Marc T. Swogger

Identifying Subtypes of Criminal Psychopaths A Replication and Extension

Psychopathy is an important construct in offender classification. Although several studies have suggested that there are two distinct subtypes of psychopaths, these studies have considerable limitations, including reliance on self-report measures, a failure to adequately address heterogeneity within the construct of psychopathy, and predictor-criterion contamination. A recent taxonomic study (Vassileva, Kosson, Abramowitz, & Conrod, 2005) identified four subgroups of offenders, including primary and secondary psychopaths. The present study uses cluster analysis to replicate and extend those findings to (a) an independent sample and (b) a Psychopathy Checklist—Revised factor model that reduces predictor-criterion contamination. Also, initial results were validated using a novel clustering method. Results show that psychopathy subtypes are replicable across methods. Furthermore, comparisons on other variables provide external validation of the subtypes consistent with prior theoretical conceptualizations.

Psychopathy and Instrumental Violence: Facet Level Relationships

The relationship between psychopathy and violence is well established. However, the extent to which psychopathy is related to different types of violent behavior warrants further study. We examined the relationship between instrumental violence, psychopathy, and psychopathic traits among 248 European American and African American adult male county jail inmates. We assessed instrumentality based on subjective motivations for respondent-identified acts of violence. Psychopathy was assessed using the PCL-R based on interview and file review. We controlled for potentially important covariates, namely IQ and prior violence. Results were in part consistent with findings from studies with adolescents, in that we identified a positive relationship between instrumentality of violence and manipulative interpersonal style. Results differed from youth studies with regard to relationships between instrumentality and other facets of psychopathy. The implications of our study are discussed with regard to treatment and the developmental stability of the relationship between psychopathic traits and instrumental violence.

A test of the reactive aggression-suicidal behavior hypothesis: Is there a case for proactive aggression?

A large body of literature suggests that aggressive behavior can be classified into two subtypes--reactive aggression (RA) and proactive aggression (PA)--which differ on dimensions of emotional arousal, control, and impulsivity. A longstanding hypothesis posits that RA underlies the association between aggression and suicidal behavior, with the implicit assumption that PA is unrelated to suicidal behavior. However, no empirical study to date has specifically investigated this question. The authors examined associations of RA and PA with suicide attempts and suicidal ideation among 878 male and female patients in substance-dependence treatment programs. They also examined the moderating effects of sex. Contrary to hypotheses, PA was associated with both suicide attempts and suicidal ideation. RA was also associated with both outcomes in unadjusted analyses but became nonsignificant for suicide attempts in multivariate analyses. Moreover, sex served as a moderator, with PA showing an association with suicide attempt among men but not women. Results indicate the need for additional studies of PA and suicidal behavior.

Psychopathy, IQ, and Violence in European American and African American County Jail Inmates.

The accuracy of the prediction of criminal violence may be improved by combining psychopathy with other variables that have been found to predict violence. Research has suggested that assessing intelligence (i.e., IQ) as well as psychopathy improves the accuracy of violence prediction. In the present study, the authors tested this hypothesis by using a contemporary measure of psychopathy, the Psychopathy Checklist--Revised (R. D. Hare, 2003), in a sample of 326 European American and 348 African American male offenders. The postdictive power of psychopathy was evident for both ethnic groups and robust across most changes in the operationalization of violence and the analysis conducted, whereas the postdictive power of IQ was not. No Psychopathy x IQ interactions were identified. Implications of these results for violence prediction are discussed.

Subtypes of partner violence perpetrators among male and female psychiatric patients.

The goal of this naturalistic study was to examine heterogeneity among female and male civil psychiatric patients with a history of intimate partner violence (IPV) perpetration. Participants were 567 patients drawn from the MacArthur Violence Risk Assessment Study (J. Monahan et al., 2001). The authors examined subtype composition among 138 women and 93 men with positive histories of IPV and compared these groups with 111 women and 225 men with no histories of IPV. Findings for men and women were consistent with reports from studies of male perpetrators in forensic and community settings in that generally violent/antisocial, borderline/dysphoric, and family only/low-psychopathology subtypes of perpetrators were identified in both men and women. This study provides preliminary evidence for the generalizability of typologies derived from nonpsychiatric partner violence perpetrators to psychiatric populations and suggests that typologies derived from studies of male IPV perpetrators may provide useful guidance for the investigation of female IPV perpetration.

