Identifying inmates at risk for disciplinary infractions: a comparison of two measures of psychopathy

Reimbursing incarcerated individuals for participation in research: A scoping review

BACKGROUND

Little is known about global practices regarding the provision of reimbursement for the participation of people who are incarcerated in research. To determine current practices related to the reimbursement of incarcerated populations for research, we aimed to describe international variations in practice across countries and carceral environments to help inform the development of more consistent and equitable practices.

METHODS

We conducted a scoping review by searching PubMed, Cochrane library, Medline, and Embase, and conducted a grey literature search for English- and French-language articles published until September 30, 2022. All studies evaluating any carceral-based research were included if recruitment of incarcerated participants occurred inside any non-juvenile carceral setting; we excluded studies if recruitment occurred exclusively following release. Where studies failed to indicate the presence or absence of reimbursement, we assumed none was provided.

RESULTS

A total of 4,328 unique articles were identified, 2,765 were eligible for full text review, and 426 were included. Of these, 295 (69%) did not offer reimbursement to incarcerated individuals. A minority (n = 13; 4%) included reasons explaining the absence of reimbursement, primarily government-level policies (n = 7). Among the 131 (31%) studies that provided reimbursement, the most common form was monetary compensation (n = 122; 93%); five studies (4%) offered possible reduced sentencing. Reimbursement ranged between $3-610 USD in total and 14 studies (11%) explained the reason behind the reimbursements, primarily researchers' discretion (n = 9).

CONCLUSIONS

The majority of research conducted to date in carceral settings globally has not reimbursed incarcerated participants. Increased transparency regarding reimbursement (or lack thereof) is needed as part of all carceral research and advocacy efforts are required to change policies prohibiting reimbursement of incarcerated individuals. Future work is needed to co-create international standards for the equitable reimbursement of incarcerated populations in research, incorporating the voices of people with lived and living experience of incarceration.

A Literature Review of the Utility of Selected Violence and Sexual Violence Risk Assessment Instruments

The rationale for this article is to comprehensively outline and describe the strengths and weaknesses of various risk assessment instruments/tools relevant to the evaluation of sexually violent and violent offenders. The author will briefly discuss ethical obligations the forensic mental health professional (FMHP) must consider when conducting risk assessments.

An Actuarial Model for Assessment of Prison Violence Risk Among Maximum Security Inmates

An experimental scale for the assessment of prison violence risk among maximum security inmates was developed from a logistic regression analysis involving inmates serving parole-eligible terms of varying length (n = 1,503), life-without-parole inmates (n = 960), and death-sentenced inmates who were mainstreamed into the general prison population (n = 132). Records of institutional violent misconduct of these 2,595 inmates were retrospectively examined for an 11-year period (1991 to 2002). Predictors affecting the likelihood of such misconduct included age, type and length of sentence, education, prior prison terms, prior probated sentences, and years served. The scale was modestly successful, as demonstrated by an overall omnibus area under the curve of .719. Double cross-validation demonstrated minimal shrinkage. The authors have termed this experimental scale the Risk Assessment Scale for Prison.

The Short-Term Assessment of Risk and Treatability (START)

A new assessment scheme-the Short-Term Assessment of Risk and Treatability (START)- presents a workable method for assessing risks to self and others encountered in mentally and personality disordered clients. This study aimed to demonstrate (a) prevalence and severity of risk behaviors measured by the START, (b) psychometric properties of START, (c) similarities and differences in START scores across different mental health professionals, and (d) concurrent validity of START with diverse negative outcomes. Treatment team members completed the 20-item, dynamically focused START for 137 forensic psychiatric inpatients. Prevalence and severity of START risk domains were measured for 51 patients detained in the hospital for 1 year. Results revealed high rates of generally low-level adverse events. With some exceptions, START scores were meaningfully associated with outcomes measured by a modified Overt Aggression Scale.

