Hare Psychopathy Checklist - AbsoluteAstronomy.com

In contemporary research and clinical practice, Robert D. Hare's

Robert Hare (psychologist)

Robert D. Hare, C.M. , is a researcher in the field of criminal psychology. He developed the Psychopathy Checklist and Psychopathy Checklist Revised , used to diagnose cases of psychopathy and also useful in predicting the likelihood of violent behavior...

Psychopathy Checklist-Revised (PCL-R) is the psycho-diagnostic tool most commonly used to assess psychopathy

Psychopathy

Psychopathy is a mental disorder characterized primarily by a lack of empathy and remorse, shallow emotions, egocentricity, and deceptiveness. Psychopaths are highly prone to antisocial behavior and abusive treatment of others, and are very disproportionately responsible for violent crime...

. Because an individual's score may have important consequences for his or her future, and because the potential for harm if the test is used or administered incorrectly is considerable, Hare argues that the test should only be considered valid if administered by a suitably qualified and experienced clinician under controlled and licensed conditions. Hare receives a royalty on licensed use of the test.

PCL-R model of psychopathy

The PCL-R is a clinical rating scale (rated by a psychologist or other professional) of 20 items. Each of the items in the PCL-R is scored on a three-point scale according to specific criteria through file information and a semi-structured interview

Semi-structured interview

A semi-structured interview is a method of research used in the social sciences. While a structured interview has a formalized, limited set questions, a semi-structured interview is flexible, allowing new questions to be brought up during the interview as a result of what the interviewee says...

. A value of 0 is assigned if the item does not apply, 1 if it applies somewhat, and 2 if it fully applies. In addition to lifestyle and criminal behavior the checklist assesses glib and superficial charm

Superficial charm

Superficial charm is "the tendency to be smooth, engaging, charming, slick, and verbally facile."The phrase often appears in lists of attributes of psychopathic personalities, such as in Hervey Cleckley's The Mask of Sanity and Robert Hare's Hare Psychopathy Checklist.Associated expressions are...

, grandiosity

Grandiosity

Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder....

, need for stimulation, pathological lying, conning and manipulating, lack of remorse, callousness, poor behavioral controls, impulsivity, irresponsibility, failure to accept responsibility for one's own actions and so forth. The scores are used to predict risk for criminal re-offence and probability of rehabilitation.

The current edition of the PCL-R officially lists four factors (1.a, 1.b, 2.a, and 2.b), which summarize the 20 assessed areas via factor analysis

Factor analysis

Factor analysis is a statistical method used to describe variability among observed, correlated variables in terms of a potentially lower number of unobserved, uncorrelated variables called factors. In other words, it is possible, for example, that variations in three or four observed variables...

. The previous edition of the PCL-R listed two factors. Factor 1 is labelled "selfish, callous and remorseless use of others". Factor 2 is labelled as "chronically unstable, antisocial and socially deviant lifestyle". There is a high risk of recidivism and currently small likelihood of rehabilitation for those who are labelled as having "psychopathy" on the basis of the PCL-R ratings in the manual for the test, although treatment research is ongoing.

PCL-R Factors 1a and 1b are correlated with narcissistic personality disorder

Narcissistic personality disorder

Narcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...

and histrionic personality disorder

Histrionic personality disorder

Histrionic personality disorder is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriately seductive behavior, usually beginning in early...

. They are associated with extraversion and positive affect. Factor 1, the so-called core personality traits of psychopathy, may even be beneficial for the psychopath (in terms of nondeviant social functioning).

PCL-R Factors 2a and 2b are particularly strongly correlated to antisocial personality disorder

Antisocial personality disorder

Antisocial personality disorder is described by the American Psychiatric Association's Diagnostic and Statistical Manual, fourth edition , as an Axis II personality disorder characterized by "...a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood...

and criminality and are associated with reactive anger, criminality, and impulsive violence. The target group for the PCL-R is convicted criminals. The quality of ratings may depend on how much background information is available and whether the person rated is honest and forthright.

