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The problem with Robert Hare's psychopathy checklist: Incorrect conclusions, high risk of misuse, and lack of reliability

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Abstract

In this article the reliability and usefulness of Hare's Psychopathy Checklist Revised (PCL-R) and the conclusions on basis of the scores are examined. It was concluded that, a) this checklist is a not a reliable tool, b) the conclusions that are linked to these PCL-R scores with regard to the treatability of psychopaths are incorrect, harmful and unethical, c) can easily be misused in legal systems and forensic psychiatric settings to dispose of problematic psychopaths, and d) the diagnostic category psychopathy should be rejected firmly because some items are subjective, vague, judgmental and practically unmeasurable, and the term psychopathy itself seems to be judgmental. Suggestions are made in order to prevent misuse of such assessment and prediction tools.
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... For example, a group of 13 forensic psychologists and psychiatrists recently published a "Statement of Concerned Experts" (De-Matteo et al., 2020), suggesting the PCL-R should not be used in specific risk assessments relevant to capital sentencing cases. These misgivings underscore the importance of reevaluating the empirical foundations of PCL psychopathy (see also , Edens, Petrila, & Kelley, 2018;Kelley, Edens, Mowle, Penson, & Rulseh, 2019;Martens, 2008;Polaschek & Skeem, 2018;Skeem & Cooke, 2010). ...
... Traditionally, there are (at least) three fundamental justifications for using the PCL scales in forensic settings, namely, that the PCL scales are predictive of (1) criminal behavior, (2) clinical treatability, and (3) a lack of conscience (e.g., Hare, 1996;Hare, 2016a;Hare & Neumann, 2009b;Hare, Black, & Walsh, 2013). Although there may be other fundamental justifications, these three claims are paramount: they are discussed in detail in the PCL manuals (Forth et al., 2003;Hare, 2003;Hare et al., 1995), they are continuously emphasized in research by the PCL scale developers (e.g., Hare, 1998aHare, , 1998bHare, , 1998cHare, , 2001Hare, , 2003Hare, , 2006Hare, , 2007Hare & Neumann, 2006, 2008, 2009aHare et al., 2012;Hare et al., 2018), and they are broadly recognized by forensic practitioners. ...
Article
The Hare Psychopathy Checklist (PCL; Hare, Neumann, & Mokros 2018) scales are among the most widely used forensic assessment tools. Their perceived utility rests partly on their ability to assess stable personality traits indicative of a lack of conscience, which then facilitates behavioral predictions useful in forensic decisions. In this systematic review, we evaluate the empirical evidence behind 3 fundamental justifications for using the PCL scales in forensics, namely, that they are empirically predictive of (1) criminal behavior, (2) treatment outcomes, and (3) a lack of conscience. We found the PCL scales can predict criminal behavior to a statistically significant degree, though with important limitations. We found no evidence of PCL psychopathy being predictive of treatment and rehabilitation outcomes. We found no evidence of PCL psychopathy being predictive of a lack of conscience. These findings disprove widespread beliefs about PCL psychopathy among forensic practitioners and questions the current and future role of the PCL scales in forensic settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved) (Source: journal abstract)
... Drugim punktem odniesienia w aktualnych badaniach nad osobowością psychopatyczną jest powstała pod koniec XX wieku dwuczynnikowa teoria psychopatii Roberta D. Hare'a. Pomimo licznych głosów krytycznych (Martens, 2008;Skeem i Cooke, 2010; propozycja ta wciąż jest najbardziej popularną koncepcją psychopatii, a powstałe na jej bazie narzędzie pomiarowe -skala PCL-R (Psychopathy Checklist-Revised; Hare, 2003) należy uznać za najczęściej stosowane w diagnozie dla potrzeb wymiaru sprawiedliwości. Podobnie jak w przypadku koncepcji Cleckleya, teoria dwuczynnikowa została oparta na podejściu operacyjnym, które zakłada, że dany konstrukt kliniczny można ująć za pomocą empirycznie weryfikowalnych wskaźników, będących jednocześnie jego kryteriami diagnostycznymi (por. ...
