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Babinski, L.M, Hartsough, C.S, Lambert, N.M. (1999). Childhood conduct problems, hyperactivity-impulsivity, and inattention as predictors of adult criminal activity. (03) 347-355. This study reconsiders the relationship of childhood Attention Deficit/Hyperactivity Disorder (ADHD) and childhood conduct problems with adult criminal activity by clarifying the role of the cardinal behaviors associated with the DSM-IV ADHD subtypes (inattention and hyperactivity/impulsivity). Since their childhood (average age 9 years), 230 male and 75 female subjects have been followed prospectively and were interviewed as young adults (average age 26 at follow-up). Early childhood behavior ratings by parents and teachers were examined to determine the role of conduct problems, hyperactivity-impulsivity, and inattention in predicting adult criminal involvement as measured by both official arrest records and self-report. Results show that both hyperactivity-impulsivity and early conduct problems independently, as well as jointly, predict a greater likelihood of having an arrest record for males, but not for females. For male subjects with 10 or more self-reported crimes, both early conduct problems and hyperactivity-impulsivity were significant predictors, both alone and in combination. Therefore, it appears that predominantly the symptoms of hyperactivity-impulsivity, but not inattention, contribute to the risk for criminal involvement over and above the risk associated with early conduct problems alone.

Anderson, S. W., Bechara, A., Damasio, H., Tranel, D., & Damasio, A. R. (1999). Impairment of social and moral behavior related to early damage in human prefrontal cortex. (11), 1032-1037. doi:10.1038/14833 The long-term consequences of early prefrontal cortex lesions occurring before 16 months were investigated in two adults. As is the case when such damage occurs in adulthood, the two early onset patients had severely impaired social behavior despite normal basic cognitive abilities, and showed insensitivity to future consequences of decisions, defective autonomic responses to punishment contingencies and failure to respond to behavioral interventions. Unlike adult-onset patients, however, the two patients had defective social and moral reasoning, suggesting that the acquisition of complex social conventions and moral rules had been impaired. Thus early-onset prefrontal damage resulted in a syndrome resembling psychopathy.

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Cooke, D. J., Michie, C., Hart, S. D., Hare, R. D. (1999). Evaluating the screening version of the Hare Psychopathy Checklist Revised (PCL:SV): An item response theory analysis. (1), 3-13. doi:10.1037/1040-3590.11.1.3 The Screening Version of the Psychopathy Checklist—Revised (PCL:SV; S. D. Hart, D. N. Cox, & R. D. Hare, 1995) was developed to complement the Psychopathy Checklist—Revised (PCL-R; R. D. Hare, 1991), and for use outside forensic settings. The PCL:SV takes less time to administer and requires less collateral information than the PCL-R. An item response theory approach was adopted to determine similarities in the structural properties of the 2 instruments and whether the PCL:SV could be regarded as a short form of the PCL-R. Eight of the 12 items in the PCL:SV were strongly parallel to their equivalent PCL-R items. Of the 4 items PCL:SV items which differed from their equivalent PCL-R items, all 4 were found to be equal or superior to their equivalent PCL-R items in terms of discrimination. The analyses confirmed previous results that the interpersonal and affective features of psychopathy have higher thresholds than do the impulsive and antisocial behavioral features; individuals have to be at a higher level of the psychopathic trait before the interpersonal and affective features become evident. The PCL:SV is an effective short form of the PCL-R.