Reliability and Validity of Two Self-Report Measures of Psychopathy

The present study assessed the psychometric properties and construct validity of two self-report measures of psychopathy in a male-college sample: the Levenson Psychopathy scales (LPS; Levenson, Kiehl, & Fitzpatrick, 1995) and the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996). Both the LPS and the PPI demonstrated good internal consistency, although selected items from the PPI correlated weakly with their respective factor scores, suggesting the need for further investigation of the factors' item content. The PPI showed stronger validity than the LPS in terms of convergent and discriminant validity of its factor scores and factor associations with two criterion variables, aggression, and anxiety. Overall, the current study provides greater support for the use of the PPI over the LPS in studies investigating psychopathic traits in nonclinical and nonforensic samples.

Self-Report Measures of Child and Adolescent Psychopathy as Predictors of Offending in Four Samples of Justice-Involved Youth

The authors examined the relation between self-report psychopathy measures and o ficial records of o fending in four samples of justice-involved youth (total N = 447). Psychopathy measures included the Antisocial Process Screening Device (APSD) and a modified version of the Childhood Psychopathy Scale (mCPS). Measures of o fending included the total number of preadmission arrest charges for three samples (n = 392) and the total number of o fenses in the year following release for two samples (n = 138). Neither measure was a strong correlate of preadmission o fenses. Although mCPS scores were associated with postrelease o fending in one sample, e fects for the APSD were observed only when reo fending was conceptualized as a dichotomous variable, indicating a lack of robustness in this association. The findings suggest caution in the use of self-report measures of psychopathic features for decision making with respect to issues of delinquency risk among justice-involved youth.

Clarifying the link between childhood abuse history and psychopathic traits in adult criminal offenders

Childhood abuse is a risk factor for the development of externalizing characteristics and disorders, including antisocial personality disorder and psychopathy. However, the precise relationships between particular types of childhood maltreatment and subsequent antisocial and psychopathic traits remain unclear. Using a large sample of incarcerated adult male criminal offenders (n = 183), the current study confirmed that severity of overall childhood maltreatment was linked to severity of both psychopathy and antisocial personality disorder in adulthood. Moreover, this relationship was particularly strong for physical abuse and the antisocial facet of psychopathy. Sexual abuse history was uniquely related to juvenile conduct disorder severity, rather than adult psychopathy or antisocial behaviors. Additionally, there was a significantly stronger relationship between childhood maltreatment and juvenile conduct disorder than between childhood maltreatment and ASPD or psychopathy. These findings bolster and clarify the link between childhood maltreatment and antisocial behavior later in life. (PsycINFO Database Record

Not my fault: blame externalization is the psychopathic feature most associated with pathological delinquency among confined delinquents

The association between psychopathy and crime is established, but the specific components of the personality disorders that most contribute to crime are largely unknown. Drawing on data from 723 confined delinquents in Missouri, the present study delved into the eight subscales of the Psychopathic Personality Inventory-Short Form to empirically assess the specific aspects of the disorder that are most responsible for explaining variation in career delinquency. Blame externalization emerged as the strongest predictor of career delinquency in ordinary least squares regression, logistic regression, and t-test models. Fearlessness and carefree nonplanfulness were also significant in all models. Other features of psychopathy, such as stress immunity, social potency, and coldheartedness were weakly and inconsistently predictive of career delinquency. Implications of these findings for the study of psychopathy and delinquent careers are discussed in this article.

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

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

Factor structure and construct validity of the psychopathic personality inventory in a forensic sample

A wealth of research has underscored the strong relationship between PCL-R scores and recidivism. However, mounting criticism cites the PCL-R's cumbersome administration procedures and failure to adequately measure core features associated with the construct of psychopathy (Skeem, Polaschek, Patrick, & Lilienfeld, 2011). In light of these concerns, this study examined the PPI and the PPI-R, which were designed to measure core personality features associated with psychopathy (Lilienfeld & Andrews, 1996; Lilienfeld & Widows, 2005). Study one examined the PPI relative to the PCL-R and examined its factor structure. The instruments shared few significant correlations and neither the PCL-R nor the PPI significantly predicted recidivism. Study two examined the PPI-R relative to the PCL-R, the PPI, both history of violence and future criminal activity and measure of related constructs. The PPI-R was significantly correlated with measures of empathy and criminal thinking and the factors were related to a history of violence and predicted future violent criminal behavior.

