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False-Positives in Psychopathy Assessment: Proposing Theory-Driven Exclusion Criteria in Research Sampling
Abstract
Recent debates in psychopathy studies have articulated concerns about false-positives in assessment and research sampling. These are pressing concerns for research progress, since scientific quality depends on sample quality, that is, if we wish to study psychopathy we must be certain that the individuals we study are, in fact, psychopaths. Thus, if conventional assessment tools yield substantial false-positives, this would explain why central research is laden with discrepancies and nonreplicable findings. This paper draws on moral psychology in order to develop tentative theory-driven exclusion criteria applicable in research sampling. Implementing standardized procedures to discriminate between research participants has the potential to yield more homogenous and discrete samples, a vital prerequisite for research progress in etiology, epidemiology, and treatment strategies.
... Instead, the nature, use and status of psychopathy should be investigated by recognising that it lies at the intersection of theoretical and practical issues that can only be satisfactorily addressed by rstly making explicit the underlying complex network of conceptual, normative, and empirical issues (Jurjako et al., 2018). These issues could represent a source of dif culties for the construct of psychopathy (Jalava et al., 2015) or a ground for a deeper appreciation of its nature (Rosenberg Larsen, 2018, and its implications for public policy, possibility of treatment options, and even philosophical theorising (Maibom, 2018). ...
... Values can also inform the background conceptions of the normal and acceptable types of behaviour, mental lives, and personality traits, against which psychiatric constructs are salient and mental disorders de ned (Bolton, 2008). Several authors have maintained convincingly that moral values, that prescribe morally permissible or impermissible ways of living, have a role of this type in the construct of psychopathy (Jalava et al., 2015;Maibom, 2014;Rosenberg Larsen, 2018; see also Schramme, 2014). A brief historical overview of the notion of psychopathy appears to con rm this. ...
... The common idea behind these labels was to capture a disorder that selectively affects a person's moral faculties given that their cognitive functioning seemed otherwise preserved. These conceptualizations of moral insanity are echoed in the contemporary conceptualization of the construct of psychopathy (Rosenberg Larsen, 2018. Some argue that exactly this is the problem with the modern scienti c study of psychopathy and that because of this value-ladenness we should not expect signi cant progress in psychopathy research and clinical practice. ...
The recurring claim that the construct of psychopathy is value-laden often is not qualified in enough detail. The chapters in this part of the volume, instead, investigate in depth the role and significance of values in different aspects of the construct of psychopathy. Following these chapters, but also by offering a background to them, we show how certain values are involved in the characterisation of psychopathy, inform societal needs satisfied by this construct, and have a central role in determining whether psychopathy is a mental disorder. Moreover, we relate this description to our criticism of the view that the entrenchment of the notion of psychopathy with values renders it in principle irreconcilable with sound psychiatric theory and practice. However, we also recognize that the value-ladenness of psychopathy leaves open other important challenges. Meeting them needs addressing interdisciplinary interrelated issues that have empirical, normative, and theoretical dimensions.
... Indeed, it seems fully probable that a person with such non-attenuated emotions (i.e. a non-psychopath) could meet the threshold for clinical psychopathy as defined by current assessment tools (e.g. The Hare Psychopathy Checklist-Revised [Hare 2003]) (see also, Larsen [2018]). ...
... With more discrete sampling, more precise data are likely to follow (e.g. Larsen 2018). Compare this to one of the main and long-standing criticisms of psychopathy research (e.g. ...
The term psychopathy refers to a personality disorder associated with callous personality traits and antisocial behaviors. Throughout its research history, psychopathy has frequently been described as a peculiar form of moral blindness, engendering a narrative about a patient stereotype incapable of taking a genuine moral perspective, similar to a blind person who is deprived of proper visual perceptions. However, recent empirical research has shown that clinically diagnosed psychopaths are morally more fit than initially thought, and the blindness-analogy now comes across as largely misleading. In this contribution, the moral-blindness analogy is explored in an attempt to qualify anew its relevance in psychopathy theory and research. It is demonstrated that there are indeed theoretically relevant parallels to be drawn between blindness and psychopathy, parallels that are especially illuminating when accounting for the potential symptomatology, dimensionality, and etiological nature of the disorder.
