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7/26/2019 Hare Psychopathy Checklist Reviewed
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In contemporary research and clinical practice, Robert D. Hare's Psychopathy
Checklist-Revised(PCL-R) is the psycho-diagnostic tool most commonly used to
assess psychopathy. Because an individual's score may have important conseuences !or
his or her !uture, and because the potential !or harm i! the test is used or administered
incorrectly is considerable, Hare argues that the test should only be considered valid i!
administered by a suitably uali!ied and e"perienced clinician under controlled and
licensed conditions. Hare receives a royalty on licensed use o! the test.
#$%-R model o! psychopathy
&he #$%-R is a clinical rating scale (rated by a psychologist or other pro!essional) o!
items. ach o! the items in the #$%-R is scored on a three-point scale according tospeci!ic criteria through !ile in!ormation and a semi-structured intervie*. + value o! is
assigned i! the item does not apply, i! it applies some*hat, and i! it !ully applies. In
addition to li!estyle and criminal behavior the checlist assesses glib and super!icial
charm, grandiosity, need !or stimulation, pathological lying, conning and manipulating,
lac o! remorse, callousness, poor behavioral controls, impulsivity, irresponsibility,
!ailure to accept responsibility !or one's o*n actions and so !orth. &he scores are used to
predict ris !or criminal re-o!!ence and probability o! rehabilitation.
&he current edition o! the #$%-R o!!icially lists !our !actors (.a, .b, .a, and .b), *hich
summarie the assessed areas via !actor analysis. &he previous edition o! the #$%-R
listed t*o !actors. /actor is labelled 0sel!ish, callous and remorseless use o! others0.
/actor is labelled as 0chronically unstable, antisocial and socially deviant li!estyle0.
&here is a high ris o! recidivism and currently small lielihood o! rehabilitation !or
those *ho are labelled as having 0psychopathy0 on the basis o! the #$%-R ratings in the
manual !or the test, although treatment research is ongoing.
#$%-R /actors a and b are correlated *ith narcissistic personality disorder and
histrionic personality disorder. &hey are associated *ith e"traversion and positive a!!ect.
/actor , the so-called core personality traits o! psychopathy, may even be bene!icial !or
the psychopath (in terms o! nondeviant social !unctioning).
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#$%-R /actors a and b are particularly strongly correlated to antisocial personality
disorder and criminality and are associated *ith reactive anger, criminality, and
impulsive violence. &he target group !or the #$%-R is convicted criminals. &he uality o!
ratings may depend on ho* much bacground in!ormation is available and *hether the
person rated is honest and !orthright.
&he t*o !actors
Factor 1: Personality "Aggressive narcissism"
1libness2super!icial charm
1randiose sense o! sel!-*orth
#athological lying
$unning2manipulative
%ac o! remorse or guilt
3hallo* a!!ect (genuine emotion is short-lived and egocentric)
$allousness4 lac o! empathy
/ailure to accept responsibility !or o*n actions
Factor 2: Case history "Socially deviant liestyle"!
5eed !or stimulation2proneness to boredom
#arasitic li!estyle
#oor behavioral control
%ac o! realistic long-term goals
Impulsivity
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Irresponsibility
6uvenile delinuency
arly behavior problems
Revocation o! conditional release
raits not correlated #ith either actor
#romiscuous se"ual behavior
7any short-term marital relationships
$riminal versatility
+cuired behavioural sociopathy2sociological conditioning (Item 8 a ne*ly
identi!ied trait i.e. a person relying on sociological strategies and trics to
deceive)
arly !actor analysis o! thePCL-Rindicated it consisted o! t*o !actors. /actor captures
traits dealing *ith the interpersonal and a!!ective de!icits o! psychopathy (e.g. shallo*
a!!ect, super!icial charm, manipulativeness, lac o! empathy) *hereas /actor dealt
*ith symptoms relating to antisocial behaviour (e.g. criminal versatility, impulsiveness,
irresponsibility, poor behaviour controls, 9uvenile delinuency).
&he t*o !actors have been !ound by those !ollo*ing this theory to display di!!erent
correlates. /actor has been correlated *ith narcissistic personality disorder, lo*
an"iety, lo* empathy, lo* stress reaction and lo* suicide ris but high scores on scales
o! achievement and *ell-being. In addition, the use o! item response theory analysis o!
!emale o!!ender #$%-R scores indicates !actor items are more important in measuring
and generaliing the construct o! psychopathy in *omen than !actor items.
In contrast, /actor *as !ound to be related to antisocial personality disorder, social
deviance, sensation seeing, lo* socio-economic status and high ris o! suicide. &he t*o
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!actors are nonetheless highly correlated and there are strong indications they do result
!rom a single underlying disorder. Ho*ever, research has !ailed to replicate the t*o-
!actor model in !emale samples.
Recent statistical analysis using con!irmatory !actor analysis by $ooe and 7ichie
indicated a three-!actor structure, *ith those items !rom !actor strictly relating to
antisocial behaviour (criminal versatility, 9uvenile delinuency, revocation o!
conditional release, early behavioural problems and poor behavioural controls) removed
!rom the !inal model. &he remaining items are divided into three !actors8 +rrogant and
Deceit!ul Interpersonal 3tyle, De!icient +!!ective "perience and Impulsive and
Irresponsible Behavioural 3tyle.
