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Manual for the Hare Psychopathy Checklist-Revised (PCL-R)
... Le TPP n'a jamais été désigné comme suffisant pour être utilisé comme une échelle de risque de récidive violente [19,39] . Pour autant, les scores de la PCL-R sont utilisés dans certaines échelles de risque. ...
... Les seules études existantes sont anciennes et portent sur des effectifs réduits [28,48] . Par conséquent, notre étude vise la mise à jour des taux de prévalence de la psychopathie sur une large cohorte de patients médicolégaux en fonction des différents seuils recommandés au sein de la littérature internationale [39,68,69] . De surcroît, elle permet l'évaluation du risque de comportements violents incluant les facettes de la PCL-R et les échelles de risque actualisées (HCR-20 et VRAG). ...
... Psychopathy checklist-revised (PCL-R) [39,77] La PCL-R est structurée autour de deux facteurs principaux et de quatre facettes. Le facteur 1 englobe les éléments affectifs, interpersonnels et narcissiques et se subdivise en une facette 1 « interpersonnelle » et une facette 2 « affective ». ...
Le trouble de la personnalité psychopathique est souvent associé aux comportements violents. Il est autant associé à la violence réactive qu'instrumentale. Cependant, les évaluations récentes du risque de comportements violents tendent à intégrer les caractéristiques antisociales plutôt que le score total de l'échelle de psychopathie de Hare (PCL-R). Les objectifs de cet article sont multiples. Outre la mise à jour de la littérature sur l'évaluation de la psychopathie et son lien avec l'évaluation des comportements violents, nous décrirons une recherche spécifique. Nous avons actualisé les taux de prévalence de la psychopathie au sein d'une patientèle médicolégale. Ensuite, nous avons analysé les corrélations entre l'échelle de psychopathie de Hare et les scores des échelles d'évaluation du risque de comportements violents statiques et dynamiques au sein de cette population. Les participants sont 384 patients médicolégaux masculins séjournant au sein de l'hôpital psychiatrique sécurisé « Les Marronniers ». Les résultats indiquent des taux de prévalence inférieurs à ceux recensés au sein de la littérature internationale. Les corrélations significatives les plus fortes se situent entre le facteur déviance sociale, la facette antisociale et les facteurs statiques des échelles d'évaluation du risque de comportements violents. En conclusion, psychopathie et comportements violents sont associés. Toutefois, ces liens sont surtout présents entre les comportements antisociaux et les facteurs statiques des évaluations du risque. Ces résultats sont cohérents avec la littérature internationale.
... Concerning the PCL-R factors, various confirmatory factor analytic models have been discussed, including a hierarchical three-factor model (e.g., Hare, 2003;) and a correlated four-factor model (e.g., Hare & Neumann, 2005). Alternatively, in a hierarchical manner, F1 and F2 can be deemed as second-order factors (comprising two first-order factors, Interpersonal and Affective or Lifestyle and Antisocial, respectively). ...
... The version used to score psychopathy most commonly reported was the PCL-R (k = 186; 86%), whereas the PCL:SV (k = 32; 15%) was less frequently reported. After converting the mean PCL:SV total scores to PCL-R equivalents (multiplication with the ratio of the maximal scores of the PCL-R/ PCL:SV = 40/24; Hare et al., 2013), the mean PCL total score across all samples was 18.98 (SD 4.55), which was distributed across the five point ranges as follows (Hare, 2003): very low (k = 2; 0.9%), low (k = 38; 18%), moderate (k = 106; 49%), high (k = 22; 10%), and very high (k = 1; 0.5%). The remaining studies did not report PCL scores (k = 56; 26%). ...
... The differential validity of the PCL-R total and factor sub-totals attests to the usefulness of treating the factor sub-totals separately for practical purposes in risk assessment. Moreover, the gradation of magnitude as described for the PCL-R total score (Hare, 2003) could easily be transferred to the factor sub-totals as well. ...
... The Psychopathy Checklist-Revised (Hare, 2003) was used to determine the presence or absence of psychopathy. This measure contains 20 items and is administered via a file review prior to the semi-structured interview (CFIS; Gacono, 2005). ...
... Although there are characteristics male and female psychopaths have in common (borderline or psychotic level of personality organization, similar cognitive style; Cunliffe et al., 2021b;Gacono, 2021;Smith et al., 2021), female psychopaths may be distinguished from their male counterparts by their negative self-image, dysphoric emotions, and heightened needs for approval and attention (as demonstrated by history, presentation, and Rorschach variables such as Lambda, SumC', SumY, SumT, SumV, SumC, INT, MOR, ROD). The aggressive, violent (in many cases physically imposing), narcissistic, grandiose, shallow, and detached presentation of male psychopath contrasts with the frequently affectively laden presentation of the female psychopath (Cunliffe et al., 2021b;Gacono, 2016;Hare, 2003). The male's grandiosity and shallow affect circumvents any threats to their self-worth including experiences that would evoke feelings of vulnerability (such as trauma). ...
... or theShipley-2 (Shipley et al., 2009), Psychopathy Checklist-Revised (PCL-R;Hare, 2003) and Comprehensive System Rorschach (CS;Exner, 2003; CS-R;Exner et al., 2022) were administered in accordance with test manual procedures. All measures were completed by doctoral-level Psychologists (Ph.D. or Psy.D.) with extensive training in the scoring, administration, and interpretation of these measures. ...
Trauma histories are ubiquitous within offender populations. Prevalence rates for trauma related diagnoses range from 12-54% for females and 4-21% for males (Adams et al., 2017). Much of the psychopathy/trauma literature from the past 20 years addresses methodological issues that obfuscate their findings (Cunliffe et al., 2021b). In this study, the relationship between trauma and psychopathy is explored by comparing the Rorschach Trauma Content Index between female psychopaths (n = 115) and male psychopaths (n = 44). Rather than being linear this relationship appears to be comorbid. Trauma-related disorders do not negate the presence of psychopathy. Offenders, both psychopathic and non-psychopathic, can exhibit histories of trauma. Total TCI scores do not differentiate among these offenders related to their histories of trauma. Our findings are used to explore what the TCI may be measuring in this offender population.
... For instance, facet 4 (antisocial behavior) directly corresponds to historical and behavioral indicators of violence. While facet 3 (lifestyle traits) predicts impulsivity and thrill-seeking behavior, which can precipitate violent offenses, the interpersonal and affective traits captured in facets 1 and 2 may exacerbate the severity or premeditated nature of violent acts (Hare, 2003;Douglas et al., 2013;Vitacco et al., 2014;Walters & Heilbrun, 2010). These distinctions emphasize the multifaceted nature of psychopathy in understanding violence. ...
... Another line of research focuses specifically on ASPD or psychopathy. It is well known that antisociality is a strong predictor of institutional misconduct yet Walters and Heilbrun (2010) found that only facet 4 (i.e., antisocial behavior) of the Psychopathy Checklist-Revised (PCL-R; Hare, 2003) predicted prison misconduct. Further research highlights that psychopathy is not a monolithic predictor of institutional misconduct. ...
... Psychopathy. We used the Psychopathy Checklist-Revised (PCL-R; Hare, 2003) to assess psychopathy. The PCL-R is based on a semi-structured interview and file review and consists of 20 items that are rated on a three-point scale (0 = item does not apply, 1 = item applies to a certain degree, 2 = item definitively applies). ...
According to the Risk-Need-Responsivity model, criminogenic needs are important in predicting violent behavior. Eight criminogenic needs are considered strong predictors: history of antisocial behavior, antisocial personality traits, criminal attitudes, criminal associates, substance abuse, family problems, poor work performance, and lack of involvement in prosocial leisure/recreation activities. The purpose of the current study was to examine whether seven criminogenic needs predict institutional misconduct in the first year of admission of Dutch patients who were admitted to a forensic hospital. Hospital records of 234 male patients were used to retrieve criminogenic needs assessed with the HCR-20 V3 , with exception of criminal associates which was coded based on file review. The frequency of institutional misconduct was rated for verbal aggression, physical aggression, and sexual aggression. Exploratory analyses examined whether there was a (predictive) relation between psychopathy facets (PCL-R factors) and HCR-20 V3 clinical and risk management scales, and institutional misconduct. This study finds that criminogenic needs did not predict physical and sexual institutional misconduct, but a history of antisocial behavior and criminal attitudes were negative predictors for verbal aggression. Psychopathy facets and HCR-20 V3 scales did not predict institutional misconduct.
