Assessments

Rater-Based Methods

Rater-Based Methods are used primarily when a parent, guardian, teacher, or other adult figure interviews with a clinician to determine the psychopathic traits of an individual. Other information, including police records, criminal history, and clinician ratings are acquired for the determination as well. This is the preferred method with youths. More resources and more time are necessary to properly evaluate with this system due to gathering and reviewing the records, as well as the interview process. As with other assessment procedures, two clinicians will assess the same individual to ensure accuracy and reliability. Because this is a sensitive population and has more negative outcomes than other diagnoses, especially for a youth, they need to be assessed and labelled correctly.

Self-Report Methods

The self-report assessment method asks a series of statements and questions for the individual to answer themselves, instead of through another figure. This technique is criticized by clinicians and researchers particularly because individuals who score high in psychopathy are inherently dishonest and lie for beneficial gain, or, quite frankly, for the fun of it. Individuals scoring high in psychopathy are motivated to make themselves look better or worse depending on the reasons for reporting. For example, they may present themselves in a better light to be released on parole, or they may present themselves to seem like they don’t remember their crimes for determinations such as Not Guilty by Reason of Insanity. Another limitation of self-reporting is that the psychopathic individual may not have internal awareness to fully understand their own behavior or lack of empathy for their actions, and so their answers may not be accurate.

Regardless, the self-report method may be more effective at gathering reports and information about the traits and beliefs that might be more difficult for a clinician to gather during an interview. For example, they may go into more detail about their childhood or life experiences that wouldn’t be obvious to ask for.

PCL-R

The Psychopathy Checklist was developed by Robert Hare in 1980, and later revised (PCL-R) in 1991 and 2003, “to identify individuals within prison or forensic settings who appear psychopathic,” and was a huge step in evolution from the previously used global rating system for criminals to determine psychopathy, which ranked on a scale of 1 (clearly non-psychopathic) to 7 (definitely psychopathic) (Patrick et al., 2007).

The identifiers of the PCL-R were created in accordance to the definition and traits and behaviors that Harvey Cleckley developed throughout the 1940s and 1950s, which Hare categorized into two distinct but correlated dimensions: the affective-interpersonal factors, and the antisocial factors. The PCL-R is considered the gold-standard psychopathic assessment instrument.

Factor 1 relates to the affective and interpersonal deficits (Patrick et al., 2008).

Affective characteristics relate to moods, feelings, and attitudes, including:

• Lack of remorse or guilt

• Lack of empathy

• Callousness

• Shallow affect

• Limited facial expression

• Limited emotional depth

Interpersonal characteristics relate to how the individual presents themselves in social situations with others, including:

• Superficial charm, glibness

• Grandiose sense of self-worth

• Pathological lying

• Manipulation and deceit

• Arrogance

• Blame externalization

Factor 2 includes the lifestyle and antisocial aspects of psychopathy (Patrick et al., 2008).

Lifestyle aspects:

• Impulsivity

• Need for constant stimulation

• Irresponsibility

• Parasitic lifestyle

Antisocial aspects:

• Poor behavioral controls

• Early childhood misconduct

• Juvenile delinquency

• Criminal behavior

The PCL-R process

“requires the clinician to give a score on each of these criteria of 0 (item does not fit), 1 (item fits somewhat) or 2 (item definitely fits). Thus, the minimum score is zero and the maximum 40. Hare himself defined psychopathy as a score of 30 or more, which will exclude most individuals with ASPD unless the subject also exhibits a number of interpersonal and affective traits. Typical group studies break down the Hare scores into the low (20 and below), moderate (21–29) and high (30 and above) ranges.” (Kiehl & Hoffman, 2012)

Other researchers use “a cut-off score of 25 to identify subclinical psychopathy, which already indicates a high level of psychopathy,” (Sanz-Garcia et al., 2021).

And Robert Hare (1996) himself states that “the mean scores for offenders in general and for noncriminals typically are around 22 and 5, respectively.”