AbstractPsychopathic behavior is characteristically amoral, but to date research studies have largely failed to identify any systematic differences in moral judgment capability between psychopaths and non-psychopaths. In this study, we investigate whether significant differences in moral judgment emerge when taking into account the phenotypic heterogeneity of the disorder through a well-validated distinction between psychopathic subtypes.

Three groups of incarcerated participants low-anxious psychopaths ( n = 12), high-anxious psychopaths ( n = 12) and non-psychopaths ( n = 24) completed a moral judgment test involving hypothetical dilemmas. The moral dilemmas featured ‘personal’ (i.e. Involving direct physical harm) or ‘impersonal’ (i.e.

Involving indirect or remote harm) actions. Compared to non-psychopaths, both groups of psychopaths were significantly more likely to endorse the impersonal actions.

The Psychopathy Checklist (PCL; Hare, 1980) and its revision (PCL-R; Hare. Was spurred largely by dissatisfactions with the ways in which other assessment procedures defined and measured psychopathy (Hare, 1980, 1985b). The Hare Psychopathy Checklist-Revised (PCL-R) Toronto, Ontario: Multi-Health Systems.

However, only the low-anxious psychopaths were significantly more likely to endorse the personal harms when commission of the harm would maximize aggregate welfare—the ‘utilitarian’ choice. High-anxious psychopaths and non-psychopaths did not significantly differ in their personal moral judgments.

These results provide novel laboratory evidence of abnormal moral judgment in psychopaths, as well as additional support for the importance of considering psychopathic subtypes. , INTRODUCTIONPsychopaths are notorious for their amoral behavior. The question of whether or not psychopaths know right from wrong (in other words, whether or not they possess the capacity for normal moral judgment) has long intrigued psychopathy researchers.

For example, in his seminal clinical descriptions of the disorder, Cleckley questions whether psychopaths are in fact ‘moral imbeciles’. Despite the long-standing interest in this topic, there is limited experimental data on the psychopath's ability to formulate normal moral judgments. The initial research in this area focused exclusively on assessing psychopaths’ developmental level of moral reasoning as per Kohlberg's influential six-stage model, which postulated a progression from lower egocentric levels to higher levels reflecting proper socialization and an appreciation of universal ethical principles. Results from these studies were mixed, with some indicating lower levels of moral reasoning among psychopaths relative to non-psychopaths (; ), some indicating higher levels and some indicating no significant difference (; ).A subsequent study examined the ability of psychopaths to distinguish ‘moral’ transgressions from ‘conventional’ transgressions. In this study, ‘moral’ transgressions were defined as acts that violate the welfare of others (e.g. A child hitting another child), whereas ‘conventional’ transgressions were defined as acts that violate rules or social convention but do not directly affect the welfare of others (e.g.

A male child wearing a skirt). Non-psychopaths rated the moral transgressions as significantly less permissible, significantly more serious and significantly less dependent on authority than the conventional transgressions. Psychopaths, on the other hand, failed to distinguish between moral and conventional transgressions on any of these ratings. However, this effect was driven by the psychopaths’ abnormally severe judgments of the conventional transgressions; psychopaths rated the moral transgressions normally.In more recent years, a moral decision-making test that distinguishes between ‘personal’ and ‘impersonal’ harms (, ) has been used to explore the psychological and neurobiological processes underlying moral judgment. In this test, the subject decides whether or not it is hypothetically appropriate to commit some type of harm or violation in order to achieve a particular favorable outcome. The ‘personal’ harms involve direct, intimate, physical contact (e.g. Pushing one person off a bridge to stop a runaway train car from hitting five people), whereas ‘impersonal’ harms involve more indirect or remote actions (e.g.

Pulling a switch to divert a runaway train car from hitting five people) or rule violations (i.e. Lying on income taxes to save money). A subset of the personal scenarios feature the choice of whether or not to commit a direct physical harm to a single individual in order to preserve the welfare of a larger number of individuals. For these ‘high-conflict’ scenarios, the choice to sacrifice one for the greater welfare of others is considered a ‘utilitarian’ response, reflecting greater concern for the mathematically rational ends than the emotionally aversive means (,; ). Dilemmas of this nature have been used to demonstrate abnormally utilitarian moral judgment in clinical populations with known deficits in social/emotional processing, such as patients with lesions involving ventromedial prefrontal cortex (vmPFC) (;; ) and patients with frontotemporal dementia (FTD). The utilitarian response pattern in these clinical populations thus appears to reflect the reduced influence of affective processes that serve to qualify the more ‘rational’ aspect of moral decision-making (; ).

Given the striking social/emotional deficits observed in psychopaths, one might expect to find similarly utilitarian patterns of moral judgment. However, a recent study testing this hypothesis found no differences in utilitarian moral judgment between psychopaths and non-psychopaths.One possible explanation for the ostensibly normal levels of utilitarian moral judgment among psychopaths is the heterogeneity of the disorder. For decades, psychopathy researchers have distinguished psychopaths with low levels of trait anxiety from those with high levels of trait anxiety (;;;;;;;,;; ). This distinction is based on the theoretical perspective that in some cases psychopathy may reflect an innate affective and inhibitory deficit (the low-anxious or ‘primary’ subtype), whereas in other cases psychopathy may arise as an indirect consequence of other temperament-related traits—most commonly involving excessive emotionality or neurotic anxiety (the high-anxious or ‘secondary’ subtype) (,;;;;; ). In a recent study using economic decision-making tests, we found that low-anxious psychopaths differed in their degree of ‘rational’ decision-making compared to non-psychopaths and high-anxious psychopaths.