... Antisocial personality disorder (ASPD) is characterized by impulsivity, irresponsibility and aggression [1]. Approximately one third of individuals with ASPD additionally meet categorical criteria for psychopathy (ASPD+P) [2], characterized by callous unemotional behaviours and a lack of remorse [3]. While individuals with and without (ASPD-P) psychopathy share features such as life-course persistent offending, heightened reactive aggression, and cognitive impairments [4][5][6], there are also differences between the groups: those with ASPD+P demonstrate an earlier onset and greater density of offending behaviours, increased use of proactive aggression, and a poorer response to interventions developed for offending populations [7-10]. ...
... We recruited healthy non-offenders from the general population through public and online advertising. All participants completed diagnostic interviews (Structured Clinical Interview for the DSM-5-Clinical and Personality Disorders (SCID-5-CV/SCID-5-PD) [1,46] and Psychopathy Checklist-Revised (PCL-R) [3]) and authorized access to their criminal records. In line with previous research in UK samples [11,13,36,44,47], we used a score of 25 as the threshold for psychopathy in this English population. ...
Behavioural, structural and functional neuroimaging differences have been demonstrated between individuals with antisocial personality disorder with (ASPD+P) or without psychopathy (ASPD-P). However, the underlying mechanisms for such differences are poorly understood, hampering progress in the development of drug treatments for this population. Intranasal oxytocin (OT) has garnered significant attention due to its prosocial effects in healthy individuals. We sought to establish the impact of OT on resting-state brain function in individuals with ASPD, and to explore whether modulation differs between individuals with and without psychopathy. We used arterial spin labelling (ASL) to measure regional cerebral blood flow (rCBF) to investigate brain function at rest and modulation of key disease-targets by a single acute dose of OT (40 IU). We used a double-blind, placebo-controlled, crossover design in males with a history of violent offending with ASPD+P (N = 17) or ASPD-P (N = 14) and a group of healthy male non-offenders (N = 22). Both ASPD subtypes showed reduced rCBF in frontotemporal regions compared to non-offenders. However, those with ASPD+P demonstrated significantly greater rCBF increases in posterior default mode network regions compared to those with ASPD-P. OT administration selectively reduced rCBF in the left basal ganglia of the ASPD-P group, an effect not observed in the ASPD+P or non-offender groups. Our results provide further evidence of functional brain differences between ASPD+P and ASPD-P groups, and a differential modulating effect of oxytocin. The neurobiological distinctions between ASPD+P and ASPD-P groups are important considerations for future therapeutic developments.
... Modern, empirically driven conceptualizations of the DT constructs recognize that these constructs are (a) multidimensional, (b) overlap because of their antagonistic "cores, " and (c) differ because of their unique underlying traits. For instance, most models and measures of psychopathy describe three to six main components, with consensual factors related to interpersonal antagonism/meanness and disinhibition (e.g., Cooke et al. 2012;Hare, 2003;Lynam & Miller, 2015;Patrick et al., 2009). Likewise, modern models of narcissism have settled on three-factor structures reflecting antagonism/entitlement, agentic extraversion/grandiosity, and narcissistic neuroticism/vulnerability (see Miller et al., 2021, for a review). ...
... Importantly, the total-score approach is largely inconsistent with their conceptualization and measurement in their larger, stand-alone literatures. For instance, most models and measures of psychopathy articulate two to six core factors (e.g., Cooke et al., 2012;Hare, 2003;Lynam & Miller, 2015;Patrick et al., 2009). Similarly, the most recent models of narcissism explicate three core factors (see Miller et al., 2021 for a review). ...
... Checklist-Revised (PCL-R; Hare, 2003), which is a psychopathy measure often used in risk assessment (Boccaccini et al., 2017;DeMatteo et al., 2014). In some jurisdictions, results from broadband self-report instruments are available to evaluators. ...
... As of the writing of this article, global personality impairment, facet, and domain scores are widely available for clinicians to use as part of the PAI Software Portfolio and online scoring via PARiConnect (Morey, 2020). These scores offer forensic practitioners an additional, self-report approach to assessing personality characteristics reflecting ASPD and psychopathic personality disorder (psychopathy) that can complement the original PAI Antisocial Features scale and subscales as well as the commonly used semistructured interview and file review PCL-R instrument (DeMatteo et al., 2014;Hare, 2003). This rescoring approach offers clinicians norm-referenced AMPD scores without the burden of learning and administering new, potentially lengthy instruments, such as the 220-item Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (Krueger et al., 2012). ...
The Personality Assessment Inventory is a broadband self-report instrument of personality, psychopathology, and response style that is commonly used in Sexually Violent Predator evaluations. These evaluations typically involve assessment of personality pathology that is empirically associated with recidivism, such as psychopathic personality disorder. Over the past several years, researchers have developed rescoring procedures for the Personality Assessment Inventory that compute information on the Alternative Model for Personality Disorders—a hybrid dimensional–categorical model of personality functioning (Criterion A) and pathological traits (Criterion B). Although these scores are available for applied use, there is limited work on their psychometric properties in forensic evaluations. The present study examines whether antisocial personality disorder and related facets predict recidivism in a sample of incarcerated men evaluated for Sexually Violent Predator status. Results suggest these scores modestly predict most forms of recidivism and sex offender registry violations. However, no score predicted sexual recidivism. This pattern suggests that these scores can inform consideration of risk for certain forms of recidivism (e.g., violent), but are perhaps less useful for determining risk of additional sexual offenses. These results provide preliminary evidence that these Personality Assessment Inventory scores modestly predict outcomes relevant to forensic practitioners and may be a viable approach to measuring personality pathology that is commonly assessed in forensic work.
... The Dark Triad was originally conceptualised as three sociallyaversive dimensions of personality comprising psychopathy (involving deception, manipulation, callousness, empathy deficits, antisocial behaviours, impulsivity, and an erratic lifestyle; Hare, 2003), narcissism (characterised by inflated self-worth, entitlement, and preoccupation with the self; Caligor et al., 2015), and Machiavellianism (traits and behaviours associated with strategic manipulation, disregard for morality, and emotional detachment; Paulhus & Williams, 2002). Researchers (e.g., Buckels et al., 2013;Chabrol et al., 2009) expanded the Dark Triad via the inclusion of 'everyday sadism', creating a Dark Tetrad of personality. ...
... An everyday sadist is someone who "seeks out opportunities to observe or even induce suffering in others" (Paulhus, 2014, p. 422). Dark Tetrad traits share features such as interpersonal manipulation and callous affect, which represent facets of Hare's (2003) Factor 1 psychopathy. Genetic and environmental factors contribute to the development of Dark Tetrad traits (Vernon et al., 2008), and research has consistently demonstrated the importance of Adverse Childhood Experiences (ACEs; Moreira et al., 2020). ...
Background
Adverse Childhood Experiences (ACEs) are linked to psychopathy, narcissism, and Machiavellianism, while positive parenting practices correlate with narcissism.
Objective
We investigated whether ACEs and Positive Childhood Experiences (PCEs) predict Dark Tetrad traits, and whether PCEs moderate these relationships.
Participants and Setting
A total of 931 participants (283 men, 632 women, 16 non-binary; Mage = 35.72 years, SD = 12.52) completed an online survey.
Method
Participants completed the NPI, SRP-III, Mach-IV, SIS, CES-17, and the BCES.
Results
ACEs predicted psychopathy, narcissism, and sadism, while PCEs were positively associated with narcissism. PCEs moderated the relationships between ACEs and (a) psychopathy, and (b) sadism.
Conclusions
The findings highlight the protective role PCEs play in the development of certain Dark Tetrad traits.
... The Psychopathy Checklist-Revised (PCL-R) is a widely used assessment tool for clinical/forensic evaluation of psychopathy (Hare, 2003). It includes 20 items and employs a semi-structured interview scale. ...
... Therefore, future research should consider the simultaneous use of multiple measures to further assess the psychometric properties of the TriPM. These measures could include the PCL-R (Hare, 2003) with semi-structured interviews and various tasks measuring behavioral responses, such as the Among the results of the subsequent 7-factor TriPM models (Roy et al., 2021), we observed that the model fit indices for both multidimensional Boldness and Disinhibition performed well, exhibiting both CFI and TLI values above 0.90 and RMSEA below 0.05. However, the fit indices for Meanness did not reach an acceptable range, with both CFI and TLI below 0.90. ...