The two factors

Factor 1: Personality "Aggressive narcissism"

Glibness/superficial charm
Superficial charm
Superficial charm is "the tendency to be smooth, engaging, charming, slick, and verbally facile."The phrase often appears in lists of attributes of psychopathic personalities, such as in Hervey Cleckley's The Mask of Sanity and Robert Hare's Hare Psychopathy Checklist.Associated expressions are...
Grandiose
Grandiosity
Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder....

sense of self-worth
Pathological lying
Cunning/manipulative
Psychological manipulation
Psychological manipulation is a type of social influence that aims to change the perception or behavior of others through underhanded, deceptive, or even abusive tactics. By advancing the interests of the manipulator, often at the other's expense, such methods could be considered exploitative,...
Lack of remorse
Remorse
Remorse is an emotional expression of personal regret felt by a person after he or she has committed an act which they deem to be shameful, hurtful, or violent. Remorse is closely allied to guilt and self-directed resentment...

or guilt
Guilt
Guilt is the state of being responsible for the commission of an offense. It is also a cognitive or an emotional experience that occurs when a person realizes or believes—accurately or not—that he or she has violated a moral standard, and bears significant responsibility for that...
Shallow affect (genuine emotion is short-lived and egocentric)
Callousness; lack of empathy
Empathy
Empathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...
Failure to accept responsibility
Moral responsibility
Moral responsibility usually refers to the idea that a person has moral obligations in certain situations. Disobeying moral obligations, then, becomes grounds for justified punishment. Deciding what justifies punishment, if anything, is a principle concern of ethics.People who have moral...

for own actions

Factor 2: Case history "Socially deviant lifestyle".

Need for stimulation/proneness to boredom
Parasitic lifestyle
Poor behavioral control
Lack of realistic long-term goals
Impulsivity
Irresponsibility
Juvenile delinquency
Early behavior problems
Revocation of conditional release

Traits not correlated with either factor

Promiscuous sexual behavior
Many short-term marital relationships
Criminal versatility
Acquired behavioural sociopathy/sociological conditioning (Item 21: a newly identified trait i.e. a person relying on sociological strategies and tricks to deceive)

Early factor analysis

Factor analysis

of the PCL-R indicated it consisted of two factors. Factor 1 captures traits dealing with the interpersonal and affective deficits of psychopathy (e.g. shallow affect, superficial charm, manipulativeness, lack of empathy) whereas Factor 2 dealt with symptoms relating to antisocial behaviour (e.g. criminal versatility, impulsiveness, irresponsibility, poor behaviour controls, juvenile delinquency

Juvenile delinquency

Juvenile delinquency is participation in illegal behavior by minors who fall under a statutory age limit. Most legal systems prescribe specific procedures for dealing with juveniles, such as juvenile detention centers. There are a multitude of different theories on the causes of crime, most if not...

).

The two factors have been found by those following this theory to display different correlates. Factor 1 has been correlated with narcissistic personality disorder

Narcissistic personality disorder

Narcissistic personality disorder is a personality disorder in which the individual is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity...

, low anxiety, low empathy, low stress reaction and low suicide

Suicide

Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...

risk but high scores on scales of achievement and well-being. In addition, the use of item response theory

Item response theory

In psychometrics, item response theory also known as latent trait theory, strong true score theory, or modern mental test theory, is a paradigm for the design, analysis, and scoring of tests, questionnaires, and similar instruments measuring abilities, attitudes, or other variables. It is based...

analysis of female offender PCL-R scores indicates factor 1 items are more important in measuring and generalizing the construct of psychopathy in women than factor 2 items.

In contrast, Factor 2 was found to be related to antisocial personality disorder, social deviance, sensation seeking, low socio-economic status and high risk of suicide

Suicide

. The two factors are nonetheless highly correlated and there are strong indications they do result from a single underlying disorder. However, research has failed to replicate the two-factor model in female samples.

Recent statistical analysis using confirmatory factor analysis

Confirmatory factor analysis

In statistics, confirmatory factor analysis is a special form of factor analysis. It is used to test whether measures of a construct are consistent with a researcher's understanding of the nature of that construct . In contrast to exploratory factor analysis, where all loadings are free to vary,...

by Cooke and Michie indicated a three-factor structure, with those items from factor 2 strictly relating to antisocial behaviour (criminal versatility, juvenile delinquency, revocation of conditional release, early behavioural problems and poor behavioural controls) removed from the final model. The remaining items are divided into three factors: Arrogant and Deceitful Interpersonal Style, Deficient Affective Experience and Impulsive and Irresponsible Behavioural Style.

In the most recent edition of the PCL-R, Hare adds a fourth antisocial behaviour factor, consisting of those Factor 2 items excluded in the previous model. Again, these models are presumed to be hierarchical with a single unified psychopathy disorder underlying the distinct but correlated factors.

The Cooke & Michie hierarchical ‘three’-factor model has severe statistical problems—i.e., it actually contains ten factors and results in impossible parameters (negative variances)—as well as conceptual problems. Hare and colleagues have published detailed critiques of the Cooke & Michie model. New evidence, across a range of samples and diverse measures, now supports a four-factor model of the psychopathy construct, which represents the Interpersonal, Affective, Lifestyle, and overt Antisocial features of the personality disorder.

