THE VULNERABILITY OF SELF-REPORT MEASURES OF PSYCHOPATHY TO POSITIVE IMPRESSION MANAGEMENT: A SIMULATION STUDY WITH INMATES Katherine R. Kelsey, M.A. Dissertation Prepared for the Degree of DOCTOR OF PHILOSOPHY UNIVERSITY OF NORTH TEXAS August 2014 APPROVED: Richard Rogers, Major Professor Jennifer L. Callahan, Committee Member Amy R. Murrell, Committee Member Vicki Campbell, Chair of the Department of Psychology Mark Wardell, Dean of the Toulouse Graduate School
Kelsey, Katherine R. The Vulnerability of Self-Report Measures of Psychopathy to Positive Impression Management: A Simulation Study with Inmates. Doctor of Philosophy (Clinical Psychology), August 2014, 138 pp., 32 tables, reference list, 117 titles. Psychopaths have long been characterized as having a remarkable disregard for the truth, to the extent that deceit is often regarded as a defining characteristic of the syndrome. Scholars described heightened concerns about how psychopaths deceitful and manipulative nature could significantly obstruct evaluations of psychopathy. The accurate evaluation of psychopathy is very important in forensic and correctional settings, and in such issues as risk assessment or dangerousness. Although the PCL-R is considered the quasi-gold standard when it comes to evaluating psychopathy, self-report measures have become more widely available and researched. Very few studies specifically evaluated response styles and self-report psychopathy measures despite the significant concerns regarding psychopathy and deception. The current study evaluated the ability of inmates with different levels of psychopathy to successfully engage in positive impression management on the SRP-4, LSRP, and PPI-R. Utilizing a repeatedmeasures, within-subjects design, 78 male inmates completed the study under genuine and simulation conditions. Overall, inmates were able to significantly lower their scores on all three self-report measures and achieved scores equivalent to and even lower than college and community samples. Inmates with higher levels of psychopathy were able to achieve larger decreases in scores on the PPI-R and on several scales for each measure. Another key finding was the identification of promising PPI-R Virtuous Responding Scale cut scores that can be utilized within forensic populations. Results indicate self-report measures should not be used to replace the PCL-R or comprehensive assessment of psychopathy in forensic evaluations; however, they do provide additional useful information and may be beneficial in other clinical settings.
Copyright 2014 by Katherine R. Kelsey ii
TABLE OF CONTENTS Page TABLE OF CONTENTS... iii LIST OF TABLES... vi CHAPTER 1 INTRODUCTION... 1 Relevant Historical Conceptualizations of Psychopathy... 3 Current Conceptualizations of Psychopathy... 8 Assessment of Psychopathy... 14 Psychopathy and Deception... 18 Current Study... 28 CHAPTER 2 METHODS... 31 Design... 31 Participants... 32 Measures... 33 Inmate Instructions... 36 Procedure... 38 CHAPTER 3 RESULTS... 42 Sample Refinement... 42 Final Sample... 43 Reliability... 46 iii
Convergent and Discriminant Validity... 48 PIM on Self-report Measures of Psychopathy... 51 Psychopathy Level and PIM Ability... 55 Impression Management Score and PIM Ability... 61 VR Scale and Detection of PIM... 63 CHAPTER 4 DISCUSSION... 71 Implications of Risk Assessments... 72 Psychopathy and Risk Assessment... 73 Self-Report Measures of Psychopathy Compared to the PCL-R... 75 Psychopathy and PIM... 81 Susceptibility of Self-Report Measures to PIM at Different Levels of Psychopathy... 82 Classification of PIM using the PPI-R VR Cut Score... 86 High Psychopathy Does Not Equal Successful PIM... 90 Professional Implications... 93 Limitations... 97 Future Directions... 98 Conclusion... 101 APPENDIX A STANDARD INSTRUCTIONS... 103 APPENDIX B PIM INSTRUCTIONS... 105 APPENDIX C INFORMED CONSENT... 107 iv
APPENDIX D DEMOGRAPHIC INFORMATION... 110 APPENDIX E MANIPULATION CHECK... 112 APPENDIX F DIFFERENCES BETWEEN INMATES WITH SUCCESSFUL AND UNSUCCESSFUL SCORES ON THE PPI-R VR SCALE UTILIZING A SINGLE-POINT CUT SCORE OF 40... 114 APPENDIX G ITEM LEVEL DIFFERENCES BETWEEN INMATES WITH SUCCESSFUL AND UNSUCCESSFUL SCORES ON THE PPI-R VR SCALE UTILIZING A WELL- DEFINED CUT SCORE OF 40... 116 APPENDIX H PCL-R FACET SCORES AS PREDICTORS OF SELF-REPORT CHANGE SCORES... 118 APPENDIX I CORRELATIONS BETWEEN THE PCL-R, SRP-4, PPI-R, AND LSRP TOTAL AND SCALE SCORES... 120 APPENDIX J POTENTIAL CUT SCORES FOR THE PPI-R VR SCALE... 122 REFERENCES... 124 v
LIST OF TABLES Table 1 Cleckley s (1941) Conceptualization of Psychopathy... 5 Table 2 Cooke and Michie s (2001) Three Factor Model of Psychopathy... 12 Table 3 Hare s (2003) Two-Factor, Four-Facet Model of the PCL-R... 13 Table 4 Key Terms Utilized by Five Simulation Studies to Describe Response Style... 20 Table 5 Rogers et al. (2002) Effects of Level of Psychopathy on Psychopathy Scores Across Genuine and PIM Conditions... 26 Table 6 Final Sample Percentages and Group Differences between Inmates with Violent vs. Non-violent Crimes as their Most Serious Charge... 44 Table 7 Differences between Inmates in the Moderate and High Psychopathy Groups on Age, Education, Total Number of Arrests, Total Number of Months Incarcerated... 45 Table 8 Types of Current and Most Serious Charges Across Psychopathy Groups... 46 Table 9 Reliability Estimates for Self-Report Measures... 48 Table 10 Correlations between PCL-R and SRP-4 Total Scores and Underlying Factors... 49 Table 11 Correlations between PCL-R and PPI-R Total Scores and Underlying Factors... 50 Table 12 Correlations Between the PCL-R and LSRP Total Scores and Underlying Factors... 51 Table 13 Effects of Condition and Measure on Psychopathy Scores... 52 Table 14 Differences for Inmates Between Genuine and PIM Conditions on Self-Report Psychopathy Measures... 53 Table 15 Reported Means and Standard Deviations for the SRP-4 Total and Scale Scores... 54 Table 16 Reported Means and Standard Deviations for the LSRP Total and Scale Scores... 55 Table 17 Effects of Condition, Measure, and PCL-R Classification on Self-report Measures... 56 vi