The Triarchic Psychopathy Measure (TriPM) is a self-report psychopathy measure, assessing Boldness, Meanness, and Disinhibition based on the triarchic model of psychopathy. It has good psychometric properties and has undergone validated in various contexts and sample settings. Given the sociocultural influences (e.g., self-construal) on psychopathy traits and the differences between Chinese and U.S. samples on some TriPM items, it is necessary to test the psychometric properties of the TriPM among Chinese male offenders to provide a reference for recidivism risk prediction and correction. The study involved 550 male offenders, all of whom completed the TriPM, the Levenson Self-Report Psychopathy Scale, and the Depression Anxiety Stress Scale-21. Results indicated the good reliability of scores on the overall scale and subscales of TriPM. Confirmatory factor analyses highlighted the superior fit of the multidimensional TriPM subscale model compared to the unidimensional model. Both the three-factor TriPM model and the seven-factor TriPM model exhibited reasonable convergent and discriminant validity with external criteria. The seven-factor TriPM model, compared to the three-factor model, offers additional insights into the relationships between TriPM factors and externally relevant criteria. This study offers new evidence supporting the applicability of the TriPM in a cross-cultural sample of offenders and reinforces the multidimensional structure of the TriPM subscales.
... Psychopathy is marked by a lack of empathy, impulsivity, and an emotional detachment that enables individuals to engage in harmful behaviour without remorse (Hare, 1991). Psychopathic characters evoke both fear and fascination, as their unpredictability and moral indiZerence challenge traditional ethical frameworks. ...
... While Thornburg's narcissism and Machiavellianism are front and centre, traces of sadism and psychopathy are also present. His willingness to exploit vulnerable individuals for personal gain suggests a callous disregard for the emotional impact of his actions, a hallmark of psychopathy (Hare, 1991). Meanwhile, his glee at exposing sensational details hints at a subtle sadistic streak; he doesn't just want to win; he wants to revel in the discomfort of those he exposes. ...
This paper explores the cultural and psychological dimensions of Die Hard (1988), employing the Dark Tetrad framework (Machiavellianism, narcissism, psychopathy, and sadism) to analyse its characters. John McClane emerges as a multifaceted hero, contrasting the calculated malevolence of Hans Gruber. Secondary characters, Ellis and Richard Thornburg, reflect 1980s corporate ambition and media opportunism, critiquing societal ethics. Die Hard transcends its genre, addressing enduring themes of heroism, power, and morality in a corporatised world
... An additional related concern lies in how the "shallow affect" item is operationalized in widely used measures of the LPE specifier, including the Inventory of Callous-Unemotional Traits (ICU) and the CU subscale of the Antisocial Process Screening Device (APSD). Theoretical and empirical frameworks define shallow affect primarily as an inability to experience a normal range and depth of emotions, as well as a lack of genuine emotional responsiveness in interpersonal contexts (e.g., being unmoved by another's sorrow or joy; Hare, 2003). However, the ICU and APSD predominantly assess restricted emotional expression when measuring shallow affect (e.g., "I hide my feelings from others"), which diverges from the theoretical conceptualization. ...
There is an emerging suggestion that incorporating the grandiose-manipulative (GM) and daring-impulsive (DI) traits alongside the callous-unemotional (CU) specifier could offer valuable insights into subtyping youths with behavior problems. However, this approach remains largely untested and speculative. To further deepen our understanding of this subject, the current study investigated the potential of these psychopathic components as specifiers for conduct problems (CP) in school-attending youths. Data from self-report (n = 2,381) and parent-report (n = 1,846) measures were analyzed to assess the GM, CU, and DI traits, CP, and related variables. Findings revealed that CP significantly predicted negative outcomes across both samples. Additionally, the GM, CU, and DI traits independently predicted theoretically and clinically relevant external variables (e.g., proactive aggression), even after controlling for CP, age, gender, and socioeconomic status, providing a basis for considering these traits as specifiers for CP. Moreover, children exhibiting CP alongside elevated levels of these psychopathic traits demonstrate higher scores in externalizing psychopathology compared to several other groups, including the subgroup of children with CP and high CU levels. These findings offer preliminary support for incorporating GM and DI traits as specifiers for CP. However, definitive conclusions regarding their inclusion in diagnostic manuals are premature, and further comprehensive evaluations of their utility are necessary to inform ongoing discussions and potential revisions.
... Individuals with psychopathy often struggle to conform to societal norms, disregard rules, and engage in actions that violate others' rights. They tend to create chaos in social environments, commit criminal acts, and harm others (Hare 1991). Psychopathy is commonly examined in two primary dimensions: the first includes personal traits such as callousness, lack of empathy, superficial charm, and manipulativeness, while the second encompasses antisocial components like irresponsibility, impulsivity, and poor behavioral control. ...
i
PREFACE
The field of clinical psychology continues its scientific efforts with
determination to understand the most complex and, at times, the darkest aspects
of human nature. Issues such as psychopathy, antisocial personality traits, and
homicidal impulses—which have significant effects on both individual and
societal levels—are becoming increasingly visible in contemporary societies.
In this context, they hold critical importance for both clinical practice and
scientific research. Similarly, psychosocial challenges brought about by modern
life, such as narcissism and psychological harassment (mobbing), are among
the fundamental issues that must be addressed to preserve mental health and
develop effective clinical interventions.
This book is a comprehensive compilation that aims to offer a
multidimensional perspective on the current issues in clinical psychology. The
studies cover a broad spectrum of topics, ranging from the role of metacognitions
in couple relationships, to personality traits known as the dark tetrad, and to
innovative uses of artificial intelligence technologies in clinical psychology
practices, as well as the assessment of personality disorders. The chapters
presented here are drawn from various research areas and are intended not only
to provide theoretical knowledge but also to offer concrete contributions to
clinical practice.
I hope that “Research in Clinical Psychology 1” will serve as a valuable
reference for professionals working in the field of clinical psychology, academics,
and all readers with an interest in psychology. It is my sincere wish that this
work will contribute meaningfully to the literature and offer an enlightening
reading experience to its audience.
... Previous structural neuroimaging research in psychopathic patients as well as participants with life-course persistent antisociality showed a strong grey matter reduction and reduced cortical thickness in especially the right STG (Carlisi et al., 2020;Miglin et al., 2022;Müller et al., 2008). In line with this, right STG grey matter correlated negatively with selfreported reactive aggression as well as the antisocial behaviour facet of the Psychopathy Checklist-Revised (PCL-R; Hare, 2003) in individuals with violent offending history (Hofhansel et al., 2020). Functionally, signal enhancement in the right STG, as well as in the superior frontal gyrus were previously shown to have an inverse relationship with moral sensitivity in criminal psychopaths (Harenski et al., 2010). ...
... This misinterpretation can adversely affect treatment outcomes and hinder efforts to prevent relapse (Ali & Adshead, 2022). To illustrate the gender bias, in the Psychopathy Checklist-Revised (PCL-R; Hare, 2003), item 1 Glibness/superficial charm literally describes "macho men" as indicator for coding the item which is clearly difficult to code for women. Forensic mental health services often focus on screening for externalizing disorders, such as Attention Deficit/Hyperactivity Disorder, Substance Use Disorders, Cluster B personality disorders, and psychopathy. ...
Important gender differences, relating to trauma history, offending and mental health needs are not sufficiently considered in most (risk) assessment and treatment procedures in forensic practice. We developed guidelines for gender-responsive work in Dutch forensic mental health care. The experiences of practitioners and forensic psychiatric patients were collected and analyzed by means of an online survey (n = 295), interviews with professionals (n = 22), female (n = 8) and male (n = 3) patients. Guidelines regarding gender-sensitive (risk) assessment and trauma-informed care were rated as most relevant in the survey. In the interviews we focused on experiences and wishes for trauma treatment and gender-mixed treatment. Practical guidelines were written based on the results of the survey, interviews and literature, and presented in expert meetings with patients and practitioners, and further refined based on their comments. Applying these guidelines may contribute to improved treatment for female patients thereby preventing relapse.
... However newer analyses suggest a three-factor structure spanning Egocentricity, Callousness and Antisocial factors (Garofalo et al., 2019). 1 The EPA was conceptualized to reflect the disorder as explained by the five-factor model of personality (Lynam et al., 2011). Only the Self-Report Psychopathy Scale (in its many versions) was developed to match the four-factor model of the revised PCL (PCL-R; Hare, 2003). ...