Diagnostic criteria and PCL-R assessment

Psychopathy is most commonly assessed with the PCL-R, which is a clinical rating scale with 20 items. Each of the items in the PCL-R is scored on a three-point (0, 1, 2) scale according to two factors. PCL-R Factor 2 is associated with reactive anger

Anger

Anger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....

, anxiety

Anxiety

Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...

, increased risk of suicide, criminality

Crime

Crime is the breach of rules or laws for which some governing authority can ultimately prescribe a conviction...

, and impulsive violence.

PCL-R Factor 1, in contrast, is associated with extraversion and positive affect. Factor 1, the so-called core personality traits of psychopathy, may even be beneficial for the psychopath (in terms of nondeviant social functioning). A psychopath will score high on both factors, whereas someone with APD will score high only on Factor 2.

Both case history and a semi-structured interview are used in the analysis.

Other mental disorders

Psychopathy, as measured on the PCL-R, is negatively correlated with all DSM-IV Axis I disorders except substance abuse

Substance abuse

A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...

disorders. Psychopathy is most strongly correlated with DSM-IV antisocial personality disorder

Antisocial personality disorder

.

The official stance of the American Psychiatric Association

American Psychiatric Association

The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...

as presented in the DSM-IV-TR

Diagnostic and Statistical Manual of Mental Disorders

The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

is that psychopathy and sociopathy are misnomers. The World Health Organization

World Health Organization

The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...

takes a different stance in its ICD-10

ICD

The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

by referring to psychopathy, antisocial personality, asocial personality, and amoral personality as synonyms for dissocial personality disorder.

Among laypersons and professionals, there is much confusion about the meanings and differences between psychopathy, sociopathy, antisocial personality disorder, and the ICD-10

ICD-10

The International Statistical Classification of Diseases and Related Health Problems, 10th Revision is a medical classification list for the coding of diseases, signs and symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or diseases, as maintained by the...

diagnosis, dissocial personality disorder.
Hare takes the stance that psychopathy as a syndrome should be considered distinct from the DSM-IV's antisocial personality disorder construct, even though ASPD and psychopathy were intended to be equivalent in the DSM-IV. However, those who created the DSM-IV felt that there was too much room for subjectivity

Subjectivity

Subjectivity refers to the subject and his or her perspective, feelings, beliefs, and desires. In philosophy, the term is usually contrasted with objectivity.-Qualia:...

on the part of clinicians when identifying things like remorse and guilt; therefore, the DSM-IV panel decided to stick to observable behaviour, namely socially deviant behaviours.

As a result, the diagnosis of ASPD is something that the "majority of criminals easily meet." Hare goes further to say that the percentage of incarcerated criminals that meet the requirements of ASPD is somewhere between 80 to 85 percent, whereas only about 20% of these criminals would qualify for a diagnosis of what Hare's scale considers to be a psychopath. This twenty percent, according to Hare, accounts for 50 percent of all the most serious crimes committed, including half of all serial and repeat rapists

Rape

Rape is a type of sexual assault usually involving sexual intercourse, which is initiated by one or more persons against another person without that person's consent. The act may be carried out by physical force, coercion, abuse of authority or with a person who is incapable of valid consent. The...

. According to FBI reports, 44 percent of all police officer murders in 1992 were committed by psychopaths.

Another study using the PCL-R to examine the relationship between antisocial behaviour and suicide

Suicide

found that suicide history was strongly correlated to PCL-R Factor 2 (reflecting antisocial deviance) and was not correlated to PCL-R factor 1 (reflecting affective functioning). Given that ASPD relates to Factor 2, whereas psychopathy relates to both factors, this would confirm Hervey Cleckley's assertion that psychopaths are relatively immune to suicide. People with ASPD, on the other hand, have a relatively high suicide rate.

Since psychopaths frequently cause harm through their actions, it is assumed that they are not emotionally attached to the people they harm; however, according to the PCL-R Checklist, psychopaths are also careless in the way they treat themselves. They frequently fail to alter their behavior in a way that would prevent them from enduring future discomfort.