Table 18 Differences for High and Moderate PCL-R Classification between Genuine and PIM Groups... 57 Table 19 Differences Between Moderate and High Psychopathy Group in SRP-4 Scale Scores Between Genuine and PIM Conditions... 58 Table 20 Differences Between Moderate and High Psychopathy Groups in PPI-R Scale Scores Between Genuine and PIM Conditions... 59 Table 21 Differences Between Moderate and High Psychopathy Group in LSRP Scale Scores Between Genuine and PIM Conditions... 61 Table 22 Effects of Condition, Measure, and PDS IM Scale Classification on Self-report Scores... 62 Table 23 Differences for Valid and Maybe Invalid Impression Management Scale Scores between Genuine and PIM Conditions... 63 Table 24 Effectiveness of PPI-R VR at Single-Point and Well-Defined Cut Scores for Likely Genuine... 66 Table 25 Effectiveness of PPI-R VR at Single-Point and Well-Defined Cut Scores for Likely PIM... 67 Table 26 Errors in the Indeterminate Category for VR Cut Scores: False Positives and False Negatives... 68 Table 27 Differences between Inmates with Successful and Unsuccessful Scores on the PPI-R VR Scale Utilizing a Well-defined Cut Score of 40... 69 vii
CHAPTER 1 INTRODUCTION The highly researched construct of psychopathy, although not classified as a formal personality diagnosis, remains a complex syndrome that is frequently used to conceptualize a significantly pathological group. Many early writers attempted to define the sick and deviant within this construct, weaving an intricate map of overlapping syndromes and inexplicit criteria. Pertinent conceptualizations of psychopathy started as early as 1806 with Phileppe Pinel, who called it mania without delirium. In his book, A Treatise on Insanity, Pinel (1806/1962, p. 156) documented various types of mental derangement, as he illuminated the idea of psychopathy: It may be either continued or intermittent. No sensible change in the functions of the understanding; but perversion of the active faculties, marked by abstract and sanguinary fury, with a blind propensity to acts of violence. In 1835, Pritchard contended psychopathy, then called moral insanity, was a syndrome that greatly disrupted society because such persons had no ability to self govern their behaviors (Cooke, 1998). Birnbaum was the first doctor to postulate that not all delinquent individuals were morally defective or constitutionally inclined to criminality and subsequently suggested the use of the term sociopath to describe those nonpsychopathic individuals (Millon, Simonsen, Birket-Smith, 1998, p. 11). These conceptualizations constitute just a few of the early writers who studied mental illness and psychopathy. The concept of psychopathy must be clearly differentiated from other antisocial patterns such as sociopathy. Partridge communicated, all individuals who, at any moment, are displaying behavior which is futile or antagonistic from the standpoint of the group may logically be regarded as sociopathic (1930, p. 55). Attempting to organize the literature, he continued 1
using the term sociopath to describe a distinct group of deviant people separate from other mental illness. He primarily focused on characteristics that our modern definition of psychopathy uses but also included persons into the sociopathic group, who better fit the diagnosis of antisocial personality disorder (APD). Despite the apparent similarities, the foundation of sociopathy is extreme deviations from prevalent societal norms. Conversely, features of psychopathy include these behaviors but also formulate essential features of personality dysfunctions, specifically chronic pathological interpersonal and affective experiences or deficits. This important distinction represents the foundation for psychopathy. As an alternative to Partridge, Lykken (1995) conceptualized these two terms, sociopathy and psychopathy, differently. He defined sociopathy as interchangeable with APD and asserted that its propensity toward criminal behavior was environmental, typically due to inadequate parenting. Conversely, psychopathic personalities resulted from a genetic difference; therefore, psychopaths engaged in antisocial behaviors because of a biological abnormality (Lykken, 1995). Regardless of the precise origin, the continually shifting formulation of psychopathy has ranged from (a) explosive, impulsive, and reckless persons in the 1920s and 1930s to (b) the more recent conceptualization of conning, manipulative, and predatory individuals (Patrick, 2010). Even now in the 21 st century, several different schools debate the nature and measurement of psychopathy. This diversity may prove problematic to forensic applications because, as Hare (1996, p. 25) pointed out, the construct of psychopathy is proving to be particularly useful in the criminal justice system, where it has important implications for sentencing, diversion, placement, and treatment options and for the assessment of risk for recidivism and violence. 2
In light of these controversies, this introduction is organized into four major sections. First, a brief overview of the historical ideas highlights the waxing and waning among researchers in their conceptualizations of psychopathy. Second, prominent, current conceptualizations of psychopathy provide the general framework for this research study. With that framework, the third major section examines the relationship of psychopathy to deception. The fourth and final section introduces the current study and its research questions. Relevant Historical Conceptualizations of Psychopathy Disparity in early conceptualizations. Starting in the 19 th and early 20 th century, prominent scholars attempted to classify and diagnose disorders from their own theoretical perspectives, leading to significant disparities in the literature. Offering his perspective about early writings on psychopathy, Partridge (1930, p. 63) wrote the statistical manual requires us to consider as psychopathic personalities a large group of persons showing abnormality expressed mainly in the character and intensity of the emotional reactions. This broad, overly inclusive standard represented the underdeveloped conceptualizations of mental health and psychopathy during that time period. Numerous catch-all phrases lumping together all mentally disordered individuals that engaged in antisocial behaviors appeared counterproductive to their rigorous study of psychopathy, and their lack of consensus or unity diluted the early writings on psychopathy. Partridge (1930, p. 61) specifically identified over 13 different terms in use, such as constitutional psychopathic personality and constitutional psychopathic inferiority. The first term represented a generally functional person with severe pathologies while the latter characterized an impaired individual with chronic instabilities and neurotic traits. A major contribution of Partridge was his extensive review of the early literature on psychopathy. In 1930, Partridge meticulously described the state of the research that included 3
