Study: Psychopathy score fails to predict sexual recidivism

Many forensic psychologists believe that psychopathy is a risk factor for sex offender recidivism. Not surprisingly, when forensic psychologists assign a sex offender a high score on a psychopathy test, it increases the risk of extreme legal sanctions such as civil commitment.

But a new study out of Texas found zero correlation between sexual recidivism and psychopathy, as measured by the widely used Psychopathy Checklist (PCL-R). If anything, sex offenders who were arrested for a new sexually violent offense tended to have lower scores on the PCL-R than those who were not rearrested!

Regular blog readers should be familiar with these researchers by now: Dan Murrie, Marcus Boccaccini and crew are the same scholars who informed us of the partisan allegiance phenomenon, in which evaluators working for the government tend to assign far higher PCL-R scores than do those working for the defense.

In their most recent study, they examined PCL-R scores from about 400 sex offenders in Texas who were released from prison and then tracked for anywhere from about two to seven years. They examined not just the total scores on the PCL-R, but also scores on the instrument's two factors, as well as four so-called facet scores. Not one of these seven PCL-R variables was a statistically significant predictor of whether a man would be arrested for a new sex crime.

“Overall, these predictive validity findings were striking because the PCL-R apparently failed to predict the type of outcome (i.e., sexually violent reoffense) for which it was administered in this context,” the authors noted.

Further, in cases in which the PCL-R was administered by more than one evaluator, the study found poor agreement between the two, even though both were working for the government. Consistent with prior research, interrater agreement was higher on Factor 2, which measures antisocial behavior and an impulsive lifestyle, than on Factor 1, which measures the vaguely operationalized personality and emotional dynamics thought to underlie psychopathy.

In an interesting twist, the researchers tried to determine whether some evaluators were more accurate than others at predicting recidivism through PCL-R scores. They identified four highly prolific evaluators; together, these three psychologists and one medical doctor had provided almost two-thirds of the PCL-R scores in the study. Although the PCL-R scores of three of these four evaluators were more likely than other evaluators' scores to correlate with a new arrest for a non-sexual crime, even these evaluators could not produce PCL-R scores that predicted sexual offense recidivism.

Despite the PCL-R’s lack of predictive validity, sex offenders with higher PCL-R scores were more likely than others to be recommended for civil commitment, indicating that the unreliable rating was far from harmless in forensic practice.

The study is: 

Murrie, D. C., Boccaccini, M. T., Caperton, J. and Rufino, K. Field Validity of the Psychopathy Checklist–Revised in Sex Offender Risk Assessment. Psychological Assessment. Click HERE to request a copy from the first author, at the Institute of Law, Psychiatry, and Public Policy.

Of related interest:

• NPR expert panel: Weighing the value of a test for psychopaths
• Psychopathy: A Rorschach test for psychologists? (blog post)

NPR series on psychopathy in court

This Thursday and Friday, NPR is airing a 2-part series about the controversial use of psychopathy in court.

In Part I on All Things Considered, psychology and science reporter Alix Spiegel shows the profound negative consequences of psychopathy on the lives of those so designated. She profiles a California prisoner whose friends and family do not believe he is a psychopath, but who will likely never win parole due to that label.

Part II (on Friday) examines the history of the Psychopathy Checklist (PCL-R) and explores how it became so entrenched in the criminal justice system. Dan Murrie’s research questioning the reliability of the PCL in adversarial contexts is highlighted. Robert Hare also expresses concerns about the way his tool is being used in court, and the corrupting influences of the adversarial system.

The show will be complemented by an online debate, “Does the PCL-R test have value in the criminal justice system?” I am one of the featured experts on the panel, so I hope some of you will visit the website; I will provide a link just as soon as it goes live.

For those of you who would rather tune in once, the show is also airing as a single piece on Friday on the radio program This American Life, and you will be able to download the podcast there as well.

Part I of the 2-part series is HERE; the online debate is HERE.

Encephelon #86: Blogging scientific mysteries

Of Florence Nightingale, free will, psychopath-hunters and -- yes -- even octopuses

It’s my turn to host the neuroscience and psychology blog carnival, Encephalon. This month, my blogger colleagues were busy analyzing fascinating unsolved mysteries in the wide-ranging fields of brain and behavior. So all of you sleuths out there, dust off your magnifying glasses and come exploring with me....

