David J. Cooke

Psychopathy : theory, research, and implications for society

1. The Alvor Advanced Study Institute R.D. Hare. 2. Psychopathy Across Cultures D.J. Cooke. 3. Psychopathy and Normal Personality T.A. Widiger. 4. The Phenotypic and Genotypic Structure of Psychopathic Traits W.J. Livesley. 5. Psychopathic Behavior: An Information Processing Perspective J.P. Newman. 6. Psychopathy, Affect and Behavior R.D. Hare. 7. Biology and Personality: Findings from a Longitudinal Project B.A. Klinteberg. 8. Callous-Unemotional Traits and Conduct Problems: Applying the Two-Factor Model of Psychopathy to Children P.J. Frick. 9. Comorbidities and Biological Correlates of Conduct Disorder K. McBurnett, L. Pfiffner. 10. Psychopathy in Adolescence: Assessment, Violence, and Developmental Precursors A.E. Forth, H.C. Burke. 11. Major Mental Disorder and Crime: An Etiological Hypothesis S. Hodgins, et al. 12. Comorbidity of Psychopathy with Major Mental Disorders N. Nedopil, et al. 13. Psychopathy and Personality Disorder: Implications of Interpersonal Theory R. Blackburn. 14. Treatment and Management of Psychopaths F. Losel. 15. Psychopathy and Risk for Violence S.D. Hart. 16. Psychopathy and Crime: Recidivism and Criminal Careers J.F. Hemphill, et al. 17. Legal Issues Associated with the Concept of Psychopathy J.P. Ogloff, D.R. Lyon. Index. List of Contributors.

Is Criminal Behavior a Central Component of Psychopathy? Conceptual Directions for Resolving the Debate

The development of the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 2003) has fueled intense clinical interest in the construct of psychopathy. Unfortunately, a side effect of this interest has been conceptual confusion and, in particular, the conflating of measures with constructs. Indeed, the field is in danger of equating the PCL-R with the theoretical construct of psychopathy. A key point in the debate is whether criminal behavior is a central component, or mere downstream correlate, of psychopathy. In this article, the authors present conceptual directions for resolving this debate. First, factor analysis of PCL-R items in a theoretical vacuum cannot reveal the essence of psychopathy. Second, a myth about the PCL-R and its relation to violence must be examined to avoid the view that psychopathy is merely a violent variant of antisocial personality disorder. Third, a formal, iterative process between theory development and empirical validation must be adopted. Fundamentally, constructs and measures must be recognized as separate entities, and neither reified. Applying such principles to the current state of the field, the authors believe the evidence favors viewing criminal behavior as a correlate, not a component, of psychopathy.

Psychopathy across cultures : North America and Scotland compared

Differences in the prevalence and presentation of psychopathic personality disorder between North America and Scotland were evaluated. R. D. Hares (1991) Psychopathy Checklist--Revised ratings obtained from a sample of 2,067 North American male prisoners and forensic patients were compared with ratings obtained from 246 Scottish male prisoners. Item response theory methods were used to examine differences in the performance of items and to equate the scale across settings. The items had equal relevance to the description of psychopathic personality disorder in both settings; however, the Scottish prisoners had to have higher levels of the underlying latent trait before certain characteristics became apparent. The prevalence of the disorder appears to be lower in Scotland. Explanations for the observed differences in terms of enculturation, socialization, and migration are explored.

An Item Response Theory Analysis of the Hare Psychopathy Checklist-Revised

Hares Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991) is the measure of choice for measuring psychopathic personality disorder. An item response theory (00) approach was adopted to analyze both test and item functioning. Data from 2,067 North American participants were analyzed. The analysis confirmed that the test was appropriate for both the diagnosis of psychopathic personality disorder and for making measures of trait strength. 1\vo correlated but distinct factors underpin scores on the PCL-R: Factor I, Selfish, Callous, and Remorseless Use of Others, and Factor 2, Chronically Unstable and Antisocial Life style. Items related to Factor I are generally more discriminating and provide more information about the trait than items relating to Factor 2. Future uses of 00 procedures in the analysis of PCL R data are discussed.

Evaluating the Screening Version of the Hare Psychopathy Checklist—Revised (PCL:SV): An item response theory analysis.

The Screening Version of the Psychopathy Checklist-Revised (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was developed to complement the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 1991), and for use outside forensic settings. The PCL:SV takes less time to administer and requires less collateral information than the PCL-R. An item response theory approach was adopted to determine similarities in the structural properties of the 2 instruments and whether the PCL:SV could be regarded as a short form of the PCL-R. Eight of the 12 items in the PCL:SV were strongly parallel to their equivalent PCL-R items. Of the 4 items PCL:SV items which differed from their equivalent PCL-R items, all 4 were found to be equal or superior to their equivalent PCL-R items in terms of discrimination. The analyses confirmed previous results that the interpersonal and affective features of psychopathy have higher thresholds than do the impulsive and antisocial behavioral features; individuals have to be at a higher level of the psychopathic trait before the interpersonal and affective features become evident. The PCL:SV is an effective short form of the PCL-R.