over 25 diverse conceptualizations of psychopathy by various authors on the subject. Through this comprehensive survey of existing literature, he eloquently expressed the conceptual disarray that researchers faced with psychopathy. Based upon his analysis (Partridge, 1930), two prominent models emerged to describe psychopathy: the Kraepelin (1915) and Schneider (1923) models. Partridge identified Kraepelin (1915) and Schneider (1923) as influential scholars who clearly articulated these two contrasting theoretical models of psychopathy. Kraepelin (1915) used behavior as the core and defining characteristic of psychopathy. His formulation closely resembles the current conceptualization of APD (APA, 2013). Essentially, he described psychopathy as the continuous violation of rules and rights of others through aggression, destruction, and deceitfulness. In contrast, Schneider developed organized categories with consistent criteria for active and passive types of psychopath. Schneider attributed psychopathy to emotional deficits and characterological pathology. According to Partridge (1930, p. 64), Schneider s estimation of the psychopathic personalities is that they are such abnormal personalities as by reason of their abnormality suffer or cause other people to suffer. Schneider focused on these emotional aspects of the personality and identified various deficits and abnormalities prominent within psychopaths. He believed psychopathic personalities displayed blunted affect and inability to experience inhibitory emotions. In his most recent work, Schneider (1950/1958, p. 126) wrote, Their character is a pitiless one and they lack capacity for shame, decency, remorse, and conscience. They are ungracious, cold, surly, and brutal in crime. In summary, Schneider and Kraepelin s diverse theories demonstrate the inherent conceptual difficulties presented by psychopathy even in modern formulations. 4
Cleckley s contributions to psychopathy. Harvey Cleckley represents one of the most influential American researchers on theoretical conceptualizations of psychopathy. From 1941 to 1976, Cleckley published five editions of his book, The Mask of Sanity, all dedicated to clarifying the conceptualization of the psychopathic personality. Cleckley modernized psychopathy with the first organized descriptions of the construct, complete with criteria. Through the case studies of 13 individuals, Cleckley (1941) described the psychopathic individual as a person able to mask fundamental deficits in his or her personality structure and who experiences an internal chaos that results in chronic, goal-oriented, destructive behavior. Importantly, he delineated 16 characteristics of personality traits and behaviors that characterized the clinical profile of psychopathy. These criteria provided the foundation we utilize today in our descriptions and measurement of psychopathy (see Table 1). Table 1 Cleckley s (1941) Conceptualization of Psychopathy Superficial charm and good intelligence Absence of delusions and other signs of irrational thinking Absence of nervousness or psychoneurotic manifestations Unreliability Untruthfulness and insincerity Lack of remorse or shame Inadequately motivated antisocial behavior Poor judgment and failure to learn by experience Pathological egocentricity and incapacity for love General poverty in major affective reactions Specific loss of insight Unresponsiveness in general interpersonal relations Fantastic and uninviting behavior with drink and sometimes without Suicide rarely carried out Sex life impersonal, trivial, and poorly integrated Failure to follow any life plan 5
Core features of a Cleckley psychopath highlight broad emotional deficits. Cleckley believed psychopaths did not have the fundamental capacities to experience and understand normal human emotions. Like Schneider, he understood psychopathy to be innate deficits in emotions while criminal behavior was a secondary product of these emotional insufficiencies. McCord and McCord. McCord and McCord (1964), highly influential researchers, formulated their description of the psychopathic syndrome based on guiltlessness and lovelessness. They theorized these two specific emotional deficits as the core characteristics of psychopathy. These researchers maintained that psychopathic individuals freely engaged in violent, criminal behavior due to an inability to experience guilt, a highly inhibitory response. McCord and McCord also described similar aspects to Cleckley s criteria: Both conceptualized psychopaths as missing typical emotional responses (Patrick, 2010), and both separated psychopathy into primary and secondary groups (Millon et al., 1998). Like Hare, McCord and McCord documented via numerous examples, the types of deception used by psychopaths and the manipulative behaviors they employed to take advantage of unsuspecting victims. These two theories differed mainly in how they postulated the impairments developed. McCord and McCord concluded it was extreme social disconnect, an inability to experience love, whereas Cleckley theorized it as a comprehensive insufficiency in emotional capacity. Lykken and biology. Despite extensive research, these very diverse conceptualizations of psychopathy have yet to establish a clear etiology for the syndrome. Recognizing these discrepancies, Lykken (1957) stated, The concept of the psychopathic personality includes so heterogeneous a group of behavior disorders as to be at least two steps removed from the level of useful psychiatric diagnosis. In an attempt to close the gap and address the etiology issue, Lykken devoted his dissertation research to test Cleckley s conceptualization of the psychopathic 6