The mystery of the bedridden activist

At Providentia, psychologist Romeo Vitelli probes the mysteries surrounding pioneering public health activist Florence Nightingale (1820-1910) in a 2-part series, "The Bedridden Activist." Dr. Vitelli (who for all of you forensic folks escaped Ontario's maximum-security Millbrook Correctional Centre after a 15-year stint) marvels at Nightingale's indefatigable crusade for the poor and downtrodden, despite a debilitating illness that rendered her unable to travel. While discussing the theories of her mysterious illness, Dr. Vitelli also corrects the historical record:

Although Florence Nightingale opposed the Contagious Diseases Act, it was not because she opposed the germ theory of disease (as some critics later argued). Even though germ theory was not taken seriously before Joseph Lister and Louis Pasteur made the theory acceptable, Nightingale actually pioneered the need for sanitation and antiseptic conditions. Her opposition to the legislation that was eventually passed stemmed from the intrusive nature of the Act (including mandatory screening of prostitutes for syphilis and detaining infected women). When the act was passed in 1864, she campaigned for its repeal. 

The mystery of free will

Should a man who takes out a murder contract on his wife and children be held responsible? For most people, the obvious answer is, “Of course!” But for pure determinists, free will is an illusion; no one is responsible for anything.

That doesn't fit well with the assumptions of our criminal and civil court systems. Or does it? As Peter reports in his post on "expertimental free will" at Conscious Entities, an odd thing happens when determinism runs up against moral values. In an experiment in which subjects were told to assume that determinism is correct (meaning people are not responsible for their actions), subjects still assigned responsibility to the man who took out a contract on his family.

The mysterious octopus

Octopuses fascinate scientists. That's partly because they are so different from mammals like us. Not only are their brain regions not arranged to correspond with bodily systems, but their individual arms can control some movement without input from their brain. Over at Cephalove, Mike Lisieski discusses a study on the unsolved mystery of exactly how an octopus’s brain uses vision to control ongoing movements. The post is, "The octopus, the maze, and why it matters: behavioral flexibility and sensory-motor integration."

The mystery of the sightless mind

While some researchers study the role of vision in the elusive octopus, others study it in humans. Janet Kwasniak at Thoughts on Thoughts reports on new research into the brains of sightless humans. In “How is the world represented without vision?,” she muses on how, given the importance of vision to our species, it is possible to produce a conscious model of the world without it. And how does the brain use the third of the cortex involved with vision when vision is idle? Attempting to solve those mysteries, the researchers used fMRI technology to compare the brains of congenitally blind people, blind people who were once sighted, and sighted and blindfolded sighted individuals.

The mystery of the calcium in the brain

Here's one that I bet few of my readers have thought much about:

Zen Faulkes at Neurodojo, a biology professor at the University of Texas-Pan American, ponders long-held assumptions about the role of calcium in neuronal functioning. How do you prove the neurons don't use calcium, he wonders? And what do they use instead? These are among the questions addressed in the post, “Neurotransmitter release without calcium.”

The mystery of the ulcer-less zebra

Daniel Lende at Neuroanthropology is highlighting the intriguing teachings of Robert Sapolsky, a MacArthur Fellow who divides his time between teaching biology and neuroscience at Stanford University and conducting stress research on baboons in Kenya. In "Robert Sapolsky and Human Behavioral Biology," Daniel provides links to an entire course of study on human behavioral biology that's available for free online at YouTube. If you’re interested in anything from memory and plasticity to schizophrenia, language, individual differences, and human sexual behavior, this 25-session course is worth checking out.


After reading Daniel’s post, I couldn't resist buying a copy of Sapolsky's latest book, Why Zebras Don't Get Ulcers, which explores stress and stress-related illness. To answer the question: Zebras don't get ulcers because they – like our ancestors – do not have to confront the chronic stresses of contemporary life, which our bodies were not designed to withstand.

The mystery of the psychopath hunter

Back to this blog’s central theme of forensic psychology I bring you (drum roll) the biggest mystery of all: What motivates US! I blogged about research into why some psychologists give higher scores than others on a measure of psychopathy. In case you haven't read the post I won't give it all away here, but the researchers found that subjects' levels of empathy and excitement-seeking affected whether they saw others as psychopathic. The post is, "Psychopathy: A Rorschach test for psychologists?"

That's it for now. Past -- and future -- issues of Encephalon are available HERE. 

Psychopathy: A Rorschach test for psychologists?

• Compassion
• Empathy
• Impulsivity
• Excitement-seeking

What do these personality traits have in common?

If you are high on any or all of them, you may be less likely to rate other people as psychopathic on the Psychopathy Checklist (PCL-R).

The PCL-R is the most widely used measure of psychopathy in the world. But in real-world forensic settings, scores vary widely depending upon which side retained the evaluator. This finding is called the "partisan allegiance" effect.

