Forensic Psych Exam 3

Hervey Cleckley

The Mask of Sanity (1941) - case studies of psychiatric patients - "semantic dementia": theory of what was wrong with psychopaths - created the 16 Criteria for Identifying Psychopathy

increasingly, PCL-R scores are used to impact decision-making in legal systems around the world. (T/F)

True

Atkins v. Virginia

capital punishment is not a suitable penalty for mentally retarded defendants; such a penalty is excessive, when involving mentally retarded defendants - edens involed in one of its appeals - court never said how diagnosis done, so jury decides

How valid are psychopathy measures in predicting "bad outcomes" for youthful offenders?

generally similiar to predictions for adults - in both, relation between recividism and PCL score is between 0.2-0.3

how strong of a correlation between PCL-R rating and yes to death verdict?

if a random pro-death pentality person (in general) rated a person high PCL-R score, would say yes to death verdict - AUC=0.72 (area under curve)

how has psychopathy assessments impacted society/laypersons?

increasing, laypersons are given opportunity, if not overly encouraged to "quantify" the psychopathic traits of not just people in the criminal just system, but for: 1. people in the news media 2. people in their social network 3. people in their occupational network - these test are usually not accurate

psychopaths are more likely to be incarcerated for...

predatory violence committed aginst a stranger

PCL-R scores are primarily introduced by experts retained by the

prosecution (DeMatteo)

for an instrument to be valid, it must first be...

reliable

instruments that are not ___ cannot be valid measures of a disorder

reliable

uses of PCL-R scores

- risk assessment - "behavioral abnormality" in SVP cases - admissibility of PCL-R evidence (rarely challenged or excluded) (little consideration of prejudical impact)

DSM-5 conduct disorder "specifier"

- "sepcifier" added to conduct disorder - can only be applied if already diagnosed with conduct disorder - used to describe person with "limited prosocial emotions" (LPE) - person must have displayed at least 2 of the characteristics persistently over at least 12 months - characteristics include: 1. lack of remorse 2. lack of empathy 3. unconcerned about performance 4. shallow or defficent affect

DeMatteo et al. (2014)

- 348 civil (SVP) and criminal cases - somewhat above-average scores relative to PCL-R norms (62 percentile) (lawyers said ppl in that means that 62% of ppl in that score will reoffend, which is wrong) - PCL-R primarily introduced by experts retained by prosecution - prosecution-retained experts provided higher scores than defense-retained experts

to what kinds of cases are PCL-R scores being introduced?

- 62% in sexually violent predator/civil commitment (because tend to get appealed more, not because crime happens more often) - 24% in parole cases to address how dangerous person is and if can be released into community - DeMatteo (2014)

What's the first word used to describe a psychopath?

- 72% use mental disorder (ex: crazy, insane) - 23& use criminal behavior (ex: serial murderer) - 5%: use "evil" - Helfgott (1997) study

how common is psychopathy?

- According to Harris, 1/100 - 3% of men according to APD - 1% of men according PCL-R - bar lower for APD

difference between sample population between Cleckley's 16 Criteria and Hare's PCL-R

- Cleckley sampled patients in psychiatric hospitals - Hare sampled prisoners - neither for general population

dominance domain of C.A.P.S.

- antagonistic - deceitful - manipulative - insincere - domineering

difference in DSM-3 regarding psychopathy

- before DSM-3, the psychopathy criteria was very similiar to Hervey Cleckley's 16 criteria, but changed for DSM-3 - made criteria less personality traits and more concrete - reason was that diagnosis by the 16 criteria was not very reliable, so wanted it to be more measureable

attachment domain of C.A.P.S.

- detached - uncommitted - unempathic - uncaring

Psychopathy & prejudice for execution (Edens et al 2005)

- edens one of the 1st to do research on this topic - mock jury research examining prejudicial effects of mental health evidence on decision-making in capital murder trails - varied identity of defendent as psychopathic, psychotic, or not disordered - results showed a statisically significant difference on support for death penalty for the groups (higher for psychopath group, 60% while others were 30s%)

phone survey that asked "what's a psychopath?"

- evil (66%) - monster (64%) - morally bankrupt (49%) - genius (34%) - Helfgott (1997)

"juvenile" psychopathy

- growing use of psychopathy measures with children and adolescents - PCL:YV, which is PCL Youth Version - introduction of PCL:YV increasing in case law over time

legal ramification/implications of being labeled a "psychopath"

- increased sentence length - indefinite commitment (absent a current offense) - denial of treatment (because of faulty Leistico study) - being moved from juvenile to adult court - execution

emotional domain of C.A.P.S.

