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The
first time psychopathy was acknowledged as a construct was in the book Mask of Sanity, by Hervey Cleckley, M.D.
originally published in 1941, according to Ednie (2001). Cleckley’s work was meant to give some
clarification to the personality disorder that was at the time, just thought of
as psychopathic personality (Cleckley, 1988). Due to advances in psychological science, psychopathy
is currently classified further in modern times as a subtype of antisocial
personality disorder in the DSM-V, including psychopathy, secondary psychopathy,
and sociopathy. This paper will focus on psychopathy and the interpretation and
validity of the tools utilized by professionals in the field to test for the
construct. Currently the foremost tool utilized by clinicians, researchers,
academics, and forensic psychologists to test an individual for psychopathy is
the Hare Psychopathy Checklist Revised (PCL-R). While this is the most recognized and used
test for the construct of psychopathy, this paper will examine the hit and miss
rates of the test along with the rates of false positives and negatives, that
occur within the administration of the tool, and the affect this has on the interpretation
and validity of the tool itself.
Defining
Hit and Miss Rates and False Positive and Negative Results
Hit and Miss Rates
Hit and miss rates are associated with the accuracy of a
tool designed to identify a particular mannerism, peculiarity, feature or
quality in a person administered the tool (L. Mancuso, personal communication,
January 18, 2016). In particular, hit
rates are the number of times that the test successfully measures the trait
that the tool purports to measure. Miss rates are the number of times that the
tool fails to measure the trait that the tool is designed to measure. Miss
rates are further categorized into false positives and negatives depending on
the result of the miss (L. Mancuso, personal communication, January 18, 2016).
False Positive and
Negative Results
Miss rates of a testing procedure or scientific tool
register as either false positive or false negative depending on whether the
test taker did or did not possess the quality or feature in reality despite the
test results (L. Mancuso, personal communication, January 18, 2016). False
positive results indicate that the test taker did have the quality being tested
when in fact the person did not, and would not have qualified for the study.
False negative results are obtained when the results indicate that the person
did not have the feature or quality but actually did have it. These types of
variances can affect the reliability and validity of the tool being used and
higher miss rates may show that the tool is ineffective (L. Mancuso, personal
communication, January 18, 2016).
Defining
Antisocial Personality Disorder: Subtypes
Primary and Secondary Psychopathy
Primary psychopathy seems to affect those with antisocial
behavior disorder in the manner that their traits have been gained through
genetics and genetically passed personality traits and temperaments more than
environmental factors (Mokros, et al., 2015). They can be from all
socioeconomic backgrounds, mostly male, emotionally charged, and have genetic
behavioral temperaments. They exhibit these behavioral factors throughout their
entire lives. These people do better in situations where defection is a
desirable trait and collaboration is frowned upon as reported by Mokros et al.
(2015). .
Secondary
Psychopathy affects those with antisocial personality disorder unlike primary
psychopathy more due to environmental factors rather than genetic
predisposition according to Mokros, et al., (2015). They go on to differentiate primary and
secondary psychopathy aside from environmental causes by predominately hailing
from low income socioeconomic backgrounds, and have varying exhibitions of
antisocial behavior during the lifespan. In primary psychopathy the behavior is more or
less consistent over the lifespan whereas the secondary psychopath may be more
influenced by current circumstance or past social trauma. Secondary psychopaths
are equally male and female where primary psychopathy is male dominated
(Mokros, et al, 2015).
Sociopathy
Sociopathy as reported by Mokros et al. (2015) describes
Lykken’s definition of a sociopath as someone who might be loyal to their own
group but not the rules of society. They are more likely to be outcasts, marked
by more disorganized behavior and acts than the psychopath. They do not
particularly excel in normal societal activities and are more likely to be
caught if living a life of criminal activities because of the disorganization
and likeliness to commit crimes of opportunity rather than premeditated well
planned out crimes. Mokros, et al. (2015)
reports that Mealy finds that sociopaths are well skilled at social deception
and resort to a manipulative and deceptive lifestyle due to a mixture of
genetic and environmental factors.
Psychopathy
as a Construct, both Primary and Secondary
Hare Psychopathy
Checklist Revised
According to the Buros Center for Testing (2016) the Hare
Psychopathy Checklist – Revised is designed to aid in assessing psychopathy in
all fields of psychology particularly in research, clinical, and forensic situations
where an accurate measure is necessary in all applications of psychological
testing tools. Edens, Cox, Smith, DeMatteo, & Sörman,
(2015) describe the PCL-R as an assessment tool used in a large variety of
applications including but not limited to risk assessment, and recidivism
prediction models. The test is a 20 item inventory measuring a two factor model
including interpersonal and affective as one facet and lifestyle and antisocial
facets as the second. Scores are graded on a Likert scale rated 0-3 and
psychopathy is diagnosed by scoring of 30 or higher being indicative of
psychopathy with a range of 0-40. (Mokros, et al., 2015).
