A Dimensional Comparison of a Self-Report and a Structured Interview Measure of Conduct Disorder.

Eligibility for a diagnosis of antisocial personality disorder (ASPD) requires evidence of antecedent conduct disorder (CD). Accurately identifying CD may be influenced by various factors, including assessment methodology. The present study used a two-parameter latent variable model to examine the relative performance of a self-report measure and a structured clinical interview in retrospectively detecting the CD spectrum among adult male offenders (N = 1,159). Self-report and clinical interview tended to converge regarding the rank order of severity indicated by CD symptom criteria. In addition, at relatively low levels of CD severity, self-report provided more information about the CD spectrum than did clinical interview. At relatively higher levels of CD severity, however, clinical interview provided more information about the CD spectrum than did self-report. Latent variable models offer a potential means of combining multiple assessment methods in a way that maximizes information gleaned by capitalizing on the contextual strengths of each approach.

Psychopathy factor interactions and co-occurring psychopathology: Does measurement approach matter?

The 2 dimensions of psychopathy as operationalized by various measurement tools show differential associations with psychopathology; however, evidence suggests that the statistical interaction of Factor 1 (F1) and Factor 2 (F2) may be important in understanding associations with psychopathology. Findings regarding the interactive effects of F1 and F2 are mixed, as both potentiating and protective effects have emerged. Moreover, approaches to measuring F1 (e.g., clinical interview vs. self-report) are based on different conceptualizations of F1, which may influence the interactive effects. The current study aims to (a) elucidate the influence of F1 and F2 on psychopathology by using both variable-centered and person-centered approaches and (b) determine whether the measurement of F1 influences the interactive effects of F1 and F2 by comparing the strength of interactive effects across F1 measures in a sample of over 1,500 offenders. Across analytic methods, there were very few cases in which F1 statistically influenced the association between F2 and psychopathology, such that F1 failed to evidence either potentiating or protective effects on F2. Furthermore, the conceptualization of F1 across psychopathy measures did not impact the interactive effects of F1 and F2. These findings suggest that F2 is probably driving the relations between psychopathy and other forms of psychopathology and that F1 may play less of a role in interacting with F2 than previously believed.

Development and validation of Triarchic construct scales from the psychopathic personality inventory.

The Triarchic model of psychopathy describes this complex condition in terms of distinct phenotypic components of boldness, meanness, and disinhibition. Brief self-report scales designed specifically to index these psychopathy facets have thus far demonstrated promising construct validity. The present study sought to develop and validate scales for assessing facets of the Triarchic model using items from a well-validated existing measure of psychopathy-the Psychopathic Personality Inventory (PPI). A consensus-rating approach was used to identify PPI items relevant to each Triarchic facet, and the convergent and discriminant validity of the resulting PPI-based Triarchic scales were evaluated in relation to multiple criterion variables (i.e., other psychopathy inventories, antisocial personality disorder features, personality traits, psychosocial functioning) in offender and nonoffender samples. The PPI-based Triarchic scales showed good internal consistency and related to criterion variables in ways consistent with predictions based on the Triarchic model. Findings are discussed in terms of implications for conceptualization and assessment of psychopathy.

Psychopathic predators? Getting specific about the relation between psychopathy and violence.

OBJECTIVE: The psychopathy checklist-revised (PCL-R; Hare, 1991, 2003) is often used to assess risk of violence, perhaps based on the assumption that it captures emotionally detached individuals who are driven to prey upon others. This study is designed to assess the relation between (a) core interpersonal and affective traits of psychopathy and impulsive antisociality on the one hand and (b) the risk of future violence and patterns of motivation for past violence on the other. METHOD: A research team reliably assessed a sample of 158 male offenders for psychopathy, using both the interview-based PCL-R and the self-report psychopathic personality inventory (PPI: Lilienfeld & Andrews, 1996). Then, a second independent research team assessed offenders' lifetime patterns of violence and their motivation. After these baseline assessments, offenders were followed in prison or the community for up to 1 year to assess their involvement in 3 different forms of violence. Baseline and follow-up assessments included both interviews and reviews of official records. RESULTS: First, the PPI manifested incremental validity in predicting future violence over the PCL-R (but not vice versa)-and most of its predictive power derived solely from impulsive antisociality. Second, impulsive antisociality-not interpersonal and affective traits specific to psychopathy-were uniquely associated with instrumental lifetime patterns of past violence. The latter psychopathic traits are narrowly associated with deficits in motivation for violence (e.g., lack of fear or lack of provocation). CONCLUSIONS: These findings and their consistency with some past research led us to advise against making broad generalizations about the relation between psychopathy and violence.

