Patrick J. Kennealy

Do Core Interpersonal and Affective Traits of PCL-R Psychopathy Interact With Antisocial Behavior and Disinhibition to Predict Violence?

The utility of psychopathy measures in predicting violence is largely explained by their assessment of social deviance (e.g., antisocial behavior; disinhibition). A key question is whether social deviance interacts with the core interpersonal-affective traits of psychopathy to predict violence. Do core psychopathic traits multiply the (already high) risk of violence among disinhibited individuals with a dense history of misbehavior? This meta-analysis of 32 effect sizes (N = 10,555) tested whether an interaction between the Psychopathy Checklist-Revised (PCL-R; R. D. Hare, 2003) Interpersonal-Affective and Social Deviance scales predicted violence beyond the simple additive effects of each scale. Results indicate that Social Deviance is more uniquely predictive of violence (d = .40) than Interpersonal-Affective traits (d = .11), and these two scales do not interact (d = .00) to increase power in predicting violence. In fact, Social Deviance alone would predict better than the Interpersonal-Affective scale and any interaction in 81% and 96% of studies, respectively. These findings have fundamental practical implications for risk assessment and theoretical implications for some conceptualizations of psychopathy.

Offenders with mental illness have criminogenic needs, too: toward recidivism reduction.

Many programs for offenders with mental illness (OMIs) seem to assume that serious mental illness directly causes criminal justice involvement. To help evaluate this assumption, we assessed a matched sample of 221 parolees with and without mental illness and then followed them for over 1 year to track recidivism. First, compared with their relatively healthy counterparts, OMIs were equally likely to be rearrested, but were more likely to return to prison custody. Second, beyond risk factors unique to mental illness (e.g., acute symptoms; operationalized with part of the Historical-Clinical-Risk Management-20; Webster, Douglas, Eaves, & Hart, 1997), OMIs also had significantly more general risk factors for recidivism (e.g., antisocial pattern; operationalized with the Level of Service/Case Management Inventory; Andrews, Bonta, & Wormith, 2004) than offenders without mental illness. Third, these general risk factors significantly predicted recidivism, with no incremental utility added by risk factors unique to mental illness. Implications for broadening the policy model to explicitly target general risk factors for recidivism such as antisocial traits are discussed.

How Often and How Consistently do Symptoms Directly Precede Criminal Behavior Among Offenders with Mental Illness

Although offenders with mental illness are overrepresented in the criminal justice system, psychiatric symptoms relate weakly to criminal behavior at the group level. In this study of 143 offenders with mental illness, we use data from intensive interviews and record reviews to examine how often and how consistently symptoms lead directly to criminal behavior. First, crimes rarely were directly motivated by symptoms, particularly when the definition of symptoms excluded externalizing features that are not unique to Axis I illness. Specifically, of the 429 crimes coded, 4% related directly to psychosis, 3% related directly to depression, and 10% related directly to bipolar disorder (including impulsivity). Second, within offenders, crimes varied in the degree to which they were directly motivated by symptoms. These findings suggest that programs will be most effective in reducing recidivism if they expand beyond psychiatric symptoms to address strong variable risk factors for crime like antisocial traits.

Validity of Factors of the Psychopathy Checklist–Revised in Female Prisoners: Discriminant Relations With Antisocial Behavior, Substance Abuse, and Personality

The validity of the Psychopathy Checklist—Revised (PCL-R) has been examined extensively in men, but its validity for women remains understudied. Specifically, the correlates of the general construct of psychopathy and its components as assessed by PCL-R total, factor, and facet scores have yet to be examined in depth. Based on previous research conducted with male o fenders, a large female inmate sample was used to examine the patterns of relations between total, factor, and facet scores on the PCL-R and various criterion variables. These variables include ratings of psychopathy based on Cleckleys criteria, symptoms of antisocial personality disorder, and measures of substance use and abuse, criminal behavior, institutional misconduct, interpersonal aggression, normal range personality, intellectual functioning, and social background variables. Results were highly consistent with past findings in male samples and provide further evidence for the construct validity of the PCL-R two-factor and four-facet models across genders.

Psychosis Uncommonly and Inconsistently Precedes Violence Among High-Risk Individuals

A small group of individuals with mental illness is repeatedly involved in violence. Little is known about how often and how consistently these high-risk individuals experience delusions or hallucinations just before a violent incident. To address these questions, data from the MacArthur Violence Risk Assessment Study were used to identify 305 violent incidents associated with 100 former inpatients with repeated violence (representing 50% of incidents and 9% of participants) and test whether psychosis-preceded incidents cluster within individuals. Results indicated that (a) psychosis immediately preceded 12% of incidents, (b) individuals were “fairly” consistent in their violence type (ICC = .42), and (c) those with exclusively “non-psychosis-preceded” violence (80%) could be distinguished from a small group who also had some psychosis-preceded violence (20%). These findings suggest that psychosis sometimes foreshadows violence for a fraction of high-risk individuals, but violence prevention efforts should also target factors like anger and social deviance.

