Psicopatía y adicciones en mujeres: Estudio comparativo utilizando el Psychopathy Checklist Revised y el Comprehensive Assessment of Psychopathic Personality / Psychopathy, addictions and female gender: Comparative study using the Psychopathy Checklist Revised and the Comprehensive Assessment of Psychopathic Personality

La investigación en psicopatía se ha centrado tradicionalmente en laevaluación de varones con el Psychopathy Checklist Revised (PCL-R). Lainvestigación en mujeres utilizando otros instrumentos de evaluación esmuy escasa. El objetivo de este estudio es evaluar la psicopatía, utilizandovarios instrumentos, es una muestra que incluya mujeres y varones. 204internos (edad media (SD) = 40,93 (11,8)), 28 mujeres (13,7%), delCentro Penitenciario de Pereiro de Aguiar (Ourense) participaron eneste estudio. Se recogieron variables sociodemográficas, consumo desustancias,antecedentes delictivos y fueron evaluados con los siguientesinstrumentos: PCL-R, Comprehensive Assessment of PsychopathicPersonality (CAPP) y el International Personality Disorder Examination.En esta muestra representativa de la población penitenciaria se observóque en el PCL-R los varones obtenían puntuaciones significativamentemás elevadas en la faceta 4 que mide la conducta antisocial. Las mujeresobtuvieron puntuaciones significativamente más elevadas en el CAPPen el dominio Self, que mide la conducta narcisista. No se obtuvoningún síntoma o ítem que permitiese discriminar claramente a lasmujeres psicopáticas de los varones psicopáticos utilizando un modelode Máquinas de Vectores Soporte. El constructo de la psicopatía essimilar para las mujeres y los hombres en esta muestra. Las mujerespresentan puntuaciones más elevadas de narcisismo y los varones deantisocialidad. Para valorar mejor estas diferencias psicopatológicas esmejor combinar el PCL-R con otro instrumento como el CAPP. Ningúnsíntoma o ítem tiene una puntuación que pueda recomendarse comométodo que permita discriminar a las mujeres psicopáticas de losvarones psicopáticos. (AU)

Traditionally, psychopathy research has focused on assessing menwith the Psychopathy Checklist Revised (PCL-R). Research on womenwith other assessment tools is scarce. The objective of this study is toevaluate psychopathy, using various tools, in a sample with both womenand men. The study involved 204 inmates (mean age (DS) = 40.93(11.8)), 28 women (13.7%), in the Pereiro de Aguiar penitentiary(Ourense). Sociodemographic, substance use, and criminal variableswere collected, and all were evaluated with the following tools: PCL-R,Comprehensive Assessment of Psychopathic Personality (CAPP),and the International Personality Disorder Examination. In thissample, when assessed with the PCL-R, males obtained significantlyhigher scores on facet 4, which measures antisocial behaviour.Women obtained significantly higher scores on the Self domain inthe CAPP, measuring narcissism. No symptom or item was able toclearly discriminate psychopathic women from psychopathic men ina Support Vector Machine model. The construct of psychopathy issimilar for women and men in this representative penitentiary sample.Women showed higher scores for narcissism and men for antisociality.It is better to combine the PCL-R with another tool such as the CAPPto assess these psychopathological differences. No symptom or itemhas a score that can be recommended as a method for discriminatingpsychopathic women from psychopathic men. (AU)

Comparison between the Psychopathy Checklist-Revised and the Comprehensive Assessment of Psychopathic Personality in a representative sample of Spanish prison inmates.