In the most recent edition o! thePCL-R, Hare adds a !ourth antisocial behaviour !actor,
consisting o! those /actor items e"cluded in the previous model. +gain, these models
are presumed to be hierarchical *ith a single uni!ied psychopathy disorder underlying
the distinct but correlated !actors.
&he $ooe : 7ichie hierarchical ;three
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psychopath (in terms o! nondeviant social !unctioning). + psychopath *ill score high on
both !actors, *hereas someone *ith +#D *ill score high only on /actor .
Both case history and a semi-structured intervie* are used in the analysis.
>ther mental disorders
#sychopathy, as measured on the #$%-R, is negatively correlated *ith all D37-I? +"is I
disorders e"cept substance abuse disorders. #sychopathy is most strongly correlated
*ith D37-I? antisocial personality disorder.
&he o!!icial stance o! the +merican #sychiatric +ssociation as presented in the D37-I?-
&R is that psychopathy and sociopathy are misnomers. &he @orld Health >rganiationtaes a di!!erent stance in its I$D- by re!erring to psychopathy, antisocial personality,
asocial personality, and amoral personality as synonyms !or dissocial personality
disorder.
+mong laypersons and pro!essionals, there is much con!usion about the meanings and
di!!erences bet*een psychopathy, sociopathy, antisocial personality disorder, and the
I$D- diagnosis, dissocial personality disorder. Hare taes the stance that psychopathy
as a syndrome should be considered distinct !rom the D37-I?'s antisocial personalitydisorder construct, even though +3#D and psychopathy *ere intended to be euivalent
in the D37-I?. Ho*ever, those *ho created the D37-I? !elt that there *as too much
room !or sub9ectivity on the part o! clinicians *hen identi!ying things lie remorse and
guilt4 there!ore, the D37-I? panel decided to stic to observable behaviour, namely
socially deviant behaviours.
+s a result, the diagnosis o! +3#D is something that the 0ma9ority o! criminals easily
meet.0 Hare goes !urther to say that the percentage o! incarcerated criminals that meetthe reuirements o! +3#D is some*here bet*een A to A percent, *hereas only about
C o! these criminals *ould uali!y !or a diagnosis o! *hat Hare's scale considers to be
a psychopath. &his t*enty percent, according to Hare, accounts !or percent o! all the
most serious crimes committed, including hal! o! all serial and repeat rapists. +ccording
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to /BI reports, percent o! all police o!!icer murders in EE *ere committed by
psychopaths.
+nother study using the #$%-R to e"amine the relationship bet*een antisocial
behaviour and suicide !ound that suicide history *as strongly correlated to #$%-R
/actor (re!lecting antisocial deviance) and *as not correlated to #$%-R !actor
(re!lecting a!!ective !unctioning). 1iven that +3#D relates to /actor , *hereas
psychopathy relates to both !actors, this *ould con!irm Hervey $lecley's assertion that
psychopaths are relatively immune to suicide. #eople *ith +3#D, on the other hand,
have a relatively high suicide rate.
3ince psychopaths !reuently cause harm through their actions, it is assumed that they
are not emotionally attached to the people they harm4 ho*ever, according to the #$%-R
$heclist, psychopaths are also careless in the *ay they treat themselves. &hey
!reuently !ail to alter their behavior in a *ay that *ould prevent them !rom enduring
!uture discom!ort.
In practice, mental health pro!essionals rarely treat psychopathic personality disorders
as they are considered untreatable and no interventions have proved to be e!!ective. In
ngland and @ales the diagnosis o! dissocial personality disorder is grounds !or
detention in secure psychiatric hospitals under the 7ental Health +ct i! they have
committed serious crimes, but since such individuals are disruptive !or other patients
and not responsive to treatment this alternative to prison is not o!ten used.
Because an individual's scores may have important conseuences !or his or her !uture,
the potential !or harm i! the test is used or administered incorrectly is considerable. &he
test can only be considered valid i! administered by a suitably uali!ied and e"perienced
clinician under controlled conditions.
Hare *ants theDiagnostic and Statistical Manual of Mental Disordersto list
psychopathy as a uniue disorder, saying psychopathy has no precise euivalent in
either theDSM-IV-TR, *here it is most strongly correlated *ith the diagnosis o!
antisocial personality disorder, or theICD-10, *hich has a partly similar condition
called dissocial personality disorder. Both organiations vie* the terms as synonymous.
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But only a minority o! *hat Hare and his !ollo*ers *ould diagnose as psychopaths *ho
are in institutions are violent o!!enders.
&he manipulative sills o! some o! the others are valued !or providing audacious
leadership. It is argued psychopathy is adaptive in a highly competitive environment,
because it gets results !or both the individual and the corporations or, o!ten small
political sects they represent. Ho*ever, these individuals *ill o!ten cause long-term
harm, both to their co-*orers and the organiation as a *hole, due to their
manipulative, deceit!ul, abusive, and o!ten !raudulent behaviour.
Hare describes people he calls psychopaths as 0intraspecies predators *ho use charm,
manipulation, intimidation, se" and violence to control others and to satis!y their o*n
sel!ish needs. %acing in conscience and empathy, they tae *hat they *ant and do as
they please, violating social norms and e"pectations *ithout guilt or remorse0. 0@hat is
missing, in other *ords, are the very ualities that allo* a human being to live in social
harmony.0
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