Although psychopathic personality traits are widely reported to be related to reduced reactivity to emotion-eliciting situations, findings are not consistent. It has been argued that these differences could be related to variations in the way psychopathy is measured. To examine whether measurement variance resulting from the use of clinical assessment versus self-report assessment could be driving such differences, this systematic review and meta-analysis investigated the comparability of relations between psychopathic traits and responsiveness to emotion-inducing tasks for clinical versus self-report measures. The systematic review resulted in eight studies and 131 effect sizes, which included studies of emotion categorization, emotion regulation, decision-making, and executive functioning tasks. Robust Variance Estimation correlated effects models revealed no significant differences between effect sizes for clinical (PCL-R) versus self-report (PPI, SRP, and LSRP) assessment-based psychopathic traits and emotion tasks. Despite the small number of studies that included both clinical and self-report assessments of psychopathy, these results do not provide any evidence for an assessment-based difference in correlations with emotional responsiveness across tasks. The findings also show no associations between scores on emotional responsiveness and indices of psychopathy. Future research on emotional responsiveness in psychopathy should include both assessment types to be able to increase the research basis for the comparison.
... Studies on psychopathy clearly show its substantial association with criminal conduct and the likelihood of reoffending. Within forensic contexts, psychopathy is commonly evaluated using instruments such as the Hare Psychopathy Checklist-Revised (PCL-R), which quantifies characteristics such as glibness, arrogance, and a parasite way of life (Hare, 2003). Persons exhibiting elevated levels of psychopathy are more prone to participating in aggressive and predatory actions, thereby presenting significant difficulties in their management within criminal justice environments. ...
Toxic personality traits, particularly narcissism and Machiavellianism, are characterized by detrimental behaviours that can negatively impact organizational climate and employee well-being. These traits are increasingly relevant in workplace studies due to their profound effects on performance, satisfaction, and organizational dynamics. This research aims to identify the factors contributing to the development of toxic personalities and assess the consequences of unmanaged toxic personalities on organizational climate, employee satisfaction, and performance, particularly at Open University Malaysia. Using a quantitative approach, the study gathered data through surveys measuring levels of narcissism, Machiavellianism, toxic personality traits, organizational climate, employee satisfaction, and job performance. Analytical methods included descriptive statistics, correlation analysis, and independent samples t-tests to identify significant relationships and variations among these variables. The findings reveal skewed distributions for narcissism, toxic personality traits, and contributing factors, with a weak positive correlation between narcissism and Machiavellianism. No significant gender differences in toxic traits were identified, and the age factor was not a significant predictor. These results underscore the subtle but present impact of toxic personalities within OUM, suggesting that, while not pervasive, toxic traits can disrupt organizational harmony if left unaddressed. This study highlights the importance of fostering a positive organizational culture by implementing targeted interventions, such as training programs, conflict resolution mechanisms, and clear human resources policies. Such measures can help mitigate the adverse effects of toxic personality traits, contributing to a healthier, more productive work environment at OUM. Further research is Malaysian Journal of Social Sciences and Humanities (MJSSH) (e-ISSN : 2504-8562) © 2025 by the authors. Published by Secholian Publication. This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY). encouraged to deepen understanding of the factors shaping toxic personality traits and their long-term impact on institutional dynamics. Contribution/Originality: This research investigates toxic personality traits, particularly narcissism and Machiavellianism, within the OUM context. It examines their prevalence, interrelationships, and impact on organizational climate and employee satisfaction. The study also explores the influence of gender and age on the manifestation of these traits.
... Edens and colleagues uncovered evidence of dimensional latent structure in their study on psychopathy in a sample of 876 prison inmates and court-ordered substance abusers. Research published within a year of Edens' investigation (Guay et al., 2007;Murrie et al., 2007;Walters et al., 2007) corroborated that psychopathy, as assessed with the Psychopathy Checklist-Revised (PCL-R; Hare, 2003) and Psychopathy Checklist-Screening Version (PCL:SV; Hart et al., 1995) was more appropriately modeled as a dimension than as a category, a finding later replicated on samples of female (Guay et al., 2018) and Asian (Ren et al., 2020) prison inmates, and also found when biomarkers were analyzed alongside PCL-R scores (Walters et al., 2015). ...
This study tested the possibility that the four facets of the Psychopathy Checklist-Revised/Screening Version (PCL-R/SV) serve as bipolar constructs in predicting future criminal justice outcomes. Organizing scores on the four facets (Interpersonal, Affective, Lifestyle, and Antisocial) into three categories—that is, lowest 25% of cases (best category), highest 25% of cases (worst category), and middle 50% of cases (intermediate category)—we tested bipolarity by crossing the three categories with a dichotomized crime/violence outcome and calculating both promotive (best category vs. worst + intermediate categories) and risk (worst category vs. best + intermediate categories) effects in six samples. Bipolarity was defined as the simultaneous presence of promotive (low scores predicting a good outcome) and risk (high scores predicting a poor outcome) effects for each PCL-R/SV facet in each sample. Odds ratios and the Cochrane–Armitage linear trend test revealed evidence of bipolarity in one of six samples for the Interpersonal facet, three of six samples for the Affective facet, five of six samples for the Lifestyle facet, and all six samples for the Antisocial facet. An item response theory analysis was then conducted, the results of which supported the facet-level findings from the odds ratio and Cochrane–Armitage analyses at the individual item level. These results provide modest (Affective facet) to moderately strong (Lifestyle and Antisocial facets) evidence of bipolarity in three of the four facets of the PCL-R/SV by showing that low scores are just as effective in predicting good criminal justice outcomes as high scores are in predicting poor criminal justice outcomes.
... B. von Frauen häufiger angegeben als von Männern und dann auch anerkannt und diagnostiziert, was dazu führen kann, dass die entsprechenden Diagnosen bei Männern seltener gestellt werden (Amelsvoort et al., 2019) Gender-Bias impliziert auch bei der forensischen Diagnostik und prognostischen Risikobeurteilung ein potentielles Risiko, einerseits bei der Formulierung einzelner Items in Fragebogen, und andererseits, welche Instrumente angewandt werden. Ein konkretes Beispiel findet sich in der Psychopathy Checklist-Revised (PCL-R), einem Instrument zur Messung von Psychopathy (Hare, 2003 (Spreen et al., 2014). ...
Forensische Psychiatrie und Psychotherapie, 34(3), ins Deutsche übersetzt von Uta Kröger.
In Haftanstalten und Maßregelvollzugskliniken sind Frauen in der Minderheit. Daher über-rascht es nicht, dass die meisten Instrumente zur Einschätzung von Rückfallrisiken für Männer entwickelt und an ihnen erprobt wurden. Erst seit einigen Jahren hat man den Eigenschaften und Risikofaktoren straffälliger Frauen mehr Beachtung gezollt und untersucht, was für ihre Behandlung erforderlich ist. Untersuchungen zeigten, dass die standardmäßig angewandten Prognoseinstrumente zur Vorhersage gewalttätigen Handelns bei Frauen weniger brauchbare Ergebnisse lieferten als bei Männern. Um Risiken bei Frauen zu prognostizieren und entspre-chende Interventionen zur Rückfallprävention zu entwickeln, bedarf es weiterer Forschung. Das ist nicht nur für die Frauen selbst und für die Gesellschaft entscheidend, sondern auch für den sozialen Kontext der Frauen, insbesondere für deren Kinder. Risk assessment for women Abstract In prisons and forensic psychiatric clinics, females are a minority. It is, therefore, no surprise that most prognostic tools were developed for men and checked with male samples. Since a couple of years more attention is paid to explore specific traits, risk factors and needs for the treatment of delinquent females. Surveys have shown that the usually applied prognostic instruments for the prediction of violent crimes were less effective when applied for females. More research is needed to predict relapse risks for women and to develop adequate treatments for them to prevent relapse. This is not only essential for the women and for society, but also for the direct life context of the women and their children.
... Ein wichtiger Risikofaktor, der in vielen Risikoinstrumenten, u.a. auch in den HCR-20, aufgenommen wurde, ist Psychopathie entsprechend den Kriterien der Psychopathie-Checklist-Revised (Hare, 2003). Diese Liste enthält 20 Merkmale von Psychopathie, die auf einer dreistufigen Skala eingestuft werden (0, 1, 2). ...
Forensische Psychiatrie und Psychotherapie, 34(3), ins Deutsche übersetzt von Uta Kröger.
