In 1941 psychiatrist Hervey Cleckley published the
first edition of his influential book, The Mask of Sanity. The book
was one of the first works to describe the psychopath. Four decades
later, researchers continue to refer to the "muddy waters" of
psychopathy. However, there is general consensus among clinicians
regarding the essential characteristics of the psychopath. There is
also a growing body of research, particularly in Canada, that
highlights the importance of identifying psychopaths in our criminal
populations. The evidence suggests that psychopaths represent a
subgroup of offenders who may be prone to violent or aggressive acts
and exhibit high reconviction rates.
While terms such as
antisocial personality, sociopath, and psychopath have been used
interchangeably, the term "psychopath" now refers to a more
stringent diagnosis. Psychopathy describes individuals who display
impulsiveness, callousness, insincerity, pathological lying and
deception, egocentricity, poor judgement, an impersonal sex life,
and an unstable life plan.
Not all psychopaths are offenders.
However a substantial proportion of criminals are psychopaths.
Estimates range from 18% to 40% of offenders, depending on the
sample.
More specifically, researchers have found that the
incidence of psychopathy is higher as the security level of the
prison increases; psychopaths fare poorer in treatment; they are
poorer risks for conditional release; tend to have longer, more
varied and more serious criminal histories; they are more
consistently violent than nonpsychopaths; and their use of violence
appears to be less situational and more directed towards particular
goals than the type of violence displayed by nonpsychopaths.
Identifying PsychopathsProcedures used to make a diagnosis
of psychopathy have included global impressions of staff, offender
responses to self-report personality tests, and rating scales or
checklists that are completed by staff. The latter two procedures
are probably the most promising methods for diagnosing psychopaths.
A good example of this type of tool is the Psychopathy
Checklist. Developed by University of British Columbia
psychologist Dr. Robert Hare, the checklist was first introduced in
1980. Since then a number of improvements have been incorporated in
the scoring procedures.
The Psychopathy Checklist
consists of 22 items (e.g. callousness, impulsivity) which were
modelled after the psychopathy criteria originally proposed by
Cleckley. In order to complete the checklist, the clinician, usually
a psychologist, must conduct a detailed interview and a
comprehensive review of the offender's file. Recent analyses of the
checklist items have demonstrated that the Psychopathy Checklist
measures not only the lack of empathy described by Cleckley
(1982), but also factors related to their chronic, unstable
lifestyle and social deviance.
Psychopathy and Conditional ReleaseA 1984 study conducted
by Dr. Steve Wong in the Prairie Region found that federal offenders
who scored high on Hare's checklist had more parole revocations,
mandatory supervision revocations and incidents of being "unlawfully
at large" than offenders who scored low on the psychopathy scale. As
a group, the psychopaths in Wong's study violated parole and
mandatory supervision more often and for more serious reasons (e.g.,
reoffending). They also applied for parole four times as often as
nonpsychopaths. Despite their rather notorious criminal and
conditional release records, they were not any less likely to be
granted parole than nonpsychopaths.
In 1988, researchers
Steve Hart, Randy Kropp and Dr. Hare, extended these findings with
another sample of federal offenders. They discovered that
psychopaths were four times as likely as nonpsychopaths to fail on
parole release. They estimated that after about three years of
follow-up, 80% of the psychopaths would fail on release compared to
20% of the nonpsychopaths. The Psychopathy Checklist was also
demonstrated to be a better predictor of release outcome than other
predictor scales which were based primarily on criminal history
information.
In collaboration with my colleagues Drs. Ray
Peters and Howard Barbaree (1989), I recently reported results which
were consistent with these findings. We studied a sample of 87
Joyceville inmates released on Unescorted Temporary Absences. Again,
psychopaths were found to be four times more likely to fail than
nonpsychopaths. We also noted that not all psychopaths fail on
parole, at least during a short follow-up period. For this reason,
the scores on the Psychopathy Checklist cannot be seen as a
sole criterion for denying conditional release.
Psychopathy and ViolencePsychopaths are more likely to use
violent and aggressive behaviour than offenders in general. This
statement applies to their criminal convictions, their institutional
performance, and their use of weapons. In addition, their use of
aggressive behaviour would appear to be more oriented toward
specific goals than situational. This is particularly the case when
psychopaths are compared to a group of violent nonpsychopaths, many
of whom were serving sentences for very violent crimes. It is
interesting that when comparing criminal careers, 85% to 97% of the
psychopaths in Dr. Hare's studies had at least one conviction for a
violent offence, compared to only about 50% of the nonpsychopaths.
All of the psychopaths in another study we conducted in the Ontario
Region had at least one violent offence.
