Do Core Interpersonal and Affective Traits of PCL-R Psychopathy Interact With Antisocial Behavior

12 Pages·2014·0.1 MB·English

PsychologicalAssessment ©2010AmericanPsychologicalAssociation
2010,Vol.22,No.3,569–580 1040-3590/10/$12.00 DOI:10.1037/a0019618
Do Core Interpersonal and Affective Traits of PCL-R Psychopathy Interact
With Antisocial Behavior and Disinhibition to Predict Violence?
Patrick J. Kennealy and Jennifer L. Skeem Glenn D. Walters
UniversityofCalifornia,Irvine FederalCorrectionalInstitution-Schuylkill
Jacqueline Camp
UniversityofNevada,LasVegas
blishers. ed broadly. Tsipnoshtcyeeicrahauloctidtplsieatvtyhwiaioicntfhctperasthyi(teecs.hgmoc.,opuraalettnhiptyiilnsyomtectrehipaaeelsru(sbaroeelrnhseaaailvnd-iayopfrfrh;eeicddgtiiihcvs)tieinnrhigtsirkbaviiittooisoflenvon)if.coelApeisnsykccleeahyroagmpqeauloytehnsygetxiodptnoilsaiiinpnshreeiwdbdhiibtceeyttdhtvehiinreodilsrieovnacicsdiseaue.laslsdDsmeovweiniacttnhocoraeef
ed puminat dinetnesreachtiiosntorbyetowfemenisbtheehaPvisoyrc?hoTphaitshymeCtah-eacnkalliysst-isReovfis3e2de(fPfeCcLt-sRiz;esR.(ND(cid:1). H1a0r,e5,552)00te3s)teIdntwerhpeetrhseornaaln-
one of its alliot to be disse ARIinneftfespeurrcplettedisvrisceoitnainndnagidlc-AaSvtoifeofcelietcahntliacvDteee.SvtrIoianacintisfacale(cdstD,c(cid:1)aeSlveo.i1sca1inpa)cr,leeadDniicdestvetihmdaenvoscieroeetlweaunlonociensqcebuaeelwyelysoonudpdlodrtenhdpoeirtcesitdinimivtceeptrlaeboceafttd(tddverii(cid:1)toitlvhee.na0nec0fe)ftetho(cedtisnIo(cid:1)ncfrteeera.ap4scee0hr)pssooctnwhaalaeelnr-.
on or d is n Afufnfdecatmiveentsaclapleracatnicdalanimypilnicteartiaocntisonforinris8k1%assaenssdm9e6n%tanodftshteuodrieetsi,carlesipmepcltiicvaetliyo.nsThfoersesofminedicnognscehpatvue-
Associatial user an aKleizyawtioorndss:ofpspyscyhcohpoaptahtyh,ya.ntisocialbehavior,disinhibition,violence,riskassessment
al du
ogicdivi
n Psychole of the in wiIthninrebcoetnhtfyoeraernss,icpsreyscehaorpcahthanydhparsacbteicceomseettirneggsu.laInrlyfacret,fesruernvceeyds fbierslitegfltahnactep,styhcehPoCpaLt-hRs’asrepr“erdeimctoivrseeuletislsitpyresedeamtosrscwonhsoisutesnetcwhaitrhma,
as
erical u of forensic diplomates in the United States indicate that the Psy- intimidation and, if necessary, impulsive and cold-blooded vio-
mn chopathyChecklist-Revised(PCL-R;Hare,2003)istheinstrument lencetoattaintheirends”(Hare,1996b,p.1).Asshownnext,this
Aso
he per that is the most often recommended and the most often used to belief is more consistent with public perceptions of psychopathy
y the assessindividuals’futureriskofviolence(Lally,2003;Tolman& (seeHelfgott,1997)thanempiricalevidence.
hted by for t MPCuLll-eRndwoares,d2es0i0g3n)e.dTtohiasssisesssopmsyecwhhoaptatshuyrprraitshinergthgaivnerniskth(aHtatrhee,
yrigolel 2006).Nonetheless,thewidespreaduseofthemeasureisprimarily PCL-R and Violence
opd s basedonitspredictiveutilityforviolentandgeneralrecidivism.At
This document is chis article is intende aPvnisldylPeca,ShtPoorieclconikagnlyJs.BySlKevehearavnnvinicaieoe;asrJl,,yaUFcaqennudidevelreJiarnelseniCtnCyiofaroemrrfepcLCt,.iaDoSlniekfapoelarenIrmntimas,,teDiItnuretvtpioioanfrnetP-;mSsGyecnhclehtunoyonllfokDPgilysl.,y,WcMUhanoinliltvoeeergrsrsy--, cHtfaheonaaerdTrrtseuehec,lrear&efitasmercHedotisofnaufrkapalstslcsstcytiboahcoernihsfhe,ofa1ueplv9yanai8rdotrlh9eyery),rf.pl,foeAiaonncclnttthtotithhnohreeuteeagPoronhpCntahemleLyresho-trioRdachnneaar(dsaHnltut(daeaFdnlriya(edeFcsctaeaootcfsrrftruaeoe1glcrl.)ga,t,it2evae1s;nde9tedH9(pdr0aiem;(cid:1)rrteshHpoa(cid:2)uenattlra.sp5tlaiwiu0vltr)o.ye,,,
T 1990; Harpur et al., 1989). Specifically, PCL Factor 1 (i.e.,
sityofNevada,LasVegas.
WethankArthurAlterman,HowardE.Barbaree,JohnCacciola,Klaus- “Interpersonal-Affective”[IA]scale;Hare,2003)isuniquelydis-
PeterDahle,KevinS.Douglas,ScottA.Duncan,JeromeEndrass,Anthony tinguished by superficial charm, a deceitful interpersonal style, a
J.J.Glover,MartinGrann,GrantT.Harris,KirkHeilbrun,RaymondA. lackofempathy,andshallowaffect.Incontrast,PCLFactor2(i.e.,
Knight,DarylKroner,WagdyLoza,AlexanderLoucks,MelanieMalterer “Social Deviance” [SD] scale; Hare, 2003) is characterized by
(principalinvestigor,JosephNewman),ChristinaMichie(principalinves- generalimpulsivity,irresponsibility,andpastcriminalandantiso-
tigor, David Cooke), Mark E. Olver, Christopher Patrick, T. H. Pham, cial behavior. Although it largely references behavior, Factor 2
ZacharyWalsh(principalinvestigor,DavidKosson),CathyWilson(prin-
alsocapturesthegeneraltraitofdisinhibition,orimpulsivityand
cipal investigor, Stephen Hart), and Nick Wilson for providing data in-
negative affectivity; this is a trait that most would not regard as
cluded in this study. Additionally, we thank Jo Ann Prause and David
specifictopsychopathy(seePatrick,Fowles,&Krueger,2009).
Wilsonfortheirassistancewithstatisticalanalyses.
OnemightassumethatthePCL-R’smeasurementofpersonality
CorrespondenceconcerningthisarticleshouldbeaddressedtoPatrickJ.
Kennealy,DepartmentofPsychologyandSocialBehavior,4322Social& features or both personality and behavioral features of psychopa-
BehavioralSciencesGateway,UniversityofCalifornia,Irvine,Irvine,CA thy drives its utility in predicting violence. As observed by Hare
92697-7085.E-mail:[email protected] (1996a),
569
570 KENNEALY,SKEEM,WALTERS,ANDCAMP
I could never understand, for example, why two individuals with psychopathy. Hare and Neumann (2008) argued that (a) IA per-
much the same scores on some actuarial device—based on similar sonality features are “intimately tied” (p. 231) with behavioral
criminalanddemographiccharacteristics—butoneegocentric,cold- features of SD because both stem from a cohesive higher order
blooded,andremorselessandtheothernot,couldpossiblypresentthe factor representing psychopathy and (b) these personality and
samerisk.(p.39)
behavioral features combine in a manner that is theoretically and
practicallyinformativebeyondtheindividualcomponents(p.234).