In practice, mental health professionals rarely treat psychopathic personality disorders as they are considered untreatable and no interventions have proved to be effective. In England

England

England is a country that is part of the United Kingdom. It shares land borders with Scotland to the north and Wales to the west; the Irish Sea is to the north west, the Celtic Sea to the south west, with the North Sea to the east and the English Channel to the south separating it from continental...

and Wales

Wales

Wales is a country that is part of the United Kingdom and the island of Great Britain, bordered by England to its east and the Atlantic Ocean and Irish Sea to its west. It has a population of three million, and a total area of 20,779 km²...

the diagnosis of dissocial personality disorder is grounds for detention in secure psychiatric hospital

Psychiatric hospital

Psychiatric hospitals, also known as mental hospitals, are hospitals specializing in the treatment of serious mental disorders. Psychiatric hospitals vary widely in their size and grading. Some hospitals may specialise only in short-term or outpatient therapy for low-risk patients...

s under the Mental Health Act

Mental Health Act 1983

The Mental Health Act 1983 is an Act of the Parliament of the United Kingdom which applies to people in England and Wales. It covers the reception, care and treatment of mentally disordered persons, the management of their property and other related matters...

if they have committed serious crimes, but since such individuals are disruptive for other patients and not responsive to treatment this alternative to prison

Prison

A prison is a place in which people are physically confined and, usually, deprived of a range of personal freedoms. Imprisonment or incarceration is a legal penalty that may be imposed by the state for the commission of a crime...

is not often used.

Because an individual's scores may have important consequences for his or her future, the potential for harm if the test is used or administered incorrectly is considerable. The test can only be considered valid if administered by a suitably qualified and experienced clinician under controlled conditions.

Hare wants the Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

to list psychopathy as a unique disorder, saying psychopathy has no precise equivalent in either the DSM-IV-TR
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

, where it is most strongly correlated with the diagnosis of antisocial personality disorder

Antisocial personality disorder

, or the ICD-10
ICD
The International Statistical Classification of Diseases and Related Health Problems is a medical classification that provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances, and external causes of injury or disease...

, which has a partly similar condition called dissocial personality disorder. Both organizations view the terms as synonymous. But only a minority of what Hare and his followers would diagnose as psychopaths who are in institutions are violent offenders.

The manipulative skills of some of the others are valued for providing audacious leadership

Leadership

Leadership has been described as the “process of social influence in which one person can enlist the aid and support of others in the accomplishment of a common task". Other in-depth definitions of leadership have also emerged.-Theories:...

. It is argued psychopathy is adaptive in a highly competitive environment, because it gets results for both the individual and the corporation

Corporation

A corporation is created under the laws of a state as a separate legal entity that has privileges and liabilities that are distinct from those of its members. There are many different forms of corporations, most of which are used to conduct business. Early corporations were established by charter...

s or, often small political sects they represent. However, these individuals will often cause long-term harm, both to their co-workers and the organization as a whole, due to their manipulative, deceitful, abusive, and often fraud

Fraud

In criminal law, a fraud is an intentional deception made for personal gain or to damage another individual; the related adjective is fraudulent. The specific legal definition varies by legal jurisdiction. Fraud is a crime, and also a civil law violation...

ulent behaviour.

Hare describes people he calls psychopaths as "intraspecies predators who use charm

Superficial charm

, manipulation

Psychological manipulation

Psychological manipulation is a type of social influence that aims to change the perception or behavior of others through underhanded, deceptive, or even abusive tactics. By advancing the interests of the manipulator, often at the other's expense, such methods could be considered exploitative,...

, intimidation

Intimidation

Intimidation is intentional behavior "which would cause a person of ordinary sensibilities" fear of injury or harm. It's not necessary to prove that the behavior was so violent as to cause terror or that the victim was actually frightened.Criminal threatening is the crime of intentionally or...

, sex

Sex

In biology, sex is a process of combining and mixing genetic traits, often resulting in the specialization of organisms into a male or female variety . Sexual reproduction involves combining specialized cells to form offspring that inherit traits from both parents...

and violence

Violence

Violence is the use of physical force to apply a state to others contrary to their wishes. violence, while often a stand-alone issue, is often the culmination of other kinds of conflict, e.g...

to control others and to satisfy their own selfish needs. Lacking in conscience

Conscience

Conscience is an aptitude, faculty, intuition or judgment of the intellect that distinguishes right from wrong. Moral judgement may derive from values or norms...

and empathy

Empathy

Empathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...

, they take what they want and do as they please, violating social norms

Norm (sociology)

Social norms are the accepted behaviors within a society or group. This sociological and social psychological term has been defined as "the rules that a group uses for appropriate and inappropriate values, beliefs, attitudes and behaviors. These rules may be explicit or implicit...

and expectations without guilt or remorse". "What is missing, in other words, are the very qualities that allow a human being to live in social harmony."

External links

Generality of Psychopathy Checklist—Revised Factors Over Prisoners and Substance-Dependent Patients.

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PCL-R model of psychopathy

The two factors

Diagnostic criteria and PCL-R assessment

Other mental disorders

See also

Further reading

External links