Facets on the psychopathy checklist screening version and instrumental violence in forensic psychiatric patients.

BACKGROUND: There is a recognised relationship between psychopathy and instrumental violence, but not all violence by people who meet the criteria for psychopathy is instrumental. AIMS: Our aims were to compare offence types among forensic psychiatric patients with and without the Psychopathy Checklist: Screening Version (PCL: SV) criteria for psychopathy. Our specific questions were whether factor 1 - the interpersonal affective dimension - was related to instrumentality and on severity of the violent crime. Our hypothesis was that the relationship between psychopathy and instrumental violence would be dependent on the severity of the violent crime. METHODS: Sixty-five male patients at the forensic psychiatric hospital in Sundsvall, all with a violent criminal history, were assessed for psychopathy through interview and records using the PCL: SV. Severity and the instrumentality of their previous violence were coded using the Cornell coding guide for violent incidents. RESULTS: The interpersonal features of psychopathy (the interpersonal facet), and only the interpersonal features were significantly associated with instrumentality and severity of violence. Instrumentality was also significantly related to the severity of the violence, independent of psychopathy score. CONCLUSIONS: The results indicated that, at least among forensic psychiatric patients, planning is more likely than not with respect to serious crimes. The specific link between interpersonal features of psychopathy and instrumental and severe violence suggests potential clinical value in recognising subtypes of psychopathy.

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.

Recidivism is related to psychopathy (PCL-R) in a group of men convicted of homicide.

It is well known that psychopaths are a group with high risk for criminality. Despite that, researchers and clinicians have not yet agreed on a general cause of psychopathy. However Raine [Raine, A. (2002). Biosocial studies of antisocial and violent behavior in children and adults: A review. Journal of Abnormal Child Psychology, 30, 311-326.] advocated a biosocial model of violent behaviour where the greatest risk for criminal behaviour occurred when both heredity and environmental risk factors (e.g., social class, childhood history) were present. In this follow-up study, 35 men convicted of homicide were assessed retrospectively for psychopathy according to the Psychopathy Checklist-Revised (PCL-R). Information on personal history, as well as from legal documents and records of offences committed by the subjects was also obtained. Fourteen of the 35 men were classified as psychopaths. Two men, both rated as psychopaths, had criminal parents. Twenty-seven of the men had a social relationship with their victim, and eleven out of these were rated as psychopaths. There was no difference in PCL-R scores between those who had a social relationship with their victim and those who did not. The psychopaths relapsed more frequently than the nonpsychopaths into criminality after their prison term. This result confirms previous research indicating that psychopathy is a risk factor for recidivism. It is, therefore, very important that psychopaths get the best possible treatment, aftercare, and supervision.