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Problematyka wczesnych symptomów psychopatii stanowi ważny obszar współczesnych poszukiwań badawczych dotyczących tego zaburzenia osobowości. Badania nad cechami psychopatycznymi występującymi u dzieci i młodzieży umożliwiają zarówno założenia psychopatologii rozwojowej, trójczynnikowe modele psychopatii, jak i opracowanie adekwatnych dla tych grup wiekowych narzędzi pomiarowych. Jednocześnie wielu klinicystów i badaczy podkreśla, że używanie pojęcia „psychopatia” w odniesieniu nie tylko do osób dorosłych niesie ze sobą pewne kontrowersje, wątpliwości i ograniczenia. Niezależnie od dylematów związanych z diagnozą wczesnej psychopatii, sam konstrukt uznawany jest za użyteczny w kontekście wyjaśniania skłonności do stosowania przemocy oraz podejmowania zachowań agresywnych przez adolescentów. Celem niniejszej pracy jest przeanalizowanie relacji zachodzącej pomiędzy nasileniem cech psychopatycznych a różnymi formami agresji u nieletnich, z uwzględnieniem roli, jaką w tej relacji mogą odgrywać poziom samooceny oraz impulsywność. W projekcie wykorzystano triarchiczną koncepcję psychopatii, zgodnie z którą strukturę zaburzenia ujmuje się jako konfigurację zuchwałości, bezduszności i rozhamowania. Zastosowany model wpisuje się w dominującą perspektywę badań nad osobowością psychopatyczną w ujęciu rozwojowym, wyróżniającą trzy podstawowe rodzaje symptomów uznawanych za prekursory zaburzenia w okresie dzieciństwa i adolescencji. Koncepcja triarchiczna pozwoliła na badanie związków psychopatii z pozostałymi zmiennymi w sposób złożony i wielowymiarowy. Badaniami objęto sześćdziesięcioosobową grupę nieletnich chłopców z młodzieżowych ośrodków wychowawczych. Pomiaru dokonano przy użyciu metod typu self-report: Triarchicznej Miary Psychopatii TriPM (w wersji TriPM-41), Kwestionariusza Agresywności Młodzieży ‒Reaktywność Emocjonalna KAM‒RE 2, Wielowymiarowego Kwestionariusza Samooceny MSEI oraz Kwestionariusza Impulsywności IVE. Uzyskane wyniki potwierdzają pogląd o istnieniu związków między symptomami psychopatii a zróżnicowaniem przejawów agresji wśród młodzieży naruszającej normy prawne. Wykazano również, że poziom samooceny badanych zależy od nasilenia dwóch z trzech komponentów psychopatii – zuchwałości i rozhamowania. Zuchwałość okazała się predyktorem dla wysokiej samooceny, podczas gdy rozhamowanie związane było z obniżonymi wskaźnikami w tym zakresie. Podjęte badania dostarczyły danych przemawiających za zasadnością traktowania psychopatii jako ważnego, osobowościowego korelatu agresji (i pośrednio: czynnika ryzyka przemocy), a także dowodów na heterogeniczność samego wzorca cech psychopatycznych u nastolatków.
... Despite the limitations of this instrument [44], because of its ease of application and the possibilities for researchers to access the population under study, the Psychopathy Check-List (PCL-R) has been used [3], specifically, the revised Spanish version [45,46]. The PCL-R is a rating scale consisting of a semi-structured interview administered by experts. ...
Article
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Psychopathy and intimate partner aggression (IPA) are two concepts that usually appear concomitantly. Male violence toward women is often considered a psychopathic trait that sometimes involves the woman’s homicide by her partner and, at other times, attempted homicide. This phenomenon has been studied by conducting interviews following Hare’s model with 92 men incarcerated under a compliance regime in a Spanish prison (Córdoba). The results detected six explanatory factors of IPA as a result of attempted homicide or homicide: criminal past and delinquency, impulsivity, the need to stand out from others, lack of empathy, manipulation of others, and instability in partner relationships. The first two factors predict a occurrence of high scores on Hare’s Psychopathy Checklist. The results are discussed, and future lines of research are presented, especially focused on the concept of dehumanization and revenge.
... Before I proceed, it is worth noting that psychopathy as a construct is not uncontroversial. It has been argued that many of the diagnostic criteria are vague, qualitative, and laden with moral value judgments, which can result in biases and poor reliability in their applications (Martens, 2008). Indeed, many of the items on the diagnostic checklist appear to be behavioral features that we consider to be immoral. ...