However,agrowingbodyofresearchchallengesthisassumption.
Althoughitisnotnecessarilyhisview,Lilienfeld(1998)artic-
ResearchsuggeststhatthePCL-R’sutilityisdrivenmorebyits
ulated this combined perspective over a decade ago: “it may be
measurementofpastantisocialbehavioranddisinhibitionthanby
that Factors 1 and II both assess personality traits relevant to
itsassessmentofinterpersonalandaffectivetraitsofpsychopathy
psychopathy,butthatthetraitsassessedbyFactorIIarerelatedto
per se (Skeem, Miller, Mulvey, Tiemann, & Monahan, 2005;
aheightenedriskforantisocialbehavior”(p.105).Lilienfeldalso
Skeem&Mulvey,2001).Meta-analysessuggestthatSDpredicts
offered an approach for testing this combined perspective—one
violence more strongly than the IA scale, with zero-order effect
thatassesseswhethertheIAandSDscalesofthePCLinteractto
sizes of r (cid:1) .28 and .18, respectively (Walters, 2003; Walters,
ers. oadly. Kstundigiehst,suGwgrgaensnt,th&attDhaehIlAe,s2ca0l0e8a).ddSsimnoilainrlcyr,emmeonstat,lubtuiltitynottoathlle, pthreedsiecptathraetoerestciaclaelsly. relevantvariables,beyondthemaineffectsof
blished br SDscaleaftercontrollingforthescales’sharedvariance(Harris, If the multiplicative (i.e., interactive) effects of the PCL-R factors
on or one of its allied pud is not to be disseminat R1CopMav9fuiuuoc9rrtpelih6tvdi,oe;nees&,ydSeI1,Askt9oQe2o9es0flu7mce0ri;aani1lHsvs&e)kee,eyaiabsMln,sboedsh1rmueui9lstnenv9hsdem3aehyt;ttaeh,avnuHe2lets.i0“,ewcae01krmh1o9sge;f9,oun8cteRti)hfdro.o.eenGgstBahoelilraauvrabsbtren,caenideglt&ttsg,hcpaaoesKCgryuleeaecil”mdsnhlhinoomibetepfeledia,sdtyette2hi,dcgx0oPmc(0snSlah0utatkor;tdrieiuibezcSeludakdmett,riifioobo&&nnner, Papropprowvttohoaaneinscpretehrwnoc,ftvorosiaiutudselnoedrdiHfams.utatoa.grhxe.gepi.emrasaoctnabvoltodihdmvpaeNertbeitadeinhnniucecdemrtedjibovmaeiennpeyntpneootprna(swrdl2epesv0tereha0cnel(t8icLiidr)veiilateoioydeffdnsifbnifeeteoireltvtedhmhed,ef(1apiZt9.croe9ete.o8,idree,imscrnptiadi.saioonn1nn)r0deso5ceefeN)f.fsreestechawltreisys--,
al Associatidual user an includinguTnhtreeaotraebtiliictayl(GCeonndsriedaeur,aGtoiogngisn,a&ndSmTeitsht,s2002). mavasarIeninal’ebstchl(tee2iv0ope0fre7avs)tetiefoninlntetdisnoticunnedg.tyaoA,sfkwaseaumsbaupseltpvtailinpydtleiiLancliaclteimievnfaeofiernelftdfhe’efescfietr(c1fvto9ir9efow8pr)e.ratfhdoevrmicIAaentcosectaohlnee
Psychologicof the indivi epxeraSscuotclnyha.lpitToysh-ibetiaosPneCsdLraanisedembqbeuohedasivteiiosonrs-abaalbsooenudgt-cwsotahnnacdteipPntCugaLldipzesabytaicothenospboaetfthwpyeseiysn-, wcwhooouuplladdthisynudgriegclaeatsteet utthhnaaitqtupbeeelryhsaotvoniaoflurit-tyub-rabesaevsdieodcleocnnoccneec.peStpuutaculhaizlaiazntaioteinfofsnescutnofifoqrupSesylDy-
an se chopathy (Lilienfeld, 1998). The PCL IA scale references traits predict violence. If both scales had unique effects, then it would
erical u that personality-based theorists favor as central to psychopathy, suggest that they work independently, but additively, to predict
Amson including superficial charm, egocentricity, poverty in affective violence. This provides little support for the PCL’s combined
he per reactions,failuretoestablishcloseinterpersonalbonds,andlackof perspective.Anumberofvariablescouldaddpredictiveutilityto
hted by ty for the a1n9x6i4e)t.yT(hCelePcCklLeyS,D19s4c1al,e1e9m76p;hLaysikzkeesna,c1h9r9o5n;iMchciCstoorrdy&ofMcrcimCoinrdal, tfehefafeetIucAtreissscotahfleep(tseryu.gceh.,togepseatntodhfeyrt,(hSaegkPee)eC,mLbu&ptethrCsiopsoedckoteie,vse2n0ion1t0mt)h.eaTatnhitetshitanwtteothraesccytaialoernes
opyrigd solel asenrdvaobthleerfeaantutirseosciaarlebfeahvaovrieodr;btyhebseehaovstieonr-sbibalsyedobthjeecotriivsetsaannddorbe-- coofmitsbipneerstoonparleidtyic-tavnidolbeenhcaevmioor-rbeapsoewdeprafrutlsl.yDthoatnhethseesdiimmpelnesisounms
This document is chis article is intende .cf(iS6clDoDea9ncSn;ctMseHecPdp)osatrydriueneciasa,hlDgi2iczani0oatao0rrtgsrii3coeen)lsno.aAssotPetsfaiescsasorstncatroationianusndtatoigoloScillntyitoyaa,glwt1tiiphcsi9etate8ihrloc:0sraAo,i“lsnW1StMas9Plh9iaDoty4nyft;uhsedyaRanimlssoovobtprihfiedtniowMessmr,meb(n1Aceat9ohnaS7ualP8dnvDD)oti.soni;srIe(o-AnMbrtmahfdraseeece(cid:1)srrtdes-, capDtuePrsepaisatetuRtnhieetapirmoyrpctoosrntoastfnrcutechteotfhUasutticmlhitayqxuimoefsatliPloyCnspL,reedIxniacmttesirnvaaicotitloeinonsnceso?f the
T terriblethings?Becauseheisapsychopath.Andhowdoyouknow predictiveutilityofPCLscaleinteractionsforviolencehavebeen
thatheisapsychopath?Becausehehasdonetheseterriblethings” rare.EarlyreportssuggestedthatPCLscaleinteractionsrelatedto
(Ellard,1988,p.387). pastviolence(Harpur&Hare,1991;ascitedinWalsh&Kosson,
Still, the PCL combines personality- and behavior-based con- 2008; see also Kosson, Steuerwald, Forth, & Kirkhart, 1997).
ceptualizationsthathistoricallyhavebeenincompetition(Lilien- However,thepossibilityofcriterioncontaminationintheseretro-
feld, 1998). On the practical front, individuals must exhibit both spectivestudiesloomslarge,giventhatitemsonbothscalesmay
interpersonal and affective traits of psychopathy and socially de- havebeenratedonthebasisofthesameincidentorincidentsthat
viant behavior to attain a score of 30 or higher on the PCL. were used to quantify the “violent” outcome of interest. For
Although research suggests that psychopathy is dimensional example, if an individual had beaten someone with a tire iron
(Edens, Marcus, Lilienfeld, & Poythress, 2006; Guay, Ruscio, without provocation, this could both serve as the criterion and
Knight, & Hare, 2007; Walters et al., 2007), a cut score of 30 is elevatescoresoncallousness(given“reportsofcallousandsadis-
specifiedinthePCL-Rmanual(Hare,2003)andappliedinprac- tic treatment of others”; Hare, 1990, p. 22) and poor behavioral
ticetoidentify“psychopaths.”Onthetheoreticalfront,proponents controls (given “charges and convictions for offenses involving
ofthePCLhaveofferedwhatwecalla“combinedperspective”on spontaneousandunprovokedviolence”;Hare,1990,p.23).