In the field of psychopathy, there is an ongoing debate about the core traits that define the disorder, and that therefore must be present to some extent in all psychopaths. The main controversy of this debate concerns criminal behaviour, as some researchers consider it a defining trait, while others disagree. Using a representative sample of 204 Spanish convicted inmates incarcerated at the Pereiro de Aguiar Penitentiary in Ourense, Spain, we tested two competing models, the Psychopathy Checklist-Revised (PCL-R), which includes criminal behaviour items, versus the Comprehensive Assessment of Psychopathic Personality (CAPP), which does not. We used two different PCL-R models, one that includes criminal items and another that does not. PCL-R factors, facets, and testlets from both models and CAPP dimensions were correlated and compared. Two different PCL-R cut-off scores, 25 or more and 30 or more, were used for the analysis. Overall, a strong correlation was found between PCL-R and CAPP scores in the whole sample, but as scores increased and inmates became more psychopathic, the correlations weakened. All these data indicate that psychopathy, understood to mean having high scores on the PCL-R and CAPP, is a multidimensional entity, and inmates can develop the disorder and then receive the diagnosis through different dimensions. The CAPP domains showed better correlations when compared with the PCL-R factors from both models, showing that an instrument for the assessment of psychopathy without a criminal dimension is valuable for clinical assessment and research purposes.

Novel validity evidence of the Psychopathy Checklist- Revised (PCL-R) in a representative sample of Spanish inmates.

Psychopathy Checklist-Revised (PCL-R) validation studies have been conducted mainly in non representative samples of North American adult male serious offenders. Research in other samples is needed to test the generalizability of PCL-R construct validity. PCL-R psychometric properties and construct validity were evaluated in a representative sample of 204 Spanish sentenced inmates. These inmates had served at least 6 months of their sentence at Pereiro de Aguiar prison. This sample was heterogeneous with respect to type of official charges and was representative, as all offenders who met the inclusion and exclusion criteria were invited to participate. Classical test theory indexes of reliability, correlations between PCL-R items, factors and facets, external correlations, and factor structure analysis demonstrated that PCL-R affective, interpersonal and lifestyle dimensions were more reliable and valid for the psychopathy than the antisocial construct in this Southern European sample.

Clinician ratings of the Comprehensive Assessment of Psychopathic Personality (CAPP) in a representative sample of Spanish prison inmates: New validity evidence.

The Comprehensive Assessment of Psychopathic Personality (CAPP) is a concept map of psychopathic personality disorder (PPD). The CAPP- Institutional Rating Scale (IRS) is a tool designed to assess CAPP symptoms in institutional settings. The CAPP contains 33 personality traits organized in six domains: attachment, behavioural, cognitive, dominance, emotional and self. Until now, much of the CAPP research has been conducted out of clinical, forensic and correctional settings using self-ratings. In the current study, the psychometric properties and construct validity of the CAPP-IRS were evaluated in a non-convenience sample of 204 Spanish convicts. Clinician ratings were employed. Participants had been imprisoned for at least 6 months at Pereiro de Aguiar Penitentiary. This group of inmates was heterogeneous with respect to type of official charges, and representative as all convicts interned for at least 6 months in this prison were screened for participation. Classical test theory indexes of reliability, correlations between CAPP items and domains and external correlations and structural analyses demonstrated that CAPP assessment is a solid and robust way of evaluating psychopathy in a correctional setting. Best fit was found for a three-factor model: attachment and emotional items associated with a callous and unemotional trait, dominance and self items associated with a pathological interpersonal style, and behavioural and residual items from other domains associated with impulsivity.

Diagnosing Psychopathy through Emotional Regulation Tasks: Heart Rate Variability versus Implicit Association Test.

BACKGROUND: Nowadays, the assessment of psychopathy relies on semistructured interviews plus file reviews. In order to improve the predictive validity of psychopathy at the individual level, tools that are not based on the rating of signs and symptoms are in great need. SAMPLING AND METHODS: The present study was conducted in a representative sample of 204 Spanish sentenced inmates. These inmates have served at least 6 months of their sentence at the Pereiro de Aguiar (Ourense, Spain) penitentiary. Psychopathy signs and symptoms were scored through interview and file review. The Implicit Association Test (IAT) and heart rate variability (HRV) experiments were also conducted. The Iowa Gambling Task (IGT) was performed as a control measure. RESULTS: Spectral HRV indices were able to detect psychopathic inmates at a significant level, while IAT experiments and the IGT could not discriminate them. HRV indices showed a more significant difference when assessing the affective-interpersonal dimensions of psychopathy. CONCLUSIONS: An HRV experiment is better than IAT in order to detect psychopathy in a representative sample of Spanish inmates.