personality. He strove to identify measureable outcomes that would assist psychology in the conceptualization and diagnosis of psychopathy. Lykken s (1957) important contribution to the literature was the development of a biologically based explanation of psychopathy. Before Lykken, a biological etiology of psychopathy was difficult to prove, leading to insufficiently founded theories. To illustrate, Karpman (1948) postulated that theories attributing psychopathic personalities to biology were inadequate, because researchers could not identify the biological precursors and did not even consider etiology when conceptualizing psychopathy. In marked contrast, Karpman (1948) focused on environmental factors, specifically, the inadequate socialization and poor parenting of children who became psychopaths. He believed psychopathy resulted from overindulgence or rejection by parents. Unlike their earlier formulations, Lykken theorized a specific biological difference contributed to psychopathy. Specifically, he formulated that as individuals lacking anxiety and fear, psychopaths are relatively incapable of avoidance learning under circumstances where such learning can only be affected through the mediation of the anxiety response (Lykken, 1957, p. 6). Through his experimental research, Lykken (1957, p. 9) identified that primary psychopaths did actually exhibit less anxiety on a questionnaire device, less galvanic skin response (GSR) reactivity to a conditioned stimulus associated with shock, and less avoidance of punished responses on a test of avoidance learning. Of all of his conclusions, the lower GSR reactivity is most interesting. After receiving shocks paired to the ringing of a bell, nonpsychopaths were conditioned to have an emotional reaction to the stimulus, yet psychopaths remained comparatively unaffected. With this work, Lykken added research evidence for a 7
biological component of psychopathy, specifically a physiological difference in emotional reactivity between psychopaths and non-psychopaths. Only a few broad commonalities have emerged from the range of foundational traits identified by leading theorists. Across theories, diminished inhibitory responses and increased emotional deficits clearly played a key role in psychopathic behavior. These characteristic deficits are observed in (a) relative lack of fear and anxiety (Lykken, 1957), (b) an innate inability to feel guilt and love (McCord & McCord, 1964), and (c) an undeveloped ability of general emotional capacity (Cleckley, 1941). Additionally, research establishes the link between these insufficiencies and the manipulative behavior commonly employed by psychopaths. Writers during this time consistently identified conning and fraudulent actions as illustrations of psychopaths interactions with others. Regardless of the individual theory, researchers generally agree that psychopaths choose to engage in purposeful acts of deception and manipulation. Current Conceptualizations of Psychopathy Psychopathy, sociopathy, and APD. As previously noted, the construct of sociopathy approximates our modern definition of APD (Lykken, 1998). Researchers have established the most likely cause of APD and sociopathy are environmental influences that may look very different depending on the specific situation. Criteria required to meet the classification of APD and sociopathy are mostly behaviorally based and markedly variable. For APD, the only characterological criterion is lack of remorse, which is not necessary to qualify for the diagnosis because only three of the seven APD criteria are required for the diagnosis of APD (APA, 2013). Toch (1998) recognized that including persons with sociopathic behaviors into the conceptualization of psychopathy would dilute the syndrome. He concluded that most criminals categorized as sociopathy or APD do not meet criteria for psychopathic personality. 8
Current conceptualizations of psychopathy are careful to distinguish psychopaths from sociopaths. Unlike APD and sociopathy, psychopathy includes both behavioral traits and personality characteristics (Cleckley, 1941; Hare, 1991). Psychopaths also differ fundamentally from sociopaths and APD in their etiology and emotional experience. APD and sociopaths generally experience a typical range of emotions and affect, whereas psychopaths do not. In contrast to APD, psychopathy is characterized by a dysfunction in emotional processing (Blair, Mitchell, & Blair, 2005) that is biologically based (Lykken, 1995). Hare and the PCL-R. Robert Hare, an eminent scholar in psychopathy research, has continued his pioneering work for more than three decades. Hare operationalized Cleckley s criteria to evaluate psychopaths, which soon led to the systematic assessment of psychopathy. In 1980, Hare developed the original Psychopathy Checklist (PCL), a semi-structured interview and rating form to assess psychopathy in adults. By 1991, Hare published the current version, the Psychopathy Checklist - Revised (PCL-R), the most widely used and studied assessment measure of psychopathy. Although the PCL-R was primarily based on Cleckley s clinical formulation of psychopathy, it also measures criminal and antisocial behaviors in addition to Cleckley (Edens, Buffington, Tomicic, & Riley, 2001). Through extensive research with the PCL-R, scholars have continued to refine the construct of psychopathy. Hare (1991) specifically asserted that the combination of personality traits and antisocial behaviors is the clear and defining theme for psychopathy. Unlike Cleckley s traditional view of psychopathy, Hare described inadequately motivated criminal behavior as a core element (Hare & Neumann, 2006). Consistent with the view of psychopathy, the PCL-R evenly assesses for both core personality traits and behaviors. Regarding personality, psychopaths display a grossly inflated and narcissistic egocentricity, in which they view themselves as superior to society s 9
rules (Hare, 1993). They lack genuine concern for others, do not experience guilt or shame, and are particularly deceitful and manipulative (Hare, 2003). In general, psychopaths display shallow emotions and severe affective deficits. As noted for Hare s model, the behavioral characteristics are considered just as salient as the personality traits. Hare (1991) described psychopaths as impulsive, presenting poor behavioral controls and lacking normal inhibitions. In 1993, Hare defined psychopaths as irresponsible with an excessive need for excitement, regardless of the consequences. These characteristics usually result in early behavioral problems and later, extensive adult antisocial behaviors and significant criminal records (Hare, 2003; Hare & Neumann, 2006). The PCL-R provides a standardized assessment for examining the underlying dimensions of psychopathy. Although Hare (1991) originally formulated a two factor model comprised of personality and behavioral characteristics, more