PSYCHOPATHYANDVIOLENCE 571
Inanefforttoaddresssuchconcerns,investigatorscanconduct violentoutcomeofinterest)weresoughtout.Asmallconvenience
prospectivestudiesoftheutilityofPCLinteractionsinpredicting sample of retrospective studies was also included, mainly to ex-
futureviolenceandcanexaminepartialeffectsizes,whichrender plore methodological quality as a potential moderator of effect
estimates of the unique predictive utility of scales by controlling size.
fortheirsharedvariance.Fewsuchprospectivestudieshavebeen Consistent with Lipsey and Wilson’s (2001) guidelines, the
published,however,andtheyhaveproducedsomewhatconflicting prospectiveandpseudoprospectivestudiesofinterestwereidenti-
findings. First, in a study of 199 male jail releasees, Walsh and fied on the basis of varied sources of information. Specifically,
Kosson (2008) found a weak but significant interaction between studieswereidentifiedby(a)inspectingpriormeta-analysesofthe
thePCLscalesinpredictingviolentreconvictionoveranaverage relation between PCL scores and violence and by reviewing the
6-yearfollow-upperiod.Second,bothSkeemandMulvey(2001) PCL-R manual; (b) searching PsycINFO, using keyword combi-
andWalshandKosson(2008)analyzeddatafromtheMacArthur nations of violence or violent with PCL, PCL-R, PCL: SV, Psy-
ViolenceRiskAssessmentStudy(MVRAS;Monahanetal.,2001) chopathyChecklist,PsychopathyChecklistRevised,andPsychop-
in which 863 civil psychiatric patients were followed for 1 year athyChecklistScreeningVersion;and(c)contactingauthorswho
ers. oadly. aofuttecrohmoespviatariladbilsechfoarrgveio.lUensicneg(tyhees/sntoan),dSakrdeeMmVaRndAMSduilcvheoyto(2m0o0u1s) wunepreubklinshoewdndatota, soerts.mTighhistphraovcee,sspiodsesnetsisfeieddl4a2rgsetupduiebsl.ished or
blished br fsoiounnd(PnCoLs-iSgnVi)fisccaanltereinlatetiroancstihoinpabnedtwfeuetnurteheviPoCleLn-cSec.rUeesnininggaVleesrs- theNmexett,aa-aunthaolyrssios,fgthiveesenshtouwdiersarweelyrethcoenitnatcetreadcttioonrebqeutewsteednataPCfoLr
ed puminat conventionalcontinuouscountofthenumberofviolentincidents, scaleshadbeenreported.Specifically,authorswereprovidedwith
one of its alliot to be disse hifcroeawqnuteevinnetcre,yr.aWctailosnhbaentdweKeonstshoenP(C20L0-S8)Vidsceanlteifsieindparewdeicatkinbguvtisoilgennicfe- SdyseusPlecvSsteSinssegscoyatrniohtsaniexenbrtafeorldcorhawctiaca).alcslAeultoulsagtthiitsonotrgiscthrereeeiltgeharveueartsnhsptoieorPrnsfCo(orLfmforsethcddaeelttehapeirslescas,onesraneeltesysstahetnuseddtAyhcenofmanol-r--
on or d is n The Present Study athniaslymsiest.aO-afnathlyesoisrig(sienealT4a2blsetu1d)i.esTihdeenrteimfieadin,i2n6gw1e6rewienrcelusdtueddieins
al Associatidual user an bperatTwchteieceantlimrteheleeviPasnCrcLiepeosfcftaohlriessaqiunmeseptitroae-ndaitncoatliiynntgtiecrvptireoeslteitnngocfeth,tehgPeivCeiLnnt-eRtrhaiecntit(ohane) erbexeacdllouilcdyaetadevdbae(i1lcaa9bu%lsee).(t6Oh2ef%irth)a,eurt2eh6foursssteudddidipeansrotiintccrieplusapdtioeodnndin(o1rt9hd%iisd),mnooerttach-oaauvnleadldynasotiast
Psychologicof the indivi rns(iupasnerkrcroeatiwpsvsoeertsthteshedmao)terednutatnictcdaaoelnroptrneeinxltesthviitanshnewtcoePhpCiitccoLh,-tiaRhtne,ids(“cm(c)doo)amsvtcabcoiiolnnamfebldimicl”itotiytnnhgleoyoffarisenputdpibcilnisaetgladsn,pt(reibear)--l 5wtehs4eat%irtmeinrawectetlerusrodesfeoppdrercbomtosievpthnee.cgaFteinovndred,twehr3oes5mrw%eeaensrw,eonyedsirieesdladepgissgncergrueibgdaeaodttpoerbtdoaeslilnpootewofc,t3site2vhpeeea,sfrfiaaxentcedstteus1fdif2zeie%ecsst
an se ported in a handful of published studies (Rosenthal & DiMatteo, representing10,555individualsforthismeta-analysis.
cu
erial 2001).Inthisstudy,wemeta-analyticallytestedthePCL-derived Codingmethodologicalqualityandmoderators. Oncedata
mn
Aso hypothesisthattheinterpersonalandaffectivefeaturesofpsycho- wereobtained,thestudieswerecodedformethodologicalquality
he per pathymultiplytheriskofviolenceamongdisinhibitedindividuals andotherpotentialmoderatorsofeffectsize.Wedidsotoaddress
hted by ty for the wwiethexapedcetntsheehbiesthoarvyioorf-baansteisdoscciaalleboefhathveioPr.CGLivtoenexppalsatinremseoasrtcohf, tpwooorcqoumaplietyllinsgtudcireitsicaisnmdsmoifximngetad-iasnsiamlyislaisr,stthuadtieiss,(isneceluSsihoanrpoef,
opyrigd solel tpheersmoneaalsituyr-eb’assepdresdcicatliev.e utility, without an interaction with the 1S9p9e7ci)f.iFcairlslyt,,tahestmudeythwodaoslocgoidceadlianste“gmrietythoofdothloegsitcuadlileysswouasndc”odifedit.