Concordance between Individual vs. Area-Level Socioeconomic Measures in an Urban Setting.

Area-level socioeconomic status (SES) measures have been used as a proxy in child health research when individual SES measures are lacking, yet little is known about their validity in an urban setting. We assessed agreement between census block-group and individual-level SES measures obtained from a caregiver telephone survey in Jackson County, Missouri. Associations with prevalence of childhood overweight (OW), low birth weight (LBW), and household smoking exposure were examined using logistic regression models. Seven hundred eighty-one households were surveyed: 49% male, 76% White, mean child age 9.4 years. We found misclassification rates of 20-35% between individual vs. area-level measures of education and income; Kappa indices ranged from 0.26-0.36 indicating poor agreement. Both SES measures showed an inverse association with LBW and smoking exposure. Area-level SES measures may reflect a construct inclusive of neighborhood resources; routine substitution of these measures should be interpreted with caution, despite similar correlations with health outcomes.

Atopic conditions other than asthma and risk of the 2009 novel H1N1 infection in children: a case-control study.

A recent study showed an increased risk of 2009 novel H1N1 influenza (H1N1) infection among asthmatic children. Little is known whether this is true for other atopic conditions. This study was designed to determine the association between atopic dermatitis and/or allergic rhinitis and the risk of H1N1 infection among children. We conducted a case-control study in Olmsted County, MN. We randomly selected children ≤18 years of age with a positive test for H1N1. Controls were randomly selected from a pool of residents with negative H1N1 tests and were matched to cases with regard to birthday, gender, clinic registration date, diagnostic test, and month of influenza testing using frequency matching. We compared the frequency of atopic conditions other than asthma between cases and their matched controls. We enrolled 168 cases and 172 controls. Among cases, 91 (54.2%) were male patients, and 106 (63.1%) were white. The median age of cases was 6.3 years (interquartile range, 3.1-11.5). Among cases, 79 (47.0%) had atopic dermatitis and/or allergic rhinitis diagnosed before or after the index date, whereas 54 (31.4%) controls had such conditions (odds ratio [OR], 1.89; 95% CI, 1.15-3.12; p = 0.012, adjusting for asthma status, 2008-2009 seasonal influenza vaccine, time of illness at index date, and other comorbid conditions). History of receiving 2008-2009 seasonal influenza vaccine was associated with H1N1 infection (adjusted OR, 2.06; 95% CI, 1.32-3.28; p = 0.002). Our results suggest an association between H1N1 infection and atopic conditions other than asthma. The association between 2008-2009 seasonal influenza vaccinations and the risk of H1N1 requires further investigation.

Asthma and severity of 2009 novel H1N1 influenza: a population-based case-control study.

BACKGROUND: Asthma has been shown to be associated with an increased risk of the 2009 novel H1N1 influenza (H1N1) infection among children. However, little is known about the role of asthma in severity of H1N1 infection. OBJECTIVE: To determine the association between asthma and other atopic conditions and severity of H1N1 infection. PATIENTS AND METHODS: We conducted a population-based case-control study. Cases were all Olmsted County, MN residents admitted to the hospital within a week of a positive test for H1N1. Controls who had a positive H1N1 but were not admitted to hospital were individually matched to cases with regard to birth day, gender, clinic registration date, diagnostic method, and calendar month of influenza testing. Asthma was ascertained using predetermined criteria. Data were fit to conditional logistic regression models. RESULTS: There were 46 eligible individuals admitted to hospitals with H1N1 infection during the study period. Ninety-seven controls were individually matched to their corresponding cases. Among cases, 23 (50%) were male and 29 (63.0%) were Caucasians. The median age at hospitalization was 20.7 years. Twenty-five (54.4%) cases had asthma before the date of hospitalization, compared to 33 (34.0%) controls (matched OR: 2.31; 95% CI, 1.13-4.73; p = 0.02). This association approached statistical significance after adjusting for all pertinent covariates (adjusted matched OR: 2.55; 95% CI, 0.98-6.64; p = 0.055). CONCLUSION: Asthma may be associated with severe H1N1 infection. In addition to timely influenza vaccination for asthmatics, consideration for prophylactic treatment for unimmunized asthmatics with significant exposure to influenza and immunized asthmatics with early flu-like symptoms should be given.