In a new twist, these same researchers that brought you partisan allegiance have found that an evaluator's personality may impact her judgments of psychopathy. Evaluators low on compassion and thrill-seeking as measured by a widely used personality test, the NEO Personality Inventory-Revised, are more likely than others to rate criminals as psychopathic.

That’s ironic, because according to the theory of psychopathy, it's supposed to be the psychopath -- not the psychologist -- who has a deficit in empathy.

The exploratory study, forthcoming in the journal Assessment, was based on a small sample of 22 individuals who were given nine hours of training by a clinical psychologist with substantial research and forensic practice experience with the PCL-R. "The daylong session was an attempt to replicate typical PCL-R training procedures," the study authors explain.

The researchers emphasize that their findings are preliminary and need to be replicated and extended. But if they hold up, they have intriguing implications not only for the psychopathy measure but also for other psychological tests with elements of subjectivity in scoring or interpretation.

The study did not examine the accuracy of the low versus high scorers. But if low-scoring evaluators are more empathetic, this implies that they may be more accurate in interpersonal assessment contexts.  

Subterranean class conflict?

Future research might examine class background, race and philosophical  beliefs to see if these influence scoring of the Psychopathy Checklist. In my informal observations, professionals who look for psychopaths under every rock tend to lack understanding of, or empathy for, those on the bottom.

Here's how that looks in practice:

The upper middle-class professional walks into the evaluation room, oblivious to the blinders and unconscious biases she brings to the table. Her subject, in contrast, is far from oblivious. With his more acute empathetic skills, the lower-class or minority individual accurately reads the professional's bias against him, which she transmits through nonverbal and other deniable cues. He also realizes that she holds all the power, and that her judgments will affect his future in very tangible ways.

He reacts with defensiveness, suspicion, or muted hostility -- especially if she is working for "the other side." But not recognizing his reaction as part of an interactional dance that she herself set in motion, the evaluator interprets his stance as evidence of intrinsic personality defect. She may see him as glib, superficially charming, conning, or manipulative -- all facets of Factor 1 (the personality dimension) on the Psychopathy Checklist.

In this interaction, all of the power belongs to the person who gets to do the labeling. Scoring and labeling the offender becomes a circular process through which the evaluator -- especially when primed by adversarial allegiance -- can  project her own class- or race-based prejudices, distancing herself from the evil other, while at the same time denying complicity. An obfuscating tautology is proffered as a simple explanation for complex and multi-determined antisocial acts.

There is more to the construct of psychopathy, of course. I focus here on its potential subjectivity because this is a facet that proponents rarely acknowledge, especially in public. Forensic experts owe a duty to explain the subjectivity of the PCL-R when it is introduced in court, where the label "psychopath" can be the kiss of death. When labeled as psychopaths:

• Juveniles are more likely to face harsh punishment in adult court.
• Sex offenders are more likely to be preventively detained.
• Capital murder defendants are more likely to receive the death penalty.

So, the next time a promising young student proposes to study psychopathy or "the criminal mind," you might give her a gentle nudge in a more fruitful direction: Rather than treading this tired old path, she might contribute more to the field by studying the psyches of professionals who assign such diagnostic labels in the first place. 

• The study is: On Individual Differences in Person Perception: Raters' Personality Traits Relate to Their Psychopathy Checklist -Revised Scoring Tendencies. The authors are Audrey K. Miller, Katrina A. Rufino, Marcus T. Boccaccini, Rebecca L. Jackson and Daniel C. Murrie. Assessment, forthcoming.

• Of related interest: Social Class, Contextualism, and Empathic Accuracy, by Michael W. Kraus, Stéphane Côté and Dacher Keltner, Psychological Science, November 2010.

Metaanalysis debunks psychopathy-violence link

No clear winner among violence risk tools

If you are looking for the best tool to assess someone's risk for violence, the array may seem confusing. Lots of acronyms, lots of statistical data about AUC's (Areas Under the Curve) and the like. What do do?

No worries. As it turns out, they're pretty much interchangeable. That is the bottom-line finding of a groundbreaking metaanalytic study in the APA journal Psychological Bulletin by three academic researchers from the United Kingdom.

The University of Nottingham researchers used sophisticated statistical tools to meta-analyze multiple studies on the accuracy of nine leading violence risk assessment tools. All nine turned out to have similarly moderate predictive accuracy, with none clearly leading the pack. And none -- the scholars warned -- were sufficiently accurate for courts to rely upon them as a primary basis for decision-making in forensic cases requiring "a high level of predictive accuracy, such as preventive detention."