The relation between self-reported psychopathic traits and distorted response styles: a meta-analytic review.

A concern among researchers is that self-report measures may not be valid indicators of psychopathic traits due to the core features of psychopathy (e.g., lying, deception/manipulation). The current study addresses this issue by combining effects sizes from studies published on or before March 31, 2010 to examine the relation between scores of 3 widely used self-report psychopathy measures--the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) and its revised version (PPI-R; Lilienfeld & Widows, 2005) and Levenson's Self-Report Psychopathy scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995) and scores on measures assessing response style (i.e., faking good and faking bad). Effect sizes were obtained from 45 studies for total, Factor 1, and Factor 2 scores (faking good: k = 54, 55, and 55, respectively; faking bad: k = 51, 50, and 50, respectively). Based on a random effects model, a significant negative association was found between social desirability/faking good and both total (r(w) = -.11, p < .01) and F2 (r(w) = -.16, p < .01) scores, and moderation analyses suggested that effect sizes varied as a function of psychopathy scale and validity scale used. Significant positive associations were also found between faking bad and both total (r(w) = .27, p < .05) and F2 (r(w) = .32, p < .05) scores. Also, moderation analyses suggested that effect sizes varied as a function of study location, psychopathy scale, and validity scale. Despite several limitations (e.g., inclusion of only published studies, limited moderators, exclusion of other measures), the general findings temper concerns of positive response bias and underscore the validity of self-report psychopathy scales.

Do the psychopathic personality traits of fearless dominance and self-centered impulsivity predict attitudes about and influences on research participation?

Little is known about potential participants' views about research, their willingness to participate in research, and the extent to which they might be susceptible to coercive attempts to compel their participation, particularly among populations at risk for exploitation (e.g., offenders). The extent to which individual differences variables, such as personality constructs (e.g., psychopathic traits), might affect participants' attitudes toward research is also essentially unknown. The present study sought to examine the psychopathy constructs of Fearless Dominance (FD) and Self-Centered Impulsivity (SCI) via the Multidimensional Personality Questionnaire-Brief Form (MPQ-BF) to assess the extent to which these traits predict attitudes towards research and susceptibility to coercion within a diverse criminal justice sample (N = 631). SCI was modestly associated with perceptions that illicit pressures regarding research participation were likely to occur, and participants high in these traits appeared somewhat vulnerable to succumbing to coercive influences. In contrast, FD failed to predict the likelihood that illicit pressures regarding research participation would occur as well as the potential that these pressures would have to impact participants' voluntariness and likelihood of participating. Implications for recruiting potential participants for research in correctional settings are discussed.

Examining attitudes about and influences on research participation among forensic psychiatric inpatients.

Although a growing body of research has examined various types of coercive practices that may occur among psychiatric patients over the years, almost no attention has been given to coercive influences that may occur specifically in the context of recruitment into research projects. Particularly for those who are institutionalized (e.g., in-patient insanity acquittees), there are significant concerns that their autonomous decision-making to consent or not may be significantly impaired due to the highly restrictive and controlled environment in which they live. This exploratory study sought to examine patients' perceptions of coercive influences by presenting them with hypothetical research vignettes regarding possible recruitment into either a biomedical or social-behavioral research project. Among 148 multi-ethnic male and female participants across two facilities, participants reported relatively minimal perceptions that their autonomous decision-making would be impacted or that various potentially coercive factors (e.g., pressures from staff) would impair their free choice to participate (or not) in such research. To the extent that such perceptions of coercion did occur, they were moderately associated with patients' more general personality traits and attitudinal variables, such as alienation and external locus of control. Limitations of this study and their implications for future research are discussed.