This document is chis article is intende MctiaatTleiothmhneo/ocmddoeemrtaapt-oialransta,iolaynns,discsowtdaaitnsisgtciocfomarlpamonseaetldhyosodifso.tlhEorgaeicechaslstetqepupsa:liissttyuddeaysncdirdibpeeondtteifniin-- (f1t1ciaur9o)iny9tnceef9;otra)iiacro;anun(odsbared)r(demcibf)ofoafepnsrrrreoeemodmntsaotpPllyeeWCacspLwtasiavelirsttsetehcsilrcoyswiir,pnefooavs2mnlo0lotloe0svnw,n3egb)me(.iodCvetAehnpontaopirkpniitnneiltcied,cviripavMcitoaiaienilotcewitnohnsnicafeoseon,frtd(HhtatahfhaniteerletPas,levCai&entLtrcfeaorrHigirtteemteawmrroaieoas-f,
T thissection. yieldedasubsetof12methodologicallysoundstudies.Second,to
Identifying/compiling studies. Studies of youth were ex- avoid mixing potentially dissimilar results, five additional poten-
cluded, given limited knowledge of the stability of psychopathic tialmoderatorswerecoded:(a)samplegender(male/female),(b)
featuresduringthetransitionfromadolescencetoadulthood(Sea- sample type (general offenders, forensic patients, psychiatric pa-
grave & Grisso, 2002; Skeem & Cauffman, 2003). Examinations tients, and sex offenders), (c) study location (Canada, United
of verbal aggression and relational aggression were excluded to States,orother),(d)studydesign(prospective,pseudoprospective,
focus on the more policy-relevant criterion variable of actual and retrospective), and (e) information source for violence out-
physical violence (e.g., including crimes of assault, murder/ come(officialcriminalrecordsobtainedprospectivelyorpseudo-
manslaughter,rape,androbbery).Focuswasdirectedtowardstud- prospectively, official criminal records combined with hospital
iesinwhichviolencewasassessedprospectivelytolimitproblems recordsand/orself-andcollateralreportobtainedprospectivelyor
with criterion contamination. Because a limited number of pro- pseudoprospectively, or official criminal records combined with
spectivestudieswereavailable,“pseudoprospective”studies(i.e., self-reportobtainedretrospectively).
retrospectivestudiesinwhichanindependentraterscoredthePCL Analyses. As suggested earlier, effect sizes for each study
on the basis of file information that predated and excluded the were calculated via hierarchical logistic regression (HLR). For
572 KENNEALY,SKEEM,WALTERS,ANDCAMP
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Association or one of its allied publishers. al user and is not to be disseminated broadly. OutcomeDFollow-up AnyviolentR—crimesAnyviolentR—crimesViolentchargeP4.5yrs(variable) ViolentP2yrs(variable)reconvictionViolentS10yrs(fixed)convictionAnyphysicalP626daysviolence(variable)AnyphysicalP626daysviolence(variable)AnyphysicalS42.91mo.violence(variable)ViolentarrestS— ViolentP1.9yrs(variable)recidivismViolentS3.6yrs(variable)convictionViolentS4.6yrs(variable)convictionViolentchargeS7.3yrs(variable) ViolentchargeS5.1yrs(variable)ViolencearrestP4.2yrs(variable) ViolentchargeS2yrs(fixed)ViolentP3.5yrs(variable)convictionViolentP3.5yrs(variable)conviction AnyviolentR—crimesViolentS9.9yrs(variable)convictionAnyviolentR—crimesArrestforviolentP2.8yrs(variable)offenseViolentP1yr(fixed)recidivism
Psychological of the individu Predictor (cid:4)PCL-RIntFile(cid:4)PCL-RIntFile(cid:4)PCL-RIntFile(cid:4)PCL-RIntFilePCL-Rfile PCL:SVfile PCL:SVfile PCL-Rfile PCL-Rfile (cid:4)PCL-RIntFilePCL-Rfile PCL-Rfile PCL-Rfile PCL-Rfile(cid:4)PCLIntFilePCL-Rfile(cid:4)PCL-RIntFile(cid:4)PCL-RIntFile (cid:4)PCL-RIntFilePCL-Rfile (cid:4)PCL-RIntFile(cid:4)PCL-RIntFile(cid:4)PCL-RIntFile
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hted by the Americay for the personal us Description SubstanceabusepatientsSubstanceabusepatientsIncarceratedsexoffendersPrisoninmates CriminaloffendersenteringprisonCivillycommittedpatientsCivillycommittedpatientsPsychiatricpatientsFederalprisoninmatesFederalprisoninmatesForensicpsych.evaluationsForensicpsych.evaluationsMax.securityhospitalinmatesSexoffendersForensichospitalinmatesSexoffendersFederalprisoninmatesFederalprisoninmates Prisoninmates FederalsexoffendersPrisoninmates Forensicinmate/patientsPrisoninmatesandcourt-mandatedsubstanceabusepatients
This document is copyrigThis article is intended solel e NGenderAge 252MAdult 39FAdult 443M21–68 349M18–40 307M22–50 117M17–84(17–86)75F19–88(20–89)91M17–65 184M20–74 105M17–50 318M16–68 34F18–72 603MAdult 396MAdult183M17–71 496M17–79206M18–55 194M18–61 2,836M18–40 113MAdult 323M19–60 213M23–73 901M17–59
c
n s s s s s s
andViole Location UnitedState UnitedState Canada Scotland Germany Canada Canada Canada Canada Canada Sweden Sweden Canada CanadaCanada UnitedStateCanada Canada UnitedState Canada UnitedState Belgium UnitedState
st
Table1ThePsychopathyCheckli Study Altermanetal.(1998) Altermanetal.(1998) Barbareeetal.(2001) Cooke&Michie(1999);Cookeetal.(2001)Dahle(2006) Douglasetal.(1999) Douglasetal.(1999) Douglasetal.(2003) Douglasetal.(2005) Gloveretal.(2002) Grannetal.(1999) Grannetal.(1999) Harrisetal.(1993);Rice&Harris(1992)Harrisetal.(2007)Heilbrunetal.(1998) Knight&Thornton(2007)Kroneretal.(2005) Kroner&Loza(2001);Loza&Loza-Fanous(2001)aNewman Olver&Wong(2006) Patrick,Zempolich,&Levenston(1997)Phametal.(2005) Poythressetal.(2006)
PSYCHOPATHYANDVIOLENCE 573