Differential correlates to self-report and parent-report of callous-unemotional traits in a sample of juvenile sexual offenders

The association of callous-unemotional (CU) traits with violence and severe antisocial behavior has led to a recent focus on the association between CU traits and sexual offending behavior. When assessing juveniles with sexual offenses, practice standards recommend that multiple sources of data are considered. However, the differential correlates of parent-report versus self-report of CU traits in juvenile sex offenders have not been investigated. A sample of 94 detained male youth (mean age = 15.22, SD = 1.48) was administered both youth and parent versions of the Inventory of Callous-Unemotional Traits (ICU), a general delinquency risk assessment tool (YLS), and a sexual offending risk assessment tool (J-SOAP-II) to investigate concordance between self-report and parent-report of CU traits as well as association with general and sex-specific risk factors. Both parent-report and self-report of CU traits were significantly related to higher general delinquency risk scores, with parent-report showing stronger correlations than self-report. Both parent-report and self-report were related to sex-specific risk factors. However, only parent-report significantly predicted static sexual risk, while self-report significantly predicted dynamic sexual risk scores. Evidence supports the importance of including both parent- and self-report of CU traits in the comprehensive assessment of sexually offending youth.

Criminal recidivism among juvenile offenders: testing the incremental and predictive validity of three measures of psychopathic features

We studied the predictive, comparative, and incremental validity of three measures of psychopathic features (Psychopathy Checklist: Youth Version [PCL:YV]; Antisocial Process Screening Device [APSD]; Childhood Psychopathy Scale [CPS]) vis-à-vis criminal recidivism among 83 delinquent youth within a truly prospective design. Bivariate and multivariate analyses (Cox proportional hazard analyses) showed that of the three measures, the CPS was most consistently related to most types of recidivism in comparison to the other measures. However, incremental validity analyses demonstrated that all of the predictive effects for the measures of psychopathic features disappeared after conceptually relevant covariates (i.e., substance use, conduct disorder, young age, past property crime) were included in multivariate predictive models. Implications for the limits of these measures in applied juvenile justice assessment are discussed.

Predicting violent infractions in a Swiss state penitentiary: a replication study of the PCL-R in a population of sex and violent offenders

BACKGROUND

Research conducted with forensic psychiatric patients found moderate correlations between violence in institutions and psychopathy. It is unclear though, whether the PCL-R is an accurate instrument for predicting aggressive behavior in prisons. Results seem to indicate that the instrument is better suited for predicting verbal rather than physical aggression of prison inmates.

METHODS

PCL-R scores were assessed for a sample of 113 imprisoned sex and violent offenders in Switzerland. Logistic regression analyses were used to estimate physical and verbal aggression as a function of the PCL-R sum score. Additionally, stratified analyses were conducted for Factor 1 and 2. Infractions were analyzed as to their motives and consequences.

RESULTS

The mean score of the PCL-R was 12 points. Neither the relationship between physical aggression and the sum score of the PCL-R, nor the relationship between physical aggression and either of the two factors of the PCL-R were significant. Both the sum score and Factor 1 predicted the occurrence of verbal aggression (AUC=0.70 and 0.69), while Factor 2 did not.

CONCLUSION

Possible explanations are discussed for the weak relationship between PCL-R scores and physically aggressive behavior during imprisonment. Some authors have discussed whether the low base rate of violent infractions can be considered an explanation for the non-significant relation between PCL-R-score and violence. The base rate in this study, however, with 27%, was not low. It is proposed that the distinction between reactive and instrumental motives of institutional violence must be considered when examining the usefulness of the PCL-R in predicting in-prison physical aggressive behavior.

A large-scale meta-analysis relating the hare measures of psychopathy to antisocial conduct

The present meta-analysis integrated effect sizes from 95 non-overlapping studies (N=15,826) to summarize the relation between Hare Psychopathy Checklists and antisocial conduct. Whereas prior meta-analyses focused on specific subdomains of the literature, we used broad inclusion criteria, incorporating a diversity of samples, settings, methodologies, and outcomes in our analysis. Our broad perspective allowed us to identify general trends consistent across the entire literature and improved the power of our analyses. Results indicated that higher PCL Total, Factor 1 (F(1)), and Factor 2 (F(2)) scores were moderately associated with increased antisocial conduct. Study effect sizes were significantly moderated by the country in which the study was conducted, racial composition, gender composition, institutional setting, the type of information used to score psychopathy, and the independence of psychopathy and transgression assessments. However, multiple regression analyses indicated that the information used to assess psychopathy did not have a unique influence on effect sizes after accounting for the influence of other moderator variables. Furthermore, racial composition of the sample was related to the country in which the study was conducted, making it unclear whether one or both of these moderators influenced effect sizes. We provide potential explanations for the significant findings and discuss implications of the results for future research.