Moreover, consistent with the theoretical distinction between primary and secondary psychopathy, the low-anxious (but not high-anxious) psychopathic group's performance was remarkably similar to that of neurological patients with affective deficits due to vmPFC brain lesions.In the present study, we seek to determine whether the low- and high-anxious subtypes of psychopath differ in their moral judgment. Using the personal/impersonal moral judgment task described above (, ), we test the hypothesis that low-anxious psychopaths, but not high-anxious psychopaths, will exhibit abnormally utilitarian personal moral judgment. METHODS ParticipantsParticipants were male inmates recruited from a medium security Wisconsin correctional institution. Inmates were eligible if they met the following criteria: under 45 years of age, IQ greater than 70, no history of psychosis or bipolar disorder, and not currently taking psychotropic medications. A total of 64 inmates met the inclusion criteria and participated in all study procedures.

Informed consent was obtained both orally and in writing.The Psychopathy Checklist-Revised (PCL-R) was used to assess psychopathy. The PCL-R assessment involves a 60–90 min interview and file review to obtain information used to rate 20 psychopathy-related items as 0, 1 or 2, depending on the degree to which each trait characterizes the individual. A substantial literature supports the reliability and validity of PCL-R assessments with incarcerated offenders. To evaluate interrater reliability, a second rater who was present during interviews provided independent PCL-R ratings for eight inmates.

The intraclass correlation coefficient was 0.85. PCL-R factors 1 and 2 scores were computed following procedures outlined in the PCL-R manual. Participant groupsParticipants were classified as psychopathic, if their PCL-R scores were 30 or greater ( n = 24) and non-psychopathic if their PCL-R scores were 20 or less ( n = 24). Participants with intermediate PCL-R scores of 21–29 ( n = 16) were not assigned to either group, and are omitted from the main analyses below.

Following the convention of previous studies identifying psychopathic subtypes (;;;;;; ), psychopaths were subdivided based on a median split of Welsh Anxiety Scale (WAS) scores. Thus, in our sample low-anxious psychopathy was defined as having a PCL-R score of 30 or greater and a WAS score of 13 or less ( n = 12), while high-anxious psychopathy was defined as having a PCL-R score of 30 or greater and a WAS score of 14 or greater ( n = 12).

The three participant groups (low-anxious psychopaths, high-anxious psychopaths and non-psychopaths; ) did not significantly differ with respect to age or estimated IQ. Low-anxious psychopaths and high-anxious psychopaths did not significantly differ in terms of PCL-R total score, PCL-R Factor 1 score or PCL-R Factor 2 score.

Est IQ, estimated IQ based on the Shipley Institute of Living Scale. WAS, Welsh Anxiety Scale; F1, Factor 1; F2, Factor 2. For each group, means are presented with standard deviations in parentheses. The three participant groups did not significantly differ with respect to age ( F = 0.76, P = 0.48) or estimated IQ ( F = 0.99, P = 0.38). The non-psychopaths had significantly lower PCL-R scores than both the low-anxious psychopaths ( t = −14.5, P. Est IQ, estimated IQ based on the Shipley Institute of Living Scale. WAS, Welsh Anxiety Scale; F1, Factor 1; F2, Factor 2.

For each group, means are presented with standard deviations in parentheses. The three participant groups did not significantly differ with respect to age ( F = 0.76, P = 0.48) or estimated IQ ( F = 0.99, P = 0.38). The non-psychopaths had significantly lower PCL-R scores than both the low-anxious psychopaths ( t = −14.5, P. Testing procedureParticipants made judgments on a series of 24 hypothetical moral scenarios, which were selected from a previously published set (,; ).

In some cases, the original scenario language was modified so as to be more easily understood by inmates with limited reading skills. Each scenario was presented on a single sheet of paper, followed by a question about a hypothetical action related to the scenario (‘Would you  in order to?’). This question format follows previous clinical and prison studies (; ). Participants circled ‘yes’ or ‘no’ to indicate their responses. ‘Yes’ responses always indicated commission of the proposed action. There was no time limit for reading the scenario description or responding to the question.

Following previous studies using this test (,;;; ), we used two classes of moral scenarios. ‘Personal’ moral scenarios ( n = 14) involved committing direct, intimate physical harm to another (i.e.

Pushing one person off a bridge to stop a runaway train car from hitting five people), whereas ‘impersonal’ moral scenarios ( n = 10) involved more indirect or remote harm (i.e. Pulling a switch to divert a runaway boxcar from hitting five people) or rule violations (i.e. Lying on income taxes).

The personal actions have been rated as significantly more emotionally aversive than the impersonal actions. STATISTICAL ANALYSISOur hypothesis pertains to specific between-group differences in moral judgment (i.e. Low-anxious psychopaths will differ from non-psychopaths in personal moral judgment, whereas high-anxious psychopaths will not differ from non-psychopaths). To compare moral judgment between groups for a particular class of scenarios, we (i) computed the proportion of ‘yes’ responses for that class of scenario for each individual, (ii) computed the mean proportion of ‘yes’ responses across all individuals in each group and (iii) compared groups in pairwise fashion with planned t-tests, with the key test of interest being low-anxious psychopaths vs non-psychopaths for personal moral scenarios.

RESULTSWe first report the moral judgment data from the non-psychopaths and the entire group of psychopaths. Across all 24 moral scenarios, the psychopaths endorsed a significantly greater proportion of the proposed actions ( M = 0.63, s.d. = 0.18) than did the non-psychopaths ( M = 0.51, s.d. = 0.12) ( t = 2.6, P = 0.01). This effect was more pronounced for the impersonal than the personal scenarios.