This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Table1(continued) (cid:3)StudyLocationNGenderAgeDescriptionPredictorOutcomeDFollow-upF1(SE)F2(SE)F1F2(SE) (cid:4)(cid:5)(cid:5)Poythressetal.(2006)UnitedStates188F18–52PrisoninmatesandPCL-RIntViolentP1yr(fixed).06(.19).07(.19).06(.06)court-mandatedFilerecidivismsubstanceabusepatients(cid:5)Ross,Hart,&WebsterCanada72M17–68PsychiatricPCL:SVfileViolentP6mths(fixed).49(.24).14(.19).12(.07)(1998)patientsrecidivism(cid:5)(cid:5)Ross,Hart,&WebsterCanada35F18–63PsychiatricPCL:SVfileViolentP6mths(fixed).60(.71).56(.45).15(.27)(1998)patientsrecidivism(cid:5)Skeem&Mulvey(2001)UnitedStates496M18–40PsychiatricPCL:SVAnyviolenceP1yr(fixed).09(.04).26(.04).02(.01)(cid:4)patientsIntFile(cid:5)Skeem&Mulvey(2001)UnitedStates367F18–40PsychiatricPCL:SVAnyviolenceP1yr(fixed).03(.05).24(.05).02(.01)(cid:4)patientsIntFile(cid:5)Urbaniok,Endrass,Switzerland99M18–77ViolentandsexualPCL:SVfileViolentS18–32yrs.15(.07).03(.07).01(.02)Rossegger,&Nolloffendersrecidivism(variable)(2007)(cid:4)Walsh&Kosson(2008)UnitedStates199M17–40JailinmatesPCL-RIntViolentP6.1yrs(variable).05(.07).09(.06).03(.02)Filerecidivism(cid:4)(cid:5)(cid:5)Walters&Duncan(2005)UnitedStates122M20–64FederalprisonPCL-RIntArrestforviolentP5.0yrs(variable).01(.08).10(.09).02(.02)forensiceval.Fileoff.(cid:5)Wilson(2000)NewZealand199M21–87IncarceratedPCL:SVViolentP5yrs(fixed).02(.07).28(.07).01(.02)(cid:4)offendersIntFileconviction (cid:1)(cid:1)Note.Ageagerangeofsample.Iinsomecases,agerangewasnotavailableandsoamoregeneralterm(i.e.,Adult)isused.PredictorversionofthePsychopathyChecklistusedandwhether(cid:1)(cid:1)(cid:1)(cid:1)thiswasbasedoneitheraninterviewandfilerevieworafilereviewonly.Ddesign(Rretrospective;Pprospective;Spseudoprospective);allretrospectivedesignsareretrospectivefollow-upstudiesinwhichthePsychopathyChecklist-Revised(PCL-R)wasscoredjustbefore,during,oraftertheoutcomedatahadbeencollected,althoughthefileinformationusedtoscorethePCL-Rexisted(cid:1)(cid:1)beforethestartofthefollow-upperiod.Inallcases,differentindividualsscoredthePCL-Randcollectedtheoutcomedata.Follow-upmeanfollow-upinmonths(fixedallparticipantsfollowed(cid:1)(cid:1)forthesameperiodoftime;variableparticipantsfollowedfordifferingperiodsoftime).F1Factor1,unstandardizedlogisticregressioncoefficients,orloggedoddsratios(BinSPSSoutputfile).(cid:1)(cid:4)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)F2Factor2.IntFileInterviewandFilereview;PCL:SVPsychopathyChecklist:ScreeningVersion;psych.psychiatric;Max.Maximum;eval.evaluation.Dashesindicatefollow-upperiodwasnotfeaturedinthestudy.aNewman,J.P.,MacCoon,D.G.,Vaughan,L.J.,andSadeh,N.(2005);Brinkley,C.A.,Newman,J.P.,Widiger,T.A.,&Lynam,D.R.(2004);Bolt,D.M.,Hare,R.D.,Vitale,J.E.,&Newman,J.P.(2004);Schmitt,W.A.,&Newman,J.P.(1999);Arnett,P.A.,Smith,S.S.,&Newman,J.P.(1997);Newman,J.P.,Schmitt,W.A.,&Voss,W.(1997).
574 KENNEALY,SKEEM,WALTERS,ANDCAMP
each HLR, violence (yes/no) was the predicted outcome, the IA gether, these studies suggest that effect sizes of interaction terms
and SD scale scores were entered on the first step, and the canbeaggregatedviathisstrategy.
interactiontermofthePCLscaleswasenteredonthesecondstep
(assuggestedbyLilienfeld,1998).HLRyieldsregressioncoeffi- Results
cientsthatareloggedoddsratios,whichcanbeusedaseffectsizes
in meta-analysis without further transformation (D. Wilson, per- Weconductedthemeta-analysesinfourbasicsteps:(a)abasic
sonalcommunication,May20,2008).Theeffectsizesusedinthis meta-analysis of all studies, (b) an exploration of the generaliz-
meta-analysis were logged odds ratios that reflect (a) the unique ability of findings across subgroups and methodologically sound
utility of the IA and SD scales in predicting violence while studies, (c) a computation of relative effect sizes via common
controlling for the scales’ shared variance (from the first HLR languageeffectsizestatistics,and(d)anestimationoftheeffectof
step)and(b)theincrementalutilityoftheIA(cid:3)SDinteractionin publication bias and the “file-drawer effect.” Each step is de-
predicting violence, beyond the additive main effects of the sep- scribednext.
aratescales(fromthesecondHLRstep). Conducting the basic meta-analysis. Table 2 presents the
ers. oadly. thoBseectahuasteacroeefufsiecdienintstchoisntrmoeltfao-ransahlayrseids varaer,iainnceesasmenocneg, spcaarlteiasl, upnreidqiucetimngaivnioelfefencctes(owfhthicehPaClsLosicsaslehoscwonregsraanpdhitchaelilryiinnteFraigcutiroen1i)n,
ed publishminated br cpthoreeeytfafabicrieileitunystsoe.dfAsbuletcchhaoucusogeehfdfcoiociinnegcnetsrson(siLshynanevacemesb,seHaeronyyrltaeoi,st&eesdtNatehbweoumintactnrhe,em2i0en0nte6tar)-l, th(hroaemngmoegee(cid:1)anne-0wit–ye2i0gchopteoefdifnitcesif)efnemctsot.sstRiszteerssou,nlgt9sl5y%ipnrdecidocainctfteieddethnvaciteoletihnnetceer;SvtDahles,s“catarnalde-
one of its alliot to be disse uldientenigslccitvery.iiboToelehftnehtcehereeb(saLiusnleittciessrt(oaizccfeotrmi,oo-Sunolatrblidepeekltrewi)npe,ueatDinslteitPCmyCoeosLtftaet-srha,cena&aPlleyCsRsLeoinsgsecaprarsrlee,edsa2iv0icna0tii8plna;rgbeSldveaiilcoetto--- dsrinacittcaiirlooeenaawcsloe”arwsroea1sds.pd11os5.n6rd(0aiptn(iog(cid:6)p(cid:6)ct.oo0r.0r0a1e0s)1o,p)noa.ennTddhsiinttsahgniesdt“oaacrsldaimn1diac-lealpvltoiloayintmitmoeniednaicnu(riime.neag.se,fefuf4leo-”cpntoostdihindzitess)
Psychological Association or of the individual user and is n awikCbmnpieoevnetpTimwte,lgahirRe-hpeseaedteaonin-rM,gnvaeewgtldaerhyrthseeswai,iaifcs&iPfnuhtechCsbceeaSetLsrgecu-wsgwawsciruczeheeraseiilggelptleta,haresstis1tnehoi9ansartn9cghrtrod6eehemdm;esvieWnemivlaoovtarhaalgercelonigrhtnasddee,cnerdetsci(hn,oSeowef2tdSie0imsdirlTt0lsnsraA3eebgr;s,maTentWtaBAiioltonouvrasdwadVeladtodeeeerbf.rrdrousseifrineaeonarctn,trshhaos&1elors.0c,tpvui.E21arid0aegtyis0wgoet8ebhnan)ryesst., cdsgsd1(IdAmcaeui-caplvi(cid:1)latldoyieselaeilcdsntl.aim4ietdonlv0feiineefidn)eoas,(c(c.nlnrairetaio.Hepnnentasp.cgogi,splezfweeyru3;eeiel.on(cid:1)5d”tv(hngd-ieceportCt0o,(cid:1)hd“voi–itdntshih1rso.teae16)sldnc1eriiiaa’nnp)nts,ltictoceioeeo(uirrnn1ewsa(ata9i“ccsanls8tot)”segri8roawr)1owdnCe.deeis0aotosdapi4shtofksoienml1(niynrnap.daa1,’ltits”te4(cid:6)niebrogas(ue(1nst.apc09dttnoos58b(cid:6)d“ir)8grec,a)egntlaw.siui0ennpfoies5iiddonctce)ieneaa.nmtldnhliTlnitsateynhlhtteyaege“ims,nssc.PdetlpTiaoiCaasnrnhrneiLddaea---