Hit and Miss Rates
Recent studies, while acknowledging the success rates of
the PCL-R in clinical and research applications have begun to question the
reliability of the scores when the application is utilized for risk assessment
in a forensic situation (Edens, Cox,
Smith, DeMatteo, & Sörman, 2015; DeMatteo, Edens, Galloway, Cox, Smith,
& Formon, 2014). They hold that the scores of forensic
examiners vary depending on whether they are in the defense or prosecuting
sides, and which type of case the forensic examiner is assessing also affects
the hit and miss rates. Prosecution rates returned a mean of 27.07 with scores
>30 =44.3 while the defense rates were only 21.52 with scores > 30 = 8.7 (DeMatteo, Edens, Galloway, Cox, Smith, &
Formon, 2014). With variances that large further testing would produce a large
hit and miss rate and take away from the total reliability of the test.
False and Positive
Negative Results
With the applications to the legal system that use this
test, false positive and false negative results can affect any number of
outcomes in a legal proceeding (Edens,
Cox, Smith, DeMatteo, & Sörman, 2015; DeMatteo, Edens, Galloway, Cox,
Smith, & Formon, 2014). Because this test is used in risk assessment
in offenders the receipt of a false positive could result in an innocent person
being convicted of a crime or a guilty person being set free based on the false
readings of risk assessment of that particular person. Another issue with false
results in this application also applies to placement is correctional
facilities which could affect the effectiveness of the staff of the facility to
keep order if the offender risk assessment is false. This is important because
levels of security are placed on prisoners based on their risk assessments for
violence.
Interpreting and Validity
Another issue regarding the validity and reliability of
any assessment tool including the Hare Psychopathy Checklist is that even
though the tool comes with a manual it must still only be administered by a
trained psychologist or psychiatrist specifically trained to score and
interpret the instrument (Edens,
Cox, Smith, DeMatteo, & Sörman, 2015; DeMatteo, Edens, Galloway, Cox,
Smith, & Formon, 2014) These two studies have shown considerable
differences in the interpretation of the scorers based on which side of the
situation they were used in, prosecution or defense. Expert witnesses who testify in courts of law
are expected to be trained in the tools that they use to assess their expert
opinions, so based on the manual included with the test there should be very
little variance. The trouble lies in the individual interpretation of the
responses by the scorer. If an instrument is scored differently across any
applications because of interpretation of the person administering the test
that would considerably reduce the validity of the instrument, as these are
designed for test and retest reliability and limited individual interpretation
of results. Unfortunately as demonstrated by the differences in interpretation
between the prosecution and defense raises a number of questions regarding the
validity of the instrument in forensic applications (Edens, Cox, Smith, DeMatteo, & Sörman, 2015;
DeMatteo, Edens, Galloway, Cox, Smith, & Formon, 2014).
Discussion
Until recently the Hare Psychopathy Checklist- Revised
has been the most used and respected tool to assess clinical patients, research
participants, and forensic psychological assessments that bear considerable
weight in the legal system (Edens,
Cox, Smith, DeMatteo, & Sörman, 2015; DeMatteo, Edens, Galloway, Cox,
Smith, & Formon, 2014). Recent studies have shown that in
forensic applications, the interpretation of the administrator can have
significant implications on the findings as false positives and negatives in
respect to future risk assessment can have longstanding implications on those
being assessed for future risk of offending behavior. (Edens, Cox, Smith, DeMatteo, & Sörman, 2015;
DeMatteo, Edens, Galloway, Cox, Smith, & Formon, 2014). Part of the issue
is that currently the instrument is regarded as such a reliable instrument that
scores are rarely questioned and usually accepted at face value without regard
to any differences in interpretation by the administrator of the test. Further
studies could include wider samples in testing the interpretation of the scores
in a legal context to have a larger impact on finding a way to cut out any
false positive and negative impacts on preventing any misrepresentation of
findings due to interpretation error.
References:
Buros
Center For Testing (2016). Hare Psychopathy Checklist-Revised 2nd Edition.
Retrieved From: http://marketplace.unl.edu/buros/hare-psychopathy-checklist-revised-2nd-edition.html
Cleckley, H., M.D., (1988) The Mask of Sanity, Fifth Edition. United States: The C.V Mosby Co.
Edens, J. F., Cox, J., Smith, S. T., DeMatteo,
D., & Sörman, K. (2015). How reliable are Psychopathy Checklist–Revised
scores in Canadian criminal trials? A case law review. Psychological
Assessment, 27(2), 447-456. doi:10.1037/pas0000048
Ednie,
K.J., M.D., (2001). "The
Clinical and Forensic Assessment of Psychopathy: A Practitioner’s
Guide." American Journal of Psychiatry, 158(10), pp. 1756–1757
DeMatteo, D., Edens, J. F., Galloway, M., Cox,
J., Smith, S. T., & Formon, D. (2014). The role and reliability of the
Psychopathy Checklist—Revised in U.S. sexually violent predator evaluations: A
case law survey. Law And Human Behavior, 38(3),
248-255. doi:10.1037/lhb0000059
Mokros, A., Hare, R. D., Neumann, C. S.,
Santtila, P., Habermeyer, E., & Nitschke, J. (2015). Variants of
psychopathy in adult male offenders: A latent profile analysis. Journal
Of Abnormal Psychology, 124(2), 372-386. doi:10.1037/abn0000042
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