For the 10 impersonal moral scenarios, the psychopaths endorsed a significantly greater proportion of the proposed actions ( M = 0.76, s.d. = 0.24) than did the non-psychopaths ( M = 0.59, s.d. = 0.18) ( t = 2.9, P = 0.006). For the 14 personal moral scenarios, the psychopaths endorsed a slightly (but not significantly) greater proportion of the proposed actions ( M = 0.54, s.d. = 0.19) than did the non-psychopaths ( M = 0.46, s.d. = 0.15) ( t = 1.6, P = 0.12). Moral judgment data for psychopaths and non-psychopaths (with SE bars).We next address the main hypothesis of this study—that low-anxious psychopaths, but not high-anxious psychopaths, would endorse a significantly greater proportion of the personal moral actions than would the non-psychopaths.

The results confirm this prediction ( and ). The low-anxious psychopaths endorsed a significantly greater proportion of the personal moral actions ( M = 0.58, s.d. = 0.16) than did the non-psychopaths ( M = 0.46, s.d. = 0.15) ( t = 2.3, P = 0.03), whereas the high-anxious psychopaths ( M = 0.49, s.d. = 0.21) did not significantly differ from non-psychopaths in their personal moral judgment ( t = 0.5, P = 0.60). This pattern of results held for the subset of 10 ‘high-conflict’ personal moral dilemmas (; ), in which the ‘utilitarian’ choice (, ) is essentially to kill one person in order to save a number of others. On this subset of ‘high-conflict’ scenarios, the low-anxious psychopaths endorsed a significantly greater proportion of the utilitarian actions ( M = 0.74, s.d. = 0.19) than did the non-psychopaths ( M = 0.61, s.d. = 0.19) ( t = 2.0, P = 0.05), whereas the high-anxious psychopaths ( M = 0.63, s.d. = 0.27) did not significantly differ from non-psychopaths ( t = 0.3, P = 0.75).

Moral judgment data for individual scenarios. Proportions of ‘yes’ judgments given by the subject groups for each of the impersonal and personal moral scenarios. ( A) Individual impersonal scenarios (numbered 1–10 on the x-axis) are ordered on the basis of increasing proportion of ‘yes’ judgments by the non-psychopaths and ( B) individual personal scenarios (numbered 1–14 on the x-axis) are ordered on the basis of increasing proportion of ‘yes’ judgments by the non-psychopaths.

Among the three groups of inmates, the low-anxious psychopaths made the highest proportion of utilitarian judgments on nearly all of the personal moral scenarios. Moral judgment data for individual scenarios. Proportions of ‘yes’ judgments given by the subject groups for each of the impersonal and personal moral scenarios. ( A) Individual impersonal scenarios (numbered 1–10 on the x-axis) are ordered on the basis of increasing proportion of ‘yes’ judgments by the non-psychopaths and ( B) individual personal scenarios (numbered 1–14 on the x-axis) are ordered on the basis of increasing proportion of ‘yes’ judgments by the non-psychopaths.

Among the three groups of inmates, the low-anxious psychopaths made the highest proportion of utilitarian judgments on nearly all of the personal moral scenarios.A different pattern of results was observed for impersonal moral judgment ( and ). On these scenarios, both the low-anxious psychopaths ( M = 0.73, s.d. = 0.20) and the high-anxious psychopaths ( M = 0.79, s.d. = 0.21) endorsed a significantly greater proportion of impersonal actions than did the non-psychopaths ( M = 0.59, s.d. = 0.18) ( t = 2.2, P = 0.03 and t = 2.7, P = 0.01, respectively). Taken together, this combination of results indicates distinct patterns of moral judgment for the low- and high-anxious subtypes of psychopathy. Whereas both psychopathic subgroups endorsed significantly higher proportions of impersonal actions, only the low-anxious psychopathic subgroup also endorsed significantly higher proportions of personal actions.This result raises the question of whether the observed group differences in personal moral judgment may be due to strict group differences in anxiety, rather than due to distinct subtypes of psychopathy. In other words, lower levels of anxiety may be associated with greater endorsement of personal moral actions, regardless of the degree of psychopathy.

To examine this possibility, we divided the group of non-psychopaths (those participants with PCL-R of 20 or less) into high-anxious and low-anxious subgroups based on a median split of WAS scores, exactly as we did for the psychopathic sample. With these criteria, we obtained n = 14 low-anxious non-psychopaths and n = 10 high-anxious non-psychopaths. As expected, WAS scores in the high-anxious non-psychopaths were significantly greater than in the low-anxious non-psychopaths ( t = 6.3, P. Scatterplot showing utilitarian moral judgment ( y-axis; proportion of ‘yes’ responses to high-conflict personal moral dilemmas) as a function of anxiety score (WAS) for the entire group of psychopaths ( n = 24). Overall there was a moderate negative correlation ( r = −0.40). The horizontal line segments on the plot indicate subjects belonging to each third ( n = 8) of the total sample, based on anxiety score.In addition to these predicted results regarding personal moral judgment, we found the somewhat unexpected result that psychopaths overall endorsed a significantly greater proportion of impersonal moral actions than did non-psychopaths—a pattern that was shared by both low- and high-anxious subgroups.

Previously found no significant differences between psychopaths and non-psychopaths on judgments for impersonal moral scenarios. The lack of significant differences in the Cima et al. Study could be due to a combination of two factors: (i) smaller sample size ( n = 14 psychopaths in the Cima et al.