Cooke, D. J., & Michie, C. (2001). Refining the construct of psychopathy: Towards a hierarchical model. (2), 171-188. doi:10.1037/1040-3590.13.2.171 Psychopathy is characterized by diverse indicators. Clinical accounts have emphasized 3 distinct facets: interpersonal, affective, and behavioral. Research using the Psychopathy Checklist-Revised (PCL-R), however, has emphasized a 2-factor model. A review of the literature on the PCL-R and related measures of psychopathy, together with confirmatory factor analysis of PCL-R data from North American participants, indicates that the 2-factor model cannot be sustained. A 3-factor hierarchical model was developed in which a coherent superordinate factor, Psychopathy, is underpinned by 3 factors: Arrogant and Deceitful Interpersonal Style, Deficient Affective Experience, and Impulsive and Irresponsible Behavioral Style. The model was cross-validated on North American and Scottish PCL-R data, Psychopathy Screening Version data, and data derived from the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) antisocial personality disorder field trial. . . . We are advocating the future revision of the full PCL-R to assist research into the nature of the disorder; however, we strongly emphasize the necessity of continuing to use the full PCL-R for risk assessment and other applied purposes. [The authors criticise the two factors analysis of PCL-R. They argue that a more appropriate account should include three factors. The interpersonal/affective factor is separated in an interpersonal and an abnormal affect component. Factor I: Arrogant and deceitful interpersonal items: 1. Glibness/superficial charm 2. Grandiose sense of self-worth 4. Pathological lying 5. Conning/manipulative. Factor II: Deficient affective experience: 6. Lack of remorse or guilt 7. Shallow affect 8. Callous/lack of empathy 16. Failure to accept responsibility for own actions. Factor III: 3. Need for stimulation/proneness to boredom 9. Parasitic lifestyle 13. Lack of realistic, long-term goals 14. Impulsivity 15. Irresponsibility. Remaining items that do not fall under any factor: 10. Poor behavioural controls 11. Promiscuous sexual behaviour 12. Early behavioural problems 17. Many short-term marital relationship 18. Juvenile delinquency 19. Revocation of conditional release 20. Criminal versatility. For a three factor analysis of psychopathy in childhood and adolescence, see Frick and Hare 2001b.]

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Wallace, J. F., & Newman, J. P. (2004). A theory-based treatment model for psychopathy. (2), 178-189. doi:10.1016/S1077-7229(04)80029-4 The most salient characteristic of the psychopath is the propensity to engage in maladaptive and inappropriate behavior of all sorts, including antisocial and criminal actions. Consequently, there is considerable interest—particularly in the field of criminology—in determining what sorts of treatment interventions are likely to be effective in modifying the problematic behavioral tendencies of this difficult population. We suggest that interventions are most likely to meet with success if they are based on an accurate understanding of the cognitive deficits that underlie psychopaths' tendency to engage in maladaptive and illegal acts. Herein, we describe a theoretical framework for conceptualizing psychopaths' information processing deficits (in which the concepts of automatic information processing and implicit cognition play central roles), then discuss implications of this formulation for the design and implementation of treatment interventions.

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Cardasis, W., Huth-Bocks, A., & Silk, K. R. (2008). Tattoos and antisocial personality disorder. (3), 171-182. doi: 10.1002/pmh.43 Objective The relationship of tattoos to the diagnosis of antisocial personality disorder (ASPD) was explored in a forensic psychiatric inpatient hospital setting. It was hypothesized that a greater proportion of forensic inpatients that possessed tattoos had ASPD than patients who did not possess tattoos. Method Forensic male psychiatric inpatients (N = 36) were administered a semi-structured interview to determine the presence of a tattoo. ASPD was determined by criteria on a Diagnostic and Statistical Manual of Mental Disorders-IV ASPD checklist. Demographic and background characteristics of the patients were collected, and details about each tattoo were obtained including a calculation of the surface area of each tattoo. Results Significantly more forensic psychiatric inpatients with tattoos had a diagnosis of ASPD compared to patients without tattoos. Patients with ASPD also had a significantly greater number of tattoos, a trend toward having a greater percentage of their total body surface area tattooed, and were more likely to have a history of substance abuse than patients without ASPD. Tattooed subjects, with or without ASPD, were significantly more likely to have histories of substance abuse, sexual abuse and suicide attempts than non-tattooed patients. Conclusions Forensic psychiatric inpatients with tattoos should be assessed carefully for the presence of ASPD as well as for substance abuse, sexual abuse and suicide attempts, factors having potentially significant influence on the assessment and treatment of such patients.