Using the Personality Assessment Inventory to predict male offenders' conduct during and progression through substance abuse treatment.

Prior research has supported the utility of the Personality Assessment Inventory (PAI; Morey, 1991, 2007) to predict various negative outcomes among offender samples, yet few studies have specifically examined its association with behavior in treatment. In this study, the PAI was administered to 331 male offenders court ordered into substance abuse treatment. Several theoretically relevant PAI scales (e.g., Antisocial Features, Borderline Features) predicted various forms of problematic conduct (e.g., disruptive behavior, aggression) and subjective and objective ratings of treatment progress. Although there was relatively limited evidence for the superiority of any one predictor over the others, the Aggression (AGG) scale demonstrated incremental validity above and beyond other indicators for general noncompliance and aggressive behavior. Interpersonal scales also predicted select treatment behavior while sharing relatively little common variance with AGG. These findings highlight the importance of distinguishing lower order and higher order dimensions on the PAI and other measures.

Voluntary consent in correctional settings: do offenders feel coerced to participate in research?

A major ethical concern in research with criminal offenders is the potential for abuse due to coercive influences that may adversely affect offenders' capacity to give voluntary consent to participate in research conducted in correctional settings. Despite this concern, to date there have been almost no systematic scientific investigations of the extent to which offenders themselves perceive that coercion occurs in these settings or that it is likely to influence their decisions about research participation. In a sample of over 600 ethnically diverse men and women recruited from various prisons and community corrections facilities in Texas and Florida, we used a vignette-based survey concerning a hypothetical research project to measure and compare offenders' global perceptions of coercive processes, as well as the differential salience and perceived coercive influence of specific factors (e.g., coercion by other inmates, inducements from staff). Somewhat surprisingly, across multiple outcome measures our participants on average reported relatively little in the way of significant coercive influences on their capacity to make voluntary decisions concerning research participation. Implications and directions for future research on coercive influences in offender research are discussed.

Awareness of the Tuskegee syphilis study: impact on offenders' decisions to decline research participation.

Ethnic and racial minorities are often under-represented in research. There is considerable speculation that Blacks, in particular, are discouraged from research participation because of researcher improprieties in the U.S. Public Health Service (USPHS) Syphilis Study at Tuskegee (aka the Tuskegee Syphilis Study [TSS]), a 40-year (1932-1972) study in which investigators withheld medical treatment from African-American men infected with syphilis. We debriefed 281 offenders who declined participation in a research study to assess the extent to which knowledge of the TSS impacted their decisions not to enroll. Relatively few (44/281; 15.6%) reported awareness of the TSS. Half (n = 22) of these "aware" individuals could cite factually accurate information about the TSS, and only four individuals indicated that awareness of TSS had "somewhat" influenced their decision to not participate. Findings suggest that the legacy of the TSS played a relatively minor role in these offenders' decisions to decline research participation.

Formal assessment of voluntariness with a three-part consent process.

Informed consent that is voluntary and made by an individual who is knowledgeable and competent is a foundational requirement for protecting human subjects from harm and exploitation that could result from research participation. In 1974 Miller and Willner proposed a two-part consent process that involved disclosure of information and assessment of comprehension. The authors propose a brief third component to the consent process: assessment of voluntariness. Three steps are involved: generate a list of potential coercive influences on the basis of the research population and the study context, develop a set of questions to assess the presence and intensity of the impact of these influences, and identify alternative courses of action should coercion be identified.

Suicidal and criminal behavior among female offenders: the role of abuse and psychopathology.