Study vs n = 24 psychopaths in our study) and (ii) more lenient criteria for classifying subjects as ‘psychopaths’ (PCL-R score ≥26 in the Cima et al. Study vs PCL-R score ≥30 in our study). Indeed, when we analyze subjects in our sample with PCL-R scores of 26–29 ( n = 10, none of whom were included in the previous analyses), we find that their mean proportion of endorsement for the impersonal actions (0.59) was identical to that of non-psychopaths (0.59), and well below that of either subtype of psychopath (0.73 and 0.79 for low- and high-anxious psychopaths, respectively). Thus the null finding in the Cima et al. Study is very likely due to their lenient criteria for identifying psychopaths. Similarly, a recent study of a community sample found no significant correlation between psychopathy score and responses to these moral scenarios. Again, we suspect that this null finding is due to the fact that the majority of subjects in that study were not actually psychopaths, as per the recommended PCL-R cutoff score for psychopathy.

DISCUSSIONIn this study, we investigated moral judgment in distinct psychopathic subtypes. In particular, we tested the hypothesis that low-anxious (primary) psychopaths, but not high-anxious (secondary) psychopaths, would exhibit abnormally utilitarian personal moral judgment. The data support this prediction.

Low-anxious, but not high-anxious, psychopaths endorsed a significantly greater proportion of the personal moral actions than did non-psychopaths. Importantly, this effect held for the subset of high-conflict personal scenarios, as well as in a comparison with the subset of non-psychopaths with similarly low levels of anxiety.Although our results challenge previous reports of normal moral judgment in psychopathy (; ), given the rigor with which we characterized subjects in this study, we view our results as the most definitive to date regarding the moral judgment capacities of psychopaths. The present results suggest that, as a whole, psychopaths are generally more willing than non-psychopaths to endorse impersonal harms or rule violations in order to achieve certain beneficial outcomes. We suppose that this reflects the general proclivity toward antisocial behavior that is shared by psychopaths, regardless of anxiety level.

However, only the low-anxious psychopaths are more willing to endorse the personal (and ostensibly more emotionally averse) harms as a means to achieving their ends, which may reflect a particular social/emotional deficit that is not necessarily shared between psychopathic subtypes.Our predicted finding of abnormally utilitarian personal moral judgment among low-anxious psychopaths warrants further discussion. As mentioned in the introduction, neurological patients with focal lesions involving vmPFC also exhibit a pattern of abnormally utilitarian personal moral judgment on this task (;; ) (although it is important to note that vmPFC lesion patients do not also exhibit heightened endorsement of impersonal actions, nor do they exhibit anywhere near the same degree of antisocial behavior in their daily lives). Nonetheless, this pattern of personal moral judgment findings (i.e. Similar decision-making profiles between vmPFC lesion patients and low-anxious psychopaths) mirrors a recent study of economic decision-making. In that study, we found that low-anxious, but not high-anxious, psychopaths performed similar to vmPFC lesion patients on the Ultimatum and Dictator Games. Since both the personal moral dilemmas and the Ultimatum/Dictator Games are presumed to index the degree to which social/affective vs cognitive/rational considerations influence decision-making (,;;; ), the remarkably convergent findings between vmPFC lesion patients and low-anxious psychopaths could tentatively be interpreted as evidence for a similarly disrupted integration of cognitive and affective factors underlying decision-making. Interestingly, the opposite pattern of behavior (decreased Ultimatum Game rejections and decreased utilitarian personal harm endorsement during moral judgment) has recently been observed in neurologically healthy adults following the pharmacological enhancement of serotonin transmission in the brain.

Taken together, these results provide intriguing clues about the neuroanatomical and neurochemical systems that mediate prosocial behavior, and hence, the neural substrates that may be defective in psychopathy.In sum, the results presented here are broadly consistent with the theoretical perspective that low-anxious (primary) psychopathy may entail a particular affective/inhibitory deficit that is not necessarily present in high-anxious (secondary) psychopathy (;;;;;; ). An aim of future research will be to specify the exact nature of the decision-making impairments—and the accompanying neurobiological dysfunction—which plague these individuals. Conflict of InterestNone declared.We thank Warden Larry Jenkins, Deputy-Warden Tom Nickels, and the staff at the Fox Lake Correctional Institution, as well as Dr Kevin Kallas and the Wisconsin Department of Corrections for making this research possible. This research was supported a grant from the National Institute of Mental Health (MH078980 to J.P.N., MH086787 to M.K.).

Despite substantial evidence for the fit of the three- and four-factor models of Psychopathy Checklist-based ratings of psychopathy in adult males and adolescents, evidence is less consistent in adolescent females. However, prior studies used samples much smaller than recommended for examining model fit.

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To address this issue, we conducted a confirmatory factor analysis of 646 adolescent females to test the fit of the three- and four-factor models. We also investigated the fit of these models in more homogeneous subsets of the full sample to examine whether fit was invariant across geographical region and setting.

Analyses indicated adequate fit for both models in the full sample and was generally acceptable for both models in North American and European subsamples and for participants in less restrictive (probation/detention/clinic) settings. However, in the incarcerated subsample, the four-factor model achieved acceptable fit on only two of four indices. Although model fit was not invariant across continent or setting, invariance could be achieved in most cases by simply allowing factor loadings on one PCL: YV item to vary across groups.

In summary, in contrast to prior studies with small samples, current findings show that both the three- and four-factor models fit adequately in a large sample of adolescent females, and the factor loadings are largely similar for North American and European samples and for long-term incarcerated and shorter-term incarcerated/probation/clinic samples. Models of the factor structure of psychological tests play a critical role in understanding and validating the constructs they are designed to assess. Scores on subsets of items for a measure that cohere similarly in diverse and independent samples provide evidence for the generalizability of the construct being measured. Evidence that a pattern of covariances is consistent with theoretical expectations makes an important contribution to construct validation. Factor models that generalize across different kinds of samples provide a foundation for subsequent scientific studies that examine whether these dimensions are characterized by similar nomological networks across samples.