an se 2001) and tests whether the pooled effect size is significantly ingful”ORs(cid:1)1.00,ns).Thus,thebehavior-based(SD)and,toa
erical u differentfromzero.Toenhanceinterpretability,thepooledeffect lesser extent, personality-based (IA) approaches to defining psy-
Amson size is reported as an odds ratio in two different forms: (a) a chopathymanifestsomeunique,additiveutilityinpredictingvio-
he per “traditional” odds ratio that represents an increase in the odds of lence. However, the scales manifest no multiplicative effect that
hted by ty for the vmviioeoalleennninccegeffufoolr”reoeavdcedhrsy1r-apotonioienttshtiaantncdrreeaaprsdreesdoeennvttishateaionPnCinLicnrcaernaedsaes(ebin)oanth“etchloiendiPdcsCalLolyf. wjooinutldpsreuspepnocrettohfePthCeLse’sfceoamtubreinseddodeesfinnoittioenxpoofnpesnytcihalolpyatihnycr.eTahsee
This document is copyrighis article is intended solel SoamfgotbrtioraatoApnadtnilhhdenlleiaiescsordpdad3uisdfn.rsd5rspfuoeoomarmvrasnimeetaditstoahei4tosfoeif.nof0eaPsnctrChpetfiofLsoseoiir-zsnsrRtettmiussmsmdtaovuaylanadetnergiyFdeuifvsaoabbeclryenyti(onnpHtrcrshosalaiuepcnr1duedvp,eloaaads2nmrtyii0doaci0tenhn2i3fi,o,f)anwte:rthrceAhiiitsnscispcssehpmmtacaamitoentsiitdvdpeaieeamnl-lelartsydpsn.d.oaedSwlrmyetuaevsconriihes--t rsDstaihzicadsiaeamokSMbrlpeetpifiatl,lloeitelitStrd,syeDsvotlaoihiiztfoesc(telc2loteehQa0annle0nvsece1dsa,oert)rv.aav,i“enatacitrtdtshaiaitovnelitlnchesyreaeiiwiingerpsanulpidesilnrftfotsifhsecaeiiaracgcgannhtnhcdciltsdfeyiidioezcenosesatii.fsnegg”Artnsnmue(isffpdcoiinn.hcrteoa7otttnwh4eetee)dshx.trsepebeNtlsfyhmofueeervlRarecteysotmrtsshtedheoevoenerefpeltgneheethsahnnswolede,mahrwaInoeoAldnne--
T (Cooper & Hedges, 1994; Rosenthal & DiMatteo, 2001). For geneouseffectscouldbeidentified.Thisapproachinvolvedmod-
moderation analyses, Metareg in STATA Version 10.1 was used erator analyses, sensitivity analyses, and meta-analysis of only
(see Harbord & Higgins, 2008). For analyses that addressed the thosestudiesratedasmethodologicallysound.
possibility of publication bias, Metatrim and Metabias routines Exploringthegeneralizabilityofeffects.
fromthesamesoftwarepackagewereused. Moderatoranalyses. Wefirsttestedfivepotentialmoderators
Although the meta-analytic strategy described here chiefly has of effect size: sample gender, sample type, study location, study
beenestablishedforadditiveeffectsizes,recentresearchsuggests design, and information source for violence. Of the 15 tests per-
thatitalsoisappropriateforaggregatingeffectsizesforinteraction formed(fivemoderators(cid:3)threeeffects),onlyonewassignificant.
terms.Onthebasisofasimulationstudy,SimmondsandHiggins Specifically,studylocationmoderatedtheeffectoftheIAscaleon
(2007) concluded that the meta-analysis of interaction terms is violence: effect sizes for studies conducted in the United States
appropriate even when high levels of heterogeneity are present. weresignificantlygreaterthanthoseconductedinothercountries
Taylor and Kim-Cohen (2007) applied this method to aggregate (b(cid:1).07,p(cid:6).05).
gene–environmentinteractioneffects(i.e.,monoamineoxidaseA Sensitivityanalyses. Althoughmoderatoranalysesdidnotre-
by childhood maltreatment) on antisocial behavior. Taken to- veal clear explanations for apparent heterogeneity in effect sizes,
PSYCHOPATHYANDVIOLENCE 575
Table2
WeightedMeanEffectSizesofPCLFactorScoresandTheirInteractionasPredictorsofViolence
PCLFactor1 PCLFactor2 PCLfactorinteraction
Subsample k OR 95%CI Q OR 95%CI Q OR 95%CI Q
Overall 32 1.04(cid:1) 1.01,1.07 65.71(cid:1)(cid:1)(cid:1) 1.15(cid:1)(cid:1)(cid:1) 1.11,1.18 80.73(cid:1)(cid:1)(cid:1) 1.00 0.99,1.00 45.54(cid:1)
Gender
Male 26 1.04(cid:1)(cid:1) 1.01,1.07 58.26(cid:1)(cid:1)(cid:1) 1.14(cid:1)(cid:1)(cid:1) 1.11,1.17 69.21(cid:1)(cid:1)(cid:1) 1.00 0.99,1.00 33.07
Female 6 1.01 0.83,1.23 7.21 1.17 0.97,1.42 7.92 0.98 0.89,1.08 9.80
Location
Canada 14 1.00 0.96,1.04 23.95(cid:1) 1.15(cid:1)(cid:1)(cid:1) 1.10,1.21 35.52(cid:1)(cid:1) 1.00 0.99,1.01 23.36(cid:1)
UnitedStates 11 1.07(cid:1)(cid:1)(cid:1) 1.03,1.11 15.90 1.13(cid:1)(cid:1)(cid:1) 1.08,1.19 30.87(cid:1)(cid:1) 0.99 0.98,1.00 14.89
Other 7 1.06(cid:1) 1.01,1.10 5.53 1.14(cid:1)(cid:1)(cid:1) 1.08,1.21 12.18 0.99 0.98,1.00 3.60
Participants
blishers. ed broadly. FSGPoeseyxrneceonhrfsiafailectrnidcers 16538 1111....00004148(cid:1) 1001....09901930,,,,1111....11005098 1124630....50451537(cid:1)(cid:1) 1111....11115704(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1) 1111....00019561,,,,1111....11229754 228638....97402036(cid:1)(cid:1)(cid:1)(cid:1) 1011....09000900 0000....99999789,,,,1111....00000012 110397....39020279
ed puminat DePsirgonspective 18 1.03 0.99,1.07 26.02 1.14(cid:1)(cid:1)(cid:1) 1.09,1.20 48.40(cid:1)(cid:1)(cid:1) 1.00 0.99,1.00 30.01(cid:1)
on or one of its allid is not to be disse (cid:1)NMpoePRtte(cid:6)she.uotred.o0doPs5olpC.poeLrgcoit(cid:1)cs(cid:1)i(cid:1)vpaleeplPcys(cid:6)tiysvcoe.hu0on1td.her(cid:1)a(cid:1)p(cid:1)yp11C402(cid:6)he.c0k0l1i111s....t000;922k(cid:1)(cid:1)numb100e...099r089o,,,f111e...100ff976ectsiz11es956...c577o507m(cid:1)piled;O111...R111074(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)(cid:1)oddsra111t...i100o328;,,,C111I...212(cid:1)190 confi13d499e...n144c001e(cid:1)(cid:1)(cid:1)i(cid:1)nterval011;...900Q900(cid:1)hom000...o999g799e,,,n111e...000it101ycoeff1ic757i...e236n613t.
