Dr. Robert Hare: Expert on the Psychopath

At first, most of the research was done on the most obvious population: male prisoners, because it was clear that while not all men who engaged in criminal acts were psychopaths, it seemed probable that psychopaths would make up a good percentage of imprisoned criminals.  The first task was to develop an instrument that proved to be a reliable way to distinguish a psychopath from a non-psychopath, and that took some time.  Once it was clear that the PCL-R was reliable and valid, the focus could be turned on imprisoned females, children at risk for developing into psychopaths, and then on the population at large.

As of this writing, Hare says, "There's been quite a bit of research on female psychopaths.  I have data in the new manual, including percentile tables, for 1200 female offenders in North America, many of whom are African-American.  The scores are a few points lower than for male offenders, but otherwise the distributions of scores are very similar.  The correlates and the predictive power of the PCL-R are much the same for female and male offenders.  For example, female psychopathic offenders re-offend at a high rate compared to other female offenders."

Then there are the children: can we spot budding psychopaths and intervene before they became dangerous adults?  A version of the PCL-R used for adolescents is the Psychopathy Checklist: Youth Version (PVL:YV), developed with Dr. Adelle Forth and Dr. David Kosson.  It has proven to be as reliable and valid as its adult counterpart. For younger children, the Antisocial Process Screening Device (APSD), developed with Dr. Paul Frick, appears to be useful for distinguishing children who show risk factors for the development of psychopathy, such as lying easily and acting without awareness of the consequences, from those who merely have social and emotional problems.

Identification of these risk factors," says Hare, "is necessary if we are ever to develop early interventions for what might become adult psychopathy.

In addition to developing a scale for younger populations, Hare was also asked by British probation officers to provide something for their use.

"Four years ago," he explains, "a senior probation officer in the UK organized a conference in Sheffield to convince me that probation and parole officers needed a tool to help them assess psychopathic features.  They couldn't use the PCL-R or the 12-item PCL:SV, because these are controlled instruments that require professional qualifications.

"So this group showed me the front page of the London Times, which said that most murders committed in the UK are committed by people out on probation or parole.  The response of the government was that the probation service was in need of close monitoring.  The probation people said that it was the job of the prison service to evaluate risk for violence before release of an offender, and that probation officers didnt have the means to assess their clients for psychopathy, a known risk factor. To do this, they wanted a tool."

Hare came up with the P-Scan.  It is a non-clinical tool for developing general impressions into a hypothesis about whether a particular person might be a psychopath, which would have implications for managing risk for violent or antisocial behavior.  It's a rough guide for law enforcement and parole officers, used to bring the person to the attention of someone who might then give a more formal assessment.

  
"It consists of 120 characteristics, 30 for impressions about interpersonal traits, like grandiosity and lying, 30 for impressions about affective traits, such as lack of remorse and shallow emotions, 30 for impressions about lifestyle features, such as impulsivity and stimulation-seeking, and 30 for impressions about antisocial behaviors.  So we have four components that match the new factor structure of the PCL-R.  The P-Scan involves scoring items that are simple descriptive statements, like 'His presence makes me feel uncomfortable,' or low-level inferences, such as Seems unable to understand the feelings of others. You don't have to be a clinician, you just have to have some experience with the individual.  We've developed a computer program so qualified professionals can access it on the Web, through Multi Health Systems.  The P-Scan report provides a hypothesis about the extent to which a person of interest might have the interpersonal, affective, lifestyle, and antisocial features of psychopathy.  The information may be helpful in dealing with the individual, but in some cases it will be an impetus for getting a clinical opinion from someone trained on the PCL-R."

In some cases the information can be used to guide law enforcement officers in their dealings with suspects. For example, to get cooperation from psychopaths it would be pointless to appeal to their conscience, or to try to make them feel something for their victims or to feel badly about what they did.  It may be more productive to offer them something that appeals to their self-interest.  Many a psychopath involved in a "deadly duet" has turned on a partner to save his or her own skin.  Education about psychopaths should be a routine part of the training of police officers. 

Not everyone has access to these instruments or has the professional qualifications to use them, so Without Conscience, based on the PCL:SV, offers some rules of thumb for spotting and dealing with the psychopaths whom any of us might encounter.