Such studies, in turn, can be used to test hypotheses about the mechanisms underlying the components of a syndrome.Psychopathy is a severe syndrome of personality pathology that is widely associated with callous and manipulative interpersonal behavior as well as impulsive and irresponsible antisocial behavior. The standard clinical measures of the psychopathy construct are the Hare Psychopathy Checklist (PCL) scales which ask raters to make inferences about underlying dispositions by integrating information from interviews, behavioral observations, and file or other collateral material. These scales include the Psychopathy Checklist-Revised (PCL-R; ), the Psychopathy Checklist: Screening Version (PCL: SV; ), and the Psychopathy Checklist: Youth Version (PCL: YV; ).Several factor models of the PCL scales have been proposed. The four-factor model suggests that individual differences in the dispositions that comprise psychopathy are underlain by differences in one or more of four correlated dimensions that reflect specific interpersonal, affective, lifestyle, and antisocial features. Evidence corroborating this model comes from confirmatory factor analyses (CFAs) of PCL scores in a variety of forensic, clinical, and community populations (e.g.,;; ). This pattern of strong correlations has been explained by a second-order general factor (; ) said to reflect the superordinate syndrome of psychopathic personality.

This interpretation is consistent with behavior genetic research that has shown that four psychopathy factors similar to the PCL factors can all be accounted for by a common genetic trait.The three-factor model is identical with respect to the first three dimensions of the four-factor model but omits the antisocial features dimension (and the five items that load on that component). Because tests of both the three- and four-factor PCL models of psychopathy often yield acceptable fit in adult and adolescent males (;;; ), these models are currently the dominant models for the internal structure of psychopathy based on clinical measures.In contrast, the fit of these factor models in female samples is more controversial. Among adult women, reported good fit for the two and three factor models. Similarly, reported good fit for the four-factor model in both male and female adult inmates, whereas suggested the factor structure is somewhat different in women than men.

Bolt, Hare, Vitale, and Newman (2004) conducted item analyses in large samples of adult male and female offenders and reported that scalar equivalence may hold, at least approximately, for male and female offenders in spite of some evidence for differential test functioning and for differential item functioning on some lifestyle and antisocial dimension items.noted that most prior factor analytic studies have involved small samples that may have provided inadequate power for examining factor structure. They emphasized the need for researchers to conduct studies with larger samples of females. Examining adolescents, reported acceptable fit for the three-factor model in a sample of female adolescents, whereas the four-factor model achieved acceptable fit only on the absolute fit indices examined. However, their sample (based on six different subsamples) included only 147 girls. Consequently, analyses were likely underpowered for evaluating both models. In addition, Forth et al.

Did not subdivide the sample to examine fit separately for incarcerated versus probation samples of girls or for samples from different parts of the world.Subsequent studies have also yielded conflicting findings. Reported reasonable fit for the three- and four-factor models in girls but only after making minor changes to the factor structures that have not been evaluated in other studies. In contrast, reported that neither the three-factor nor the four-factor model yielded generally acceptable fit among incarcerated German adolescent females.

In an Item Response Theory analysis, reported that some of the same items that are most discriminating in male samples were most discriminating in a sample of female youth. However, they noted that some items were more or less discriminating in girls than in boys. Despite a few recent studies the relative dearth of research in this area is of concern because of the potential differences in measurement structure and in the correlates of constructs which can occur across sex. Although prior studies provide some information about the factor structure of PCL: YV psychopathy in specific settings and locations, the small size of these samples is likely to work against obtaining good fit for both the three- and four-factor models.The possibility of a different factor structure for girls than for boys is especially interesting in light of evidence that some of the correlates of scores (on clinical measures of psychopathy) in males do not consistently generalize to female samples. For example, associations between psychopathic traits and response modulation deficits (; cf., ) and affective modulation of startle reflexes appear less consistent in adult female than male samples. Although some studies have yielded relatively similar patterns of correlations for psychopathy ratings in females and in males (; ) or patterns of correlations in females similar to those previously reported for males (; ), other studies have cast doubt on the construct validity of PCL: YV scores among female adolescents (; ).It is important to keep in mind that all of the findings on the factor structure of psychopathy reviewed above are based on PCL measures of psychopathy.

Factor analytic studies can only provide evidence on the structure of a construct as assessed using a specific measure. Even so, evidence that the factor structure differs for girls and boys when psychopathy is assessed with the PCL: YV would suggest the possibility that some of the differences in behavioral and physiological correlates of psychopathy ratings may reflect differences in the nature of the psychopathy construct in girls. In brief, evidence that the symptoms of psychopathy (as assessed by clinical measures) cohere differently for girls than boys would suggest that different features may be critical to the expression of psychopathy in girls and would increases the plausibility of the perspective that different mechanisms may account for the appearance of these symptom dimensions.In contrast, evidence for a similar underlying factor structure would suggest that a psychopathy measure is performing similarly in boys and girls. To the extent that the symptoms examined cohere in similar ways across sex, it becomes more likely that a pattern of similar correlations between psychopathy ratings and external criteria reflects similar underlying mechanisms. Although evidence for similarity in internal structure does not invalidate the differences reported in correlational studies, it would be consistent with the possibility that similar mechanisms may account for those relationships between psychopathy and external criteria that are similar in males and females.As noted above, one of the chief limitations of prior factor analytic investigations in females has been the use of small samples.