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Is psychopathy born or made? Contemporary psychopathy research shows that there is much wrong with this question. It is increasingly accepted that the development of psychopathy is dependent on multiple causal factors interacting with one another. However, there remains the major theoretical challenge of understanding the relations between these multiple causal factors in the developmental process. In this paper, I argue that the conventional picture of gene-environment interactionism does not offer an adequate account of psychopathy development. Instead, I propose that a theoretical framework from the philosophy of biology, namely developmental systems theory, can facilitate a better understanding of psychopathy development that captures the contingent and dynamic relations between multiple causal factors. Some practical implications of a developmental systems theory approach to psychopathy are also explored.
... El estudio de la psicopatía en el contexto forense contribuye a ampliar los conocimientos de este constructo para los peritos en psicología y para los que imparten justicia, a fin de evitar repercusiones jurídicas importantes, tales como un etiquetamiento poco ético y sanciones jurídicas severas (Martens, 2008). En el contexto penitenciario puede coadyuvar a la detección y ubicación de las personas con psicopatía dentro de los reclusorios, así como para el diseño de un plan de actividades más adecuado a sus necesidades criminogénicas. ...
... Second, the tool is highly sensitive to and dependent on the administrator, the type of interview, and scorings. Therefore, some researchers have criticized the validity of this tool (Dahle, 2006;Martens, 2008). ...
Article
Antisocial traits have severe outcomes for the perpetrator, victim, and society. Developing an assessment tool for antisocial traits that is theoretically grounded, has strong psychometric properties, and can be administered in the general population is very important for the identification and treatment of the problems associated with antisocial traits. The initial item pool was generated as the result of an extensive literature review based on criteria of Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5). Items were examined through exploratory factor analysis in a sample of 2,051 residents of Tehran. The structural validity was tested on a separate 2,049 people. The final version explains 58.4% of the total variation of the construct and included 20 questions loaded on six factors. The resultant Antisocial Traits Scale (ASTS-20) has the potential to be a useful measure for early detection of at-risk people who should be targeted by preventive interventions aimed at reducing the likelihood of criminality or recidivism.
... Alternatively, it may be that the traits presumed to underlie the psychopathy construct should in fact be attributed to several distinct constructs that are correlated in some samples but not in others. These, and related concerns may explain why there is limited evidence of psychopathy's ability to predict offending and recidivism risk in forensic samples, despite its purported overrepresentation in these samples (Gendreau, Goggin, & Smith, 2002;Martens, 2008). ...
Thesis
In recent forensic practice, psychopathy has been used extensively to predict dangerousness and violent recidivism risk, informing sentencing decisions (i.e. capital punishment). In one recent survey, a third of evaluators reported using Hare’s Psychopathy Checklist in every forensic evaluation they completed. Based on research with offender samples, developers of the construct posit that psychopathic individuals are rare in the population, immune to intervention, and chronically prone to violence. Yet these assertions have only limited support in studies utilizing community samples. All the while, an increased prevalence of childhood maltreatment in offender samples has been documented. Despite similarities in behavioral manifestations of psychopathy and maltreatment, the divergent validity of these constructs has not been evaluated. Similarly, the roles of psychopathy and adversity have not been explored in legal decision-making research, despite the reported over-representation of individuals with these traits among offenders. In this dissertation, a community sample of young men completed a two-part protocol, meant to (a) evaluate the adversity-psychopathy hypothesis, (b) explore the influence of individual differences on legal decision-making using a novel, Choose-Your-Own-Adventure (CYOA) paradigm, and (c) evaluate the effectiveness of the paradigm as a research and intervention tool. The sample attained remarkably-high Self-Reported Psychopathy (4th Ed; SRP-4) scores yet failed to achieve the factor structure devised by its authors. Adverse Childhood Experiences (ACEs) predicted a small, but significant portion of the variability in psychopathy scores. In the CYOA, psychopathy scores did not significantly predict any participant decision. Notably, Dark Triad traits were predictive of participant’ self-assigned guilt status. The influence of prior decisions made, and particularly, of the self-assigned guilt status, was noted across several decisions. In a subsequent evaluation, participants perceived the paradigm as realistic, reported high rates of emotional engagement, and demonstrated learning in response to decisions and their outcomes, suggesting that the paradigm has utility in advancing further research on legal decision-making.
... recommended a typical cut-off score of 22 to 24±6-8 for criminal populations. However, in that range there may be many false positive results, and both psychopaths and non-psychopaths may be included 9,21 . In Canada, the cut-off level was reported as 25, instead of 30, for the categorical file-only psychopathy diagnosis. ...