Childhood physical abuse, aggression, and suicide attempts among criminal offenders

Childhood physical abuse (CPA) has numerous short and long-term negative effects. One of the most serious consequences of CPA is an increased risk for suicide attempts. Clarifying the mechanisms by which CPA increases risk for suicidal behavior may enhance preventive interventions. One potential mechanism is a tendency toward aggression. In a sample of 266 criminal offenders, ages 18-62, we examined the relationships among CPA, lifetime aggression, and suicide attempts and tested lifetime history of aggression as a mediator of the relationship between CPA and suicide attempts. Results indicated that CPA and aggression were associated with suicide attempts. Consistent with our hypothesis, lifetime aggression mediated the CPA and suicide attempts relationship. Findings suggest that aggression may be an important mediator of the relationship between CPA and suicide attempts among criminal offenders, and are consistent with the possibility that treating aggression may reduce risk for suicide attempts.

Psychopathy and axis I psychiatric disorders among criminal offenders: relationships to impulsive and proactive aggression.

Both psychopathology and aggression are heterogeneous constructs. Determining which forms of psychopathology relate to risk for different classes of aggressive behavior has implications for risk recognition and management. This study examined the relationships of impulsive aggression (IA) and proactive aggression (PA) to psychopathy and symptoms of several Diagnostic and Statistical Manual Axis I disorders in a sample of criminal offenders. Results replicated prior findings from community samples of a broad relationship between psychopathology and IA. PA was related only to psychopathy. An interaction was found whereby IA was associated with impulsive-antisocial traits of psychopathy only for individuals with moderate to high levels of generalized anxiety. Results indicate that assessing and treating several Axis I disorders in offenders may decrease risk for IA. Moreover, current findings raise the possibility that generalized anxiety is a key, modifiable component of the relationship between IA and impulsive-antisocial traits.

Stressful life events and suicidal behavior in adults with alcohol use disorders: Role of event severity, timing, and type

BACKGROUND Stressful life events (SLEs) play a key role in suicidal behavior among adults with alcohol use disorders (AUD), yet there are meager data on the severity of SLEs preceding suicidal behavior or the timing of such events. METHOD Patients in residential substance use treatment who made a recent suicide attempt (cases, n=101) and non-suicidal controls matched for site (n=101) were recruited. SLEs that occurred within 30 days of the attempt and on the day of the attempt in cases were compared to SLEs that occurred in the corresponding periods in controls. SLEs were categorized by type (interpersonal, non-interpersonal) and severity (major, minor) and were dated to assess timing. Degree of planning of suicide attempts was also assessed. RESULTS Major interpersonal SLEs conferred risk for a suicide attempt, odds ratio (95% CI)=5.50 (1.73, 17.53), p=0.005. Cases were also more likely to experience an SLE on the day of the attempt than on the corresponding day in controls, OR (95% CI)=6.05 (1.31, 28.02), p=0.021. However, cases that made an attempt on the day of a SLE did not make lower planned suicide attempts compared to other cases, suggesting that suicide attempts that are immediately preceded by SLEs cannot be assumed to be unplanned. CONCLUSIONS Results suggest the central importance of major interpersonal SLEs in risk among adults with AUD, a novel finding, and documents that SLEs may lead to suicide attempts within a short window of time (i.e., same day), a daunting challenge to prevention efforts.

Psychopathy and Risk Taking Among Jailed Inmates

Several clinical descriptions of psychopathy suggest a link to risk taking, but the empirical basis for this association is not well established. Moreover, it is not clear whether any association between psychopathy and risk taking is specific to psychopathy or reflects shared variance with other externalizing disorders, such as antisocial personality disorder, alcohol use disorders, and drug use disorders. The present study aimed to clarify relationships between psychopathy and risky behavior among male county jail inmates using both self-reports of real-world risky behaviors and performance on the Balloon Analogue Risk Task (BART), a behavioral measure of risk taking. Findings suggest that associations between externalizing disorders and self-reported risk taking largely reflect shared mechanisms. However, psychopathy appears to account for unique variance in self-reported irresponsible and criminal risk taking beyond that associated with other externalizing disorders. By contrast, none of the disorders was associated with risk-taking behavior on the BART, potentially indicating limited clinical utility for the BART in differentiating members of adult offender populations.

Depressive and Posttraumatic Symptoms Among Women Seeking Protection Orders Against Intimate Partners: Relations to Coping Strategies and Perceived Responses to Abuse Disclosure

This investigation examined the relationship of abuse-specific coping strategies and perceived responses to abuse disclosure to symptoms of depression and posttraumatic stress among 131 women seeking a protection order against an intimate partner. Disengagement, denial, and self-blame coping strategies, as well as blaming of the participant by others, were associated with greater depressive and posttraumatic symptoms. None of the strategies of coping or responses to abuse disclosure were negatively related to depressive or posttraumatic stress symptoms. Findings suggest that mental health providers may find it useful to address these negative styles of coping while public education campaigns should target victim blaming.