Recently,
psychopathy was measured in a sample of sex offenders serving
sentences in a mental institution in Massachusetts. Researchers Dr.
R. A. Prentky and Dr. R. A. Knight reported that the incidence of
psychopathy was 25% in a pedophile sample and 40% in a rapist
sample. The relationship between psychopathy and sex offending
therefore has important assessment and treatment implications. This
is an important area that has only recently begun to be
investigated.
Although not all inmates are psychopaths, with
approximately 20-30% meeting stringent criteria such as the
Psychopathy Checklist, they do represent a significant
proportion. The Psychopathy Checklist provides information
that differentiates between inmates in terms of release outcome and
aspects of violence. These findings provide compelling evidence that
this is an important area for continued research in
corrections.
To date the Psychopathy Checklist has
only been used in a research context and it is unclear how
comparable clinical applications will be (i.e., parole assessments).
As well, issues such as labelling, classification errors, ethical
concerns and treatment intervention must be addressed before the
assessment of psychopathy can be incorporated into correctional
policy. Labelling an inmate as psychopathic is open to potential
abuse, particularly since some of the defining characteristics are
historical and therefore cannot change.
It may prove to be
more useful to describe an inmate's needs and, consistent with what
is known about psychopaths, present a treatment strategy to address
these needs. Such a strategy might suggest ways to modify his
behaviour and to manage the inmate upon release. Because not all
psychopaths fail when released, using a particular cutoff score on
the Psychopathy Checklist will introduce decision errors.
Also, withholding release because of a particular diagnosis raises
certain ethical concerns, particularly for the psychologist who
provided the diagnosis. The research suggests that a reasonable
approach would be to conditionally release most nonpsychopaths, but
to be very selective about releasing psychopaths, and then only with
appropriate safeguards.
The assessment of psychopathy
requires considerable training, a thorough understanding of what
psychopathy is, and the availability of very detailed background
information regarding the inmate. The Psychopathy Checklist
remains inferential despite very good scoring criteria. Once an
individual is assessed as being psychopathic, an obligation exists
to provide treatment targeted at improving prognosis. Unfortunately,
there is little consensus at present regarding the most appropriate
treatment intervention.
Future research topics in this area
could include more detailed and longer follow-up recidivism studies,
early predictors of psychopathy and violence in psychopaths,
psychopathy and sexual offenders, application of the Psychopathy
Checklist to a clinical setting, the relationship between the
Psychopathy Checklist and less inferential measures,
intervention strategies, and whether or not there are different
dimensions of psychopathy.
Research on criminal psychopaths
has yielded some interesting findings, particularly with respect to
recidivism and violence. The Psychopathy Checklist, however,
is still very much a research instrument. While psychopathy is a
promising area for future research, much work remains to be done
before it can be rationally incorporated into policy.
Readers who
are interested in pursuing this topic further should consult the
following references. The list contains some of the key references
to the research studies and other scholarly work on
psychopathy.
Cleckley, H. (1982). The Mask of Sanity (6th
ed.). St. Louis, MO: Mosby.
Hare, R.D. (1980). A research
scale for the assessment of psychopathy in criminal populations.
Personality and Individual Differences, 1, 111-119.
Hare,
R.D. (1985). Comparison of procedures for the assessment of
psychopathy. Journal of Consulting and Clinical Psychology, 53,
7-16.
Hare, R.D. & McPherson, L.M. (1984). Violent and
aggressive behaviour by criminal psychopaths. International Journal
of Law and Psychiatry, 7, 35-50.
Hare, R.D., McPherson, L.M.,
& Forth, A. (1988). Male psychopaths and their criminal careers.
Journal of Consulting and Clinical Psychology, 56,
710-714.
Harpur, T.J., Hakstian, A.R., & Hare, R.D.
(1988). Factor structure of the Psychopathy Checklist. Journal of
Consulting and Clinical Psychology, 56, 741-747.
Hart, S.D.,
Kropp, P.R. & Hare, R.D. (1988). Performance of male psychopaths
following conditional release from prison. Journal of Consulting and
Clinical Psychology, 56, 227-232.
Ogloff, J.R.P., Wong, S.
& Greenwood, A. (1988). Treating psychopaths. Behavioral
Sciences and the Law, in press.
Serin, R. C., Peters, R. De V
& Barbaree, H. E. (1989). Psychopathy and release outcome:
Implications for clinicians and decision makers. Manuscript in
preparation.
Wong, S. (1984). The criminal and institutional
behaviour of psychopaths. User Report, Programs Branch, Ministry of
the Solicitor General of Canada.
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