recent models include three factors and four factors. In the next paragraphs, these three prominent, competing models are compared and contrasted. Two factor model. In 1988, Harpur, Hakstian, and Hare identified two main components with the PCL-R using exploratory factor analysis to delineate psychopathy: Factor 1, Affective- Interpersonal Features of Psychopathy and Factor 2, Impulsive Antisocial Behavior. These two dimensions included most of the PCL-R items, and together, they conceptualize psychopathy. Factor 1 includes eight items (1, 2, 4, 5, 6, 7, 8, 16) whereas Factor 2 consists of nine items (3, 9, 10, 12, 13, 14, 15, 18, 19). The three remaining PCL-R items (i.e. promiscuous sexual behavior, many short-term marital relationships, and criminal versatility) did not initially load onto either factor. Later, Item 20 (criminal versatility) was added to Factor 1 (Hare, 2003). Fowles and Dindo (2006, p. 14) articulated, Factor 1 relates to the predatory inclinations and deficient 10
emotional reactivity associated with psychopathy, whereas Factor 2 relates to impulsivity/disinhibition, early and chronic antisocial behavior. In the past, this model has been supported and called the gold standard by several researchers (e.g., Cooke, 1998; Salekin, Rogers, & Sewell, 1996). Three factor model. Cooke and Michie (2001) provided an alternative conceptualization of PCL-R psychopathy and its dimensions. In analyzing the results of several studies, Cooke and Michie (2001) used item response theory to determine three factors as the best fit model of psychopathy. Thirteen original PCL-R items fit into the three factors that load onto the superordinate construct. According to Cooke and Michie (2001), Factor 1 (Items 1, 2, 4, and 5) is described as Arrogant and Deceitful Interpersonal Style; Factor 2 (Items 6, 7, 8, and 16) as Deficient Affective Experience; and Factor 3 (Items 3, 9, 13, 14, and 15) as Impulsive and Irresponsible Behavioral Style. Essentially, Cooke and Michie (2001) separated the traditional Factor 1 into two, more specific factors, and excluded several antisocial/behavioral items. Cooke and Michie (2001) asserted that the construct of psychopathy should emphasize interpersonal deceit, affective deficits, and impulsivity. The most prominent difference between the two factor and three factor models was the exclusion of antisocial behaviors from the three factor model. With this exclusion, Cooke and Michie (2001) reiterated Cleckley s original conceptualization and asserted that criminal behaviors were not significant to understanding psychopathy. They emphasized the importance of including deceitful and manipulative interpersonal style into the construct of psychopathy. With this three factor model, deception was now organized as prominent piece of psychopathic personalities, appearing to replace chronic antisocial behaviors. Table 2 illustrates Cooke and Michie s three factor model of the PCL-R and psychopathy. 11
Table 2 Cooke and Michie s (2001) Three Factor Model of Psychopathy Arrogant and Deceitful Interpersonal Items Deficient Affective Experience Items Impulsive and Irresponsible Items Items not loading onto factors Glibness/ superficial charm Lack of remorse or guilt Need for stimulation/ proneness to boredom Poor behavioral controls Grandiose sense of self worth Pathological lying Conning/manipulative Shallow affect Parasitic lifestyle Promiscuous sexual behavior Callous/lack of empathy Failure to accept responsibility for own actions Lack of realistic, longterm goals Impulsivity Irresponsibility Early behavior problems Many short-term marital relationships Juvenile delinquency Revocation of conditional release Criminal versatility Two-factor, four-facet model. In 2003, Hare wrote the second edition of the PCL-R technical manual, which added a two factor, four facet model to the literature. This model is very similar to Cooke and Michie s three factor model. Two main differences emerge between these models: facets vs. factors, and excluded items. First, Hare retained his original idea of two factors and he added four facets, two for each factor. Factor 1 still consists of interpersonal and affective characteristics while Factor 2 encompasses antisocial behaviors. Hare retained five of the seven items that Cooke and Michie had excluded to constitute the antisocial facet. The remaining two items (promiscuous sexual behavior and many short-term marital relationships) fall under Factor 2 but do not specifically load onto either facet. By creating four facets, Hare was able to again emphasize what many researchers identify as a central component to 12
psychopathy, specifically, the link between emotional/ affective traits and antisocial behaviors. In the second PCL-R manual, Hare (2003) compared and contrasted these three models; he contended that his latest model is better empirically supported than Cooke and Michie s three factor model. Table 3 illustrates Hare s two-factor, four-facet model of psychopathy. Table 3 Hare s (2003) Two-Factor, Four-Facet Model of the PCL-R Interpersonal/ Affective Factor Social Deviance Factor Interpersonal facet Affective facet Lifestyle facet Antisocial facet Glibness/superficial charm Lack of remorse or guilt Need for stimulation/proneness to boredom Poor behavioral controls Grandiose sense of self worth Pathological lying Conning/manipulative Shallow affect Parasitic lifestyle Early behavior problems Callous/lack of empathy Failure to accept responsibility Lack of realistic, longterm goals Impulsivity Irresponsibility Juvenile delinquency Revocation of conditional release Criminal versatility Note. Two PCL-R items fall under Factor 2 but do not load onto any of the four facets. These items are promiscuous sexual behavior and many short-term marital relationships. All three PCL-R models were essential in the evolution of our current conceptualizations of psychopathy. The original two factor model played a crucial role in guiding our understanding of psychopathy. The subsequent three factor model and two-factor, four-facet model are both extensively researched and provide more encompassing representations of the psychopathic personality. Like most diagnoses, psychopathy is a heterogeneous syndrome, which may present differently in various populations and cultures, and across gender. Hare (2003) asserts that while both models provide strong evidence for PCL-R validity, each model 13