Widely touted PCL-R's "Factor 1" a bust

In a result with potentially momentous implications for forensic practitioners, the researchers found that Factor 1 of the Psychopathy Checklist-Revised (PCL-R) does not predict violence. As you know, Factor 1 purports to measure the core constellation of a psychopathic personality (superficial charm, manipulativeness, lack of empathy, etc.). When introduced in court, evidence of psychopathy has an enormously prejudicial impact on criminal offenders.

But, the PCL-R's much-ballyhooed ability to predict certain types of violence owes only to the instrument's second factor, according to the metaanalysis by researchers Min Yang, Steve Wong, and Jeremy Coid. And that's no surprise. After all, Factor 2 measures the criminogenic factors (criminality, irresponsibility, impulsivity, history of delinquency, etc.) that even a fifth-grader knows are bad signs for a future of law-abiding citizenship.

In my experience, the Factor 1 items -- the ones purporting to measure an underlying personality profile -- are the ones more likely to be inflated by some evaluators. That's because many of these items are pretty subjective. Glib? Superficially charming? If you don't like a guy -- and/or he doesn't like you -- you are more likely to rate these negative items as present. That's one of my hypotheses for the large evaluator differences and partisan allegiance effects found with the PCL-R in forensic practice.

Cumulatively, the emerging PCL-R findings beg the question:

Why introduce the Psychopathy Checklist in court if other violence risk tools work just as well, without the implicitly prejudicial effect of labeling someone as a "psychopath"?

Psychopathy evidence skyrocketing in juvenile cases

Despite (or perhaps because of, in some cases) its prejudicial impact, the construct of psychopathy is increasingly being introduced in court cases involving juveniles. It is often used to infer that a youth should get a longer sentence because he or she is dangerous and not amenable to treatment.

Skyrocketing use of psychopathy evidence in juvenile cases
Source: Viljoen et al, Psychology, Public Policy, and Law (2010)

The first systematic review, published in the current issue of Psychology, Public Policy, and Law, found the use of psychopathy evidence against juveniles skyrocketing in both Canada and the United States. Psychopathy evidence is typically introduced when juveniles are being sentenced as adults and in sex offender commitment cases. It is also introduced in a variety of other cases, including ones involving disputed confessions, competency to stand trial, and criminal responsibility, report authors Jodi Viljoen, Emily MacDougall, Nathalie Gagnon, and Kevin Douglas.

In one egregious case showing how judges may improperly use evidence of psychopathy, a Canadian judge reasoned that a youth's "psychopathic device [sic] score" showed that under his "shy and unassuming" exterior lurked "a monster" that "at any time ... may well come alive." As a result, the judge sentenced this minor to an adult penitentiary.

Such inferences of unremitting danger and untreatability are improper. A large proportion of youths measured high in psychopathy score lower on psychopathy instruments once they mature. And so-called psychopathic youths are far from untreatable; in one recent study by Michael Caldwell and colleagues, after intensive treatment youths who scored high in psychopathy were actually less likely to recidivate than a comparison group in a juvenile jail.

"[T]he introduction of psychopathy evidence into juvenile forensic contexts has been somewhat rushed and premature at times," the authors conclude.

Have risk prediction tools hit the ceiling?

Researchers have been toiling for almost five decades to perfect risk prediction tools. Unfortunately, they keep running into an insurmountable obstacle: A large proportion of violence is situational. It's affected by environmental context, not just qualities internal to the individual. And not only that, but it is always extremely hard to predict a rare event.

Based on their metaanalytic findings, the UK researchers say maybe it's time to stop searching for the holy grail. Maybe we've reached the ceiling of predictive efficacy.

Violent behavior is the result of the individual interacting with the immediate environment. Although it may be possible to improve on our understanding and predicting what an individual may do in hypothetical situations, it will be much more difficult to predict the situation that an individual actually encounters in the open community. Even predicting violence within an institutional environment is difficult, where the assessor has much more information about that environment.

Instead, they say, it is time to turn our attentions to interventions that can reduce risk:

Building a better model of violence prediction should not be the sole aim of risk prediction research, which is just one link in the risk assessment-prediction-management triad that aims to achieve violence reduction and improved mental health…The risk, need and responsivity principles derived from the theory of the psychology of criminal conduct provide a useful theoretical framework for risk reduction intervention. Appropriate risk assessment can identify high-risk individuals in need of more intensive management and intervention…. Using tools with dynamic risk predictors to assess risk can identify appropriate changeable treatment targets linked to violence.

