Adverse childhood events and self-harming behaviours among individuals in Ontario forensic system: the mediating role of psychopathy.

BACKGROUND: Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients. METHODS: This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs. RESULTS: ​​​The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years. CONCLUSION: Among forensic patients in Ontario, psychopathy mediates​ ​the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated.

Psychopathy among condemned capital murderers.

Psychopathy is an important forensic mental health construct. Despite this importance, the research base of psychopathy among individuals convicted of capital murder is limited. Archival data were collected from a sample of 636 persons convicted of capital murder and sentenced to death in the State of California. Psychopathy was assessed using the Psychopathy Checklist - Revised (PCL-R) instrument. Data on criminal careers and other behavioral disorders were also extracted. The sample mean PCL-R total score was 23.31 (SD = 9.92) and one-third of individuals in this sample were considered clinically psychopathic with PCL-R total scores of 30 or greater. Factor analytic examination yielded support for four facets: affective, interpersonal, lifestyle, and antisocial. Criterion validity findings revealed positive correlations of psychopathy scores with Antisocial Personality Disorder (ρ = 0.72), Conduct Disorder (ρ = 0.46), sexual sadism (ρ = 0.24), Oppositional Defiant Disorder (ρ = 0.20), ADHD (ρ = 0.15), arrest charges (r = 0.56), prison sentences (r = 0.53), and age of arrest onset (r = -0.57). Individuals convicted of capital murder and sentenced to death reflect heterogeneity in psychopathy with some individuals exhibiting pronounced psychopathic features.

The Influence of Psychopathy on Incarcerated Inmates' Cognitive Empathy.

(1) Background: there is an ongoing debate about whether psychopathic traits increase or decrease cognitive empathy/Theory of Mind. (2) Methods: using a representative sample of 204 Spanish convicted inmates incarcerated at the Pereiro de Aguiar Penitentiary in Ourense, Spain, we investigated the relationship between two tools for the assessment of psychopathy, the Psychopathy Checklist-Revised (PCL-R) and the Comprehensive Assessment of Psychopathic Personality (CAPP), and the Reading the Mind in the Eyes Test (RMET), a well-known measure of cognitive empathy. (3) Results: The results showed no clear connection between the scores on the psychopathy assessment tools and RMET performance. This lack of association was stronger when the age variable was included in the multivariate analysis. (4) Conclusions: the results of this study failed to detect any clear link between psychopathy and cognitive empathy performance. Accordingly, our results indicate that psychopathy neither improves nor worsens cognitive empathy.

Psychopathic femicide: The influence of psychopathy on intimate partner homicide.

High scores in psychopathy were associated with acts of violence, and the prevalence of this condition is greater among the prison population than among the general population. In terms of its relation to femicide, two studies, one carried out in Sweden and another in Spain with a prison population, found that psychopathy is an uncommon condition among perpetrators of femicide. This study analyzes 97 cases of femicide in the whole of Spain, in which it was possible to evaluate the degree of psychopathy of the perpetrators using the Psychopathy Checklist-Revised (PCL-R). The scores are analyzed not only directly, but also in terms of Factors and Facets. The results show an average in the total score of the PCL-R of 14.4, with only 13 subjects (13.4%) presenting scores of 25 or more, and just 3 (3.1%) of these presenting scores of 30 or higher. It was found that, in general, high scores in psychopathy are associated with shorter relationships and less time between the first complaint, the breakup, and the femicide. What is more, characteristics of the victims, such as addiction to toxic substances or economic dependency, also demonstrated a relationship to the scores of the perpetrators of femicide in the PCL-R. Lastly, it was found that the scores in the different dimensions of psychopathy are associated with different types of violence, whereby there was a noteworthy difference between the most explicit violence and control exercised over the partner.

Variants of psychopathic personality in Korean and UK incarcerated offenders: Using latent profile analysis and discriminant analysis.