may better fit different populations. Individual investigators are therefore faced with the decision of which PCL-R model best fits their research design and population. Assessment of Psychopathy Limitations of the PCL-R. Although several scholars (e.g. Patrick, 2006) assert that the PCL-R constitutes the gold standard for assessing psychopathy, it has several significant limitations that complicate or limit its use in correctional settings (Edens et al., 2001). Pragmatically, the PCL-R presents itself as a labor intensive instrument, requiring trained investigators and practitioners for its use. It is also time consuming, typically requiring 90-120 minutes for the interview portion, which may spread over several sessions (Hare, 2003). Additionally, the collateral review usually takes 60 minutes and possibly longer if the file is extensive (Hare, 2003). In conventional settings, the training and time commitment can strain limited resources. Hare (1991, 2003) emphasized the importance of extensive record review to address the impact of deception and manipulation, used by incarcerated examinees, on the accuracy of psychopathy assessments. Without file review, the PCL-R ratings are based solely on the respondent s self-report. However, files often lack important information in most correctional settings, which limits the PCL-R s usefulness. In addition, Hare (1991) believed the adversarial nature of these evaluations would cause most individuals to engage in some type of deceitful response style. Hare (2003) cited one quantitative research study (Rogers, Vitacco, Jackson, Martin, Collins, & Sewell, 2002) that found the Psychopathy Checklist: Youth Version (PCL: YV; Forth, Kosson, & Hare, 2003) was susceptible to response styles. Without further research in this area, Hare (2003, p. 33) cautioned that evaluators have adequate forensic training and experience and a demonstrated ability to carefully integrate interview and file information. 14
In regards to utilizing the PCL-R to monitor treatment effects, Hare (1998) acknowledged that the PCL-R is primarily scored on the basis of static and historical factors that will not change appreciably over time. Therefore, the measure cannot be utilized to evaluate changes occurring as a response to treatment over time. Given these limitations posed by using the PCL- R, other methods have become more widely available and researched. In particular, self-report measures are often substituted for the PCL-R or other validated measures of psychopathy. Self-report measures of psychopathy. In the past few decades, self-report measures of psychopathy have become more prominent in the realm of forensic assessment. Three scales have emerged with good validity and reliability, which will be the focus of the current research: (a) the Self-Report Psychopathy Scale-fourth edition (SRP-4; Paulhus, Neumann, & Hare, in press), (b) the Psychopathic Personality Inventory Revised (PPI R; Lilienfeld & Widows, 2005), and (c) the Levenson Self-Report Psychopathy Scale (LSRP; Levenson, Kiehl, & Fitzpatrick, 1995). These three self-reports were designed to address the shortcomings of previous psychopathy measures and have been extensively researched (Lilienfeld & Fowler, 2006). A short introduction to these measures follows while a more technical description of their psychometric properties is included in the methods section. Self-Report Psychopathy Scale-Fourth Edition. The SRP-4 (Paulhus et al., in press) evolved from the three earlier versions of the SRP and was designed to assess the four facets of psychopathy that correspond to the PCL-R two-factor, four-facet model (Hare, 2003; Hare & Neumann, 2008). The original version of the SRP (29-items) was developed as a self-report equivalent to the PCL (Mahmut, Menictas, Stevenson, & Homewood, 2011) with the total scores demonstrating moderate correlations (.35; Hare, 1985). The 60-item second version, SRP-II (Hare, Harpur, & Hemphill, 1989), demonstrated moderate correlations with the PCL-R (.38 to 15
.54; Hare, 1991; Zágon & Jackson, 1994). Interestingly, Williams and Paulhus (2004) found the SRP-II did not evidence a similar two-factor structure as the PCL-R. Regarding recent versions, the SRP-III (Williams, Paulhus, & Hare, 2007) has been around longer, but the SRP-4 is the most current version; however, they both utilize the same items (64 items) and same four scales (C. S. Neumann, personal communication, August, 2, 2011). The SRP-4 includes four subscales: (a) Interpersonal Manipulation (IPM), (b) Callous Affect (CA), (c) Erratic Lifestyle (ELS), and (d) Criminal Tendencies (CT). It is the only selfreport inventory whose subscales correspond to the PCL-R two-factor, four-facet model. Psychopathic Personality Inventory Revised. The PPI (Lilienfeld & Andrews, 1996) was also initially developed and validated for use with non-offender samples. However, Lilienfeld and Widows (2005) updated the PPI with a revised version (PPI-R) that is more applicable to forensic populations. To accommodate limited literacy and attention span, they decreased the reading level for the PPI-R. Additionally, they reworded culturally specific expressions and reduced the overall length of the PPI-R items (Lilienfeld & Widows, 2005). Like the PPI, the PPI-R has validity indices, designed to evaluate response styles, including impression management, malingering, and inconsistent responding. Levenson Self-Report Psychopathy Scale. The LSRP was originally developed to detect self-reported psychopathic features in non-institutional samples. Primary and secondary scales were designed to assess a protopsychopathic interpersonal philosophy (Levenson et al., 1995). However, several studies (Brinkley, Diamond, Magaletta, & Heigel, 2008; Brinkley, Schmitt, Smith, & Newman, 2001; Sellbom, 2011; Walters, Brinkley, Magaletta, & Diamond, 2008a) have found it is effective at measuring psychopathy in incarcerated populations. It is now widely used in both research and the assessment with institutionalized samples. 16