Small samples can lead to poor fit even though the fit might be quite good when examined within large enough samples. Another limitation of prior studies is that none of the above mentioned studies compared factor models across youth in different countries or continents, and no prior studies have compared the fit of the different models in different kinds of settings. The Current StudyThe primary goal of the present study was to test the factor structure underlying PCL: YV-based psychopathy in a large sample of adolescent females. We assembled data from a large number of prior published studies that used the PCL: YV with adolescent girls. This provided us with a relatively large dataset of 776 adolescent females (646 with no missing values). In examining this large sample, we hoped to provide greater clarity on the factor structure of psychopathy in adolescent females.A secondary goal of this study was to evaluate the fit of the best-fitting models in more homogeneous subgroups of participants and to assess whether the models demonstrated invariance for subsamples of participants assessed in different continents and participants assessed in different settings.

Samples in the PCL: YV ManualSampleNSettingCountryMethod1.37arrested/inpatient (I)Canada (NA)S2.43arrested/inpatient (I)Canada (NA)F3.54high risk probation (D)Canada (NA)F4. Bauer, Whitman, and Kosson (in press)80incarcerated (I)United States (NA)S5.28incarcerated (I)United Kingdom (E)SAdditional Samples6.21detention center (D)United States (NA)S7.45detention center (D)United States (NA)S8.38detention center (D)United States (NA)S9.37court evaluation (D)United States (NA)S10.49court evaluation (D)Canada (NA)F11.171incarcerated (I)Germany(E)S12. Fowler et al. (2009)11psychiatry/ped clinic (D)United Kingdom(E)S13.99substance misuse clinic (D)Sweden (E)S14. Das, de Ruiter, & Doreleijers (2008)67secure treatment facility (I)Netherlands (E)SIncarcerated369 Samples 1, 2, 4, 5, 11, 14Probation277 Samples 3, 6, 7, 8, 9, 10, 12, 13North American285 Samples 1, 2, 3, 4, 6, 7, 8, 9, 10European361 Samples 5, 11, 12, 13, 14. Psychopathy Checklist: Youth Version (PCL: YV)The PCL: YV is a multi-item rating scale that assesses interpersonal and affective characteristics as well as overt behaviors associated with psychopathy. The measure is designed to be completed by trained observers who rate the presence of each trait disposition on the basis of a semi-structured interview and a review of case history information or other collateral source(s).

Ratings based on both interview and collateral data are described as obtained using the standard assessment method. The PCL: YV manual also permits the use of files only to complete the instrument but suggests caution in interpreting file-only scores, as the file-only method commonly provides substantially less information for scoring several of the interpersonal and affective items. Even so, prior factor analytic studies indicate acceptable fit for both PCL-R scores and PCL: YV scores completed solely on the basis of institutional files (Bolt et al., 2004; ). Scores of 0 ( consistently absent), 1 ( inconsistent), or 2 ( consistently present) for each item of the PCL: YV reflect inferences about the consistency of the specific tendency or disposition across different situations and sources of information.Scores on the PCL: YV have demonstrated internal consistency, with alpha coefficients ranging from.79 to.94 for total scores and mean inter-item correlations ranging from.44 to.63 (; ). Alphas for factor scores have ranged from 68 to.77 in the validation sample and from.50 to.82 in smaller samples (;; ) with one exception. Lower alphas for factor scores are expected in light of the number of items that contribute to each factor. Researchers have obtained good to excellent inter-rater reliability for total scores (ICCs range from.82 to.98; see;;; ).

The inter-rater reliability for factor scores is more variable, ranging from.43 to.86 (; ). PCL: YV scores correlate moderately with indices of externalizing psychopathology, instrumental violence, criminal activity, and antisocial behavior, and predict recidivism in male adolescents (;;;;;;;, ). Preliminary AnalysesPrincipal analyses were based on participants with complete data. To ensure that the same participants were included in three-factor and four-factor analyses, only participants with complete data for the 18 items needed for the four-factor analyses were included in these analyses. Complete data for the 18 items were available for 646 adolescent females (369 incarcerated females and 277 females drawn from less restrictive settings (probation, detention centers, and clinics).Supplementary analyses were also conducted including cases containing missing values.

These analyses included 776 adolescent females (423 incarcerated and 353 probation/detention/clinic adolescents). To test the assumption of full information CFAs that missing data were missing at random (i.e., that there are no systematic reasons why some items were not scored for some participants), we first conducted analyses to ascertain whether missing data covaried with differences on demographic variables. Chi square analyses revealed that missing values were more prevalent in North American than in European datasets, χ 2 (1) = 94.35, p. Confirmatory Factor Analyses of the PCL: YV in the Full Sample of Female AdolescentsWe first examined the fit of the various factor models in the full sample. The one-factor and two-factor models were examined using the same 18 items as in the four-factor model.

The CFA for the one-factor model indicated unacceptable fit for two of the four primary fit indices examined, χ2 (78) = 699.37, p. Model/Fit IndexFull Sample( n = 646)Restrictive Setting( n = 369)Less Restrictive Setting( n = 277)North American Adolescents( n = 285)European Adolescents( n = 361)Three-factorχ2 (df)219.87 (45)133.573 (42)117.612 (37)86.264 (40)128.401 (40)CFI0.9220.8970.9220.9560.925TLI0.9550.9210.9560.9780.947RMSEA0.0780.0770.0890.0640.078SRMR0.0600.0720.0730.0580.069Four-factorχ2 (df)367.64 (79)270.719 (68)196.994 (61)146.633 (70)254.718 (63)CFI0.9060.8250.9090.9420.890TLI0.9520.8740.9490.9740.930RMSEA0.0750.0900.0900.0620.092SRMR0.0630.0870.0800.0630.083. CFI = Comparative Fit Index (.90); TLI = Tucker–Lewis Index (.90); RMSEA =Root Mean Square Error of Approximation (. Confirmatory Factor Analyses of the PCL: YV in Subsamples of Female AdolescentsBoth models also yielded consistently adequate fit in the North American subsample. In fact, model fit was in the good to excellent range for both of the relative fit indices and in the reasonable range for both absolute fit indices for both models despite a substantial drop in sample size from 646 to 285 cases (which makes the size of the subsamples sub-optimal for assessing the fit of the four-factor model).

