What We Need To Know About Psychopaths

{Page Two}

Compiled & Presented By

Bonnie M. Wells

PCL-R Model Of Psychopathy

The PCL-R is a clinical rating scale (rated by a psychologist or other professional) of 20 items. Each of the items in the PCL-R is scored on a three-point scale according to specific criteria through file information and a semi-structured interview. A value of 0 is assigned if the item does not apply, 1 if it applies somewhat, and 2 if it fully applies. In addition to lifestyle and criminal behavior the checklist assesses glib and superficial charm, grandiosity, need for stimulation, pathological lying, cunning and manipulating, lack of remorse, callousness, poor behavioral controls, impulsivity, irresponsibility, failure to accept responsibility for one's own actions and so forth. The scores are used to predict risk for criminal re-offence and probability of rehabilitation.

The current edition of the PCL-R officially lists four factors (1.a, 1.b, 2.a, and 2.b), which summarize the 20 assessed areas via factor analysis. The previous edition of the PCL-R[3] listed two factors. Factor 1 is labelled "selfish, callous and remorseless use of others". Factor 2 is labelled as "chronically unstable, antisocial and socially deviant lifestyle". There is a high risk of recidivism and currently small likelihood of rehabilitation for those who are labelled as having "psychopathy" on the basis of the PCL-R ratings in the manual for the test, although treatment research is ongoing.

PCL-R Factors 1a and 1b are correlated with narcissistic personality disorder and histrionic personality disorder. It is associated with extroversion and positive affect. Factor 1, the so-called core personality traits of psychopathy, may even be beneficial for the psychopath (in terms of nondeviant social functioning).

PCL-R Factor 2a and 2b are particularly strongly correlated to antisocial personality disorder and criminality and is associated with reactive anger, criminality, and impulsive violence. The target group for the PCL-R is convicted criminals. The quality of ratings may depend on how much background information is available and whether the person rated is honest and forthright.

Hare's Checklist and other mental disorders

Psychopathy, as measured on the PCL-R, is negatively correlated with all DSM-IV Axis I disorders except substance abuse disorders. Psychopathy is most strongly correlated with DSM-IV antisocial personality disorder.

Factor 1: "Aggressive narcissism"

Glibness/superficial charm

Grandiose sense of self-worth

Pathological lying

Cunning/manipulative

Lack of remorse or guilt

Shallow affect

Callous/lack of empathy

Failure to accept responsibility for own actions

Promiscuous sexual behavior

Factor 2: "Socially deviant lifestyle"

Need for stimulation/proneness to boredom

Parasitic lifestyle

Poor behavioral control

Lack of realistic, long-term goals

Impulsivity

Irresponsibility

Juvenile delinquency

Early behavior problems

Revocation of conditional release

Traits not correlated with either factor

Many short-term marital relationships

Criminal versatility

The official stance of the American Psychiatric Association as presented in the DSM-IV-TR is that psychopathy and sociopathy are obsolete synonyms for antisocial personality disorder. The World Health Organization takes a similar stance in its ICD-10 by referring to psychopathy, sociopathy, antisocial personality, asocial personality, and amoral personality as synonyms for dissocial personality disorder.

Among laypersons and professionals, there is much confusion about the meanings and differences between psychopathy, sociopathy, antisocial personality disorder, and the ICD-10 diagnosis, dissocial personality disorder. Hare takes the stance that psychopathy as a syndrome should be considered distinct from the DSM-IV's antisocial personality disorder construct, even though ASPD and psychopathy were intended to be equivalent in the DSM-IV. However, those who created the DSM-IV felt that there was too much room for subjectivity on the part of clinicians when identifying things like remorse and guilt; therefore, the DSM-IV panel decided to stick to observable behaviour, namely socially deviant behaviours. As a result, the diagnosis of ASPD is something that the "majority of criminals easily meet." Hare goes further to say that the percentage of incarcerated criminals that meet the requirements of ASPD is somewhere between 80 to 85 percent, whereas only about 20% of these criminals would qualify for a diagnosis of what Hare's scale considers to be a psychopath. This twenty percent, according to Hare, accounts for 50 percent of all the most serious crimes committed, including half of all serial and repeat rapists. According to FBI reports, 44 percent of all police officer murders in 1992 were committed by psychopaths.

Another study using the PCL-R to examine the relationship between antisocial behaviour and suicide found that suicide history was strongly correlated to PCL-R Factor 2 (reflecting antisocial deviance) and was not correlated to PCL-R factor 1 (reflecting affective functioning). Given that ASPD relates to Factor 2, whereas psychopathy relates to both factors, this would confirm Hervey Cleckley's assertion that psychopaths are relatively immune to suicide. People with ASPD, on the other hand, have a relatively high suicide rate.

Since psychopaths frequently cause harm through their actions, it is assumed that they are not emotionally attached to the people they harm; however, according to the PCL-R Checklist, psychopaths are also careless in the way they treat themselves. They frequently fail to alter their behavior in a way that would prevent them from enduring future discomfort.

PCL-R Model Of Psychopathy

The Hare Psychopathy Checklist-Revised (PCL-R) is a diagnostic tool used to rate a person's psychopathic or antisocial tendencies. People who are psychopathic prey ruthlessly on others using charm, deceit, violence or other methods that allow them to get with they want. The symptoms of psychopathy include: lack of a conscience or sense of guilt, lack of empathy, egocentricity, pathological lying, repeated violations of social norms, disregard for the law, shallow emotions, and a history of victimizing others.

Originally designed to assess people accused or convicted of crimes, the PCL-R consists of a 20-item symptom rating scale that allows qualified examiners to compare a subject's degree of psychopathy with that of a prototypical psychopath. It is accepted by many in the field as the best method for determining the presence and extent of psychopathy in a person.

The Hare checklist is still used to diagnose members of the original population for which it was developed— adult males in prisons, criminal psychiatric hospitals, and awaiting psychiatric evaluations or trial in other correctional and detention facilities. Recent experience suggests that the PCL-R may also be used effectively to diagnose sex offenders as well as female and adolescent offenders.

Purpose

The PCL-R is used for diagnosing psychopathy in individuals for clinical, legal or research purposes. Developed in the early 1990s, the test was originally designed to identify the degree of a person's psychopathic tendencies. Because psychopaths, however, are often repeat offenders who commit sexual assaults or other violent crimes again and again, the PCL-R is now finding use in the courtroom and in institutions as an indicator of the potential risk posed by subjects or prisoners. The results of the examination have been used in forensic settings as a factor in deciding the length and type of prison sentences and the treatment subjects should or should not receive.

More to come when time permits: // Bonnie