A prospective comparison of two measures of psychopathy in the prediction of institutional misconduct

This study examined the predictive validity of two widely used measures of psychopathic traits, the Psychopathy Checklist--Revised (PCL-R; Hare, 2003) and the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996). Records of institutional infractions were obtained for a young adult sample of prison inmates (N = 46), who were followed for approximately two years following administration of these two scales. The PPI total and two factor scores predicted the total number of infractions committed (r ranging from .28 to .36). PPI Factor I showed some evidence of stronger associations with non-aggressive infractions (r = .36), whereas PPI Factor II was the strongest correlate of aggressive misconduct (r = .24). The total and facet scores of the PCL-R were not significantly predictive of any form of institutional misconduct, with effect sizes ranging from negligible to small (median r = .14, r ranging from -.01 to .21).

Risk Factors for Institutional Misconduct Among Incarcerated Women: An Examination of the Criterion-Related Validity of the Personality Assessment Inventory

Although widely researched in male offender samples, relatively little is known about the clinical utility of the Personality Assessment Inventory (PAI; Morey, 1991) among female prisoners. In this study, we examined the utility of various theoretically relevant PAI scales to predict 3 types of institutional misconduct (general, aggressive/defiant, and covert infractions) in a sample of 113 female inmates incarcerated for at least 1 year. The Antisocial Features (ANT) scale was the most consistent and effective predictor of misbehavior, with limited evidence to suggest that other PAI scales could demonstrate any incremental validity beyond this measure. More important, ANT continued to be associated with institutional misconduct even after controlling for criminal background variables such as prior convictions and a history of violence.

Predictive validity of the Dutch PCL:YV for institutional disruptive behavior: findings from two samples of male adolescents in a juvenile justice treatment institution

The present prospective study examined the predictive validity of the Dutch version of the Psychopathy Check List: Youth Version for disruptive behavior in male adolescents during treatment. The study comprised two samples admitted to different secure treatment institutions in The Netherlands, Jongerenhuis Harreveld (n = 81) and Rentray (n = 66). Overall, the results demonstrate that psychopathy is a significant predictor of institutional disruptive behavior, and physical violence in particular. Furthermore, Hare's traditional Factor 2 was more strongly related to disruptive incidents than Factor 1. By using the recently proposed three- and four-factor models of psychopathy, insight into the pattern of associations between psychopathy dimensions and different types of disruptive behavior was obtained. The antisocial dimension of psychopathy appeared to be more strongly related to severe incidents than the lifestyle dimension. Regression analyses identified significant contributions of the antisocial and lifestyle dimensions to the prediction of incidents. The relatively small degree of variance explained underlines the importance of other risk factors to identify adolescents at risk of disruptive behavior during institutional treatment.

Psychopathy factors and risk for aggressive behavior: a test of the "threatened egotism" hypothesis

The primary purpose of this study was to examine psychopathy within a model of aggressive behavior that encompasses narcissism and "threatened egoism." This model was advanced by Baumeister and his colleagues (e.g., R. F. Baumeister, L. Smart, & J. M. Boden, 1996; B. J. Bushman & R. F. Baumeister, 1998). We examined whether the threatened egotism model extends to the construct of psychopathy and whether the two factors underlying psychopathy exhibit different associations with aggression within this model. Self-report data, correctional officer and counselor reports, and disciplinary report information obtained for 98 male inmates provided partial evidence that psychopathic individuals tend to respond aggressively when confronted with an ego threat. Moreover, psychopathic individuals exhibited this pattern of aggression more strongly than did narcissistic individuals. These findings bear potentially useful implications for the understanding and treatment of aggression in forensic populations.