Problematischer Gebrauch psychotroper Substanzen ist ein beachtlicher Risikofaktor für strafbares Handeln und Gewaltanwendung. Untersucht ist das vor allem im Hinblick auf Männer. Was Frauen betrifft, sollte noch weiter geforscht werden.
Ziel der Untersuchung: Herausgearbeitet werden soll, inwiefern sich bei forensisch psychiatrischen Patienten Unterschiede zwischen Frauen und Männern finden, was erstens den Konsum psychotroper Substanzen betrifft und zweitens, wie sich dieser auf ihre Straffälligkeit auswirkt.
Stichprobe und Methode: Die Akten von 275 Frauen und 275 Männern, die zwischen 1984 und 2014 in einer von vier forensisch-psychiatrischen Einrichtungen untergebracht sind bzw. waren, wurden anonymisiert und untersucht, wie häufig die Patient*innen während der Behandlung gewalttätig und, nach ihrer Entlassung (78 Frauen), wieder rückfällig geworden sind.
Ergebnisse: Obwohl die Prävalenz problematischen Konsums psychotroper Substanzen bei Frauen recht hoch war (57%), fand sich bei Männern eine signifikant höhere Prävalenz (68%). Bei Männern war die DSM-IV-Diagnose Substanzabhängigkeit häufiger gestellt worden und sie hatten auch ihr Indexdelikt häufiger begangen, während sie unter dem Einfluss von Substanzen gestanden hatten. Anhand dieses Missbrauchs konnte bei ihnen das Risiko neuer Gewalttaten während der Behandlung besser vorhergesagt werden. Sowohl Frauen als auch Männer mit problematischem Substanzkonsum hatten bedeutend mehr historische Risikofaktoren als solche ohne eine entsprechende Vorgeschichte. Bei den Frauen war eine Vorgeschichte problematischem Substanzgebrauch kein signifikanter Marker für einen Rückfall nach der Entlassung.
Schlussfolgerung: Zwischen den Geschlechtern gibt es Unterschiede, was problematischen Substanzkonsum betrifft, wobei bei den Männern der Zusammenhang mit Straffälligkeit enger ist. Diese Unterschiede sollten bei der Behandlung von Suchtmittelabhängigkeit in forensischen
Einrichtungen berücksichtigt werden.
... Es gibt hinreichend Gründe zu der Annahme, dass auch in der forensisch-psychiatrischen Versorgung eine geschlechtsspezifische Voreingenommenheit besteht und eine Rolle bei der Fehlinterpretation von Risiken und psychischen Gesundheitsbedürfnissen spielen kann (Ali & Adshead, 2022). Zur Veranschaulichung: In der Psychopathy Checklist-Revised (PCL-R; Hare, 2003) beschreibt Item 1 Trickreich sprachgewandter Blender mit oberflächlichem Charme wörtlich "Macho-Männer" als Indikator für die Kodierung des Items, was bei Frauen offensichtlich schwer zu kodieren ist. Da sich die forensisch-psychiatrische Untersuchung häufig auf das Screening von externalisierenden Störungen, Cluster-B-Persönlichkeitsstörungen, Psychopathie und Risikofaktoren konzentriert, können Krankheiten wie Depressionen, Angstzustände oder PTBS übersehen werden, auch bei Männern. ...
Forensische Psychiatrie und Psychotherapie, 34(3), ins Deutsche übersetzt von Uta Kröger. Es wurden Unterschiede festgestellt zwischen weiblichen und männlichen forensischen Psych-iatriepatienten in Bezug auf Trauma-Anamnese, straffälliges Verhalten und psychische Bedürf-nisse. Diese geschlechtsspezifischen Unterschiede werden bei den meisten (Risiko-) Beurtei-lungs-und Behandlungsverfahren in der forensischen Praxis nicht ausreichend berücksichtigt. In diesem Projekt wurden Leitlinien für geschlechtergerechtes Arbeiten in der niederländischen forensischen Psychiatrie entwickelt. Mittels einer Online-Umfrage (N = 295) und Interviews mit 22 Fachleuten, acht weiblichen und drei männlichen Patienten wurden die Erfahrungen sowohl von Fachleuten als auch von forensischen Psychiatriepatienten gesammelt und ausge-wertet. Die Themen, die für die Behandlung weiblicher Patienten als am relevantesten genannt wurden, waren 1) geschlechtssensible (Risiko-)Beurteilung; 2) traumainformierte Pflege; 3) Unterstützung bei Kontakt mit Kindern. Auf der Grundlage dieser Ergebnisse wurden prak-tische Leitlinien erstellt, die anschließend in Expertensitzungen mit forensischen Patientinnen und Praktikern vorgestellt und als Folge der entsprechenden Kommentare weiter verfeinert wurden. Die Anwendung dieser Leitlinien kann zu einer verbesserten Behandlung von Patien-tinnen in der forensischen Psychiatrie beitragen und so Rückfälle verhindern sowie hoffentlich eine bessere Zukunft für diese Frauen und ihr Umfeld, insbesondere ihre Kinder, ermöglichen.
Working with women in forensic mental health care: Guidelines for gender responsive assessment and treatment Abstract Differences have been found between female and male forensic psychiatric patients, relating to trauma history, offending behavior and mental health needs. These gender differences are not sufficiently taken into account in most (risk) assessment and treatment procedures in forensic practice. In this project, guidelines were developed for gender-responsive working in Dutch forensic mental health care. The experiences of both practitioners and forensic psychiatric patients were collected and analyzed by means of an online survey (N = 295) and interviews with 22 professionals, eight female patients and three male patients. The topics mentioned as most relevant for the treatment of female patients were 1) gender-sensitive (risk) assessment; 2) trauma-informed care; 3) support with contact with children. Practical guidelines were written based on these results and subsequently presented in expert meetings with forensic patients and with practitioners, and further refined based on their comments. Applying these guidelines may contribute to improved treatment for female forensic psychiatric patients thereby preventing relapse and hopefully a better future for these women and their surroundings, especially their children.
... Antisocial personality patterns are typically assessed using diagnostic criteria for antisocial personality disorder (American Psychiatric Association, 2013), the Psychopathy Checklist-Revised (Hare, 2003), or a self-report psychopathy assessment (e.g., Falkenbach et al., 2007). These measures capture facets of antisociality including not only personality characteristics but also behavior related to impulsivity and low self-control. ...
Little is known regarding the criminogenic needs of men and women who self-report intimate partner violence (IPV). We examined criminogenic and noncriminogenic needs of men and women within the general population who self-reported in three groups: perpetrating physical IPV, perpetrating non-IPV physical violence, and nonviolence perpetration. The sample included 847 men and 1437 women from the Interpersonal Conflict and Resolution (iCOR) Study. Those who self-reported IPV exhibited criminogenic and noncriminogenic needs, ranging from antisocial personality patterns (10%) to criminal associates (69%). Participants who self-reported engaging in IPV had the most criminogenic and noncriminogenic needs, had similar needs to those reporting non-IPV violence, and had consistently more needs than the nonviolence group. Overall, women reported more noncriminogenic needs than men. Community-based IPV treatment programs accepting individuals from multiple referral sources should anticipate variation in criminogenic and noncriminogenic needs among participants, especially relative to gender and referral type.
... Lastly, the visual analysis focused on one of the most notorious diagnoses in forensic psychiatry: psychopathy. Psychopathy is characterised by persistent patterns of callousness, a lack of empathy, egocentric behaviour, and a disregard for the rights of others, often accompanied by a lack of remorse for harmful actions (Hare, 2003). ...
... Diese Studie wurde an den drei Standorten der Van der Hoeven Klinik in Utrecht (NL) durchgeführt, einem Zentrum für klinische forensische Psychiatrie, in dem sowohl Männer als auch Frauen mit einem strafrechtlichen (etwa 60 % pro Jahr) oder zivilrechtlichen Paragraphen (etwa 40 % pro Jahr) aufgenommen werden). Der Anteil der Frauen an der Gesamtpopulation mit sowohl straf-als zivilrechtlichen Paragraphen beträgt etwa 20 %. Hare 2003). Bei der Einstufung als Vorfall mit suizidaler Absicht wurde auf gemeldete suizidale Äußerungen wie "Ich habe es getan, weil ich nicht mehr leben will" geachtet, oder wenn der Vorfall von Mitarbeitern als Suizidversuch beschrieben wurde. ...