Utilizing psychopathy self-reports. Self-report measures of psychopathy provide an alternative assessment approach that does not pose the same limitations as the PCL-R. Reliable and valid self-report measures of psychopathy can be advantageous in several ways; they would (a) allow for group administration and time efficient screening, (b) eliminate reliance on collateral data, and (c) provide a more dynamic personality measure that may be sensitive to changes in functioning from successful treatment and interventions (Edens et al., 2001). At present, these advantages cannot be achieved with the PCL-R. By definition, psychopathic individuals have little insight into their own behaviors as well as a significant inability to describe themselves accurately (Hare, 1993). Therefore, selfreports can provide valuable information about how the respondents view themselves and the world (Lilienfeld & Fowler, 2006). Lilienfeld and Fowler (2006) use an item from the Psychopathic Personality Inventory (PPI; Lilienfeld & Andrews, 1996) to demonstrate this observation. For example, when an individual endorses I often get blamed for things that aren t my fault, a true response is unlikely to be an accurate reflection of reality; however, it is an accurate illustration of blame externalization engaged in by persons with psychopathic personalities (Lilienfeld & Fowler, 2006, p. 111). Often expressed indirectly, these self-report responses can offer valuable information about the presence of key characteristics of psychopathy. Studies (Book, Holden, Starzyk, Wasylkiw, & Edwards, 2006; Edens et al., 2001; Rogers et al., 2002) illustrate that individuals with higher levels of psychopathy can successfully engage in socially desirable responding on self-report measures of psychopathy when compared to those low on psychopathy. For instance, adolescent psychopaths can effectively engage in socially desirable responding during forensic evaluations, effectively decreasing their total PCL: YV 17
scores (Rogers et al., 2002). Research has also shown that persons with psychopathic personalities are more likely to engage in socially desirable responding than non-psychopathic individuals in an effort to self enhance their own image (Blair et al., 2005; Hare, 1991, 2003; Hare & Neumann, 2006; Lykken, 1995; Millon et al., 1998; Vitacco & Neumann, 2008). Despite general abilities at deception, psychopathic offenders are not more adept than other offenders at malingering. In particular, research has found that psychopaths have the same likelihood of being detected when feigning mental disorders as their nonpsychopathic counterparts (Book et al., 2006; Edens, Buffington, & Tomicic, 2000; MacNeil & Holden, 2006; Rogers et al., 2002). One explanation is that psychopaths may not understand psychopathology any better than others and, therefore, are not more adept at malingering. Psychopathy and Deception Prominent writers throughout history identified numerous deceptive acts as principal characteristics of psychopathic personalities (for a review, see Millon et al., 1998). Kraepelin explicitly described psychopaths as deceitful, continuously manipulating and conning other people for their own personal gain (Patrick, 2010). Cleckley (1941) illustrated psychopathic personalities as untruthful, insincere, and unreliable. Four of his 16 criteria describe dishonesty and characterological traits that may facilitate deceitful acts. Specifically, they include (a) superficial charm, (b) unreliability, (c) untruthfulness and insincerity, and (d) lack of remorse or shame. Importantly, his descriptions focus on the psychopath s ability to successfully mask these insufficiencies in order to appear normal and take advantage of those around them. Deception and manipulation continue to be important fundamental traits identified by most recent writers of psychopathy, clearly providing a link from the past to the present. Porter and Woodworth (2006, p. 488) aptly summarized the connection from past to present, 18
Psychopaths long have been characterized as having a remarkable disregard for the truth (e.g. Cleckley, 1976; Hare, 1998; Meloy, 1988; Porter, Birt, Yuille, & Herve, 2001), to the extent that deceit often is regarded as a defining characteristic of the disorder. In 1998, Richards illustrated Cleckley s concept of manipulative deception as beneficial to psychopaths; they learn to fit in and gain social advantage. Richards (1998, p. 75) further elaborated on the developmental process of psychopathy as the maturation of deceptive processes: At the interpersonal level, conscious deception and the related attitude of contempt for the deceived other begin to predominate over other kinds of interactions. Hare (1991) discussed his concerns about the deceptive nature of the psychopath and how this could significantly affect evaluations; explaining that conning and manipulation directly relates to criminal versatility. He was concerned that the majority of psychopathic individuals would put forth considerable effort to manipulate and minimize their deviant responses on psychopathy measures (Hare, 2003). Experimental studies manipulating deception and psychopathy. The current body of research encompasses very few studies specifically evaluating response styles and psychopathy and even fewer measuring psychopaths ability to deceive on self-report measures. This section provides a review of the five studies that explicitly examined self-report psychopathy measures and deceptive response styles. Among the five main research studies discussed in the following sections, five separate but related terms were used to describe the response style of Positive Impression Management (PIM). Book et al. (2006) described inmate response styles as faking good. Similarly, MacNeil and Holden (2006) also classified inmates as fakers and faking good. While Edens et al. (2001) used PIM and faking good interchangeably. Table 4 demonstrates the number of terms used to describe PIM and Negative Impression Management (NIM). For the current study, 19
PIM was used to describe all types of favorable deceptive responding, including faking good, socially desirable responding, defensiveness, and underreporting. Conversely, NIM was used to describe all unfavorable response styles, such as faking bad, social nonconformity, and feigning. Table 4 Key Terms Utilized by Five Simulation Studies to Describe Response Style Study Key terms used to describe PIM Key terms used to describe NIM Edens et al., 2001 Edens et al., 2000 MacNeil & Holden, 2006 Book et al., 2006 Rogers et al., 2002 Positive impression management Faking good Socially desirable responding Fakers Faking good Faking good Positive impression Socially desirable responding Positive dissimulation Social desirability Defensiveness Negative impression management Faking bad Feign Dissimulation Fakers Faking bad Feign Malinger Faking bad Malingering Negative dissimulation Social nonconformity Note. PIM = Positive Impression Management; NIM = Negative Impression Management. Response styles on the PPI in college samples. Edens et al. (2001) conducted a repeatedmeasures simulation study to evaluate the effects of PIM on the PPI and the Marlowe-Crowne Social Desirability Scale (MCSDS; Crowne & Marlowe, 1960). Specifically, they challenged undergraduates to significantly lower their PPI and SDS scores by engaging in PIM. They also assessed the effectiveness of the PPI Unlikely Virtues scale, which is intended to detect PIM. 20