Comparison of individual-level versus area-level socioeconomic measures in assessing health outcomes of children in Olmsted County, Minnesota.

BACKGROUND: Socioeconomic status (SES) is an important determinant of health, but SES measures are frequently unavailable in commonly used datasets. Area-level SES measures are used as proxy measures of individual SES when the individual measures are lacking. Little is known about the agreement between individual-level versus area-level SES measures in mixed urban-rural settings. METHODS: We identified SES agreement by comparing information from telephone self-reported SES levels and SES calculated from area-level SES measures. We assessed the impact of this agreement on reported associations between SES and rates of childhood obesity, low birth weight <2500 g and smoking within the household in a mixed urban-rural setting. RESULTS: 750 households were surveyed with a response rate of 62%: 51% male, 89% Caucasian; mean child age 9.5 years. Individual-level self-reported income was more strongly associated with all three childhood health outcomes compared to area-level SES. We found significant disagreement rates of 22-31%. The weighted Cohen's κ indices ranged from 0.15 to 0.22, suggesting poor agreement between individual-level and area-level measures. CONCLUSION: In a mixed urban-rural setting comprised of both rural and urbanised areas, area-level SES proxy measures significantly disagree with individual SES measures, and have different patterns of association with health outcomes from individual-level SES measures. Area-level SES may be an unsuitable proxy for SES when individual rather than community characteristics are of primary concern.

Polymorphism of the interleukin-1 receptor antagonist gene: a factor in susceptibility to rheumatoid arthritis in a Spanish population.

OBJECTIVE: To assess whether an interleukin-1 receptor antagonist gene (IL1RN) polymorphism is associated with disease susceptibility and/or severity in a Spanish population of patients with rheumatoid arthritis (RA). METHODS: An 86-bp variable-number tandem repeat polymorphism within IL1RN intron 2 was analyzed by polymerase chain reaction in genomic DNA obtained from 247 unrelated patients with RA (group A) and 287 healthy control subjects. The polymorphism analysis was repeated in a second group of 194 patients with RA (group B). Clinical information from patients in group A was used to compare activity and severity data in patients stratified according to the different alleles or genotypes. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were used to determine the strength of the association of the different alleles or genotypes with RA activity or severity. RESULTS: In the control group, the allelic frequencies were 76% for IL1RN*1 (4 repeats), 21% for IL1RN*2 (2 repeats), 3% for IL1RN*3 (5 repeats), and 0.3% for IL1RN*4 (3 repeats). In group A patients with RA, both the frequency (OR 1.47, 95% CI 1.1-1.96, P = 0.007) and carriage rate (OR 1.6, 95% CI 1.1-2.2, P = 0.01) of allele IL1RN*2 were significantly increased. The increased frequency of IL1RN*2 was confirmed in group B patients with RA (OR 1.44, 95% CI 1.1-1.97, P = 0.01). In patients with RA, homozygosity for IL1RN*2 was associated with an increased number of affected articular areas during the first year of followup but not with other parameters of disease activity or severity. CONCLUSION: Our results suggest that IL1RN has a role in determining susceptibility to RA in the Spanish population.