Since the popularization of the Psychopathy Checklist-Revised (PCL-R), research on the construct of psychopathy has drastically increased. However, there has been little research examining the extent to which psychopathy varies across different cultures. This study is the first to use latent profile analysis to examine cultural variations in psychopathic traits between large samples of male inmates in Korean (n = 1102) and UK (n = 1316) prisons. Supplementary discriminate analysis was also used to validate the classification profiles and determine which items of the PCL-R were most important in defining the differences or similarities between each of the classes in the two large samples. Based on the analysis, two variants of primary psychopathy could be distinguished in the Korean sample but not in the UK sample. Conversely, only secondary psychopathy was identified in the UK sample. This result was also confirmed by supplementary analysis, which verified classification accuracy and also provided structure matrixes listing the correlations between each PCL-R item and the two discriminant functions. Our results point to the possibility of cultural differences in the structure of psychopathy and provide practical implications for clinical assessment and diagnosis.

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)

Clarifying fearlessness in psychopathy: An examination of thrill-seeking and physical risk-taking.

Fearlessness has been described among the traits associated with psychopathy; however, disparities in conceptualizations of fear and how related elements are operationalized among different measures of psychopathic traits have led to some enduring controversy. Here we address a subset of elements characterizing fearlessness represented in thrill-seeking and physical risk-taking among a large sample of incarcerated individuals (n = 688). We examine these relationships utilizing Hare's Psychopathy Checklist Revised (PCL-R), the Psychopathy Personality Inventory-Short Form (PPI-SF), and the Zuckerman Sensation Seeking Scale (SSS). Among males, the Thrill and Adventure Seeking (TAS) scale of the SSS was not related to features of the PCL-R, but was highly correlated with Fearless Dominance (FD) of the PPI-SF. Among females, TAS was only modestly correlated with PCL-R total score, but neither of the two PCL-R factors. PPI-SF FD remained a strong predictor of TAS among females. We argue for a careful consideration of the boundaries of the term "fearlessness" as it relates to diverse manifestations of behavior and varied conceptualizations of psychopathy. We also reiterate apparent differences between males and females in the presentation of psychopathic traits.

Predictive validity of the HCR-20V3 in a sample of Australian forensic psychiatric patients.

The Historical Clinical Risk Management-20 Version 3 is the latest iteration in the HCR-20 series, adopting novel changes such as the addition of Relevance ratings and non-requirement to include the Psychopathy Checklist-Revised. This study aimed to examine these changes and compare the predictive validity of the HCR-20V3 to the HCR-20V2. The sample comprised of 100 forensic psychiatric patients, retrospectively followed up for a maximum period of approximately 13 years post-discharge from the Thomas Embling Hospital. Recidivism data were sourced from official police records. Results indicated good to excellent inter-rater reliability. The HCR-20V3 significantly predicted violent recidivism (area under the curve = .70 to .77), levels of accuracy that were not significantly different from the HCR-20V2. HCR-20V3 Relevance ratings failed to add incremental validity above Presence ratings; however, the PCL-R improved upon the HCR-20V3's validity. The study represented one of the first evaluations of the HCR-20V3 in Australia.

A Plea for Preregistration in Personality Disorders Research: The Case of Psychopathy.

In response to a crisis of confidence, several methodological initiatives have been launched to improve the robustness of psychological science. Given its real-world implications, personality disorders research is all too important to not follow suit. The authors offer a plea for preregistration in personality disorders research, using psychopathic personality (psychopathy) as a prominent case example. To suit action to word, the authors report on a preregistered study and use it to help refute common misconceptions about preregistration as well as to illustrate that the key strength of preregistration: transparency outweighs its (perceived) disadvantages. Although preregistration will not conclusively settle the many debates roiling the field of psychopathy and other personality disorders, it can help to verify the robustness of empirical observations that inform such debates.

Clarifying Conceptions Underlying Adult Psychopathy Measures: A Construct Validity Metric Approach.

Although the Psychopathy Checklist-Revised (PCL-R) and Psychopathic Personality Inventory (PPI) ostensibly measure the same construct, they seem to emphasize different conceptions of psychopathy. This study was designed to clarify these differences by testing how well the PCL-R and PPI map alternative conceptions of psychopathy. Construct validity metrics were used to compare patterns of associations between psychopathy measures and 14 theory-relevant criterion variables that were observed in a sample of 1,281 offenders-with patterns of associations that were predicted based on alternative psychopathy conceptions. PCL-R total scores were most consistent with Karpman's affective dysfunction-centered secondary conception, and PPI total scores were most consistent with the McCords' lovelessness-based conception. Although similarities emerged at the factor level, the PPI demonstrated higher levels of consistency between theory-based predictions and observed relations than did the PCL-R. These results provide direction for refining measures in future research and interpreting PCL-R and PPI scores in current practice.