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Objectives: Psychopathy is a distinct personality organization and differs from antisocial personality disorders in many aspects. Its diagnosis is challenging but also critical to predict criminality. In this context, Psychopathy Checklist Revised (PCL-R) is a useful tool in the diagnosis of psychopathy. Its reliability and validity was shown in various populations but has not been studied in a Turkish population. Our aim was to demonstrate the reliability and validity of PCL-R in Turkish. Methods: 425 male subjects with antisocial personality disorder and 125 controls without any psychiatric diagnosis were included in the study. DSM-5 diagnostic criteria were used and PCL-R was administered to all participants. The reliability of the Turkish version of PCL-R was determined by test–retest and internal consistency methods. In the ROC analysis performed with PCL-R, DSM-5 criteria were taken as a gold standard, the sensitivity; specificity and cut-off values of PCL-R were estimated. To evaluate the adequacy of the scale construct validity, Exploratory Factor Analysis and Kaiser-Meyer-Olkin (KMO) and Barlett tests were applied. Reproducibility of the test was evaluated by Pearson correlation coefficient. Re-test was performed with 171 subjects two weeks after the first test. Results: In reliability analysis, the Cronbach’s alpha internal consistency coefficient was calculated to be α=0.977. Pearson correlation coefficient of test-retest was r=0.94 (p<.001). Item-total correlations ranged from 0.18 to 0.94. Its sensitivity and specificity was 98.3% and 100.0%, respectively, with a cut-off point of 20. In principal component analysis, two factors had Eigen values greater than 1. These two factors accounted for 76.54% of the variance in PCL-R scores. Conclusions: PCL-R (Turkish) is a valid and reliable measure of psychopathy to detect psychopathic traits. However, more studies on psychopathy need to be conducted in different Turkish sample groups.
Chapter
It is elementary logic, that a precondition for a sentence to be a scientific proposition is that it have a truth value (the latter, potentially determinable with reference to empirical evidence); and a precondition that it have a truth value, is that it have a sense. It is argued, herein, that, in consequence of ambiguity attendant to the grounds of ascription of the focal term, psychopathy (and cognates), linguistic expressions relating to the issues of the existence- and causes- of psychopathy, are absent a sense; in consequence, are not adjudicable in terms of empirical evidence. Preliminary conceptual elucidations, preconditional for a dissolution of the ambiguity, and, hence, the entry of the issues into a fruitful, cumulative, line of empirical investigation, are undertaken.
Chapter
s Psychopathy is an important construct for research and applied usage in forensic context. Rigorous assessment with suitable instruments is imperative for the evolution of research on etiology, risk assessment, prevention, and intervention. Since the construction of the Hare Psychopathic Scale and consequently revised versions, that are consider a reference, there has been an exponential growth in the study of psychopathy and its evaluation instruments. This chapter focus in the psychometric qualities of several instruments that assess the psychopathy and antisocial behavior.
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00:00.0 Dr. Martens is director of the W. Kahn Institute of Theoretical Psychiatry and Neuroscience and advisor of the Forensic Psychiatry Hospital in Assen, The Netherlands. Psychopathy is characterized by diagnostic features such as superficial charm, high intelligence, poor judgment and failure to learn from experience, pathological egocentricity and incapacity for love, lack of remorse or shame, impulsivity, grandiose sense of self-worth, manipulative behavior, poor self-control, pathological lying, promiscuous sexual behavior, juvenile delinquency, and criminal versatility among others (Cleckley, 1982; Hare et al., 1990). As a consequence of these criteria the psychopath has the image of a cold, heartless, inhuman being. But do all psychopaths show a complete lack of normal emotional capacities and empathy? Like healthy people, many psychopaths love their parents, spouse, children and pets in their own way, but have difficulty loving and trusting the rest of the world. Furthermore, psychopaths do suffer emotionally as a consequence of separation, divorce, death of a beloved person or dissatisfaction with their own deviant behavior (Martens, 1997). Sources of Sadness Psychopaths can suffer emotional pain for a variety of reasons. Like anyone else, psychopaths have a deep wish to be loved and cared for. This desire remains frequently unfulfilled, however, as it is obviously not easy for another person to get close to someone with such repellent personality characteristics. Psychopaths are at least periodically aware of the effects of their behavior on others and can be genuinely saddened by their inability to control it. The lives of most psychopaths are devoid of a stable social network or warm, close bonds. The life histories of psychopaths are often characterized by a chaotic family life, lack of parental attention and guidance, parental substance abuse and antisocial behavior, poor relationships, divorce, and adverse neighborhoods (Martens, 2000). They may feel that they are prisoners of their own etiological determination and believe that they had, in comparison with normal people, fewer opportunities or advantages in life.
