Psychopathy among the Forensic Defense system in Belgium

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Psychopathy among the Forensic Defense system in Belgium Pham, T+*, Kosson, D.S., Ducro, C*, Stafford, M.C./ +UMons. Service of Legal Psychology. *Center of Research in Social Defense. Rosalind Franklin University of Medecine and Science /Institute Philippe Pinel of Montréal

Collaborators Claire Ducro, Xavier Saloppé Alexandra Ducolombier Laurie Mertens, Candice Morsaint, Ornella Giovagnoli, Justine Gwiscz Anne-Sophie Scohier Laurence Willocq Morgan De Vos

The concept of psychopathy has been widely the target of validation studies concerning its factor structure. However less factor structure studies have been conducted among forensic patients. This study addresses the factor structure of the PCL-R (Hare 2003) among a French European population.

Social Defense system

Comparisons characteristics between inmates and internees 7

Lower mean age 42 32

94 IQ (WAIS)

Risk recidivism 40 35 30 25 20 15 10 5 0 inmates (N=301; 4 ans) internees (N=96; 3 ans) General Sexual Violent non sexual

10 HCR- 20 scores

Prevalences of major mental disorders (M.I.N.I., Mini InternaHonal Neuropsychiatric Interview (Sheehan et al.,1998) 12

(N=208) % 13

97 % of patients present a least a major mental disorder. 51 % present an axis-i comorbidity Mean diagnosis is 1,8. 14

Prevalence of personality disorders (Structured Clinical Interview for DSM- IV Axis II Personality, Disorders.) 15

(N=208) (%) Cluster B: 57% Cluster A : 37% Cluster C: 25% 16

73% of patients present at least a personality disorder. 46% present a comorbidity. The mean diagnoses is 1.6. 54 % present Axis I and Axis II comorbidity. 17

Psychopathy among internees 18

Psychopathic scores and prevalence

DiagnosHc data (Axis II) N=178 Factor 1 Factor 2 Total score PCL- R r r r Cluster A,005,065,024 Cluster B,107,355*,296* Cluster C -,058,067 -,030 *p < 0,01

DiagnosHc data (Axis I) N=124 Factor 1 Factor 2 Total score PCL- R r r r PsychoHcs disorders -,165 -,125 -,190* Mood disorders -,121,000 -,022 Substance Abuse,018,385**,239** Anxiety disorders -,141 -,030 -,024 **p < 0,01 * p < 0,05

Confirmatory indexes for Belgian Inmates Models N X 2 df X2/df CFI RMSEA Four facets Pham et al. (2011) 121 76,33 41 1.86.96.08 Willemsen (2011) 93 188,6 129 1,46.86.07 Three factors Pham et al. (2011) 121 59,6 30 1,99*.95.09* Willemsen (2011) 93 91,3 62 1,47.91.07

CFI Good >.90 to.95 RMSEA: - Great >.05 - Good <.08 - Fair <.1 Fit indexes (see Kline, 1998) X2/df <2 : adequate fit

Method Par;cipants The sample includes male adults forensic pahents from a security hospital. Inside the Social Defense Law System. Analyses We used the M Plus program for conduchng confirmatory factor analyses with the WLSMV eshmator. (MC Stafford).

Method The analyses considered only complete data. Frequent missing items for 19 and 12 of PCL- R Low sample size.

Psychopathy D5 Factor 1 Factor 2 D6 Factor 1 Factor 2 Factor 3 D3 Factor 4 D1 D2 D4 PCL1 PCL2 PCL4 PCL5 PCL7 PCL8 PCL6 PCL16 PCL3 PCL14 PCL15 PCL9 PCL13 PCL10 PCL12 PCL18 V19 PCL20 E1 E2 E4 E5 E7 E8 E6 E16 E3 E14 E15 E9 E13 E10 E12 E18 E19 E20

Four facets model F2 F3 F4 F1.50.60.66 F2.67.49 F3.80 Mean= 62

Psychopathy D1 Factor 1 D2 Factor 2 Factor 3 D3 PCL1 PCL2 PCL4 PCL5 PCL7 PCL8 PCL6 PCL16 PCL3 PCL14 PCL15 PCL9 PCL13 E1 E2 E4 E5 E7 E8 E6 E16 E3 E14 E15 E9 E13

Three factors model F2 F3 F1.50.59 F2.76 Mean: 59

Confirmatory indexes for forensic patients Models N X 2 df X2/df CFI RMSEA Four factors 97 67.10 38 1,76.936.089 Three factors 97 44,75 28 1,59.957.079

Confirmatory indexes Relative adequacy of models of psychopathy among forensic patients Chi square is slightly lower for the three factor model

Psychopathy Checklist Revised (PCL- R, Hare, 2003) R2<.26 1. Glibness/Superficial Charm 2. Grandiose sense of Self Worth 3. Need for shmulahon/proneness to Boredom 4. Pathological Lying 5. Conning/ManipulaHve 6. Lack of Remorse or Guilt 7. Shallow Affect 8. Callous/Lack of empathy 9. ParasiHc Lifestyle 10. Poor Behavioral Controls 11. Promiscuous Sexual Behavior 12. Early Behavioral Problems 13. Lack of realishc, long- term goals 14. Impulsivity 15. Irresponsability 16. Failure to accept responsability for own achons 17. Many short- term marital relahonships 18. Juvenile Delinquency 19. RevocaHon of condihonal release 20. Criminal versahlity

Four facets and three factors models: Three Items presenhng the lowest R- Square eshmates Deficient affechve facets/factor: 16. Failure to accept responsability for own achons: R2 <.26 ParasiHc and impulsive lifestyle: 3. Need for shmulahon/proneness to Boredom: R2 <.26 9. ParasiHc Lifestyle <.26

Discussion Concerning the four facets (Neumann and Hare, 2007 or three factors (Cooke & Michie, 2001), Analyzes suggested that CFA indexes including Chi-Square, CFI and RMSEA presented a rather good fit among the forensic populations.

Discussion One important limitahon concerned the small sample with comparison to the internahonal literature. The overall CFA indexes suggested a rather good fit for models of psychopathy.

Discussion These results are congruent with prison Belgian Data. The results are encouraging for the implementahon as diagnosis and stahc measure of the psychopathy, as measured by the PCL- R.

Contact: thierry.pham@umons.ac.be 37