... Moreover, it has been suggested that more theory-driven exclusion criteria are needed to solve the false-positive problem in psychopathy (Rosenberg Larsen, 2018). Although the mere specification of exclusion criteria in itself J o u r n a l P r e -p r o o f does not equate more theory-driven decisions, it is a move in the right direction and allows for comparisons across studies. ...
Psychopathy is a personality construct that encompasses a constellation of traits reflecting emotional dysfunction and antisocial behavior. This constellation has consistently been linked to poor decision-making, often focused on personal and monetary gains at the others’ expense. However, there remains a lack of a systematic examination of how psychopathy is related to the prospect of obtaining monetary gains as a function of social context. Therefore, we conducted a series of meta-analyses to elucidate these relationships. Our findings indicated that elevated levels of psychopathy are related to a reduced tendency to cooperate with others, and no difference in the extent to which knowledge of others’ retaliation possibilities informs decision-making. However, the type of social economic decision-making game employed moderated the association between psychopathic traits and total gain obtained, suggesting that context plays a key role in moderating the link between psychopathic features and decision-making. These findings advance our understanding of psychopathy and open new avenues for research on adaptive and maladaptive social behavior in individuals with high levels of psychopathic traits.
... Međedović, Bulut, Savić, & Đuričić, 2018) they inherit all of the problems related to such classifications (see section 2 above). They include heterogeneity and low construct validity which lead to forming groups of people that often do not share meaningful cognitive, biological, or aetiological underpinnings (Cooke, 2018;Jurjako, Malatesti, & Brazil, 2019b;Međedović, Petrović, Kujačić, Đorić, & Savić, 2015;Rosenberg Larsen, 2018). In that sense they fail to fulfil the standards for being a biomedical natural kind (Brzović et al., 2016(Brzović et al., , 2017Maibom, 2018). ...
... The problem with this assessment procedure is that these samples are not representative of what is here assumed about psychopathy, that it is a condition of having global degree-specific diminished emotional dispositions. In fact, there are good reasons to think that clinical samples are more heterogenous than typically assumed (Hicks & Drislane, 2018), but also that these clinical assessment tools yield a substantial number of false-positives regardless of what theory of psychopathy we operate with (Larsen, 2018). In order for us to develop a proper research protocol that can actually test the moral psychological capacities of psychopathy (as defined here), it seems that we first need to develop a reliable and valid method to select people who can be said to have, for instance, globally degree-specific diminished emotional dispositions (assuming that such a condition even exists). ...
Psychopathy has been theorized as a disorder of emotion, which impairs moral judgments. However, these theories are increasingly being abandoned as empirical studies show that psychopaths seem to make proper moral judgments. In this contribution, these findings are reassessed, and it is argued that prevalent emotion-theories of psychopathy appear to operate with the unjustified assumption that psychopaths have no emotions, which leads to the hypothesis that psychopaths are completely unable to make moral judgments. An alternative and novel explanation is proposed, theorizing psychopathy as a degreespecific emotional deficiency, which causes degree-specific differences in moral judgments.
... As one reviewer of this article pointed out, maybe the overall actuarial data on diagnosed psychopaths are simply too weak to make any truthful assertions about the patient class (this concern is also raised in Serin, Brown, and Wolf [2016]). Such a reservation would be even stronger if we weigh the possibility of large-scale false positives within the PCL-R patient class (Larsen 2018). ...
... As one reviewer of this article pointed out, maybe the overall actuarial data on diagnosed psychopaths are simply too weak to make any truthful assertions about the patient class (this concern is also raised in Serin, Brown, and Wolf [2016]). Such a reservation would be even stronger if we weigh the possibility of large-scale false positives within the PCL-R patient class (Larsen 2018). ...
The psychiatric diagnosis of psychopathic personality – or psychopathy – signifies a patient stereotype with a callous lack of empathy and strong antisocial tendencies. Throughout the research record and psychiatric practices, diagnosed psychopaths have been predominantly seen as immune to psychiatric intervention and treatment, making the diagnosis a potentially strong discriminator for treatment amenability. In this contribution, the evidence in support of this proposition is critically analyzed. It is demonstrated that the untreatability perspective rests largely on erroneous, unscientific conclusions. Instead, recent research suggests that practitioners should be more optimistic about the possibility of treating and rehabilitating diagnosed psychopaths. In light of this finding, concrete ethical challenges in the forensic practice surrounding the psychopathy diagnosis are discussed, adding to a growing body of research that expresses skepticism about the forensic utility of the diagnosis.
