The four facets of psychopathy add predictive utility over and above Antisocial Personality Disorder for various aspects of clinical and criminal behavior. This is the bottom line of a recently published article in the International Journal of Forensic Mental Health. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | International Journal of Forensic Mental Health | 2013, Vol. 12, No. 4, 265-273
The Multifaceted Construct of Psychopathy: Association with APD, Clinical, and Criminal Characteristics among Male and Female Inmates
AuthorJanet I. Warren, University of Virginia Mandi Burnette, University of Rochester
Our study examined the multiple facets of psychopathy and their relationship with personality, mental health and criminal behavior in male and female inmates. At an item level, many Antisocial Personality Disorder (APD) symptoms were not significantly associated with the Affective facet of the PCL-R, yet all were significantly associated with the other three facets of psychopathy. At a diagnostic level, the associations between APD and PCL-R facets were consistent and pervasive, but varied in strength by psychopathy facet. Despite a great deal of overlap between psychopathy and APD, we found some differences in the direction and magnitude of association between APD, psychopathy facets, and criminal and clinical characteristics. Notably, among a forensic sample, psychopathy facets conferred additional risk for antisocial behavior, violence, and other forms of personality pathology, even after adjusting for levels of APD. Future directions for psychopathy research are discussed.
facets of psychopathy, Antisocial Personality Disorder, personality disorders, male and female inmates
Summary of the Research
“The current study aimed to better understand the interface between APD and psychopathy, and test the independent contributions of psychopathy as a multifaceted construct, in the prediction of clinical and criminal behavior of male and female inmates” (p. 265). Male (n = 288) and female (n = 183) inmates were randomly selected from high-, medium-, and low-security prisons in Texas and Ohio to complete a battery of tests, including measures of personality (Structured Interview for Personality Disorders: SIPD-IV), psychopathy (Psychopathy Checklist Revised 2: PCL-R), psychiatric history (Prison Background Information Survey; Beck Depression Inventory: BDI-II; and the Novaco Anger Scale: NAS), and violence and victimization (Prison Violence Inventory: PVI; Revised Conflict Tactics Scale: CTS-2). Statistical analyses were conducted to determine which components of psychopathy (Affective, Interpersonal, Lifestyle, Antisocial) add predictive utility over and above APD.
Results showed “a strong association between APD symptoms and the PCL-R. This association held across all four facets of psychopathy, though the Lifestyle and Antisocial facets demonstrated the strongest associations with APD symptoms…each facet of psychopathy was strongly associated with APD, [although] correlations between the Affective and Interpersonal facets were smaller in magnitude” (p. 268).
In terms of the associations between psychopathy and personality disorder, “psychopathy was strongly associated with APD and Narcissistic personality, and was moderately associated with Paranoid, Borderline, and Histrionic personality. APD demonstrated a similar pattern of associations. With regard to Cluster A, moderate associations were observed between Paranoid PD, Schizotypal PD and psychopathy. Schizoid PD was associated with all facets of psychopathy except for the Interpersonal facet. Finally, Cluster C personality disorders demonstrated small negative associations with psychopathy and its facets” (p. 268).
With respect to clinical characteristics, “after adjusting for gender and age, APD was significantly associated with cocaine, marijuana, and methamphetamine use, as well as in the prediction of drug use disorders. The Antisocial facet of psychopathy added unique value in the prediction of regular use of nearly all substances, and the presence of a substance use disorder. The Lifestyle facet of psychopathy added unique value in the prediction of cognitive anger, behavior regulation, and total anger.
In contrast, the Affective facet of psychopathy was negatively associated with regular use of cocaine and heroin, and with the presence of a substance use disorder. The Affective facet was also negatively associated with levels of depression. Similar patterns were observed for the Interpersonal facet, which was negatively associated with the regular use of alcohol, cocaine, marijuana, and methamphetamine. The Interpersonal facet was associated with higher levels of anger regulation” (p. 269).
Regarding criminal history, “APD was generally associated with a more severe pattern of criminal behavior, and this held after adjusting for age and gender. Once again, the Antisocial facet of psychopathy added unique variance to the prediction of violent, nonviolent, and juvenile offense histories. However, the Affective and Interpersonal facets of psychopathy tended to be negatively associated with criminal offense histories” (p. 269).
The Antisocial facet of psychopathy was also associated with perpetration of aggression in prison and with relational victimization.
Translating Research into Practice
“Consistent with prior research, [the authors] found a strong association between psychopathy and APD within an incarcerated sample. However, results suggested psychopathy is multifaceted, and there may be some utility in breaking psychopathy down into its facets. Namely, [these] findings suggested different patterns of associations with clinical and criminal characteristics across the facets of psychopathy, even after accounting for gender and APD” (p. 269).
Thus, despite the overlap in the constructs of psychopathy and APD, psychopathy facets appear to add predictive utility over and above APD. The implications of this are that researchers and clinicians might wish to consider a finer-grain analysis of the facets of psychopathy in addition to consideration of overall level of psychopathy or diagnosis of APD.
Even after accounting for APD, the Antisocial facet of psychopathy was significant in the prediction of substance use, some aspects of anger, and criminal histories. This facet of psychopathy also added value in the prediction of perpetration of aggression in prison. Combined, such data suggest that psychopathy may be helpful in identifying individuals with heightened risk for continued antisocial behavior and interpersonal deficits—even among a sample of incarcerated individuals” (p. 269).
Other Interesting Tidbits for Researchers and Clinicians
“Notably, the Affective facet of psychopathy demonstrated a different pattern of associations as compared to other facets of psychopathy. The Affective facet was not as strongly associated with APD, and demonstrated a negative association with many violence and risk behaviors. The Affective facet includes items such as lack of remorse, shallow affect, lack of empathy, and failure to accept responsibility, which may reflect core aspects of psychopathy. Once possibility is that the origins of this facet may have roots in a neurobiological or environmentally based emotional non-reactivity and deficits in affective-motivational functioning, though additional research is needed to better understand the associations between specific facets of psychopathy and neurobiological risk” (p. 272).