J.B.

Helfgott, PhD/ Department of

Criminal Justice/ Seattle University
CRJS 450
THE PSYCHOPATH
Lecture 3: Clinical Considerations in
Understanding Psychopathy
Robert Hare and the PCL-R

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Clinical-Cultural Perspectives on Psychopathy
Clinical
Psychopathy can be
considered categorically
as a clinical disorder of
personality.
Disorder is characterized
by a particular set of
traits and behaviors that
are often associated with
criminality.
Shaped by environmental
and cultural forces.
Cultural
Psychopathy can be
considered dimensionally
as a personality dynamic
used by non-
psychopaths, to a greater
or lesser extent, as a tool
with which to commit
immoral acts without
remorse or shame.
Shaped by environmental
and cultural forces.

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
The PCL-R
Concept of psychopathy has become
operational for use in empirical research
with the advent and standardization of the
Psychopathy Checklist (PCL) and subsequent
Psychopathy Checklist Revised (PCL-R).

The PCL-R differs from Antisocial
Personality Disorder in that its criteria
capture both the behavioral and personality
features of traditional concept of psychopathy
based on Cleckleys work.

The PCL-R is regarded as the first
reliable and valid measure of
psychopathy offering researchers a long-
awaited tool with which to empirically study
and clinically assess the condition

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Versions and Offshoots of the PCL-R
J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Cleckleys Psychopathy Criteria
(From The Mask of Sanity (1941))
Superficial charm and good intelligence
Absence of delusions and other signs of irrational thinking
Absence of nervousness or psychodeurotic manifestations
Unreliability
Untruthfulness and insincerity
Lack of remorse or shame
Inadequately motivated antisocial behavior
Poor judgement and failure to learn from experience
Pathological egocentricity and incapacity for love
General poverty in affective reactions
Specific loss of insight
Unresponsive in general interpersonal relations
Fantastic and uninviting behavior with or without drink
Suicide rarely carried out
Sex life impersonal, trivial, and poorly integrated
Failure to follow any life plan

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
DSM-IV-TR Antisocial Personality Disorder
Pervasive pattern of disregard for and violation of the rights of
others occurring since age 15 years, as indicated by three (or more) of the
following:
failure to conform to social norms with respect to lawful behaviors as
indicated by repeatedly performing acts that are grounds for arrest
deceitfulness, as indicated by repeated lying, use of aliases, or conning others
for personal profit or pleasure
impulsivity or failure to plan ahead
irritability and aggressiveness, as indicated by repeated physical fights or assaults
reckless disregard for safety of self or others
consistent irresponsibility, as indicated by repeated failure to sustain consistent
work behavior or honor financial obligations
lack of remorse, as indicated by being indifferent to or rationalizing having hurt,
mistreated, or stolen from another

Individual is at least age 18 years.

Evidence of Conduct Disorder with onset before age 15 years.

Occurrence of antisocial behavior is not exclusively during the course of
Schizophrenia or a Manic Episode.

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Robert Hares Research
Hare has worked for over 25 years on the
development and standardization of the PCL-R.

The Hare Psychopath is a hybrid of the
Cleckley psychopath and the DSM APD
classification.

Encompasses both personality and behavioral
features of the condition.

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
The PCL-R
20 Characteristics consisting of:
Factor 1 (Personality/Aggressive Narcissism)
Factor 2 (Behavior/ Antisocial Lifestyle)

Recent studies using Item Response Theory
suggests 4 factor model:
Interpersonal
Affective
Lifestyle
Antisocial
J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
The PCL-R Factors 1 & 2
Factor 1
Glibness/Superficial
charm
Grandiose sense of self-
worth
Pathological lying
Conning/manipulative
Lack of remorse or guilt
Shallow affect
Callous/lack of empathy
Failure to accept
responsibility for own
actions
Factor 2
Need for
stimulation/proneness to
boredom
Parasitic lifestyle
Poor behavioral controls
Early behavior problem
Impulsivity
Irresponsibility
Juvenile delinquency
Revocation of conditional
release

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Items not included in factors
Many short-term marital relationships
Criminal versatility
Promiscuous sexual behavior
Lack of realistic, long-term goals

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Factors may not carry equal weight
Some research suggests that Factor 1
may be a more important discriminant.

Better reflects the defect in affect or
fundamental disidentification with humanity
(though some would argue that even the
PCL-R does not adequately assess this central
feature of the disorder).

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Hare & Neumann (2006). The PCL-R Assessment of Psychopathy. In Patrick, C.J. (Ed.) Handbook
of Psychopathy, pp. 58-90).
J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Administering and Scoring the PCL-R
Each of the 20 items is scored on a 0 to 2
point scale based on interviews and case file
information:
0 indicates the item does not apply, that the
individual does not exhibit the characteristic or
exhibits opposite characteristics
1 indicates that the item applies to a certain
extent, but not to the degree necessary to score a
2 because of too many exceptions or doubts
2 indicates that the item applies and shows a
good match in essential respects.
In cases where there is not enough information to
confidently score a particular item, the item is
omitted, and the total score prorated.
J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
What do PCL-R scores mean?
30 = primary/true psychopath
20-29 = secondary psychopath/APD
< 20 = nonpsychopath
J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Research on the PCL-R
Individual studies and metaanalyses
show that high PCL-R scores are
associated with:
Violent recidivism
General recidivism
Sexual sadism and deviant sexual arousal
Institutional misconduct
Escapes from correctional facilities
Assault/murder of police officers
J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Important to Keep in Mind . . .
Most psychopaths (PCL-R 30) meet the criteria for
diagnosis of APD.

Most APDs are not psychopaths.

In forensic populations, are 50-80% APD and 15-25%
psychopaths.

A PCL-R score 30 has powerful implications
important to consider ethical-legal consequences of
test.

Administration and scoring of the PCL-R
requires specialized training dont try it at home!

J.B. Helfgott, PhD/ Department of
Criminal Justice/ Seattle University
Recommended Reading
(Not included in required reading for course)
Hart, S. & Hare, R.D. (1997). Psychopathy:
Assessment and association with criminal conduct. In
Stoff, D.M., Breiling, J., & Maser, J.D. (Eds),
Handbook or Antisocial Behavior (pp. 22-35). New
York: John Wiley.

Patrick, C. J. (Ed). (2005). The handbook of
psychopathy. New York: The Guilford Press.