- lacks anxiety - lacks pleasure - lacks emotional depth - lacks emotional stability - lacks remorse

behavioral domain of C.A.P.S.

- lacks perseverance - unreliable - reckless - restless - distruptive - aggressive

Comprehensive Assessment of Psychopathic Personality (CAP)

- listed 6 different "domains" in which psychopaths dispplay characteristics of 1. Self Domain 2. Emotional Domain 3. Dominance Domain 4. Attachment Domain 5. Behavioral Domain 6. Cognitive Domain

compared to the minimally acceptable reliability of an instrument, how does PCL-R's reliablity compare across field studies?

- minimal acceptable reliability= 0.85 - PCL-R: 0.56 (soooo, not very reliable in field than in lab setting)

what do jurors think of "psychopaths"?

- most give example of known serial killer - 2nd highest is a fictional killer - 3rd: no response - 4: someone they know - from smith et al. 2014 study

Edens, Guy, & Ferandez (2003)

- newspaper story conserning real case (simmon, who was under 18) - manipulation of testimoney regarding presence of psychopathic traits (not actual use of the term pyschopath) - increase of support for execution - a replication of Truong study which found more supported death for healthy defendant, which was shown by Edens to be because they included defendant's write-up , which had psychopathic traits, in all groups

what % of women do we incarcerate in the U.S. relative to men?

- no specific %, but in general, there are factors that affect sentening versus men and women - women has to be much worse to get a sentence

predictive vality of PCL-R in women

- not a good predictor of recividism in women - weak and mostly non-significant effects for female delinquents (Edens 2007)

how is Hare's PCL-R different in its assessment compared to Cleckley's 16 Criteria?

- ppl similiar to Cleckley don't think criminal features has to do with personality, so don't think should be in assessment - the antisocial features in the PCL-R is where it's different from the 16 Criteria, as it's tied to criminal behavior (similiar to DSM-3)

predatory vs reactive violence

- predatory: planned, proactive (kind that psychopaths more likely to do) - reactive: heat of moment

Rice psychopathy treatment program

- seemed from results that psychopathic treatment doesn't help, may make worse (violent recidividm was 77% in treatment grp compared to 55% in control) - not a true experiment, a quasi exp - treatment actually included forced admin. of drugs, sleep deprivation, and basically torture - adolesense rehabiliation effort actually show that recividism decreases

self domain of C.AP.S.

- self-centered - sense of uniqueness - sense of entitlement - self-justifying

PCL-R relation to Atkins case

- some lawyers are essentially trying to use high PCL-R scores as an exclusionary criterion to rule out potential mitigating/exculpary factors (mental retardation) - edens: presence of psychopathy (high PCL-R) doesn't mean can't also be psychotic or mentally impaired (not a this or that)

Leistico et al. (2008)

- study that made the inaccurate conclusion that greater confidence when using PCL-R to predict risk among women than men - results showed that effect size was larger in samples with higher proportions of women - this isn't because of more confidence for using PCL-R in women though, this is actually due to the averaging of women's lower scores and men's higher score

cognitive domain of C.A.P.S.

- suspicious - lacks concentration - intolerant - inflexible - lacks planfulness

frequent examples of psychopaths in smith et al. 2014 study

- ted bundy - charles manson - Jeffrey Dahmer

"semantic dementia"

- termed used by Hervey Cleckley to describe psychopathy - term describes psychopathy as being severely emotionally impaired, to the point verbal and emotional expression is disconnected from reality - can teach to say the "right" things, but doesn't mean actually see it that way (like being colorblind)

how reliably is the PCL-R scored "outside the lab"?