On the validity of validity scales: The importance of defensive responding in the prediction of institutional misconduct

This study examined the effects of defensive responding on the prediction of institutional misconduct among male inmates (N = 349) who completed the Personality Assessment Inventory (L. C. Morey, 1991). Hierarchical logistic regression analyses demonstrated significant main effects for the Antisocial Features (ANT) scale as well as main effects for the Positive Impression Management (PIM) scale in some instances. Significant ANT x PIM interactions also were evident, particularly when examining recommended cut scores on these scales. These results demonstrate the predictive validity of ANT with prisoners and reinforce the importance of context when considering whether validity scales are in fact valid.

Assessing Psychopathic Personality Traits With the MMPI–2

In this study, we examined the utility of the MMPI-2 (Butcher et al., 2001) in assessing psychopathic personality traits. We explored whether MMPI-2 scales that measure affective and interpersonal traits add to the instrument's social deviance measures in assessing global psychopathy and its two facets. Our study of 281 male and female college students indicates that the MMPI-2 Social Deviance scales (e.g., Clinical Scales 4 and 9, ASP) predict substantial variance in the social deviance factor and affiliated subscales of the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996), whereas MMPI-2 measures of affective and interpersonal functioning predict substantial variance in the affective-interpersonal PPI factor. In addition, the results of two regression models indicate that the Restructured Clinical scales provide the most parsimonious assessment of psychopathic personality traits.

The Latent Structure of Psychopathy in Youth: A Taxometric Investigation

Using taxometric procedures, the latent structure of psychopathy was investigated in two studies of children and adolescents. Prior studies have identified a taxon (i.e., a natural category) associated with antisocial behavior in adults as well as children and adolescents. However, features of this taxon suggest that it is not psychopathy but rather a broader class consistent with the construct of life course persistent antisocial behavior. Because the only prior study of youth used a non-clinical sample, the base rate of psychopathy may have been too low to reveal a psychopathy taxon, especially against the background of a broader and more prevalent antisocial behavior taxon. Therefore, this investigation sought to increase the likelihood of finding a psychopathy taxon (should one exist) by increasing its expected base rate through inclusion of clinical cases in the samples studied. Results produced evidence for both a broad antisocial behavior problem taxon consistent with past research and a much lower base rate taxon consistent with prevalence expectations for psychopathy. These findings support the existence of latent taxa for both psychopathy and a broader class of antisocial behavior problems. Further taxometric research appears to be warranted, which should use a broader array of indicators, with greater specificity to psychopathy.

Understanding the risk factors for violence and criminality in women: the concurrent validity of the PCL-R and HCR-20

This study explores the performance of 132 female maximum-security inmates on the Psychopathy Checklist-Revised (PCL-R) and the HCR-20 (Historical, Clinical, and Risk Management Scheme) to examine the concordance between these two risk assessment instruments, and to assess their potential usefulness in determining level of risk for violent behavior and other forms of criminality. The two instruments demonstrated consistent and highly significant correlations across total scores, factor scores, and subscale scores. When the two instruments were entered into a multiple regression analysis to predict violent and non-violent crime, the HCR-20 did not add to the variance explained by the PCL-R. These results confirm earlier research that suggests that there is little or no difference between these two risk assessment instruments in their relationship to community or institutional violence. Further, Receiver Operating Characteristics (ROC) analyses show that both instruments demonstrated an inverse ability to predict convictions for murder, a close to chance ability to predict violent crime, but a shared ability to predict property and minor crime. Broadly, these results suggest that psychopathic women are involved in chronic patterns of non-violent criminality, while women charged and convicted of murder generally do not have elevated scores on the PCL-R or HCR-20. The relevance of these findings to rehabilitation and treatment is discussed.

Predictions of future dangerousness in capital murder trials: is it time to "disinvent the wheel"?