Overall, Edens et al. (2001) found that simulators, regardless of psychopathy level or simulation instructions, produced significant decreases in PPI total scores. Simulation conditions included one of three hypothetical scenarios (Edens et al., 2001): (a) applying for position of a police officer; (b) applying for employment as an airline pilot; or (c) being screened for a presentence evaluation after being convicted of a crime. All three scenario instructions yielded significant decreases in PPI total scores from the genuine condition with effect sizes ranging from 0.37 to 0.48. However, the type of scenario instructions did not significantly affect undergraduates ability to engage in PIM. Edens et al. (2001) found that undergraduates with higher psychopathy levels had much larger decreases in their PPI scores compared to those with lower levels of psychopathy. The high psychopathy group achieved significant effect sizes across all three simulation instructions, with Cohen s d values of 0.86, 0.97, and 1.82 (police recruit, pilot applicant, and criminal scenario, respectively). Conversely, the low psychopathy group had minimal decreases in their PPI scores, with a mean effect size of 0.17 between the three simulation scenarios. Regarding the PPI Unlikely Virtues scale, Edens et al. (2001) found that undergraduates significantly increased their scores across the genuine and PIM conditions (d = 0.91). Similarly, SDS scores were also greatly increased from genuine to PIM (d = 1.39), suggesting that the two validity scales functioned in the expected direction. However, results were not as successful regarding the classification accuracy of the two scales. Edens et al. (2001) successfully classified many undergraduates engaging in PIM; although, a significant number of respondents were able to avoid detection on this scale. Therefore, the PPI Unlikely Virtues scale could not be used as a reliable scale for detecting PIM. Similarly, disappointing results were found for the SDS scale. 21
Edens et al. (2000) employed a repeated-measures simulation design to evaluate the effects of NIM on the PPI. In the simulation condition, undergraduates were asked to convincingly feign psychosis on the PPI and the Minnesota Multiphasic Personality Inventory, second edition, Psychoticism Scale (MMPI-2; Harkness, McNulty, & Ben-Porath, 1995). The authors also evaluated the effectiveness of the PPI Deviant Responding scale, which was designed to detect malingering and NIM. Edens et al. (2000) found that level of psychopathy was unrelated to undergraduates ability to successfully engage in NIM when feigning psychosis or psychopathy on the PPI. More specifically, the authors found no significant relation between genuine-condition psychopathy level and ability to increase psychopathy and psychosis scores in the simulation condition. Additionally, Edens et al. (2000, p. 289) identified that the PPI Deviant Responding scale was successful at detecting most undergraduates engaging in NIM, with a high overall diagnostic efficiency, AUC =.98 (SE =.01), p.001, and a 95% confidence interval ranging from.96 to 1.00. Together, both studies (Edens et al., 2001 and Edens et al., 2000) evaluated the effects of response styles on the PPI and established the efficacy of two PPI scales for detecting deception in an undergraduate sample. Edens et al. (2001) established the PPI Unlikely Virtues scale was not effective at successfully identifying undergraduates engaging in PIM. While Edens et al. (2000) identified that the PPI Deviant Responding scale has an excellent classification rate for those undergraduate respondents engaging in NIM. These two studies also evaluated the effects of psychopathy levels and ability to simulate either PIM or NIM on the PPI. Edens et al. (2001) found that undergraduates with higher levels of psychopathy, measured by PPI total scores, were able to significantly lower their scores in the 22
simulation condition (PIM) when compared to those with lower levels of psychopathy (d = 1.12 and d = 0.07, respectively). In contrast, Edens et al. (2000) identified that level of psychopathy did not improve undergraduates ability to engage in NIM without detection. Edens et al. (2000) found that only 12 undergraduates successfully evaded detection on the PPI Deviant Responding scale, and there were no significant differences in the mean genuine PPI total scores between successful and unsuccessful undergraduate responders (351.33 vs. 353.40, respectively). Additionally, Edens et al. (2000) found that genuine PPI total scores did not significantly correlate with the Deviant Responding scale scores (r = -.10) or psychoticism scores (r = -.11) in the simulation condition. This finding suggests that higher psychopathy levels are not related to an increased endorsement of genuine or improbable symptoms of psychosis when engaging in PIM (Edens et al., 2000). Contrary to popular belief, these findings suggest that undergraduates higher in psychopathy are not more adept at malingering than those low in psychopathy. However, results from Edens et al. (2001) support the historical notion that psychopathic personalities are better able to successfully engage in PIM. Response styles on the HPSI in college samples. Book et al. (2006) utilized an undergraduate sample to evaluate psychopathy and deception on the Holden Psychological Screening Inventory (HPSI; Holden, 1996). They established psychopathy levels with the LSRP and measured effective deception with the HPSI, instructing undergraduates to complete the HPSI while engaging in PIM or NIM. Specifically, they asked undergraduates to try to appear like someone without psychological problems or personality flaws or to make themselves appear mentally disturbed, and having serious psychological problems (Book et al., 2006, pp. 606-607). 23