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In this study, the relative fits of three different factor-structure models of adolescent reckless behavior were examined using the Reckless Behavior Questionnaire (RBQ) with individual samples of college and high school students. Both one- and two-factor models were found to be satisfactory representations of the RBQ with both samples. In order to test the construct validity of the one- and two-factor models, relations between instruments generally associated with reckless behavior were examined by gender. Using the two-factor model, gender differences were found for both the college and high school samples; thus, it was determined to be the more parsimonious fit of the data given previous research supporting gender differences. Findings are discussed in terms of current conceptualizations of factor patterns of adolescent problem behavior and implications for future investigations.
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Although psychopaths demonstrate emotional abnormalities such as shallow affect, lack of empathy, incapacity for love, lack of guilt or remorse, lack of fear, and emotional processing and response deficiencies they may show normal emotional responses or emotional hypersensitive in other areas. The correlates of emotional incapacities, emotional hypersensitivity, and normal emotional activities in psychopaths are studied and discussed in this paper. Emotional hypersensitivity might be linked with: a history of neglect, rejection and abuse; insult; changes which are forced or not under control of the psychopath; obstacles that prevent the psychopath to do what he or she wants to do; narcissistic injury; broken friendships or relationship. Normal emotional functioning might be associate with grief, warm relationship, adequate attention, disease, academic and/or occupational success, impressive events, confrontations, contemplation and maturation, hidden suffering (also as a result of neurobiological determination).
Psychopaths in remission could be valuable in the treatment of fellow psychopaths. Suggestions are made for adequate selection of candidates and required conditions. A case report is presented in order to illustrate and support the thesis. Research is needed into the possibilities and determinants of therapeutic involvement of remitted psychopaths in the treatment of other forensic psychiatric patients.
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Psychopathy has gained increasing importance in the field of risk assessment in the last decade, in large part because of the established association between this construct and future violence and criminality. Situations in which the prediction of "future dangerousness" is at issue appear to be logical areas in which the assessment of psychopathic traits would be relevant to decision-making. One recent application of psychopathy has been its inclusion in death penalty cases, wherein Psychopathy Checklist-Revised (PCL-R) scores have been introduced to support the position that a defendant will represent a "continuing threat" to society - even if serving a life sentence in prison. Despite such claims, a review of the relevant research indicates that the empirical basis for these conclusions is minimal at present. This article summarizes what is known about the relationship between psychopathy and violence, and reviews the legal and professional implications of this research in relation to the use of the PCL-R in the penalty phase of capital cases.
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The Hare Psychopathy Checklist-Revised is a reliable and valid measure of a clinical construct, psychopathy. Its validation includes, but is not limited to, its role in risk assessment. Nevertheless, some commentators have questioned the validity of the Psychopathy Checklist-Revised because it does not consistently outperform purpose-built risk instruments. We contend that this view is misdirected and reflects a very narrow view of construct validation. The framework for our discussions is the conceptually and methodologically flawed "lesson in knowledge cumulation" recently proffered by Gendreau, Goggin, and Smith in which they arrived at the unwarranted conclusion that the Level of Service Inventory-Revised is generally superior to the Psychopathy Checklist-Revised for predicting recidivism and violence. We argue that both instruments are useful, but for different reasons. The Level of Service Inventory-Revised is a specialized risk tool, whereas the Psychopathy Checklist-Revised and its derivatives measure one of the most explanatory and generalizable risk factors identified to date.
Article
The Psychopathy Checklist-Revised (PCL-R; Hare, 1991) was originally developed as a research tool for assessing psychopathy among incarcerated offenders. The past decade has witnessed a growing interest in the use of the PCL-R in applied settings. In response, authors have offered guidelines for the instrument's adaptation to clinical and forensic assessment (Bodholdt, Richards, & Gacono, 2000; Gacono & Hutton, 1994; Gacono, 1998; Gacono, 2000a; Hare, 1998). In this article, we outline key issues that impact the forensic use of the PCL-R. First, we analyze the admissibility of PCL-R testimony by available legal and professional standards. While the PCL-R weathers tests and standards for admissibility, errors in its application may compromise the admissibility or utility of PCL-R findings. In a second section, these considerations are discussed in offering standards for professional practice.