Uses and abuses of the Hare Psychopathy Checklist
- David Crighton, Deputy Chief Psychologist, Office of the Chief Psychologist, Fry NE2, Ministry of Justice, 2 Marsham Street, London SW1P 4DF, UK;
Notions of psychopathic personality and personality disorder have a lengthy history within criminal justice and mental health settings. Issues of how to assess and intervene with this group of individuals also continue to present significant challenges for both services. Those categorised as psychopathic or personality disordered may behave in ways that are seriously damaging both to themselves and to others. There has also been frequent criticism and, at times, castigation of services for failing to engage with these groups and protect the public effectively.1
Such pressures have provided impetus to the search for reliable and valid assessments of psychopathy with prognostic value. The Psychopathy Checklists (PCL) is a family of structured assessments developed in the USA by Robert Hare2 3 (see box 1). They are based loosely on the criteria for psychopathy set out by Cleckley,4 although it should be noted that significant differences exist. The most commonly used version in practice is the full length Psychopathy Checklist in its revised form (PCL-R). This is a structured checklist that yields an overall score, which is generally divided into two factors. Factor 1 (F1) relates to the selfish, callous and remorseless use of others, factor 2 (F2) relates to a chronically unstable and antisocial lifestyle. Each of the factors can be further divided into facets, with F1 comprising interpersonal and affective facets and F2 comprising lifestyle and antisocial facets.5 6
Box 1 The Psychopathy Checklist
The PCL-R is a 20 item clinical rating scale completed by an appropriately trained practitioner.
Items are rated on a 3 point scale: 0 if the item does not apply at all, 1 if the item applies somewhat, 2 if the item fully applies.
These ratings are generally used to produce ratings on two factors.
Factor1: “Aggressive narcissism”
Grandiose sense of self-worth