Two studies of psychopathy
I’ve written before about psychopathy. Here, I add more confusion to discussion of its clinical assessment. Larsen, Koch, Jalava & Griffiths (2022) published “Are Psychopathy Assessments Ethical? A view from forensic mental health” in Journal of Threat Assessment and Management. I am starting with this one because, increasingly, clinicians are being asked to complete threat assessments, especially of adolescents who have been charged or incarcerated. Yet, we know that most adolescents have not yet finished developing their personalities and identity. Here’s the abstract:
Psychopathic personality disorder, or psychopathy, is a psychiatric diagnosis associated with callous personality traits and chronic antisocial behaviors. During the past 2 decades, psychopathy assessments have been routinely utilized to inform violence prediction, threat management, sentencing, parole, etc. However, recent empirical research has questioned the reliability and utility of psychopathy assessments, sparking concerns about the ethics of their use. The present contribution adds to this ethical discourse, arguing that forensic mental health practitioners should refrain from using psychopathy assessments because they violate two of the most fundamental ethical standards in their disciplines to “promote well-being” and “to do no harm,” traditionally labeled the principle of beneficence and the principle of nonmaleficence. Indeed, psychopathy assessments provide no clear benefit to the patient, and there are de facto and potential harms causally associated with their intended use, which are evidentially not outweighed by any significant social benefits. The article concludes by recommending a near-universal cessation of psychopathy assessments, a recommendation that is especially pressing due to the availability of alternative assessment strategies and the risk of professional–ethical sanctions.
Clinicians who have conducted psychopathy assessments may well agree with Larsen et al.’s conclusion. While their work is largely conceptual, the next study makes a conceptual argument using an incarcerated sample. Drislane et al. (2022) published “Latent Variable Model of Triarchic Psychopathy Constructs in an Incarcerated Offender Sample: Factor reliability and validity” in Psychological Assessment.
The triarchic model of psychopathy posits that three distinct trait dispositions—disinhibition, meanness, and boldness—contribute to the interpersonal, affective, and impulsive-unrestrained features of this condition and is represented to varying degrees in all conceptualizations and measures of psychopathy. Using data for incarcerated males (n = 273) and females (n = 83) from 10 different prisons in Italy, we specified a latent variable model of the triarchic trait constructs in which scale measures of disinhibition, meanness, and boldness composed of items from the following inventories served as indicators: Triarchic Psychopathy Measure, Psychopathic Personality Inventory–Revised, Minnesota Multiphasic Personality Inventory-2 Restructured Form, and NEO Five Factor Inventory. A correlated three-factor solution evidenced adequate model fit, with individual triarchic trait scales loading strongly onto their target factors. The model exhibited comparable fit and factor loadings when specified using data for males only, and its factors showed expected relations with pertinent criterion variables, including measures of normative personality and clinical dysfunction along with staff ratings of prison behavior and release prognosis. Extending prior research with nonclinical participants from the U.S., present study results demonstrate the viability of a latent variable model of the triarchic traits in an incarcerated offender sample from a separate culture (Italy). The significance of this work lies in the potential of the triarchic traits to serve as conceptual–empirical points of reference for integrating findings across studies of psychopathy employing diverse samples and assessment measures.
What I like about their approach is that it makes intuitive sense. I am not surprised that their model worked better for males given the much smaller number of females. The fact that they utilize normative personality measures, clinical dysfunction measures, and staff ratings of behavior and release prognosis is also appealing. Most importantly, they emphasize diverse assessment measures and diverse samples. Taken together, recent research recommends caution in diagnosing psychopathic characteristics especially when attempting to predict future behavior.