Although recent U.S. Supreme Court decisions regarding the death penalty (e.g., Atkins v. Virginia, 2002) have renewed interest in mental health issues, one topic that has not received much attention recently is the ongoing use of expert testimony to support claims that defendants represent a "continuing threat to society." In this article, we (a) review prior research relevant to determining the accuracy of clinical predictions that capital defendants will commit future acts of criminal violence; (b) summarize new data from current and former death row inmates in Texas that bolster the claim that such predictions are gross overestimates of risk; and (c) review extant research addressing the potential utility of various risk assessment instruments that increasingly are being used to reinforce clinical predictions in capital trials. Despite significant recent advances in the field of risk assessment, clinical assertions that a defendant is likely to commit future violent acts appear to be highly inaccurate and ethically questionable at best. Moreover, available research offers little support for the claim that the accuracy of these predictions will be appreciably improved by relying on more structured risk assessment measures that have some demonstrated predictive validity in other contexts.

A taxometric analysis of psychopathic personality

Although a common assumption throughout much of the professional and popular literature is that psychopaths are qualitatively different from others, very few studies have examined the latent structure of psychopathy. Whether psychopathy is a discrete category or a continuous dimension may have implications for research on the assessment, etiology, and treatment of this disorder. This study examined the latent structure of psychopathy in a sample of 309 jail and prison inmates. Three taxometric procedures were used to analyze indicators drawn from the Psychopathic Personality Inventory (S. O. Lilienfeld & B. P. Andrews, 1996), a self-report instrument. Consistent with prior studies that used other measures of psychopathy, none of the analyses was consistent with a taxonic solution, suggesting that psychopathic personality may be best understood as existing on a continuum.

Psychopathy in women: a review of its clinical usefulness for assessing risk for aggression and criminality

Despite a flurry of studies examining psychopathy in women, and the recent release of the second version of the Hare Psychopathy Checklist--Revised manual, there is still little consensus whether the lateral extension of the current conceptualization of psychopathy to women is appropriate. In particular, very little agreement exists concerning the clinical utility of the Hare psychopathy measures to assess women's risk of future offending and violence. This article presents a comprehensive review of studies of the association between psychopathy, antisocial behavior, and violence, in diverse samples of women, and looks at similarities and differences between these constructs in males and females. Findings from inmates and offenders, civil and forensic psychiatric patients, substance abusers, and community samples indicate a consistently lower base rate of psychopathy among women than among men. With some exceptions, correlates of psychopathy in women relevant to risk assessments for crime and violence tend to be modest and significant, generally mirroring what we see in men. Clinicians and policy makers charged with the care and management of women at risk for criminal offending and violence are likely to find the PCL-R and PCL:SV have clinical utility; however, cautious application is called for and ongoing research is required.

The impact of mental health evidence on support for capital punishment: are defendants labeled psychopathic considered more deserving of death?

Controversy surrounds the use of the Hare Psychopathy Checklist--Revised (Hare, 1991, 2003) in capital murder cases, where it has been introduced to support prosecution claims that a defendant represents a "continuing threat to society". Although widely presumed to have a prejudicial impact (e.g., American Psychological Association, 2004), little is known about how the lay public reacts to data derived from ostensibly stigmatizing assessment instruments such as the PCL-R. The present study examined the effect of psychopathy data on layperson attitudes by having 203 undergraduates review a capital murder case where the results of the defendant's psychological evaluation were experimentally manipulated. When expert testimony described the defendant as psychopathic, a much larger percentage of participants supported a death sentence (60%) than when testimony indicated that he was psychotic (30%) or not mentally disordered (38%). Interestingly, participant ratings of how psychopathic they perceived the defendant to be--regardless of the testimony condition to which they had been assigned--also predicted support for a death sentence. Given the limited probative value of the PCL-R in capital cases and the prejudicial nature of the effects noted in this study, we recommend that forensic examiners avoid using it in these trials.

Incremental validity and the assessment of psychopathology in adults

Results from studies on incremental validity are described for (a) interviews, (b) personality inventories, (c) projective techniques, and (d) brief self-rated and clinician-rated measures. In some of the studies (clinical judgment studies), psychologists were given increasing amounts of information. In other studies (statistical prediction studies), increasing amounts of assessment information were entered into a statistical prediction rule. Although relatively little research has been conducted on incremental validity, results that have been obtained tend to favor the use of interviews, personality inventories (e.g., the Minnesota Multiphasic Personality Inventory--2; J. N. Butcher, W. G. Dahlstrom, J. R., Graham, A. Tellegen, & B. Kaemmer, 1989), and brief self-rated measures (e.g., the Anxiety Sensitivity Index, S. Reiss, R. A. Peterson, D. M. Gursky, & R. M. McNally, 1986). Results are generally less encouraging for projective techniques.