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Cale, E. M., & Lilienfeld, S. O. (2002b). Sex differences in psychopathy and antisocial personality disorder: A review and integration. (8), 1179-1207. Although the correlates and causes of psychopathy and antisocial personality disorder (ASPD) have been the subject of extensive investigation, researchers in this area have until recently focused almost exclusively on males. As a consequence, relatively little is known about psychopathy and ASPD in females. In this paper, we review the empirical literature in sex differences in the base rates, mean symptom levels, correlates, and factor structure of psychopathy and ASPD. In addition, we discuss the potential sex-differentiated phenotypic expressions of psychopathy and ASPD (e.g., somatization disorder [SD]) as well as sex differences in the developmental trajectories of these conditions. There is suggestive evidence that these conditions may be differentially expressed across biological sex, although further investigation of this issue is warranted. We conclude with recommendations for future research in this area, including suggestions for embedding the study of sex differences in psychopathy and ASPD within a construct validational framework. . . . The most consistent finding across studies is that psychopathy and ASPD are more prevalent in males than in females. However, the magnitudes of these sex differences are uncertain

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Bloom, H., Webster, C., Hucker, S., & De Freitas, K. (2005). The Canadian contribution to violence risk assessment: History and implications for current psychiatric practice. (1), 3-11. Retrieved from Academic Search Complete database. Over the past quarter-century, Canadian researchers, clinical practitioners, and policy specialists have made several notable contributions to the broad field of violence risk assessment and management. In part, these contributions have been fostered by major changes in law over this period; in part, they have been spurred by findings from large-scale Canadian prediction-outcome studies. This paper offers references for a range of Canadian-inspired assessment schemes designed to evaluate psychopathy and potential for violence against others. . . . It is to be hoped that this paper will give readers unfamiliar with the emerging specialty of risk assessment a clearer idea of the purpose of recently evolved assessment schemes like the Hare PCL-R, VRAG, HCR-20, HCR-20CG, SAVRY, EARL-20B, EARL-21G, and START.

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Blackburn, R., Logan, C., Donnelly, J. P., & Renwick, S. J. D. (2008). Identifying psychopathic subtypes: Combining an empirical personality classification of offenders with The Psychopathy Checklist-Revised. (6), 604-622. doi: 10.1521/pedi.2008.22.6.604 Mentally disordered offenders who were psychopathic according to the Psychopathy Checklist-Revised (PCL-R) were divided into primary psychopath, secondary psychopath, controlled, and inhibited groups on the basis of a validated empirical classification, using the Antisocial Personality Questionnaire (APQ). They were compared on the factors and facets of the PCL-R, criminal history, Axis I and Axis II psychopathology, experience of child abuse, personality, interpersonal style, and clinical ratings of risk and treatability, to determine the utility of the APQ classification in identifying subtypes of psychopath. Significant differences between APQ primary and secondary psychopaths on several measures support the identification of these groups with the primary and secondary psychopaths hypothesized by Karpman (1948) and others. However, further differences suggest that the controlled and inhibited groups represent additional variants of primary and secondary psychopath, respectively. The results provide further evidence for the heterogeneity of psychopaths, and suggest that the PCL-R encompasses several distinct subtypes of abnormal personality.

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Carveth, D. L. (2007, April 28th). Degrees of psychopathy vs. "The Psychopath" comments on J. Reid Meloy's "A Psychoanalytic View of the Psychopath." Paper presented at the 18th Annual Day in Psychoanalysis, Toronto, ON. Criminal gangs are wary of severe psychopaths for their extreme narcissism makes them unreliable and untrustworthy gang members. In his recent review of the concept of "antisocial personality disorder," Meloy (2007a) writes that "A substantial body of research has shown that, at most, only one out of three patients with antisocial personality disorder has severe psychopathy. . . . Meloy (2007b) summarizes his view of the psychopath by underlining three factors: no attachment, underarousal and minimal anxiety. . . . I would argue that there can be no significant wrongdoing without at least some degree, however mild, of narcissism and psychopathy, for without these our attachment to, our identification with, and our empathy and concern for others—i.e., our conscience—would restrain us. . . . two concerns: that establishing a concrete conception of a group the psychopath invites projection and scapegoating and two, the denial of a psychopathic dimension is a problem because people should be forced to confront the degree of psychopathy and each of us rather than projecting it onto a group

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