The studies included in the metaanalysis were from six countries: the United Kingdom (11), Canada (9), Sweden (3), the United States (3), Holland (2), and Germany (1). The instruments included the PCL-R, the PCL:SV, the HCR-20, the VRAG, the OGRS, the RM2000V, the LSI/LSI-R, the GSIR, and the VRS, as well as seven instrument ubscales: PCL-R Factor 1 and Factor 2, the 10-item Historical subscale, the five-item Clinical subscale, and the five-item Risk Management subscale of the HCR-20; and the Static and Dynamic scales of the VRS.

Dr. Wong, former Research Director at the Regional Psychiatric Centre in Saskatoon, Saskatchewan, studied psychopathy and high-risk offenders for 25 years and developed the Violent Risk Scale and the Violence Risk Scale-sexual offender version before becoming a special professor at the Institute of Mental Health at the University of Nottingham. Dr. Yang is a professor of medical statistics with the Faculty of Medicine and Health Sciences at the University of Nottingham. And Dr. Coid, Director of the Forensic Psychiatry Research Unit, is principal investigator of the UK Home Office’s Prisoner Cohort Study and also studies the epidemiology of violent and criminal behavior at the population level.

The articles reported on here are:

• Yang, M., Wong, S.C.P., & Coid, J. (2010). The efficacy of violence prediction: A metaanalytic comparison of nine risk assessment tools. Psychological Bulletin, 136, 740-767. Correspondence to: Min Yang.
  

• Viljoen, J.L., MacDougall, E.A.M., Gagnon, N.C., & Douglas, K.S. (2010). Psychopathy evidence in legal proceedings involving adolescent offenders. Psychology, Public Policy, and Law, 16, 254-283. Correspondence to: Jodi Viljoen.
  

Of related interest:

• Boccaccini, M.T., Turner, D.B., & Murrie, D.C. (2008). Do some evaluators report consistently higher or lower PCL-R scores than others? Findings from a statewide sample of Sexually Violent Predator evaluations. Psychology, Public Policy, and Law, 14, 262-283. Correspondence to: Marcus Boccaccini.
  

• Murrie, D.C., Boccaccini, M.T., Johnson, J.T., & Janke, C. (2008). Does interrater (dis)agreement on Psychopathy Checklist scores in Sexually Violent Predator trials suggest partisan allegiance in forensic evaluations? Law & Human Behavior, 32, 352-362. Correspondence to: Marcus Boccaccini.

Online alert: Ethics and peer review articles

I said I was done blogging about the psychopathy controversy for awhile. But I did want to alert readers to the fact that the International Journal of Forensic Mental Health has opened up its two articles so that you can download them for free for a limited time. Those articles pertain to ethics and the peer-review process. The articles are:

• Threats to Sue, Peer Review, and Potential Implications for Science and Law: A Commentary by Norman Poythress and John P. Petrila

• The Dark Side of Peer Review by Stephen D. Hart

Click on either title to go to the downloadable pdf.

Psychopathy brouhaha: It's a wrap (I hope!)

Today's Scientific American has more on the censorship controversy I've featured here in recent weeks. As regular readers know, the flap centers around allegations that psychopathy researcher Robert Hare tried to silence critics by threatening to sue. The controversial article was finally published this month in the American Psychological Association publication Psychological Assessment, but the fallout continues.

The column by J.R. Minkel, oddly titled "Fear Review," features a rundown, including commentary by prominent scholar Stephen Hart:

People familiar with the matter say the scale's author, Robert Hare of the University of British Columbia, deserves only partial blame for the delay, to be shared with the American Psychological Association (APA), the journal's publisher. But they say Hare's use of legal threats has at best subverted the peer review process that is the crux of modern scientific progress, and could at worst encourage junior researchers in the field of forensic psychology to pursue other lines of research.

"I find this action to be completely inconsistent with the man I had [great] respect and affection for," says Stephen Hart of Simon Fraser University in British Columbia, a collaborator and former student of Hare's. "People I speak with automatically think, 'Well, what's in that article that makes him so upset? What's he so afraid of?'

After reading all of the publicly available materials on the controversy, as well as numerous email posts on professional listservs, here's how I boil things down to the essence:

• The Skeem and Cooke article is an important scientific analysis of the theoretical construct of psychopathy, which is increasingly being used as a weapon in court with grave consequences for those it is deployed against.

• Not surprisingly, Robert Hare disagrees with Skeem and Cooke. Specifically, he does not agree with their claim that his Psychopathy Checklist or the underlying psychopathy construct centralizes criminality.

• Hare claims that Skeem and Cooke distorted his work. In a written response, he gives three examples of alleged distortions. Presumably, since he was preparing his response for publication, he picked the best examples he could find to illustrate his complaint. Yet, these are nowhere near as egregious as I had imagined they would be, given his threat to sue.