Forensische Psychiatrie und Psychotherapie, 34(2), 187-198, ins Deutsche übersetzt von Uta Kröger. Selbstverletzendes Verhalten von Patienten der forensischen Psychiatrie hinterlässt bei allen Beteiligten oft einen starken Eindruck und ist ein wichtiger Prädiktor für Gewalt gegen andere während der Behandlung. Ziel dieser Studie ist es, Selbstverletzungen von Patienten zu be-schreiben, die in die forensische Psychiatrie eingewiesen wurden. Im Zeitraum von 2008 bis 2019 wurden insgesamt 299 Selbstverletzungen registriert, die von 106 Patienten während der Behandlung in einem Zentrum für forensische Psychiatrie begangen wurden. Alle aufgezeich-neten Vorfälle von Selbstverletzung wurden analysiert und nach Schweregrad kodiert mit Hilfe der MOAS+. Bei der Mehrheit der Vorfälle (87,6 %) handelte es sich um selbstverletzendes Verhalten ohne Suizidabsicht. Die häufigsten Methoden waren das Schneiden mit Glas, zer-brochenem Geschirr oder einem (Rasier-)Messer und das Verschlucken gefährlicher Flüssig-keiten oder Gegenstände. Es gab 10 Selbsttötungen, die fast alle durch Erhängen mit einem Seil oder Gürtel erfolgten. Die Mehrzahl der Vorfälle wurde auf der MOAS+ als schwer oder äu-ßerst schwer eingestuft. Weibliche Patienten verursachten im Durchschnitt dreimal so viele Vorfälle wie männliche Patienten. Die Studie zeigt, dass selbstverletzendes Verhalten in der forensischen Psychiatrie regelmäßig vorkommt und in der Regel schwerwiegend ist. Die Aus-wirkungen auf die Betroffenen und Zeugen der Vorfälle, die Motive und Auslöser für das selbst-verletzende Verhalten und eine wirksame Behandlung sind noch zu erforschen.
... In 1980, Hare initially developed the Psychopathy Checklist (PCL) as a 22item scale in order to assess the clinical construct of psychopathy (Hare, 1980(Hare, , 2016. Later, the PCL was revised leading to the current 20-item version (PCL-R; Hare, 1991Hare, , 2003. In the meantime, the PCL-R has become an international standard instrument for the measurement of psychopathic traits (Hare et al., 2000). ...
There is some evidence that testosterone-lowering medications (TLM) may be an effective treatment for men convicted of sexual offenses by attenuating paraphilic sexual fantasies and behaviors and reducing the recidivism risk. To date, however, only little is known about the effects of TLM stopping on risk-relevant aspects. Therefore, the current study aimed at examining the recidivism risk as measured by Stable-2007 as well as official records of reoffenses in 29 men having stopped TLM treatment as compared to 37 men with ongoing TLM treatment. The Stable-2007 was rated retrospectively at 4 time points: committal to forensic treatment (T1), starting (T2) and stopping of TLM treatment (T3), and at reporting date (T4). There was a significant decrease in Stable-2007 scores over time, but there were no significant group differences. Within the stopped-TLM group, there were no significant differences between T3 and T4, implying that the recidivism risk remained stable over an average observation period of 4.5 years after TLM stopping. In addition, there was no significant difference in actual reoffending rates between the groups. For sexual reoffending, the percentages were 17.2% for the stopped-TLM group and 10.8% for the ongoing-TLM group. However, although the current results suggest that there is at least no increase in risk assessment (i.e., Stable-2007) after having stopped TLM, the actual reoffending rates of both groups were higher than expected. This once again demonstrates that TLM stopping decisions remain very difficult to make. Further studies are urgently needed to draw clearer conclusions.
... Records regarding mental health diagnoses (see the Supplemental Psychiatric Diagnoses in the online supplemental materials) were available for nearly all study participants. Static-99, Static-99R, and Hare psychopathy checklist-revised (PCL-R) assessments (Hanson & Thornton, 2000;Hare, 2003) were available for most study participants, and records regarding prison conduct and juvenile corrections involvement were available for many. ...
Individuals convicted of sexually violent offenses with mental disorders that make it more likely than not that they would reoffend sexually if released to the community qualify for indefinite, involuntary civil commitment as sexually violent persons (SVPs) in Wisconsin. This study assessed recidivism among residents dismissed or discharged from SVP commitments. Comparisons of 144 dismissed, 236 discharged, 274 individuals living under civil commitment, and 51 individuals who died while committed under Wisconsin’s SVP program found a variety of sociodemographic and clinical differences between the groups. Sexual recidivism rates of 121 dismissed and 124 discharged individuals with five or more years of follow-up after release did not significantly differ from one another. The fixed 5-year recidivism rate for sexually violent offenses was 11.8% and 14.7% over a variable follow-up mean of 14.5 years. Recidivism rates for combined violent or nonviolent sexual offenses were 12.7% over a fixed 5-year follow-up, and 17.1% over the average variable follow-up period of 14.5 years. Static-99R scores at dismissal/discharge did not discriminate recidivists from nonrecidivists. The Static-99R Routine sample norms were better calibrated for predicting the expected number of sexual recidivists over 5 and 10 years after release.
... This profile was more frequently related to violent crimes (homicide, serial killing, sexual violence, and torture). The second profile, "antisocial," was focused on the lifestyle and antisocial facets, mostly: need for stimulation, parasitic lifestyle, impulsivity, irresponsibility, poor behavioural control, early behavioural problems, and juvenile delinquency (Factor 2 75 ). This profile was related to violence (fighting/beating, vandalism, threats, impulsive aggression), substance use, robbery, and to a lesser extent, sexual assault, drug trafficking, handling stolen goods, fraud, and elder abandonment. ...
... for a meta-analytic review, see Sleep et al., 2019), which has a three-factor structure: Meanness, Boldness, and Disinhibition. The Meanness and Disinhibition factors of the TriPM reflect the core components of Hare's (1980Hare's ( , 1991Hare's ( , 2003 conceptualization of psychopathy; Meanness includes "deficient empathy, lack of affiliative capacity, contempt for others, predatory exploitativeness, and empowerment through cruelty or destructiveness," and Disinhibition entails "impulsiveness, weak restraint, hostility and mistrust, and difficulties in regulating emotion" (Patrick & Drislane, 2014, p. 628). The Boldness factor of the triarchic model was derived from Cleckley's observations and previous work with the Fearless Dominance factor from the Psychopathic Personality Inventory (Lilienfeld & Andrews, 1996); it reflects "proclivities toward confidence and social assertiveness, emotional resiliency, and venturesomeness" (Patrick & Drislane, 2014, p. 628). ...
Despite the importance of psychopathy—a construct with robust relations with externalizing outcomes—little is known about how psychopathic traits manifest in middle-age to older adulthood. In the present investigation, we used a large and diverse sample of older adults from the St. Louis Personality and Aging Network to examine psychopathy’s nomological network and whether these traits change over four time points spanning approximately 10 years. We also explored whether these changes were associated with changes in other important constructs (e.g., physical and psychological functioning) across the same time span. Psychopathy was operationalized in two ways: (a) via the factors of the triarchic psychopathy model, Meanness, Disinhibition, and Boldness, and (b) using a more macro approach via the Five-Factor Model Psychopathy Resemblance Index. We found that (a) the nomological network of psychopathy appears to be consistent with what has been observed in samples of younger adults, (b) psychopathic traits remain stable over time as adults make the transition from midlife to later life, and (c) changes that were observed are significantly related to changes in several important outcomes, including physical health, mental health, relationship satisfaction, intimate-partner aggression, and social functioning.
... The VRAG-R uses clinical records to assess the patients' risk of violence recidivism and is suitable for male patients who have committed serious violent or sexual offenses [128]. The PCR uses interviews and information from the patient's file record to appraise the patient's level of psychopathy [129]. It is composed of questions addressing emotional detachment and antisocial behavior. ...
The belief that people suffering from psychiatric disorders are more violent, in particular psychotic patients that do not have insight into their illness, is very common in the general population. Therefore, this review aimed to present a more accurate depiction of the link between lack of insight and violent behavior, by evaluating the existing scientific literature on the topic. For this purpose, a literature search on PubMed, Embase, and Google Scholar was conducted, selecting the relevant papers published during a 20-year period (2004–2024). The paper defined insight as a multi-dimensional concept and discussed its classification, explanatory models, and clinical implications, followed by a presentation of several insight-measuring scales. The meaning of violent behavior, its prevalence, underlying mechanisms, and different measuring scales were discussed, followed by the confounding factors that influence the relationship between insight and violent behavior, treatment options for violence in forensic psychiatry settings, and methods to improve medication adherence. Contrasting results were observed regarding the impact of each factor on leading to violent acts, which suggested that the relationship between insight and violence is more complex than previously thought. In conclusion, increased attention must be paid to the investigated dimensions of both the concepts and the confounding factors, with further research required on this topic.