Does Staff See What Experts See? Accuracy of Front Line Staff in Scoring Juveniles' Risk Factors.

Although increasingly complex risk assessment tools are being marketed, little is known about “real world” practitioners’ capacity to score them accurately. In this study, we assess the extent to which 78 staff members’ scoring of juveniles on the California-Youth Assessment and Screening Instrument (CA-YASI; Orbis Partners, Inc., 2008) agree with experts’ criterion scores for those cases. There are 3 key findings. First, at the total score level, practitioners manifest limited agreement (M ICC = .63) with the criterion: Only 59.0% of staff scores the tool with “good” accuracy. Second, at the subscale level, practitioners’ accuracy is particularly weak for treatment-relevant factors that require substantial judgment—like procriminal attitudes (M ICC = .52)—but good for such straightforward factors as legal history (M ICC = .72). Third, practitioners’ accuracy depended on their experience—relatively new staff’s scores were more consistent with the criterion than those with greater years of experience. Results suggest that attention to parsimony (for tools) and meaningful training and monitoring (for staff) are necessary to realize the promise of risk assessment for informing risk reduction.

How Well Do Juvenile Risk Assessments Measure Factors to Target in Treatment? Examining Construct Validity

There has been a surge of interest in using 1 type of risk assessment instrument to tailor treatment to juveniles to reduce recidivism. Unlike prediction-oriented instruments, these reduction-oriented instruments explicitly measure variable risk factors as “needs” to be addressed in treatment. There is little evidence, however, that the instruments accurately measure specific risk factors. Based on a sample of 237 serious juvenile offenders (Mage = 18, SD = 1.6), we tested whether California Youth Assessment Inventory (CA-YASI) scores validly assess the risk factors they purport to assess. Youth were assessed by practitioners with good interrater reliability on the CA-YASI, and by research staff on a battery of validated, multimethod criterion measures of target constructs. We meta-analytically tested whether each CA-YASI risk domain score (e.g., Attitudes) related more strongly to scores on convergent measures of theoretically similar constructs (e.g., criminal thinking styles) than to scores on discriminant measures of theoretically distinct constructs (e.g., intelligence, somatization, and pubertal status). CA-YASI risk domain scores with the strongest validity support were those that assess criminal history. The only variable CA-YASI risk domain score that correlated more strongly with convergent (Zr = .35) than discriminant (Zr = .07) measures was Substance Use. There was little support for the construct validity of the remaining 6 variable CA-YASI risk domains—including those that ostensibly assess strong risk factors (e.g., “Attitudes,” “Social Influence”). Our findings emphasize the need to test the construct validity of reduction-oriented instruments—and refine instruments to precisely measure their targets so they can truly inform risk reduction.

Psychometric Properties of the MAYSI-2 Among Latino Adolescent Offenders:

The Massachusetts Youth Screening Inventory-Second Version (MAYSI-2) has been widely adopted by juvenile justice agencies to identify adolescents in the juvenile justice system who have a mental disorder. Despite this, evidence of the ability of the MAYSI-2 to generalize across different ethnic groups is limited. Because Latinos are overrepresented in the juvenile justice system, we examined the psychometric properties of each subscale in a sample of 472 Latino juvenile offenders using confirmatory factor analyses (CFA), Pearson’s correlation coefficients, and simple linear regressions. The CFA models suggest adequate fit for Latino youth, and the correlations and regressions show strong convergent validity with the K-SADS-PL for a number of MAYSI-2 subscales, lending support to the generalizability of the MAYSI-2 to Latino adolescents. These results may be particularly beneficial for juvenile justice system administrators who render mental health treatment recommendations for youth offenders of different ethnicities.

The Role of Stigma Toward Mental Illness in Probation Officers’ Perceptions of Risk and Case Management Decisions:

Recommendations for supervising offenders with mental illness have evolved from a narrow focus on treating psychopathology to an integration of mental health treatment and correctional interventions. Probation officers likely have inflated perceptions of risk for offenders with mental illness, which may result in improper risk assessment and misinformed risk management practices. In a sample of 89 probation officers, we examined perceptions of risk for probationers with and without mental illness and explored whether stigmatizing attitudes toward mental illness affect perceptions of risk and risk management strategies. Officers did not overestimate risk for offenders with mental illness, and stigma toward mental illness bore little influence on risk ratings and case management decisions. However, officers did rate the offender with mental illness as higher risk than the nondisordered offender and chose more punitive responses to a violation he committed—despite being informed that the offenders were of the same risk classification.