offenders

Purpose. Psychopathy has been shown to be related to the onset, frequency, and course of antisocial behaviour in criminal offenders. The purpose of the present study was to use cluster analysis to explore the existence of subtypes of criminal offenders in male inmates, based on the two empirically validated dimensions of psychopathy and several other dimensions previously proposed for differentiating offender groups. Methods. Two hundred male inmates participated in the study. Scores on the two dimensions of the Psychopathy Checklist–Revised ( Hare, 1991 ), the Interpersonal Measure of Psychopathy ( Kosson, Steuerwald, Forth, & Kirkhart, 1997 ), DSM‐IV diagnoses for alcohol and drug abuse/dependence, and anxiety were standardized and were included in two different types of cluster analyses. Both Ward's hierarchical method and K‐means non‐hierarchical method revealed the presence of four subtypes of criminal offenders in the sample. The four‐cluster solution was replicated when the sample was split in half and identical cluster analyses were performed on the two subsamples. Results. Two types of cluster analyses identified four subtypes of criminal offenders in two samples of jail inmates. Two of the clusters resembled primary and secondary psychopaths described in the literature, the third group exhibited some antisocial and psychopathic features, and the fourth group was non‐psychopathic. Conclusions. Findings suggest that considering the individual contributions of the two dimensions of psychopathy in lieu of the construct as a whole may prove useful in identifying relatively homogeneous groups of criminal offenders.     

A Multilevel Examination of the Relationship Between Racial Tension and Attitudes Toward the Police

Prior research has established the effect of race and ethnicity on citizens’ perceptions of the police. This paper serves to build on this body of literature by examining the effect of racial tension on attitudes toward the police. Specifically, we conduct multilevel analyses using survey data from Seattle, Washington to explore whether individual perceptions of racial tension and/or community-level racial tension are related to residents’ attitudes toward the police. The results show that attitudes toward the police were generally less favorable among respondents who perceived racial tension or mistrust in their communities. Additionally, community racial tension had significant contextual effects on residents’ perceived racial profiling by the police. This study has implications for future police policy: understanding how racial tension shapes perceptions of the police will assist in selecting and adapting crime control strategies.     

Aggression, psychopathy and brain imaging — Review and future recommendations

Violent behavior appears to result from a complex web of interacting genetic as well as environmental factors. Psychopathy is a strong predictor for relapse in violent acts. The current review shed light on rapidly expanding knowledge in brain imaging related to violent behavior and psychopathy. A literature search was performed in PubMed, Cochrane and PsycInfo combining the key words: mentally disordered offender/aggression/violence/ crime/forensic psychiatry/brain imaging neuroimaging/fMRI/MRI/PET/SPECT/lack of empathy/psychopathy and antisocial personality disorder. The reviewed material, which consisted of 48 articles, indicates a rather strong consensus on the connection between dysfunctional parts of the frontal and temporal lobes and violent antisocial behavior and psychopathy. In future studies, it would be useful to focus on the limbic system and to investigate which parts of the frontal lobes and cerebral networks that are of interest in the psychopathic personality. Moreover, the reviewed material highlights some of the methodological difficulties in this area of research such as selection bias in the recruitment of patients, inadequate matching of control subjects, and sometimes incongruous results. In the future we hope that brain imaging can be used to map biological deviations in different offenders in order to try to learn more about the different mechanisms behind violent behaviors.     

Assault in prison and assault in prison psychiatric treatment

Studies have described measures associated with assault in the community, but few have identified measures associated with assault in prison or prison psychiatric treatment. In this study, prison assault histories and assaults while in prison psychiatric treatment for 222 randomly selected male inmates were evaluated. Using record reviews, interviews, neuropsychological, Rorschach, and psychopathy measures, risk factors for assault in prison and in prison psychiatric treatment were identified. Youth Authority placement, inhalant use, antisocial lifestyle, neurological injury, neuropsychological impairment, and higher PCL-R Factor II ratings were associated with assault in prison. Absence of major mental disorder, neurological impairment, or psychotic thinking, but presence of psychopathy was associated with assault in prison psychiatric treatment. In identifying risk for violence, the importance of (1) the context in which violence occurs; (2) the need for clear admission criteria for prison psychiatric treatment; and (3) the need to develop risk assessments that are specific to prison environments are emphasized.     

Early traumatization and psychopathy in female and male juvenile offenders

Childhood traumatization is expected to have a significant impact on the development of antisocial and aggressive behavior in adulthood. Psychopathy as a syndrome that can predict future violent and aggressive behavior in adults is therefore believed to be associated with early traumatization. The association between early childhood victimization and violence might at least be mediated through psychopathy. The present study examined the relationship between early emotional, physical or sexual trauma and neglect and psychopathy in incarcerated delinquent female and male juveniles using the Childhood Trauma Questionnaire (CTQ) and the Psychopathy Checklist—Youth Version (PCL-YV). A sample of detained adolescents (n = 185) was compared to adolescent students (n = 98). Also, gender differences were analyzed with respect to the association of trauma and psychopathy. As expected, our analyses revealed higher scores of traumatization in delinquent juveniles compared to school adolescents. Hypothesized relationships between physical traumatization and the PCL-YV total score could be confirmed among criminal boys, but not among delinquent girls. Results, therefore, indicated that an association exists between early physical, but also emotional traumatic experience and psychopathy in detained boys. In girls, however, other family-related variables, such as non-parental living arrangements, seemed to be more influential in developing the psychopathy syndrome than traumatization.     

Reconciling psychopathy and low self-control

Although both reflect a self-centered, antisocial personality, psychopathy and low self-control have seldom been examined together. This study created scales reflecting both common and unique elements of both constructs, investigated their factor structure, and explained variance in delinquency. Four alternative hypotheses were tested: that low self-control and psychopathy constitute a single construct, that they constitute primary and secondary psychopathy or interpersonal and intrapersonal traits, or that they constitute Antisociality—the tendency to perform antisocial acts—and (low) Self-Direction—the tendency to act in one's long-term beneft. Models containing Antisociality and Self-Direction fit better than alternatives and accounted for substantial variance in offending.     

Psychopathy, traumatic exposure, and lifetime posttraumatic stress

This study examined two theoretical models on the interaction between psychopathy, traumatic exposure, and lifetime posttraumatic stress in a sample of 81 male detainees. In Model 1, the interpersonal and affective features of psychopathy were assumed to protect against posttraumatic stress. In Model 2, the lifestyle and antisocial traits of psychopathy were assumed to lead to a lifestyle that increases the risk of traumatic exposure and subsequent posttraumatic stress. The authors found significant negative bivariate associations between Psychopathy Checklist-Revised (PCL-R) total, Interpersonal and Affective facet scores, and posttraumatic stress. Model 1 was confirmed, as they found the interaction between the Affective facet and traumatic exposure had a significant negative effect on posttraumatic stress. Model 2 was rejected. The authors' findings confirm that the interpersonal and affective features of psychopathy are associated with an emotional deficit and that the affective features of psychopathy are crucial for understanding the relationship between psychopathy and anxiety.