al Associatidual user an wsuebgprrooucpesedthedatwmiitghhstehnasviteivmitoyreanhaolmysoegsetnoeo(au)siedfefnectitfysizpeospaunladti(obn) ssuizbegsrofourptshewseerheonmooggerenaetoeurstshuabngr0o.0u7p.sTwheirred,vitrhtuealalvyeirdaegnetiecfafletcot
Psychologicof the indivi Tcssiuoazgmbeglspeeatsort2eeedssthbhtioyomswteahsteehtoQwhmehsoetaQgthteiesnsrtetiacotht,uiewsstilhecaiftcftaheencrctdwasneeizrfbeefeesmcawtfofiersteichztgeetdehnfeboeyrroavsleaeiazmrcaahpblllleeoeffstfhiez1ace2nt. ts(theaannemcdepyfl1feie.n:0c01te).fs0fif4ezocer(tsastpnhlrdeeond1idnu.s0tce4cer)oadcnfftofoiirodrnIetA.hnecT,eh1een.t1otil5ritmeh(ae(itnaegpddepn1ave.ra1rera5nil)atilzbfyaiolbhritieylStietDayrn,oodgafencnrdoeens0ous.u9ilsst9s-)
n e
as subgroupsdefinedbyourfourpotentialmoderators. obtainedforthefullsample.
cu
erial Threeresultsarenoteworthy.First,homogeneouseffectscould Isolatingmethodologicallysoundstudies. Next,werananal-
mn
Aso be isolated. For the IA, SD, and interaction effects, results were yses using only the subsample of 12 methodologically sound
he per homogeneousforseven,five,and10ofthe12subgroups,respec- studies.Inkeepingwithpastresults(Walters,2003),thisreduced
hted by ty for the tviavreileyd.Sveercyonlidt,tlaec:rTohssetshteasnedahrodmdoegveinaetioounsssfuobrgtrhoeupIAs,secffaelec,tssitzaens- hweetreerongoenloenitgyerasmigonnigficeafnfetcftosr.tAhesIsAhoswcanlei,nnoTratbhleein2t,eQracstitoatni,stbicust
opyrigd solel d0a.0r1d,dreesvpiaetcitoivnelsyc,alaen,darnadwthdeififrerienntecreasctbioetnwweeenreth0e.0m2o,s0t.e0x3t,reamnde roefmreasiunletdswsigasnicfoicnasnisttfeonrttwheithSDthastcaolbet.aAingeadinfo,rhothweefvuelrl,(tahpepparaettnetrlny
This document is chis article is intende
T
Figure1. UniqueutilityofPCLscalesandtheirinteractioninpredictingviolence,basedon32effectsizes.The
figuredepictsthe“clinicallysignificant”oddsratio,indicatinganyincreaseintheoddsofviolenceforeveryone
standarddeviationincreaseonthePCLscaleorinteraction.PCL(cid:1)PsychopathyChecklist;OR(cid:1)oddsratio.
(cid:1)p(cid:6).05.(cid:1)(cid:1)(cid:1)p(cid:6).001.
576 KENNEALY,SKEEM,WALTERS,ANDCAMP
more heterogeneous) sample. That is, the SD scale significantly fortheSDscalewerevirtuallyidenticaltothoseobservedinboth
increased the odds of violence (OR (cid:1) 1.14 vs. 1.15 for the full the entire sample and methodologically sound subsample (see
sample)anddidnotinteractwiththeIAscaletodoso(OR(cid:1)1.0 Table2).Third,althoughthismeta-analysisincludedstudieswith
vs.1.0forthefullsample).AlthoughtheeffectoftheIAscalelost variable follow-up periods (see Table 1), survival analysis could
statistical significance in this methodologically sound subsample notbeappliedtoaccountforcensoreddatabecausethevariables
(OR(cid:1)1.02,nsvs.1.04,p(cid:6).05forthefullsample),thisappears neededwerenotconsistentlyavailableintheoriginalstudies.We
tobeafunctionofreducedpowerbecausemethodologicalquality recommend that studies routinely collect these data (i.e., days to
didnotmoderatetheeffectoftheIAscaleinthefullsample. first violence and days of follow-up) to permit a future meta-
Conveyingrelativeeffectsizes. Toconveytherelativeeffect analysis within a survival framework. Fourth, this meta-analysis
sizesofthethreepredictors(SD,IA,andinteraction),weusedthe focused on the policy-relevant outcome variable of whether any
entire sample of 26 studies to compute common language effect violenceoccurredornot;wecouldnottestwhetherFactor1plays
size indicators, which indicate the probability that an effect size aparticularroleinasmallerclassofinstrumentalviolencebecause
randomly selected from one distribution will be greater than an moststudiesdonotspecifyviolencetype.Givenconflictingfind-
ers. oadly. e&ffWecotnsgiz,e19ra9n2d,opm.3ly61s)e.leRcetesudltfsroinmdiacnaotethtehratdtihsetriubnuitqiounep(MredciGctriavwe ilnengcseo(nsewehCeathmepr,FSakcetoerm1,&speBcairfcichaalrldy,r2e0la1t0e)s,twoeinrestcroummmenetnadl vthioa-t
blished br umtialjiotyritoyftohfesStuDdisecsal(e80w.6o2u%ld)eaxncdeewdothualdtoefxtcheeeIdAthsactaloefinthteheinvtears-t smtuedtai-easnarolyustiisn.eFlyiftmh,abkeecasuuscehthdiisffsetruednytiaptrieosnesnttsompeetram-aintaalytfiuctaullrye
ed puminat action between the PCL scales in virtually all studies (95.63%). obtained group-level effect sizes, care should be taken to avoid
one of its alliot to be disse EtlhavraAgetnedodmfthrtaeehjseousrin(intniygqounopeefuxpcbiarsletsiecdenasictt)(tiio6vin9ne.t2ebu3ritaa%iclsit).ti.yonBofbeectthaweuesIeeAnptsuhcbealliPecCawtLioounslcdablieeaxssc,ienienda- gFopereonormepsarloaeyml.iizneitneingradfciivtniwddiuintahglssS,DtIoAtionfeddaoitvusirdoeu.saTlmhsias(yi.iesr.ej,luatshtteensoetrtcootnhlogeglcyiactsaoelvffoaiorlllamecnoycs)et.
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an se of these methods yielded no evidence of publication bias for any ologicallysoundstudies,prospectivestudies,andpseudoprospective
cu
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T variance.Second,theIAscaledidnotinteractwiththeSDscaleto disinhibition and past violent, criminal, and antisocial behavior.
predict violence. After noting study limitations, we analyze each Sometimes, core interpersonal and affective features of psycho-
findinganditsimplicationforpracticeinviolenceriskassessment pathyaddpredictiveutilitytothesefeatures.Incontextsinwhich
and for the PCL-R conceptualization of psychopathy that com- bothscaleshaveuniqueeffects,thisindicatesthattheycanwork
binespersonalityandbehavioralperspectives. independently,butadditively,topredictviolence.