We examined the operationalization of psychopathy through a multi-method framework in a community sample of 250 participants, who were oversampled for psychopathic traits. Psychopathy was operationalized through clinician-rated measures, including the Psychopathy Checklist: Screening Version and the Comprehensive Assessment of Psychopathic Personality (CAPP): Symptom Rating Scale, as well as the Triarchic Psychopathy Measure and the CAPP-Self Report. Using Exploratory Structural Equation Modeling and controlling for self-report and clinical rating method variances, a four-factor model of psychopathy emerged with factors representing Boldness, Disinhibition, Affective, and Interpersonal traits. We examined the validity of the four-factor model by investigating associations between each factor and conceptually relevant scales, and the results generally supported construct validity. The Interpersonal factor was considered to contribute to the model theoretically in the factor analysis, but the incremental validity of this factor above and beyond the Boldness and Affective factors was not supported by available criterion measures.
This chapter covers the role and relevance of personality disorder (PD) in general, and psychopathy in particular, for sexual offending behavior. It begins with a review of the clinical and etiologic relevance of PD in sexual offending, including base rates of PD in forensic and correctional adult male sexual offending samples. The chapter proceeds with a review of the psychopathy construct, its role and relevance in the commission of sexual violence, and its representation in sexual offending populations as moderated by victim profile. The chapter then reviews the risk-relevance of PD and psychopathy in sexual violence risk assessment and management, including the intersection of these diagnoses with other clinically and forensically meaningful risk constructs (e.g., sexual deviance). The chapter concludes with a discussion of sexual violence treatment and risk management considerations for psychopathy in sexual offending populations, including a model for treatment and a review of recent treatment outcome research.
This chapter features an evidence-informed approach to sexual recidivism risk assessment. It begins with a definition and overview of sexual recidivism risk assessment and its purpose of sexual recidivism prevention by way of linking assessment and intervention through the lens of the risk-need-responsivity model. The chapter then reviews a number of best practice considerations that include use of multiple information sources, evaluating the accuracy and credibility of information, assessing multiple domains of functioning, use of static and dynamic measures, consideration of nonsexual recidivism risk measures, applications of risk assessment information, and consideration of ethnocultural diversity and other risk mitigating agents. A representative sampling, of sexual recidivism risk measures are covered, including a brief description of the measure along with its associated functions and features to guide the use of such measures in sexual recidivism risk assessment.
This chapter describes the heterogeneity found in psychodynamic perspectives particularly as applied to understanding and treating sex offenders. Classical and contemporary psychodynamic perspectives are described in terms of their philosophical differences as is the impact of specific psychodynamic perspectives on the therapeutic relationship. The case of a serial child sex offender is examined through the lens of various psychoanalytic theories to demonstrate how different perspectives bring about multiple alternative understandings of the sex offender as a unique person. As demonstrated in this case example, psychodynamic perspectives contribute to a holistic approach to the rehabilitation of sex offenders that can assist in and augment the benefits achieved by time-limited, reductionistic, manualized treatment programs. A ‘both-and’ rather than ‘either-or’ attitude to the treatment of sex offenders is proposed that seeks to maintain a balance in recognizing the priority of recidivism risk reduction according to empirical research findings while appreciating the complexity of the sex offender’s psychopathology which gives rise to their criminal behavior.
In this chapter, the authors, all of whom are both researchers and clinicians—experienced in forensic or clinical psychology or psychiatry—draw on the scientific literature and their different clinical perspectives to reflect on what can be considered “best practices” in the rehabilitation of perpetrators of sexual homicide. Recommendations are made for assessment, treatment, and management from custodial settings to the community. To do this, factors that are central to a comprehensive forensic case formulation are considered, from the role of anger, violence, and sadistic fantasy to psychopathology and differentiating characteristics compared to non-homicide sexual offenders or as a function of victim type (male, female, child). The chapter also addresses an often overlooked fact that most perpetrators of sexual homicide do not kill more than once. Scientific knowledge pertaining to serial sexual homicide offenders is therefore looked at with the aim of understanding this phenomenon and to consider where limitations remain in the evidence base underlying assessment and management practices when working with both serial and non-serial offenders.
Voyeurism, exhibitionism, and frotteurism are recognized by the American Psychiatric Association (APA) as sexual paraphilias that involve sexual arousal derived from non-consenting individuals (APA, Diagnostic and statistical manual of mental disorders, 2013). This chapter will focus on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition [DSM-5] definitions of Voyeuristic, Exhibitionistic, and Frotteuristic Disorders. This chapter will be divided into two parts. In the first part, what is known about Voyeuristic, Exhibitionistic, and Frotteuristic Disorders is presented in terms of diagnostic criteria, prevalence, frequency, age of onset, and scope of the problem separately by disorder. However, given the overlap between the disorders and the dearth of research about these paraphilias in general, the second part of the chapter will broadly discuss comorbidity, differential diagnosis, etiological theories, clinical assessment, and interventions for all three paraphilias in tandem and will conclude with recommendations for future research.
Background
Men convicted of sexual offenses (MCSO) can be treated with testosterone-lowering medications (TLM) in order to support the control of paraphilic sexual fantasies and to decrease the risk of sexual recidivism. However, due to partly severe side effects, TLM should not be a lifelong treatment.
Aim
The Change or Stop Testosterone-Lowering Medication (COSTLow)-R Scale was developed to assist forensic professionals in deciding on whether to change or stop TLM treatment in MCSO. The current study aimed to evaluate the scale in forensic outpatient aftercare practice.
Methods
The COSTLow-R Scale was applied retrospectively in a forensic-psychiatric outpatient institution in Hesse, Germany, on 72 MCSO. TLM was stopped in 30 patients (41.7%). Moreover, 10 forensic professionals of the institution (23.3%) as well as an experienced working group within the institution focusing on the treatment of MCSO, qualitatively evaluated the COSTLow-R Scale by participating in an open designed survey.
Outcomes
The COSTLow-R Scale ratings as assessed by forensic professionals were collected. In addition, a survey was performed among these professionals about the usefulness of the scale and their practical experiences with it.
Results
TLM stopping decisions were significantly associated with three COSTLow-R Scale items: the compliance for monitoring effects and side effects, the possibility of psychotherapy before TLM treatment, and the therapeutic alliance before starting TLM treatment. In sum, the decision towards stopping TLM was more likely for patients whose compliance was considered higher, and for those who had demonstrated a greater treatment readiness as well as therapeutic alliance before starting TLM. The forensic professionals described the scale as a good and structured tool that displays which aspects are important to consider during TLM treatment decisions.
Clinical Implications
The COSTLow-R Scale provides structure to the decision whether to change or stop TLM and should thus be implemented in the forensic treatment process of patients with TLM more frequently.
Strengths & Limitations
Although the small sample size limits generalizability of the findings, the present study was conducted directly in a forensic center and, therefore, has high external validity and a strong impact on the life and health of patients treated with TLM.
Conclusion
The results indicate that the COSTLow-R Scale can be a useful instrument facilitating the TLM decision-making process by providing a structured compendium of criteria. Further research is still needed to evaluate the scale and to provide additional evidence for the results of the current study.
The use of risk assessment instruments is essential for the assessment, treatment, and management of violence risk; it is thus critical to examine their properties when implemented in novel settings with diverse forensic subpopulations. This study evaluated the convergent and predictive properties of three risk assessment instruments in a sample of 109 forensic patients found Not Criminally Responsible on Account of Mental Disorder (NCR). A retrospective longitudinal cohort design was employed to examine the Historical Clinical Risk Management-20 Version 3 (HCR-20V3), Revised Violence Risk Appraisal Guide (VRAG-R), and Level of Service/Case Management Inventory (LS/CMI) rated from archived hospital records. LS/CMI risk scores and risk bands predicted general (area under the curve [AUC] = .70–.73) and violent (AUC = .76–.91) recidivism with moderate to large effects and performed similarly to the VRAG-R and HCR-20V3. Calibration analyses demonstrated that LS/CMI scores overpredicted the risk of general recidivism in Moderate to Very High risk bands. Results supported the convergent validity and discrimination properties of study measures; however, mixed evidence was found for the calibration properties of the LS/CMI. The potential utility of risk instruments in the appraisal and management of offending behavior among forensic mental health patients is discussed.