In contrast, only the three-factor model yielded consistently acceptable fit in the European subsample. The fit of the four-factor model was in the fair to acceptable range for three of four indices examined but slipped barely below acceptable levels for the CFI.Both models also yielded generally acceptable fit for the subsample of youth in less restrictive (i.e., probation, detention, and clinic) settings.

In brief, the fit was acceptable to good for both models for both measures of relative fit and for the SRMR. However, the RMSEA yielded only fair fit for both models in this subsample.

In contrast, only the three-factor model yielded generally acceptable fit for the subsample of incarcerated girls. Only the CFI slipped below acceptable levels for this model. For the four-factor model, both relative fit indices were unacceptably low, and both indices of absolute fit indicated only fair fit.In summary, both the three- and four-factor models had good fit to the data (i.e., were able to reproduce the observed item covariance structure with adequate precision) in the full sample, and both models provided reasonable fit among North American girls. Even among European girls, both models generally provided at least fair to reasonable fit. Similarly, with the exception of the RMSEA, both models provided adequate levels of fit among girls on probation and in detention. The only subsample in which the pattern of findings suggested fit below conventional levels of acceptability was the incarcerated subsample, for which the four-factor model yielded unacceptable fit on two indices and only fair to acceptable it on the other two indices examined.

Tests of Model Invariance between North American and European SamplesTo test whether the three-factor model fit equally well in North American and European adolescent females, we conducted two multiple group CFAs (MGCFAs) and compared the fit for the two models using a chi-square difference test. First, we allowed Mplus to freely estimate all model parameters separately by sample (i.e., factor loadings and item thresholds), fixing scale factor values at 1.0, factor means at 0, and factor variances at 1 as is the default in Mplus in multi-group analyses when using the default delta parameterization. Under these conditions, the model yielded evidence of acceptable fit on all three indices other than the chi-square, χ 2 (80, N = 646) = 216.89, p. B1 = Threshold 1; b2 = Threshold 2.

In this table, restrictive setting refers to youth facilities providing long-term incarceration, whereas less restrictive settings include probation, short-term detention, and clinic settings.We also examined whether the four-factor model fit equally well in the North American and European samples. Again, the unconstrained model yielded evidence of acceptable fit on all indices, χ 2 (132, N = 646) = 411.24, p. Tests of Model Invariance between Incarcerated and Detention/Probation/Clinic SamplesA similar set of analyses was conducted to assess measurement invariance as a function of setting, although, as noted above, the sample size for these comparisons was sub-optimal for assessing the four-factor model. Once again, the MGCFA for the three-factor model allowing separate estimation of parameters across the two settings demonstrated acceptable fit on both relative and absolute fit indices, χ 2 (79) = 251.20, p. DiscussionThe principal aim of this study was to examine the fit of the three- and four-factor models of psychopathy as assessed with the PCL: YV in a large sample of adolescent females.

Because no large-scale analyses have previously been reported, this study was designed to provide greater clarity on the factor structure of the PCL: YV in adolescent females. Analyses revealed consistently acceptable fit for both models in this large sample. More specifically, the TLI and SRMR suggest good to excellent fit for both models, and the CFI and RMSEA indicate acceptable although not excellent fit for both models. The Internal Structure of PCL: YV Psychopathy in SubsamplesThe subsample analyses suggest that both the three-factor and four-factor models also provide a reasonable representation of PCL: YV item score intercorrelations in most of the smaller subsamples examined. It must be emphasized that although these subsamples were larger than those in prior factor analytic studies of the PCL: YV in girls, they were smaller than is recommended for testing the four-factor model. Because the three- and four-factor models estimate 29 and 42 free parameters, tests of these models should include at least approximately 300 and 420 subjects, respectively (using a 10:1 ratio of subjects-to-free parameters; ). Therefore, our subsamples of approximately 300 (Ns = 277 to 369) should have been adequate to evaluate the three-factor model but may have been somewhat underpowered with respect to the four-factor model.That the models yielded evidence of adequate fit in the less restrictive (probation/detention/clinic) sample and in the North American sample and generally adequate fit in the European sample provides evidence for the robustness of these models.

There was also some evidence for invariance of the three-factor model (i.e., allowing only one item loading to freely vary), but this same situation was not evident for the four-factor model. It is important to keep in mind that these analyses nevertheless allowed the groups to differ in their thresholds. Whereas differences in the pattern of indicator-to-factor loadings are commonly interpreted as indicating differences in factor structure, differences in thresholds refer to distinctions in the levels of the underlying latent constructs at which the items are maximally discriminating. Overall, the findings here showed that levels of psychopathy tend to be higher in prisons (i.e., settings involving long-term incarceration) than in community and detention (short-term incarceration) settings. Similarly, levels of psychopathic traits appear to be higher in North American than in European settings (; ). In other words, higher levels of psychopathic traits must be present, on average, in individuals from North American and prisons samples before the items provide information (discrimination) on those with (versus without) psychopathic personality features.In spite of the generally acceptable fit for both models for subsamples in different continents and across settings, the multi-group analyses also demonstrated that the fit was better when the different subsamples were allowed to differ in some item loadings. Even allowing the indicator-to-factor loadings to differ for one or two items was sufficient to render the chi-square difference test (regarding constrained versus unconstrained models) nonsignificant for the three-factor model.