• Hare accuses two well respected psychology-law leaders, Norm Poythress and John Petrila, of being biased and misinformed. But nothing in his response supports this. Poythress and Petrila, in their article in the International Journal of Forensic Mental Health that set this whole ball in motion, were careful not to take sides in the underlying scientific debate over psychopathy. Rather, they focused on the threat to academic freedom and science posed by threats to sue: "Academic freedom rests on the premise that advances in science can only occur if scholars are permitted to pursue free competition among ideas. This assumes that scholars have the liberty to do their work free from limitations imposed by political or religious pressure or by economic reprisals."

• Hare has claimed elsewhere that his "lawsuit threat was meant only to get the 'attention' of APA, Skeem, and Cooke and force changes to the article." In his essay, he expresses bafflement at the ensuing, lengthy delay in the article's publication. To claim that his threat to sue did not contribute to the lengthy delay is either disingenuous or naïve. Especially in the wake of other controversies, such as the Rind debacle in which the U.S. Congress blasted the APA's publication and peer review process, the Association is undoubtedly very gun-shy and reactive over lawsuit threats.

The bottom line:

After analyzing all sides of the issue, I find that the Skeem and Cooke article is an important and timely contribution to the field, and that threats to sue over such publications set a dangerous precedent. As Poythress and Petrila point out in their commentary, potential negative effects of defamation threats against scientific researchers include -- among other things -- that:

1. researchers avoid critical research out of fear of lawsuits,
2. academics avoid volunteering as peer reviewers, and
3. journal editors self-censor on controversial topics

Censorship -- or even the appearance of censorship -- is especially dangerous when it involves critique of a construct that may be used in a partisan manner in the forensic arena.

Hare is entitled to express his opinion, but nothing in his public response changes these bottom lines. Rather, as Jennifer Skeem notes in today's Scientific American piece, all of this peripheral controversy distracts from the scientific critique of psychopathy, including her critique that was silenced for three years before finally seeing the light of day.

I sure hope this is my last blog post for a while on this topic!

PRIVATE NOTE TO TODAY'S "ANONYMOUS" BLOG COMMENTER:
I regret that I had to reject your comment about the pecuniary angle from publication.
While I found it quite interesting, I had no easy way to substantiate its accuracy.

GENERAL NOTE TO COMMENTERS:
I encourage comments, but it's nice to know who is talking;
please consider signing your name (or at least a pseudonym).

My prior coverage includes:

• Psychopath guru blocks critical article: Will case affect credibility of PCL-R test in court? (May 30, 2010)
• More coverage of psychopathy censorship controversy (June 1, 2010)
• Psychopathy controversy goes primetime (June 10, 2010)
• New York Times covers psychopathy debacle ( June 12, 2010)

New York Times covers psychopathy debacle

I had no idea when I broke the news of this censorship controversy that it would generate so much mainstream attention. First Science ran with it, and today it's made the New York Times; I am told other major U.S. and international news outlets have made inquiries. I hope this affair will serve as a dramatic lesson to others who might think about making legal threats when someone criticizes their work. The move certainly backfired against psychopathy guru Robert Hare.

Certain theories have weightier real-world implications than others. When a capital case defendant is labeled a "psychopath" in court, it can literally mean the difference between life and death. Similarly, the pejorative label has serious consequences for someone facing lifelong civil detention as a sexual predator. Thus, critical analysis of the reliability and validity of the underlying theory is essential. Researchers whose work lends itself to partisan forensic application should expect scrutiny.

Here's what Benedict Carey, health beat reporter at the New York Times, had to say:

Academic disputes usually flare out in the safety of obscure journals, raising no more than a few tempers, if not voices. But a paper published this week by the American Psychological Association has managed to raise questions of censorship, academic fraud, fair play and criminal sentencing -- and all them well before the report ever became public.

The paper is a critique of a rating scale that is widely used in criminal courts to determine whether a person is a psychopath and likely to commit acts of violence. It was accepted for publication in a psychological journal in 2007, but the inventor of the rating scale saw a draft and threatened a lawsuit if it was published, setting in motion a stultifying series of reviews, revisions and legal correspondence.

"This has been a really, really troubling process from the beginning," said Scott O. Lilienfeld, a psychologist at Emory University and a collaborator with one of the paper's authors. "It has people wondering, 'Do I have to worry every time I publish a paper that criticizes someone that I’ll get slapped with a lawsuit?' " The delay in publication, he said, "sets a very dangerous precedent" and censors scientific discourse….