Childhood abuse is relatively prevalent among women and is an important risk factor for both criminal behavior and suicide-related behavior (SRB). Based on a sample of 266 female offenders, we address one theoretical and one practical issue. First, from a theoretical perspective, we assess whether internalizing (depression and anxiety) and externalizing (substance abuse and antisocial behavior) psychopathology mediate the relation between abuse on the one hand, and SRB or criminal behavior, on the other. Results indicate that externalizing problems mediate the relation between childhood abuse and both lifetime SRB (fully) and lifetime criminality (partially). Second, at a practical level, results indicate that a subscale of the Revised Psychopathy Checklist (PCL-R; Hare, 1991) that assesses lifetime criminal behavior adds incremental utility to postdicting SRB, beyond the variance accounted for by self-report measures of abuse and externalizing problems. However, none of the measures-including the PCL-R-predicted future recidivism.

Adjudicative competence: evidence that impairment in "rational understanding" is taxonic.

In Dusky v. United States (1960), the U.S. Supreme Court articulated 3 abilities that determine a criminal defendant's competence to stand trial: He or she must be able to consult with counsel, have a factual understanding of the proceedings, and have a rational understanding of the proceedings. Although the legal determination of a defendant's competence involves a dichotomous judgment, the latent structures of the constructs that underlie the abilities articulated in Dusky are unknown. The current study focused on the rational understanding prong of the Dusky standard. We hypothesized that, whereas factual knowledge of the legal system and ability to assist counsel may fall on a continuum, plausible (i.e., rational) beliefs about legal proceedings may be dichotomous in nature. Taxometric analyses of the Appreciation scale of the MacArthur Competence Assessment Tool--Criminal Adjudication, with a sample of 721 defendants, provided support for a taxonic structure.

Identifying subtypes among offenders with antisocial personality disorder: a cluster-analytic study.

The question of whether antisocial personality disorder (ASPD) and psychopathy are largely similar or fundamentally different constructs remains unresolved. In the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994), many of the personality features of psychopathy are cast as associated features of ASPD, although the DSM-IV offers no guidance as to how, or the extent to which, these features relate to ASPD. In a sample of 691 offenders who met DSM-IV criteria for ASPD, we used model-based clustering to identify subgroups of individuals with relatively homogeneous profiles on measures of associated features (psychopathic personality traits) and other constructs with potential etiological significance for subtypes of ASPD. Two emergent groups displayed profiles that conformed broadly to theoretical descriptions of primary psychopathy and Karpman's (1941) variant of secondary psychopathy. As expected, a third group (nonpsychopathic ASPD) lacked substantial associated features. A fourth group exhibited elevated psychopathic features as well as a highly fearful temperament, a profile not clearly predicted by extant models. Planned comparisons revealed theoretically informative differences between primary and secondary groups in multiple domains, including self-report measures, passive avoidance learning, clinical ratings, and official records. Our results inform ongoing debates about the overlap between psychopathy and ASPD and raise questions about the wisdom of placing most individuals who habitually violate social norms and laws into a single diagnostic category.

Multimethod assessment of psychopathy in relation to factors of internalizing and externalizing from the Personality Assessment Inventory: the impact of method variance and suppressor effects.

Research to date has revealed divergent relations across factors of psychopathy measures with criteria of internalizing (INT; anxiety, depression) and externalizing (EXT; antisocial behavior, substance use). However, failure to account for method variance and suppressor effects has obscured the consistency of these findings across distinct measures of psychopathy. Using a large correctional sample, the current study employed a multimethod approach to psychopathy assessment (self-report, interview and file review) to explore convergent and discriminant relations between factors of psychopathy measures and latent criteria of INT and EXT derived from the Personality Assessment Inventory (Morey, 2007). Consistent with prediction, scores on the affective-interpersonal factor of psychopathy were negatively associated with INT and negligibly related to EXT, whereas scores on the social deviance factor exhibited positive associations (moderate and large, respectively) with both INT and EXT. Notably, associations were highly comparable across the psychopathy measures when accounting for method variance (in the case of EXT) and when assessing for suppressor effects (in the case of INT). Findings are discussed in terms of implications for clinical assessment and evaluation of the validity of interpretations drawn from scores on psychopathy measures.