Psychopathy and impulsivity: The relationship of psychopathy to different aspects of UPPS-P impulsivity.

Impulsivity is thought to be a major component of psychopathy. However, impulsivity is a multi-faceted concept, and different facets may have differential relationships to psychopathy. We measured impulsivity via the UPPS-P in a sample of prisoners and in patients in a personality disorder service resident in secure psychiatric care. Psychopathy in the prison sample was measured via the clinician-rated Psychopathy Checklist: Screening Version and in the patients via the Psychopathy Checklist-Revised. We found that the Lifestyle/Antisocial factor (Factor 2) was associated with acting rashly when emotional (Negative Urgency and Positive Urgency). However, the Interpersonal/Affective factor (Factor 1) was associated with reduced impulsivity in the domains of premeditation and perseverance, and its unique variance was also associated with less rash behaviour. The Interpersonal facet (Facet 1) was particularly associated with reduced impulsivity. The results show that individuals with high Interpersonal traits of psychopathy can plan carefully and are persistent in their goals. This may underpin instrumental violence and criminal behaviour. Thus, a simple unitary understanding of the relationship between psychopathy and impulsivity may not be valid and may distort the multifaceted relationship between the two concepts that could assist in the assessment and management of psychopathic offenders.

Tracking Psychopathy in Female Italian Inmates: The Role of the DSM-5 Alternative Model of Personality Disorders Dysfunctional Personality Domains.

OBJECTIVE: The present study aimed at testing the relationships between measures of psychopathy and measures of the DSM-5 Alternative Model of Personality Disorders (AMPD) domains in a sample of female offenders who were serving their sentences in Italian prisons. METHOD: Thirty-eight Italian adult female inmates were underwent the Italian versions of the Psychopathy Checklist-Revised (PCL-R) and of the Personality Inventory for DSM-5-Informant Report Form (PID-5-IRF). RESULTS: According to MM robust regression analysis results, high scores on the PID-5-IRF Disinhibition domain scale and low scores on the PID-5-IRF Anxiousness trait scale were significant and substantial predictors of the PCL-R total score. CONCLUSIONS: As a whole, our findings support the hypothesis that assessing the DSM-5 AMPD domains (and traits) may be important for tracking psychopathy in female inmates.

Psychopathy in a Multiethnic World: Investigating Multiple Measures of Psychopathy in Hispanic, African American, and Caucasian Offenders.

Despite the forensic relevance of psychopathy and the overrepresentation of Hispanics in the United States' criminal justice system, these two issues remain underexplored, particularly with self-report measures of psychopathy. We investigated the criterion validity of three psychopathy measures among African Americans, Caucasians, and Hispanics in a sample of 1,742 offenders. More similarity than dissimilarity emerged across groups. The factor structures of psychopathy measures among Hispanic offenders were consistent with previous findings. Few significant differences emerged between Hispanic and Caucasian offenders, with most differences emerging between African Americans and the other ethnic groups. In such instances, the correlates of psychopathy were typically weaker for African Americans. The Psychopathy Checklist-Revised yielded fewer psychopathy × ethnicity interactions than the Psychopathic Personality Inventory and Levenson Primary and Secondary Psychopathy Scales. Overall, these psychopathy measures showed reasonable validity across these cultural groups.

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.

Psychopathy Checklist-Revised Use and Reporting Practices in Sexually Violent Predator Evaluations.

We surveyed evaluators who conduct sexually violent predator evaluations ( N = 95) regarding the frequency with which they use the Psychopathy Checklist-Revised (PCL-R), their rationale for use, and scoring practices. Findings suggest that evaluators use the PCL-R in sexually violent predator cases because of its perceived versatility, providing information about both mental disorder and risk. Several findings suggested gaps between research and routine practice. For example, relatively few evaluators reported providing the factor and facet scores that may be the strongest predictors of future offending, and many assessed the combination of PCL-R scores and sexual deviance using deviance measures (e.g., paraphilia diagnoses) that have not been examined in available studies. There was evidence of adversarial allegiance in PCL-R score interpretation, as well as a "bias blind spot" in PCL-R and other risk measure (Static-99R) scoring; evaluators tended to acknowledge the possibility of bias in other evaluators but not in themselves. Findings suggest the need for evaluators to carefully consider the extent to which their practices are consistent with emerging research and to be attuned to the possibility that working in adversarial settings may influence their scoring and interpretation practices.