Dr. Hare's clinical scale, called the Psychopathy Checklist, Revised, is one of the few, if not the only, psychological measures in forensic science with any scientific backing…. Dr. Skeem and Dr. Cooke warned in their paper that the checklist was increasingly being mistaken for a complete definition of psychopathy -- a broader personality construct that includes deceitfulness, impulsivity and recklessness, though not always aggression or illegal acts. The authors contended that Dr. Hare's checklist warps that concept by making criminal behavior a more central component than it really is…. {NOTE: The New York Times later issued a correction of the above portion that is in red; clearly, it's wrong to call the PCL "one of the few, if not the only," forensic psychology measures with any scientific backing!}

"When we first wrote the paper," [Jennifer Skeem] said, "we saw it simply as a call to the field to recognize we were going down a path where we were equating an abstract concept with a checklist, and it was preventing us from looking at the concept more closely."

Carey's full article is HERE. I will be sure to keep readers posted on any further developments.

POSTSCRIPT

This evening, readers alerted me that Robert Hare has posted a lengthy response giving his side of the controversy. His essay, "On Fairness in Academic Debate: A Commentary on Poythress and Petrila (2010) and Related Matters," claims that Poythress and Petrila's critical opinion piece in the International Journal of Forensic Mental Health (see my May 30 blog post) was biased and one-sided. He presents a timeline of the events surrounding the lengthy delay in publishing the underlying psychopathy article by Skeem and Cooke in Psychological Assessment, and gives specific examples of their allegedly egregious misrepresentations of his work. He comments:

… Poythress and Petrila and Hart failed to give an impartial and complete account of the situation. Their actions resulted in publication and circulation of a seriously biased account of events, and a commentary in the June 11 issue of Science, which noted that there are several sides to every issue…. I have no arguments with their thoughtful and commendable views about the nature of scientific debate and peer review, and about the potential fallout from threats of litigation…. I would welcome a formal investigation of the entire matter by an appropriately impartial body. I also would be willing to engage in open debate with the parties involved…. Contrary to the characterizations of others, I made extensive efforts to use the academic system in this case, but [the Skeem and Cooke] article went beyond the boundary of fair academic debate and criticism. The nature of the issue and the authors' refusal to correct their egregious statements gave me no reasonable alternative….

Would I do it again, given similar circumstances? Perhaps not, for like a whistle-blower the focus soon turns to the person who made the complaint and not on the issues and events that led to the complaint. Further, many in the scientific community believe that there are no grounds for litigation concerning academic works, no matter what the circumstances. I’ve learned from this experience that not all academics and scientists play by the accepted rules of science, and that legal redress for those claiming injustice is frowned upon by many as rocking the academic/scientific boat, however leaky it may be; a professional Catch-22 that serves to deny academics the legal rights enjoyed by the rest of the population.

His full statement is HERE. Again, I encourage readers interested in this subject to read Skeem and Cooke's Psychological Assessment article, rebuttal, and surrebuttal and form your own opinions.

Psychopathy controversy goes primetime

More than a million people worldwide will get a chance to learn about psychology's internal controversy over psychopathy tomorrow, when Science publishes an article on the censorship allegations that I blogged about May 30.

Perhaps not coincidentally, just as the June 11 issue of the world's leading scientific news outlet hits the presses, the American Psychological Association is suddenly publishing the disputed article that was siderailed for more than three years.

Forensic psychologists Jennifer Skeem and David Cooke submitted the contested article to Psychological Assessment in 2006. It was peer reviewed, accepted, and scheduled for publication in 2007, but was derailed after Robert Hare, inventor of the Psychopathy Checklist (PCL), threatened to sue for defamation.

As you will remember from my previous blog post, the controversy surfaced in an opinion piece last month in the International Journal of Forensic Mental Health by two psychology-law leaders.

"[T]he threat of litigation constitutes a serious threat to academic freedom and potentially to scientific progress," wrote attorney John Petrila and psychologist Norman Poythress. "Academic freedom rests on the premise that advances in science can only occur if scholars are permitted to pursue free competition among ideas. This assumes that scholars have the liberty to do their work free from limitations imposed by political or religious pressure or by economic reprisals."

Hare now says he is "upset colleagues are suggesting he squelched academic debate," Science writer John Tavris reports, as his "lawsuit threat was meant only to get the 'attention' of APA, Skeem, and Cooke and force changes to the article."

The Science report is a sidebar to a larger piece on reform efforts over plaintiff-friendly libel laws in the United Kingdom. That country's laws, in which the defendant bears the burden of proof, are under fire from around the world over their allegedly chilling effect on scientific research on controversial topics. Critics say they encourage "libel tourism," in which corporations sue there over alleged offenses that occurred elsewhere.