Despite numerous studies examining the relationship between psychopathy and online behaviors, most have relied on measures that assess psychopathy as a unidimensional construct. However, this contradicts the prevailing view in clinical and research settings that define psychopathy as a multidimensional construct. To address this gap in the literature, the current study examined the relationships between multiple dimensions of the psychopathy construct, as measured by the Youth Psychopathic Traits Inventory-Short Version (YPI-S), and indices of cybercrime, cyber abuse, sadfishing, Instagram addiction, and Instagram activity metrics (daily time spent, frequency of sharing stories/posts, and selfie-sharing), as well as indices of successful online careers in the context of Instagram. A sample of 490 university students (aged 18-46 years; M = 23.92, SD = 7.16; 76.32% female) participated by completing an online version of the measures. Results indicated that each component of the psychopathy construct demonstrated unique associations with online behaviors, suggesting that these components may reflect distinct underlying motivations for engaging in specific online activities. Findings underscore the importance of utilizing multidimensional measures of the psychopathy construct in social media research, rather than relying on unidimensional measures such as those assessing Dark Triad or Tetrad traits. Overlooking this approach may lead to a less comprehensive understanding of the nuanced relationships between psychopathy and online behaviors.
This is the first book to analyze empirically supported treatments by using the newest criteria from the American Psychological Association's Society of Clinical Psychology, Division 12. Clinicians, scholars, and students all need to stay updated on the treatment research, and this book goes beyond providing updated treatment information by pointing readers to other useful treatment manuals and websites for continuing to stay up-to-date. The chapters, all written by prominent experts, highlight the best available evidence for specific disorders by breaking treatments down into credible components. With an emphasis on treatments for adults, chapters also share information about treatments for youth. Other variables that influence treatment are discussed, including assessment, comorbidity, demographics, and medication. Each chapter also corresponds with a chapter in the companion book, Pseudoscience in Therapy, presenting a full picture of the evidence base for common treatments.
The Dark Triad (DT), encompassing narcissism, Machiavellianism and psychopathy traits, poses significant societal challenges. Understanding the neural underpinnings of these traits is crucial for developing effective interventions and preventive strategies. Our study aimed to unveil the neural substrates of the DT by examining brain scans from 201 individuals (mean age: 32.43, 105 females) using the unsupervised learning algorithm transposed independent vector analysis (tIVA). tIVA, known for identifying complex patterns in neuroimaging data, detected 15 joint grey matter (GM) and white matter (WM) networks. Of these networks, four were associated with the DT. The first component comprises areas within the reward network, including the thalamus, caudate, anterior cingulate and prefrontal regions. The second component encompasses regions within the executive network, predominantly involving prefrontal and posterior areas. The third component includes regions within the default mode network (DMN), such as the angular gyrus, the precuneus and the posterior cingulate cortex. Lastly, the fourth component overlaps with areas of the visual network, primarily located in the occipital and temporal lobes. Within these networks, the reward‐related component correlated with narcissism, suggesting an association with the need for constant interpersonal rewards to enhance self‐esteem and grandiosity in narcissistic individuals. Conversely, the DM‐related component correlated with Machiavellianism, potentially reflecting the heightened strategic thinking employed by Machiavellian individuals for manipulation purposes. In line with established trends, sex differences emerged, with males displaying notably higher DT scores. Our findings offer insights into the intricate neurobiological bases of the DT personality and hold implications for future research and interventions.
Violence in psychiatric settings presents a significant risk to patients, staff, and society at large. With over 400 risk assessment tools available globally, their applications and the risks they assess vary, allowing for diverse use in different situations. This scoping review investigated the risk management tools utilized in North America’s forensic psychiatry and acute psychiatric units, aiming to identify which ones are mainly used. A comprehensive search was conducted across PubMed, Embase, and PsycINFO databases, following PRISMA Guidelines, covering the literature from their inception date until 2023. Criteria for study inclusion required a focus on risk management tool use in forensic or acute psychiatric settings, originality (original studies, case reports, or systematic reviews), and a North American context. Out of 3059 identified studies, 40 were thoroughly analyzed. Commonly used risk assessment scales include HARM-FV, eHARM-FV, HCR-20, PCL-R, START, BVC, and DASA, with their reliability varying by the clinical context and the assessed population. The review highlights the heterogeneous application of static and dynamic scales across clinical settings, underscoring a need for more precise tools to improve risk assessments in forensic psychiatry, signaling a call for the development and validation of more sophisticated assessment instruments.
La psicopatía es un trastorno de la personalidad que se caracteriza por la falta de empatía, la tendencia a la manipulación y el comportamiento antisocial por parte de la persona que lo padece. En el ámbito de la justicia penal, este trastorno plantea desafíos significativos en cuanto al riesgo del fenómeno criminal, las decisiones judiciales y estrategias de reinserción social, por lo que en este este escrito se analizan las características clínicas de la psicopatía y su relación con la criminalidad, así como las implicaciones que surten en el sistema de justicia penal en México.
Bu araştırmanın amacı, demografik özelliklere göre futbol seyircilerinin Karanlık Üçlü (Makyavelizm, Narsisizm ve Psikopati) kişilik özellikleri ile saldırganlık türleri (Fiziksel Saldırganlık, Sözel Saldırganlık ve Tahrik) arasındaki ilişkiyi belirlemektir. Araştırmaya 113 erkek 133 kadın olmak üzere toplamda 246 futbol seyircisi katılmıştır. Veriler çevrimiçi olarak Kişisel Bilgi Formu, Karanlık Üçlü Ölçeği ve Spor Seyircisi Saldırganlık Ölçeği kullanılarak toplanmıştır. Bulgular, erkeklerin kadınlara göre daha yüksek Narsisizm, Psikopati, Fiziksel Saldırganlık, Sözel Saldırganlık ve Tahrik davranışlarını sergilediğini göstermektedir. Eğitim durumuna göre anlamlı bir fark bulunmazken, maç seyretmek için tribüne gidenler daha yüksek Narsisizm puanları almıştır. Aktif spor yapanlar, yapmayanlara kıyasla daha yüksek Makyavelizm, Narsisizm, Sözel Saldırganlık ve Tahrik davranışları sergilemiştir. Korelasyonel değerlerde; Makyavelizm ile fiziksel saldırganlık arasında anlamsız ilişki, sözel saldırganlık ve tahrik arasında ise anlamlı ilişkiler bulunmuştur. Narsisizm, fiziksel saldırganlık, sözel saldırganlık ve tahrik ile anlamlı ilişkiler göstermiştir. Psikopati, fiziksel saldırganlık, sözel saldırganlık ve tahrik ile anlamlı ilişkiler sergilemiştir. Araştırma, Karanlık Üçlü kişilik özellikleri ile saldırganlık türleri arasındaki ilişkilerin demografik faktörlere göre farklılık gösterebileceğini, Karanlık Üçlü kişilik özelliklerinin bazı türleri ile saldırganlık türleri arasında anlamlı korelasyonlar olduğunu göstermiştir. Bu faktörlerin daha iyi anlaşılması, spor ortamlarındaki olumsuz davranışların önlenmesine ve seyirci deneyiminin iyileştirilmesine katkı sağlayabilir.
The Proposed Specifiers for Conduct Disorder (PSCD) is a tool designed to measure psychopathy through its grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder subscales. The present study aimed to assess the psychometric properties of the PSCD’s parent and child self-report versions with a sample of 149 justice-involved youths (55% boys) and their parents (71% mothers) in Iran. Results indicated that both versions of the PSCD confirmed the originally proposed hierarchical four-factor structure. Internal consistency of both PSCD versions’ component scores was satisfactory, and correlations with theoretically related variables supported the PSCD scores’ validity. Also, good to excellent agreement between parent and child PSCD scores were found. The parent-report PSCD scores offered significant incremental validity over the child-version scores in predicting child-reported conduct problems, proactive aggression, and delinquency. Furthermore, both informant versions of the PSCD provided significant added values over an alternate measure of youth psychopathy in predicting externalizing psychopathology. The findings suggest that both versions of the PSCD are useful for assessing psychopathy subscales in Iranian justice-involved adolescents and hold promise for generating further research on this topic.
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