Consequently, some of the item loadings are not identical across geographical region and setting. Yet, most of the differences in item-to-factor loadings that we observed are small enough that they do not result in significant differences in overall model fit. However, in each case, there was at least one PCL: YV item for which the difference in loadings was substantial enough to produce a significant chi-square difference test unless the loadings on this item were permitted to vary across groups. In summary, in most cases there were apparent differences in some loadings (as shown in ), but these differences were not sufficient to produce a lack of invariance.In contrast, for the four-factor model, even allowing the loadings on one or two items to vary across groups was not sufficient to obtain evidence of structural invariance for the four-factor model. In this case, the multi-group analysis continued to demonstrate a lack of invariance even when loadings were estimated separately for several indicators. LimitationsAs discussed in the Introduction, factor analytic studies can make a valuable contribution to the construct validation enterprise. Evidence that a structural model accounts for the pattern of covariances among item scores in a new population and thus can be generalized to the pattern observed in other populations provides powerful evidence that the larger construct which a given measure assesses is similar across the two populations.

Thus, our results highlighting that scores on PCL factor indicators covaried in similar ways in adolescent girls versus what has been found with other samples suggests that the PCL-based conceptualization of psychopathy is likely similar in adolescent girls, compared with other diverse samples. At the same time, factor analytic studies have notable limitations with respect to construct validity research. Evidence for patterns of similar coherence among item scores and similar covariance among factor scores does not ensure that the underlying construct is the same. Consequently, it remains possible that the nomological network surrounding psychopathy and the four (or three) components of psychopathy is different in critical ways in adolescent females than in adolescent males.Other types of studies and research designs are necessary to evaluate relationships between psychopathy (and psychopathy components) and the quasi-criteria linked to psychopathy in adults and in adolescent males. Even so, the existence of similar internal structure in adolescent females assessed with the PCL: YV provides a foundation that permits clearer interpretation of the pattern of correlations with theoretically informed criteria in studies of adolescent females.

1Some researchers have argued that the antisocial dimension of the four-factor model should be excluded based on conceptual grounds and have specifically argued that antisociality is not central enough to psychopathy to justify its inclusion. This argument is beyond the scope of the current study, and we encourage interested readers to see Skeem and Cooke (2010) and, for recent discussions of relevant issues. We note here only that some of these discussions do not make clear that the five items comprising the dimension commonly referred to as the antisocial dimension are not scored on the basis of participation in antisocial behavior per se. Rather, these items are designed to assess early, persistent, and versatile expressions of antisocial behavior that distinguish some individuals who commit antisocial behavior from other individuals who commit antisocial behavior2The internal structure of self-reports and observer ratings of psychopathic features depends upon the instruments used. For example, analyses of mother and teacher ratings of psychopathic traits in pre-adolescents, as measured by the Antisocial Process Screening Device , suggest a slightly different three-factor structure than has been identified using PCL-based measures.

Factor structures resulting from analyses of self-report scores are variable across instruments, with studies reporting evidence for three-factor and four-factor structures similar to those seen in the PCL measures for scores on the Self-Report Psychopathy Scale and the Youth Psychopathy Inventory (;; ) but reporting very different factor structures for some other self-report measures (e.g., ). In some cases, different studies using the same instrument suggest different internal structures. For example, different factor analytic studies of scores on the Psychopathic Personality Inventory suggest disparate solutions involving two versus three dimensions (;; ).3Forth et al. Also did not use an optimal model estimation strategy for conducting their analyses. EQS Version 5.6 and LISREL Version 8.30 were not designed for use with ordinal item indicators. Mplus has advantages in analyses of ordinal indicators. When one of us re-conducted the CFAs on the 147 females examined by Forth et al.

Using Mplus, results indicated acceptable fit for both the three- and four-factor models.4Of course, even if a psychopathy measure functions similarly in boys and girls, it remains possible that the phenotypic similarities reflect different underlying mechanisms. Conversely, it could be argued that the same mechanisms operate in females and males, but that these mechanisms are associated with different constellations of features in girls and boys; however, this latter perspective does not appear very parsimonious.5Results for full-sample analyses including missing values indicated generally acceptable fit for the three-factor and four-factor models; however, the CFI slipped to.90 and.89 for the three- and four-factor models. Both models were also generally acceptable for the North American and European subsamples, although the CFI slipped to.89 for the four-factor model in both subsamples. For analyses limited to incarcerated girls, the CFI was low for the three-factor model (CFI =.89), and, as in principal analyses, both relative fit indices were unacceptable for the four-factor model (CFI =.82, TLI =.87). For analyses of girls on probation, under detention, or at clinics, both models yielded low CFIs (.89 and.88 for the three- and four-factor models) and borderline unacceptable RMSEAs (.099 and.097).

Additional multi-group analyses demonstrated that fit was also poorer when both loadings and thresholds were constrained to be equal in the two groups. Results of these analyses are available upon request.Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at.

Contributor InformationDavid S. Kosson, Department of Psychology, Rosalind Franklin University of Medicine and Science.Craig S. Neumann, Department of Psychology, University of North Texas.Adelle E.

Forth, Department of Psychology, Carleton University.Randall T. Salekin, Department of Psychology, University of Alabama.Robert D. Hare, Department of Psychology, University of British Columbia.Maya K.

Krischer, University of Cologne.Kathrin Sevecke, Department of Child and Adolescent Psychiatry, University of Cologne.