The four-factor model of the Psychopathy Checklist--Revised: validation in a Dutch forensic inpatient sample.

In The Netherlands, the Ministry of Security and Justice requires the assessment of the Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Hare, 2003) in all forensic psychiatric inpatients. To examine the four-factor structure of the Psychopathy Checklist-Revised, confirmatory factor analysis (CFA) was conducted using a Dutch sample of forensic psychiatric inpatients (N=411) and the results indicated acceptable fit. Also, using multiple group CFA, the four-factor model provided an acceptable fit in both patients with a personality disorder and patients with a psychotic disorder, and there was reasonably good evidence of measurement invariance between these two subgroups. Furthermore, correlations with external measures of aggression and personality traits provided additional support for the validity of the four-factor model in patients with a personality disorder. In patients with a psychotic disorder fewer significant correlations with external measures were found. Taken together, the results support the use of the four-factor structure in Dutch offenders who are detained under hospital order.

Personality traits and violent behavior: a comparison between psychopathic and non-psychopathic male murderers.

The relationship between psychopathy and traits of temperament and character in a specific population of criminals, such as murderers, has not been sufficiently investigated. This study assesses the relationship between psychopathy and temperament and character traits in murderers. The sample consisted of 118 men divided into three groups: psychopathic murderers (N=40), non-psychopathic murderers (N=40) and 38 non-psychopathic non-criminals (controls). All individuals were evaluated by Psychopathy Checklist Revised (PCL-R) and The Temperament and Character Inventory (TCI). Psychopathic murderers presented higher scores than the other two groups in PCL-R; both criminal groups presented higher scores than non-psychopathic non-criminals. Psychopathic murderers showed lower scores than non-psychopathic murderers on Harm Avoidance, Reward Dependence, Persistence, Self-Directness and Cooperativeness. There was no difference between murderers groups regarding Novelty Seeking and Self-transcendence. In all TCI personality traits psychopathic and non-psychopathic murderers showed scores lower than controls, except Harm Avoidance for non-psychopathic murderers. In conclusion, most personality traits assessed by TCI were associated with psychopathy, while Novelty Seeking and Self-transcendence were associated with homicidal behavior independently of the psychopathy.

Confiabilidad y validez de la Escala de Psicopatía Revisada de Hare (PCL-R) en la población carcelaria cubana / Reliability and validity of the Psychopathy Checklist-Revised (PLC-R) in a Cuban prison sample

Las propiedades psicométricas de la Escala de Psicopatía de Hare (PCL-R) han sido estandarizadas en diferentes países. Este artículo evalúa si la PCL-R puede ser validada en la población carcelaria cubana. La muestra estuvo compuesta por 124 sujetos, presos por cometer crímenes violentos, a quienes se les aplicó la adaptación española de Moltó et al. (2000). La confiabilidad y la consistencia interna de la escala fueron similares a otros estudios realizados. El análisis factorial mostró una estructura de dos factores, donde el Factor 1 representa los rasgos que describen la conducta antisocial y el Factor 2, los rasgos que describen las relaciones interpersonales y la afectividad. Los dos factores exhiben una alta correlación con distintos instrumentos validados que miden rasgos de personalidad, lo que confirma la validez del constructo.

The psychometric properties of the PCL-R (Psychopathy Checklist-Revised) have been standardized in numerous countries. This article evaluates if the PCL-R can be also validated in the Cuban prison population. The sample was compound by 124 males inmates, imprisoned for committing violent crimes. The PCL-R Spanish version of Moltó et al. was applied. The reliability and the internal consistency of the scale were consistent with similar investigations. A two factor structure was obtained. Factor 1 describes the Antisocial behavior and Factor 2 describes the Interpersonal-Affective traits of the scale. The two factors showed different patterns of correlation with validated instruments to measure personality traits and confirm the reliability of the construct.