PCL-R psychopathy predicts disruptive behavior among male offenders in a Dutch forensic psychiatric hospital

In this study, the relationship between psychopathy, according to the Dutch language version of Hare's Psychopathy Checklist-Revised (PCL-R), and various types of disruptive behavior during inpatient forensic psychiatric treatment is investigated. Ninety-two male participants were administered the PCL-R following admission to an inpatient forensic hospital. From daily hospital information bulletins, incidents of verbal abuse, verbal threat, physical violence, and violation of hospital rules were derived. Also, the number of seclusion episodes was recorded. As expected, significant correlations were found between PCL-R scores and verbal abuse, verbal threat, violation of rules, total number of incidents, and frequency of seclusion. Psychopaths (PCL-R > or = 30) were significantly more often involved in incidents than nonpsychopaths. Multiple regression analyses revealed that the PCL-R Factor 2 score in particular contributed uniquely to the prediction of the total number of incidents. The findings are discussed in terms of their clinical implications.

Psychometric analysis of the Psychopathic Personality Inventory (PPI) with female inmates

This study evaluated the reliability, internal structure, and validity of the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) among female inmates (n = 153) housed at a multilevel prison facility. Findings from this research suggested both strengths and weaknesses associated with PPI psychopathy assessment. Reliability of the PPI was supported by internal consistency analyses of scale and subscale item sets, and test-retest reliability was supported by findings obtained with a subsample (n = 36) retested an average of 49 days after initial test administration. Validity of the PPI total score was also supported by moderate to very high correlations with other self-report measures of psychopathy. Relative weaknesses of the PPI were evident by the low or negative associations among many of the PPI subscales, moderate associations that PPI total scores demonstrated with response set indexes, and the similarity of PPI total scores among female inmates and undergraduates. Findings from this research are considered in relation to possible sex differences in the expression of psychopathy and challenges associated with the assessment of the psychopathy construct with self-report methods.

Psychopathy scores predict adolescent inpatient aggression

This prospective study found that psychopathy scores predicted aggressive behavior among 72 adolescent psychiatric inpatients, even after controlling for age, sex, socioeconomic status, length of hospital stay, and independent self-report measures of impulsivity and conduct problems. Psychopathy was assessed within 3 days of hospital admission by clinical raters trained in the use of Hare's Psychopathy Checklist-Revised. Aggressive behavior was recorded by clinical staff members who were unaware of psychopathy ratings. Adolescents rated higher in psychopathy exhibited higher frequencies of both reactive and instrumental aggressive behavior than adolescents rated lower in psychopathy. Post hoc regression analyses revealed that psychopathy had incremental validity in predicting aggression beyond the contribution of clinical diagnosis or scores on the Millon Adolescent Clinical Inventory.

Views of the downward extension: comparing the Youth Version of the Psychopathy Checklist with the Youth Psychopathic traits Inventory

Increasing interest in "juvenile psychopathy" has been met with scholarly debate about the validity of directly extending the adult construct of psychopathic personality disorder to youth. To inform this debate, this study of 160 serious adolescent offenders compared two alternative, adult-based conceptualizations of juvenile psychopathy: that of the Psychopathy Checklist: Youth Version (PCL:YV) and the self-report Youth Psychopathic traits Inventory (YPI). The results indicate that these two conceptualizations overlap only partially, with the YPI focusing more tightly on core interpersonal and affective features than the PCL:YV. Each conceptualization is reliable and predicts different forms of short-term institutional misbehavior. However, only the YPI possesses a theoretically coherent, inverse association with anxiety. Despite this promise, these conceptualizations of psychopathy are less strongly associated with one another than they are with psychosocial markers of developmental maturity. This raises questions about their divergent validity and ability to identify a disorder that will remain stable during the transition from adolescence into adulthood. Implications for future longitudinal research on the validity, manifestations, and course of juvenile psychopathy are discussed.