Five limitations must be borne in mind while interpreting the Utility of social deviance in predicting violence does not
resultsofthisstudy.First,althoughweobtainedunpublisheddata depend on core IA traits of psychopathy. Additive effects
and our analyses yielded no evidence of publication bias, it is providelittlesupportfortheconceptualizationofpsychopathythat
possible that the present results overestimated the relation of the specifically combines personality-based and behavior-based ap-
PCLscoreswithviolence,giventhe“file-drawer”effect.Second, proaches. This remains true even if measures of psychopathy
theQstatisticwasstatisticallysignificantfortheSDscaleevenin predominantlyareusedasviolenceriskassessmenttools:Anum-
the methodologically sound studies, suggesting that this scale’s berofvariables(e.g.,neighborhooddisadvantage)couldbeadded
effect is inconsistent across studies. This concern is tempered by to core interpersonal and affective traits to increase the PCL’s
findingsthathomogeneouseffectsidentifiedinseveralsubgroups predictive utility for violence, but this would not mean those
PSYCHOPATHYANDVIOLENCE 577
variableswereessentialfeaturesofpsychopathy.IAtraitsshould ServicesInventory(Andrews,Bonta,&Wormith,2006)arehighly
interact with socially deviant features to predict theoretically rel- associated with the PCL-R (Kroner, Mills, & Reddon, 2005; see
evantoutcomes,ifthetwoPCLscalescombinetocaptureaunitary alsoSkeem,Polaschek,&Manchak,2009),performaswellasthe
construct that is more informative than the simple sum of its PCL-Rinpredictingviolence(Gendreauetal.,2002),andassess
personality- and behavior-based parts (see Hare & Neumann, a broader range of factors (e.g., criminogenic thinking and peer
2008). The central finding of this meta-analysis is that the PCL associations) that provide direction for reducing risk. Fourth, the
scales do not interact to predict violence. This lack of effect was PCLisnotaresource-efficientriskassessmentmethod,giventhat
homogeneousacrossstudies. the PCL takes clinical expertise and 2–3 hr to complete (Hare,
Theabsenceofaninteractionbetweenthetwoscalesmeansthat 2003), its IA scale contributes little to prediction, and self-report
theutilityofSDinpredictingviolencedoesnotbecomestrongeror measures(includingself-reportpsychopathyscales)oftenperform
weakerasafunctionofcoreIAtraitsofpsychopathy,orviceversa. aswellasinterview-basedriskappraisalinpredictingviolenceand
Regardlessofhowemotionallydetachedorinterpersonallydeceit- other criminal behavior (Walters, 2006; for psychopathy, see
ful an individual is, a chronic criminal history and impulsivity/ Campetal.,2010;Edens,Poythress,Lilienfeld,&Patrick,2008;
ers. oadly. ninecgraetaisvee oafffeocnteivisttyanwdialrldprdeedviicattivoinoleinncSeDreilnatcirveealsyesstrthoengrliys—k aonf Eefdfiecnise,nPtloyytihmrepsrso,vLeilrieonufteinlde,Pcoartrriecckti,o&naTlepstr,a2ct0i0ce8).(iT.eo.o,lsdethcaisticoanns
blished br vdiiosilnehnicbeitebdya6n0%ind(isveieduFailg’surleife1s)t.ylNeohamsabtteeern,hocowreapnstiyscohcoiaplatahnidc afibsocualtcplliamceamtee.ntandrelease)areparticularlyimportantintoday’s
ed puminat traits will predict violence relatively weakly—an increase of one Second, beyond practical implications for risk assessment, the
one of its alliot to be disse soptnsaylInymcdh1apor4ldpi%caadt(tehsivoyein.eastFiofTionghrueirnaesrseI1Aes)su.sltitrnsagitosvfiiontlhceirnsecaemseresitsatk-haeannarildsyksciosonfhcveaipvoetlueanclceienztirnbaygl rigpmerrsoepudullinitccsdtaeotpdiforatnthhcsiet.siocSmraypleley(tcaHi-afaanirncdeaall&tlyhyse,iNostrehheuiatsmivceasatnliulmnyd,ypi2mo0crp0taao8sntr)sttatbhnduatottuolfbuiamttcctioootnemrdietnhtsht.eeerAoParcCepttiLrioac-ncaRs-l
on or d is n pcaraticotnicsa.lFiimrspt,litchaetiolinms,itaenddultiimlitiyteodfbcuotriemIpAorttraanittsthaenodrethtieciarlfiamilpulrie- ttihcealPoCuLtc-oRmiesotfypoibcvailolyusupseodlicaysrealervisakncaessisesvsimoleenntceto,ogli.veInn tthhaist
al Associatidual user an t(womhiiinsc)theinratietcrtpiswreipttahretiSdoDonmoinifnptahrneetdlPyicCtaiLpn-pgRlvieiindolte(hnseeceerisiTskodalimsrseaecnstlsym&reenlMetvucaolnlnettnetdoxottrhiene, dp&oermKsoalneinian,li,itty1-9db9oa7ess)edncaocntonsbceeeepmrteustaohllaivzteatdthioebnydseosbifamptepslybycehctowopmeaetbnhiynbi(neshgeaevthPioeimrlk-.oanAnidss
Psychologicof the indivi 2biatn0eshd0pa3e(v)ir.nisoAormn-ltbaohlasiosttuyecgd-abhsdaeitsshset)ediliPlnpaCcstiyoLocrn’rhseoocppftradebtidahsisyicnitslhiavfibboeeirultivtcoiiolnointlaynennoidscteeacsnhpatirieosmfoploycerinbaeslaimsbtyeea.dhliWagovnnhiaoientrnst, o“c(1nob9ons4etsrt1pev)alelrmdatitociboudynlealWro.lfyidpsieagrteissrofnyaainnldigtyLifytrpnasaiytmsc”h(o(1pp9.a9t1h88y),0i)ss,utrcoohobtceeodumnibdnienrCasltteoioconkdsleaaysr’eas
an se told that an individual’s score on a measure of psychopathy sug- Ourfindingshavefewerimplicationsfortheoriesthatarealter-
cu
erial gests that they are at risk for violence, professionals may reason nativestothePCL-Rcombinedperspective.Thevastmajorityof
mn
Aso that suchtheoriesplacenoparticularpremiumonexplainingviolence
he per as an expression of core psychopathic traits. So, variables other
hted by ty for the bbsheeoccaauuuldsseebtethhereeyylaatrcievaleellmoyuoestlaiyosnyvafiloelywrupnsoycthochenronspecaattsehdslitttootltevhiecmtrioemsretizoetfhthahunemvoaubnljineteycrt,saa,bnlidet tthraaintsvainodlenlecsesmspaeycibfeicudsiesdinthoibteitsetdt-haentiinstoecriaacltifoenatbueretws.eCenancdoirdeatIeAs
opyrigd solel a1n8d5)t.ouseviolenceasatooltoobtainwhattheywant(Hare,1999,p. ilneacrlnuidnegsauncdhimthpeoairrye-dreelmevoatniotnvaalrpiarbolceesssaisngpo(soerepZaesiseirv&e aNveowidmanacne,
This document is chis article is intende IcfbfoherrhOtooavunlvdiriiocorlterehhsniapusctrtleeotas,drnyispcuitrongsofdgfsaeieivnsmsisttdiiitsoluhaonaarcalt’iflasasultbiubmmereheaphayuabvlvesiriohieovracr-ivatbsyilaoul,,srge.ngqdeeugcsiatotetntihvcsaeeitpmatthfupfealeyylci,ztaiavtrtheiitaoyatn,tperaimansskd-t 2absthcs0easot0Tuwtr7aeme)kc.etpeahnntneiothtnnaoesdegevPeadatCbhnofLecoure-r,tRatrthhfeateeshceetarioonerrrcstyeuhsr-lceaitonrscsrft’eoiovsrfemuantenrhdeddiels,arvtissiittooetaurlnneadsdntyhiicvinepecg.hsaTacoslhislfeeeunnymptgisaeefylidscccohtopooumrponemacdxteehoissryns-t
T phasizing the disinhibition and chronic criminality of ASPD are (Skeem&Cooke,2010).Arefinedunderstandingofpsychopathy
most useful for the purpose of risk assessment. Although this andrelatedconstructscanonlyimprovepsychologicalassessment
conceptualizationisembodiedbytheSDscaleofthePCL-R,we andlegaldecisionmakinginappliedsettings.
recommendtheuseofpurpose-builtriskassessmenttoolsinstead.
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