Lecture 3: Clinical and Forensic Assessment of Psychopathy I

FORENSIC PSYCHOLOGY

LECTURE 3

Clinical and Forensic Assessment of Psychopathy

Forensic Psychology 1

Recommended Reading

Gacono, Carl B. (2000), The Clinical and Forensic Assessment of

Psychopathy Practitioners Guide.

London: Lawrence Erlbaum Associates .

(Chapters 3, 4, 6, 7, 8, 10, 13).

Howitt, Dennis), (2009) , Introduction to Forensic and Criminal Psychology:

3rd Edition.

London: Pearson Prentice Hall – Chapter 20.

Millon, Theodore; Simonsen, Erik; Birket-Smith, Morten; and Davis, Roger D.

(1998), Psychopathy: antisocial, criminal and violent behaviour.

New York:

Guilford .

(Reading: Chapters 1, 2, 4, 6, 9, 12, 10, 12, 27).

Articles:

Hare, Robert D. (1998).

The Hare PCL-R: Some issues concerning it's use and misuse . Legal and Criminal Psychology. 3, 99-119.

Herpertz, Sabine and Sass, Henning (1997).

Psychopathy and antisocial syndromes . Current Opinion in Psychiatry. 10, 436-440.

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Forensic Psychology

Aims of Lecture

Examine the link between mental illness and crime

 Describe what is meant by the term “psychopathy” and understand the difficulties associated with defining psychopathy

Describe the usefulness of the Hare Psychopathy Checklist –

Revised (PCL-R).

Examine the concept of assessing risk and recidivism in forensic populations.

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Forensic Psychology

Mental Illness and Crime

Concept of Mental Illness is perceived in different ways between the professions of psychology and law. The media have an effect on the public perception of mental illness and crime.

Link et al (1992) –Sample of 500 never treated residents/mental patients in NYC. Psychiatric Epidemiology

Research Interview – assessing mental illness symptoms.

Although patients reported higher levels of violence, age, gender and education level were a higher predictor of violent behaviour than psychotic symptoms.

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Forensic Psychology

Mental Illness and Crime

Swanson (1990) – US study using the Diagnostic Interview

Schedule. While schizophrenia was associated with violence, substance abuse was a greater predictor in the likelihood of violent behaviour.

Hodgins (1997) Stockholm – 15,000 born in 1953

MEN - 32% with no mental illness criminals/ 50% of mentally ill criminal

WOMEN - 6% with no mental illness criminals/ 19% of mentally ill criminal

Why?

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Forensic Psychology

History of Psychopathy

“We cannot treat, except empirically, what we do not understand and we cannot prevent what we do not comprehend”

Brittain (1970)

Pinel (1800 ’s)

“Manie Sans Delire” – insanity without a confusion of mind.

Patients engaged in impulsive and self damaging acts, despite the fact that their reasoning was intact and that they knew what they were doing was irrational.

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Forensic Psychology

History of Psychopathy

Cleckley (1976) – “The Mask of Sanity” – Proposed that psychopaths present a convincing mask with superficial charm, good intelligence, etc, yet are impulsive, have poor judgment and lack remorse.

16 characteristics including interpersonal, affective, cognitive and behavioural characteristics associated with an impulsive, irresponsible lifestyle.

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Forensic Psychology

Cleckley’s Characteristics

Superficial Charm

Absence of Delusions

Absence of Nervousness

Unreliability

Lying

Lack of Remorse

Anti-social Behaviour

Poor Judgment

Egocentric

Poor Reactions

Lack of insight

Unresponsiveness in interpersonal relations

Alternative behaviour

Threat of Suicide

Promiscuous

Lack of Life Plan

Forensic Psychology

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Terms

Antisocial Personality Disorder(ASPD)

Sociopathy

Psychopathy

(Terms used interchangeably in the literature)

Sociopathy diagnosis in DSM I

– sexual deviation, alcoholism and anti-social behaviour were features.

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Forensic Psychology

Anti Social Personality Disorder

18 years

Conduct Disorder before age 15

Violations of law

Disregard for others/self

Deceitfulness

Impulsivity

Irritable/aggressive

Lack of Remorse

Forensic Psychology

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Hare Psychopathy Checklist

PCL-R – 20 item 40 point scale completed with a semi-structured interview, and a review of independent and historical and contemporaneous data

PCL-SV – 12 item scale

Factor 1 – Interpersonal/affective features – callousness, lack of remorse.

Factor 2 – behavioural/affective features – socially deviant lifestyle.

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Forensic Psychology

Hare Psychopathy Checklist

1.

Glibness/Superficial Charm

2.

Grandiose sense of self-worth

3.

Need for stimulation/proneness to boredom

4.

Pathological Lying

5.

Conning/Manipulative

Forensic Psychology

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Hare Psychopathy Checklist

6.

Lack of remorse or Guilt

7.

Shallow Affect

8.

Callous/Lack of Empathy

9.

Parasitic Lifestyle

10.

Poor Behavioural Controls

Forensic Psychology

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Hare Psychopathy Checklist

11.

Promiscuous Sexual Behaviour

12.

Early Behavioural Problems

13.

Lack of Realistic Long Term Goals

14.

Impulsivity

15.

Irresponsibility

Forensic Psychology

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Hare Psychopathy Checklist

16.

Failure to accept Responsibility for Own Actions

17.

Many Short Term Marital Relationships

18.

Juvenile Delinquency

19.

Revocation of Conditional Release

20.

Criminal Versatility

Forensic Psychology

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Anti Social Personality Disorder/Psychopathy

Behavioural Criteria in ASPD – behaviour that is observable and can be agreed on by clinicians, but

Does not inform us about character

Does not predict behaviour

Does not suggest any specific type of treatment

Most psychopaths will meet criteria for DSM ASPD but ASPD will not meet criteria for psychopathy

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Forensic Psychology

Anti Social Personality Disorder/Psychopathy

Psychopathy – behavioural criteria and personality traits

APA (1994) – forensic population study:

80% met criteria for ASPD

15-25% met criteria for psychopath.

Quinsey, Rice & Harris follow-up study of offenders(1995):

Psychopath – 80% committed offences

Non-psychopath – 20% committed violent offences

Forensic Psychology

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Administration of PCL-R

Historical information

Record review

Clinical Interview

Greater than or equal to 30 psychopath

Over 32.5

– likely to be violent .

Forensic Psychology

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