- texas v. swift: MH examiner scorred swift a 33 and said 90/100 would give exact same score, which is not the case (more variability), which is what Edens testified in court - people v. parker: 2 different PCL-R scores, 10 vs 25, which are completely difference percentiles (not good)

interview with a real psychopath video

- video was about sex offender named Robert - groomed daughter at 18 months old to be his "perfect sexual mate" - displayed a lot of psychopathic characteristics, such as failure to accept responsibiility, grandiose, superfically charming, lack of remorse - had a total of 24 victims - probably would have gotten a 2 in variety of crime in PCL-R, according to Edens

relationship between PCL-R score and violent recidivism (prospective)

- violent recidivism: committing a new violent crime after released - higher PCL-R, higher violent recidivism, relatively (not absolute)

class survey results

- voted manipulative and lacking remorse as characteristics of psychopaths, which is consistent with experts - unlike general community, didn't rate delusion beliefs highly (probs bc we know that's a sign of psychosis not psychopathy) - highest item: many psychopaths don't commit crimes (which is right" - most rated "distracters" (non-psychopathic traits) highly

idealy, what is the minimally acceptable reliability in an instrument?

0.85 average correlation

key features of psychopaths

1) Intelligence & social skills 2) Criminality - Furnham, Daoud, & Swami (2009)

interpersonal features in the Personality factor of the PCL-R

1. Glib/Superficial charm 2. Grandiose Self-Worth 3. Pathological lying 4. Conning/manipulative - refered by Edens as the "mask"

affective features in the Personality factor of the PCL-R

1. lacks remorse 2. shallow affect 3. lacks empathy 4. failure to accept responsibility - refered by Edens as "what's underneath the mask"

lifestyle features in the behavior/lifestyle factor of the PCL-R

1. need for stimulation/proneness to boredom 2. parasitic lifestyle 3. impulsivity 4. lack of life goals (ex: prisioner wanting to go to the NBA ) 5. irresponsibility

2 factor model of Hare's PCL-R

1. personality (interpersonal/affective features) 2. behavioral/lifestyle features - more recent models have 3-4 facets

antisocial features in the behavior/lifestyle factor of the PCL-R

1. poor behavioral controls 2. early behavior problems 3. juvenile delinquency 4. revocation of conditional release 5. criminal versatility (if do a variety of crimes)

average PCL-R score of male prisioners

21-22

average PCL-R score in community

4-5

Psychopathy Checklist-Revised (PCL-R)

Developed by Robert Hare, it is the best-known and most heavily researched instrument for the measurement of criminal psychopathy. - used almost exclusively to assess ppl already inolved in the criminal justice system - extensive file data required to score 20 items (0-2 scale) - conducting a life history intervie is preferred

relationship between PCL-R score and prospective (future) crime

a higher PCL-R score predicts higher chance of reoffending once released - shows PCL-R has predictive validity

psychopathy

a personality disorder characterized by long-standing emotional, interpersonal, and behavioral deficits that cause significant harm or distress (mostly to other people) - controversial in mental heath and legal fields

What PCL-R score can classify one as a "psychopath"?

above or equal to 30 (score from 0-40)

the 16 Criteria for Identifying Psychopathy

created by Hervey Cleckley which included criteria such as: (to name a few) 1. lack of remorse and shame 2. untruthfulness and insincerity 3. egocentricity 4. unresponsiveness 5. absense in affective rxns 6. superficial charm 7. absense of delusions and nervousness 8. poor judgement

laypersons have very negative views of psychopathy. is this prejudice bad though?

edens: "depends" - evidence must be considered in the context of its probative value (relevanct), which includes its level of reliability

how reliable are assessments of psychopathic traits over time?

lynam et al. (2007) - Pittsburgh Youth Study (n=271) - 13 y/o to 24 y/o follow-up - overall correlation= 0.31 - stable enough to see related, but still not super reliable in long term

how do women tend to score in the PCL-R compared to men?

tend to score lower than men - avg female prisoner: 13-15 - avg male prisioner: 20-22 - bigger disparities in community samples

layperson prototypicality ratings based on C.A.P.S. characteristics

top 6 characterics of what laypersons believe a psychopath are 1. manipulative 2. lacks remorse 3. delusional beliefs 4. self-centered 5. self-justifying 6. domineering - wrongly thought of delusional beliefs as being a psychopath, when really part of psychosis

PCL-R scores predict..

various socially troubling behaviors 1. history of violent & non-violent crime 2. future violent/non-violent crime 3. treatment response

robert hare

wrote Without a Conscience: The Disturbing World of the Psychopaths amoung Us (1993/1999) - threatened to sue Edens for defamation bc he made an article criticizing him lol - created the psychopathy checklist

psychopaths commit __ times the number of violent crimes as do non-psychopathic criminals

~2 times

what percentage of prisoners can be labelled as "psychopaths" according to their PCL-R scores?

~20-25%