Using the PCL-R to help estimate the validity of two self-report measures of psychopathy with offenders.

Two self-report measures of psychopathy, Levenson's Primary and Secondary Psychopathy scales (LPSP) and the Psychopathic Personality Inventory (PPI), were administered to a large sample of 1,603 offenders. The most widely researched measure of criminal psychopathy, the Hare Psychopathy Checklist-Revised (PCL-R), served as a provisional referent for estimating the construct validity of these self-report measures with offenders. Compared with the LPSP, the PPI displayed higher zero-order correlations with the PCL-R, better convergent and discriminant validity, and more consistent incremental utility in predicting PCL-R scores. Furthermore, using a variant of Westen and Rosenthal's approach to evaluating the construct validity of a new measure, compared with the LPSP, the PPI's pattern of associations with measures of 35 external criterion variables was more similar to the pattern observed for the PCL-R. Results generally provide stronger support for the validity of the PPI than the LPSP in offender populations using the PCL-R as a provisional benchmark, particularly for assessing interpersonal and affective features of psychopathy.

Personality traits in clinically referred aviators: two clusters related to occupational suitability.

BACKGROUND: The Five Factor Model (FFM) of normal personality provides a compelling framework for investigating personality subtypes in large military populations. The FFM was used to determine whether a sample of clinically referred military aviators exhibited commonly occurring personality clusters. METHODS: The Revised NEO Personality Inventory (NEO-PI-R) was used to evaluate 956 clinically referred U.S. Naval aviators and flight officers on the domains of neuroticism (N), extroversion (E), openness (O), agreeableness (A), and conscientiousness (C). The scores were subjected to model-based cluster analysis and emergent clusters were compared with respect to their scores and clinical outcomes. RESULTS: A two-cluster model provided the best fit to the data. MANOVA indicated significant differences between the two cluster groups with respect to four of the five factors (N, E, A, and C). The greatest differences were for N and E, with the smaller group (Group 1, N = 291) being significantly more neurotic and less extroverted than Group 2 (N = 665). Cluster membership had more specificity (0.74) than sensitivity (0.59) for predicting adverse clinical outcome, with the probability of an adverse clinical outcome increasing from 0.14 to 0.28 for those in the neurotic and introverted Group 1. CONCLUSIONS: Elevated neuroticism and depressed extraversion were the defining traits of the personality cluster less suited for aviation duty (Group 1). Results support assessment of neuroticism and extroversion during clinical mental health evaluations related to military aviation duty.

A latent class factor approach to identifying subtypes of juvenile diversion youths based on psychopathic features.

Latent class factor analysis allows for the estimation of a dimensional construct such as psychopathy through factor analysis while also examining the heterogeneity of the sample. We report the results of a latent class factor analysis examining the psychometric structure of a widely used measure of psychopathy, as well as internalizing (i.e. anxiety) and externalizing indices, among diversion program youths involved in an intervention study. The results indicated that four subgroups of adolescents existed in the data: one with high psychopathic features and externalizing problems, but low anxiety; one with moderately high affective and behavioral psychopathic features and externalizing problems, but low anxiety; one with moderately high interpersonal and behavioral psychopathic features, externalizing problems, and anxiety; and one with very low psychopathy scores, anxiety, and externalizing problems. The validity of these subgroups was assessed comparing prior family problems, substance use, and offending measures, and one-year follow-up measures of recidivism, detention days, substance use, and program completion. This study offers partial support for the existence of psychopathy subgroups and has implications for future studies of psychopathy typologies. In addition, this study employed a methodology for classification that permits consideration of the dimensional nature of a construct, and as such has implications for a variety of research areas.

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).