Psychopathy is a personality disorder that has attracted considerable interdisciplinary interest. In fact, the idea of a group of people with abnormal morality and interpersonal relations raises important philosophical, legal, and clinical issues. However, before engaging these issues, we ought to examine whether this category is scientifically grounded, namely whether this way of grouping individuals is explanatory and not merely a byproduct of our tendency to segregate people seemingly different from us. In this paper, we frame the issue in terms of the question whether ‘psychopathy’ designates a natural kind. We argue that currently there is no sufficient evidence for an affirmative answer to this question. Furthermore, we draw some philosophical implications of this result and examine three ways of dealing with the category of psychopathy. These include: We could eliminate the category, revise it, or subscribe to a more encompassing account of kinds, which will be able to capture psychopathy as it is currently conceptualized. We argue that a revision of the category of psychopathy is to be expected with the empirical and theoretical advancements. However, we also emphasize its current role in research, clinical and forensic practices as a scientific category in the making, or as we argue, a pragmatic kind.
In this paper it is proposed that important components of moral development and moral judgment rely on two forms of emotional learning: stimulus-reinforcement and response-outcome learning. Data in support of this position will be primarily drawn from work with individuals with the developmental condition of psychopathy as well as fMRI studies with healthy individuals. Individuals with psychopathy show impairment on moral judgment tasks and a pronounced increased risk for instrumental antisocial behavior. It will be argued that these impairments are developmental consequences of impaired stimulus-aversive conditioning on the basis of distress cue reinforcers and response-outcome learning in individuals with this disorder.
Although psychopathic individuals are often considered immoral in their thinking, research support for this view has been inconsistent. We examined psychopathy's relation to two indices of moral reasoning and decision-making, namely (1) Kohlbergian moral dilemmas and (2) sacrificial moral dilemmas in an undergraduate sample (N = 191). We hypothesized that psychopathic traits would not be strongly associated with moral reasoning on Kohlbergian moral dilemmas, but that they would be associated with a greater willingness to engage in utilitarian moral judgment by virtue of psychopathic individuals' affective deficits and emotional detachment. We expected these relations to be most pronounced for the psychopathy subdimensions Fearless Dominance and Coldheartedness. Counter to prediction, we found only a modest negative association between psychopathic traits and Kohlbergian moral reasoning. Psychopathic traits did not relate consistently to utilitarian decision-making. These results suggest that, despite the common perception that psychopathic individuals are deficient in moral understanding, psychopathic traits may be largely unassociated with profound moral reasoning deficits.
Psychopathic individuals are often characterized as lacking a moral sense. Although this hypothesis has received ample experimental attention over the past decade, findings have been inconsistent. To elucidate the relationship between psychopathy and abnormal moral judgment, we conducted a meta-analysis of the research on psychopathy and morality-related variables (k = 23, N = 4376). A random effects model indicated a small but statistically significant relation between psychopathy and moral decision-making (rw = .16) and moral reasoning (rw = .10) tasks. These results reveal at best modest support for the common perception that psychopathic individuals fail to understand moral principles. A secondary meta-analysis (k = 9, N = 4294) of the growing body of literature on the relationship between psychopathy and moral reasoning on moral foundations measures provides preliminary evidence that psychopathic individuals may possess a differential set of "moral taste buds" than less psychopathic individuals. We discuss the implications of the results from both meta-analyses for models of the etiology of psychopathy and the criminal responsibility of psychopathic individuals. (PsycINFO Database Record
Antisocial behavior is a heterogeneous construct that can be divided into subtypes, such as antisocial personality and psychopathy. The adverse consequences of antisocial behavior produce great burden for the perpetrators, victims, family members, and for society at-large. The pervasiveness of antisocial behavior highlights the importance of precisely characterizing subtypes of antisocial individuals and identifying specific factors that are etiologically related to such behaviors to inform the development of targeted treatments. The goals of the current review are (1) to briefly summarize research on the operationalization and assessment of antisocial personality and psychopathy; (2) to provide an overview of several existing treatments with the potential to influence antisocial personality and psychopathy; and (3) to present a procedure for integrating and using biological and cognitive measures as starting points to more precisely characterize and treat these individuals. A focus on integrating factors at multiple levels of analysis will uncover person-specific characteristics and highlight potential targets for treatment to alleviate the burden caused by antisocial behavior.