Limitations of Diagnostic Precision and Predictive Utility in the Individual Case: A Challenge for Forensic Practice

Knowledge of group tendencies may not assist accurate predictions in the individual case. This has importance for forensic decision making and for the assessment tools routinely applied in forensic evaluations. In this article, we applied Monte Carlo methods to examine diagnostic agreement with different levels of inter-rater agreement given the distributional characteristics of PCL-R scores. Diagnostic agreement and score agreement were substantially less than expected. In addition, we examined the confidence intervals associated with individual predictions of violent recidivism. On the basis of empirical findings, statistical theory, and logic, we conclude that predictions of future offending cannot be achieved in the individual case with any degree of confidence. We discuss the problems identified in relation to the PCL-R in terms of the broader relevance to all instruments used in forensic decision making.

One measure does not a construct make: directions toward reinvigorating psychopathy research--reply to Hare and Neumann (2010).

In our article by J. L. Skeem & D. J. Cooke, (2010), we outlined the dangers inherent in conflating the Psychopathy Checklist-Revised (PCL-R; R. Hare, 1991) with psychopathy itself. In their response, R. Hare and C. Neumann (2010) seemed to agree with key points that the PCL-R should not be confused with psychopathy and that criminal behavior is not central to psychopathy; at the same time, they said we provided no clear directions for theory or research. In this rejoinder, we clarify our argument that progress in understanding the unobservable construct of psychopathy hinges upon setting aside procrustean dependence on a monofocal PCL-R lens to test (a) actual theories of psychopathy against articulated validation hierarchies and (b) the relation between psychopathy and crime. In specifying these conceptual and applied directions, we hope to promote constructive dialogue, further insights, and a new generation of research that better distinguishes between personality deviation and social deviance.

Psychopathy Across Cultures

Like the poor, psychopaths have always been with us (Cleckley, 1976; Rotenberg & Diamond, 1971); while they appear in all societies — no matter what the level of economic development — the prevalence of the disorder shows marked cross-cultural variation (Mealey, 1995). This chapter will examine what we know about the cross-cultural variation in the rate and nature of psychopathy. The overarching themes of the chapter are that a cross-cultural perspective is not only necessary if we are to apply the diagnosis in an ethical manner, but also, such a perspective can inform research both about the nature and the etiology of the disorder.

Cognitive behaviour therapy for violent men with antisocial personality disorder in the community: an exploratory randomized controlled trial

BACKGROUND Little information exists on treatment effectiveness in antisocial personality disorder (ASPD). We investigated the feasibility and effectiveness of carrying out a randomized controlled trial of cognitive behaviour therapy (CBT) in men with ASPD who were aggressive. METHOD This was an exploratory two-centre, randomized controlled trial in a community setting. Fifty-two adult men with a diagnosis of ASPD, with acts of aggression in the 6 months prior to the study, were randomized to either treatment as usual (TAU) plus CBT, or usual treatment alone. Change over 12 months of follow-up was assessed in the occurrence of any act of aggression and also in terms of alcohol misuse, mental state, beliefs and social functioning. RESULTS The follow-up rate was 79%. At 12 months, both groups reported a decrease in the occurrence of any acts of verbal or physical aggression. Trends in the data, in favour of CBT, were noted for problematic drinking, social functioning and beliefs about others. CONCLUSIONS CBT did not improve outcomes more than usual treatment for men with ASPD who are aggressive and living in the community in this exploratory study. However, the data suggest that a larger study is required to fully assess the effectiveness of CBT in reducing aggression, alcohol misuse and improving social functioning and view of others. It is feasible to carry out a rigorous randomized controlled trial in this group.

Explicating the Construct of Psychopathy: Development and Validation of a Conceptual Model, the Comprehensive Assessment of Psychopathic Personality (CAPP)

Psychopathic personality disorder (PPD) has important clinical and forensic implications. But much more effort has been devoted to assessing or diagnosing PPD than to explicating or defining it. In the first part of this paper, we describe the development of a conceptual model or “concept map” of PPD. Based on a systematic review of descriptions of PPD in the clinical and research literature, as well as consultation with subject matter experts, we identified key features of the disorder and translated them into 33 symptoms, presented as natural language (i.e., non-technical) trait descriptive adjectives or adjectival phrases. Each symptom in turn was defined by three synonymous adjectives or adjectival phrases. The 33 symptoms were grouped rationally to reflect six domains of personality functioning. In the second part of the paper, we discuss research completed and in progress intended to validate the CAPP conceptual model.