Psychopathic traits predict attitudes toward a juvenile capital murderer

The current study manipulated the presence/:absence of psychopathic traits and the ethnicity (Black/:White) of a juvenile capital murderer to examine their impact on layperson attitudes regarding what types of legal sanction were appropriate. Participants (N=360) reviewed a newspaper article concerning a death row inmate who was appealing his sentence primarily based on the fact that he committed the crime when he was 16 years of age. Compared to those in the control condition, those who read a scenario in which the defendant had been described at trial as exhibiting psychopathic traits (e.g. remorselessness, pathological lying) were significantly more likely to support a death sentence and less likely to believe he should receive any treatment in prison. Moreover, participant ratings of the extent to which they believed the defendant exhibited prototypically psychopathic traits (regardless of whether they were in the psychopathy or control condition) also significantly predicted these criterion measures. Ethnic status was relatively less influential, although participants were somewhat more punitive towards a Black defendant than a White defendant when considering the relevance of possible mitigating factors (e.g. history of sexual abuse).

Clinical assessment

Are clinical psychologists' assessment practices cost-effective? Are they scientifically sound? Are they fair and unbiased? Financial pressures from managed care interests, recent developments in the law, and multicultural issues are forcing the profession to confront these hard questions regarding accountability. Our review discusses the important changes that have begun to alter the field of personality assessment and describes recent research on clinical judgment and its implications for the future. We conclude that clinical psychology can adapt to future conditions by developing assessment strategies that are economical, scientifically sound, and culturally sensitive.

Further validation of the psychopathic personality inventory among offenders: personality and behavioral correlates

The Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) is a relatively new self-report measure that has shown considerable promise as an index of psychopathic traits in both nonoffender and offender samples. The present study examined the construct validity and predictive utility of the PPI by examining its association with theoretically relevant scales of the Personality Assessment Inventory (PAI; Morey, 1991) among 60 male prison inmates, and its ability to predict institutional misbehavior in an expanded sample (n = 89). As expected, correlations with the PAI scales were highest for the Antisocial Features (ANT) and Aggression (AGG) scales (rs = .68 and .57, respectively). The PPI also predicted various forms of nonviolent and physically aggressive disciplinary infractions significantly better than chance (point biserial correlations ranging from .26 to .37).

Assessment of "juvenile psychopathy" and its association with violence: a critical review

Interest in the construct of psychopathy as it applies to children and adolescents has become an area of considerable research interest in the past 5-10 years, in part due to the clinical utility of psychopathy as a predictor of violence among adult offenders. Despite interest in "juvenile psychopathy" in general and its relationship to violence in particular, relatively few studies specifically have examined whether operationalizations of this construct among children and adolescents predict various forms of aggression. This article critically reviews this literature, as well as controversies regarding the assessment of adult psychopathic "traits" among juveniles. Existing evidence indicates a moderate association between measures of psychopathy and various forms of aggression, suggesting that this construct may be relevant for purposes of short-term risk appraisal and management among juveniles. However, due to the enormous developmental changes that occur during adolescence and the absence of longitudinal research on the stability of this construct (and its association with violence), we conclude that reliance on psychopathy measures to make decisions regarding long-term placements for juveniles is contraindicated at this time.

An investigation of the relationship between psychopathic traits and malingering on the psychopathic personality inventory

This study employed a repeated-measures simulation design to examine (a) the specific effects of malingering on a recently developed measure of psychopathy, the Psychopathic Personality Inventory (PPI), and (b) the broader association between psychopathic traits and dissimulation. One hundred and forty-three participants completed the PPI twice (both under standard instructions and with instructions to feign psychosis), and also completed post-test questionnaires assessing their attitudes toward engaging in malingering across several hypothetical settings. When attempting to feign psychosis, participants produced elevated scores on a validity scale designed to identify deviant responding, and use of a cross-validated cutoff score with this scale produced high sensitivity and specificity rates across the honest and malingering conditions. Furthermore, PPI scores (in the honest condition) were significantly correlated with a willingness to engage in dissimulation across various hypothetical forensic/correctional scenarios. Results are discussed in terms of the "fakability" of the PPI, as well as the relationship between psychopathic personality features and malingering more generally.