PCL-R reification hampering science

The contested article by Skeem and Cooke, "Is Criminal Behavior a Central Component of Psychopathy? Conceptual Directions for Resolving the Debate," posits that the field of forensic psychology has prematurely embraced Hare's Psychopathy Checklist-Revised (PCL-R) as the gold standard for psychopathy, due in large part to legal demands for a tool to predict violence. Yet the PCL-R's ability to predict violent recidivism owes in large part to its conflation of the supposed personality construct of psychopathy with past criminal behavior, they argue:

[T]he modern justice context has created a strong demand for identifying bad, dangerous people…. [The] link between the PCL and violence has supported a myth that emotionally detached psychopaths callously use violence to achieve control over and exploit others. As far as the PCL is concerned, this notion rests on virtually no empirical support…. [T]he process of understanding psychopathy must be separated from the enterprise of predicting violence.

Criminal behavior weighs heavily in the PCL's 20 items because the instrument emerged from research with prisoners. But using the PCL-R's consequent ability to predict violence to assert the theoretical validity of its underlying personality construct is a tautological, or circular, argument, claim Skeem and Cooke. Or, as John Ellard put it more directly back in 1998:

"Why has this man done these terrible things? Because he is a psychopath. And how do you know that he is a psychopath? Because he has done these terrible things."

Rebuttal and response

Alongside the critique, Psychological Assessment has published a rebuttal by Robert Hare and Craig Neumann, along with a surrebuttal by Cooke and Skeem. Hare and Neumann accuse the critics of erecting a straw-man argument and misrepresenting their work:

The very title of their article is a straw man based on the unfounded claim that Hare and his colleagues consider criminality to be central or fundamental to the psychopathy construct. Their claim is bolstered by arguments misconstruing our published work and that of others and by quotes of our work that have been taken out of context or reconstructed in such a way that it appears that we have said something that we did not say. Skeem and Cooke also made highly selective use of the literature, often omitting published studies that directly contradict or do not support the points they attempted to make, particularly with respect to the role of antisocial tendencies in clinical and empirical conceptions of psychopathy. These tactics are inconsistent with their tutorial on the philosophy of science, compromise their arguments, and divert attention from any legitimate issues raised in their article. We contend that Skeem and Cooke did the field a disservice by presenting an inaccurate account of the role of the PCL–R in theory and research on psychopathy, both applied and basic.

I encourage readers to analyze all three papers, along with the two reports in Science, and draw your own conclusions.

• My original post on the controversy is HERE; a brief followup is HERE.
• Science writer John Travis' blog post on the story, in Science Insider (with more links), is HERE.
• Coverage at Mind Hacks is HERE.
• For more background and links on the UK libel law reform campaign, see my March 27 post, "Lie detection critic silenced by lawsuit."
  

The current issue of Psychological Assessment contains another article pertaining to the controversial psychopathy construct. In their abstract of "Validity of Rorschach Inkblot scores for discriminating psychopaths from nonpsychopaths in forensic populations: A meta-analysis," authors James Wood, Scott Lilienfeld and colleagues assert:

Gacono and Meloy (2009) have concluded that the Rorschach Inkblot Test is a sensitive instrument with which to discriminate psychopaths from nonpsychopaths. We examined the association of psychopathy with 37 Rorschach variables in a meta-analytic review of 173 validity coefficients derived from 22 studies comprising 780 forensic participants…. The present findings contradict the view that the Rorschach is a clinically sensitive instrument for discriminating psychopaths from nonpsychopaths.

More coverage of psychopathy censorship controversy

The controversy over Robert Hare's attempt to block publication of a peer-reviewed article critical of his psychopathy construct is getting more attention since Sunday's blog post. Among the online coverage:

• The Chronicle of Higher Education has a brief report.

• The ever-excellent Mind Hacks blog has a report and critical commentary, later reposted on Psydir News.

• Intellectual Competence and the Death Penalty gives it a nod, as does Kevin Cole, Dean at the University of San Diego School of Law, at his CrimProf blog.

• And they're even blogging about it over in Gothenburg, Sweden!

Overwhelmingly, opinion is that Dr. Hare shot himself in the foot by threatening legal action against the researchers and the journal. Hopefully, this debacle will serve as a cautionary tale for others whose research undergoes critical scrutiny due to forensic or other public-policy implications.

Psychopathy guru blocks critical article

Will case affect credibility of PCL-R test in court?

Despite recent evidence that scores on the Psychopathy Checklist-Revised (PCL-R) vary widely in adversarial legal contexts depending on which party retained the evaluator, the test has become increasingly popular in forensic work. In Texas, indeed, Sexually Violent Predator (SVP) evaluators are required by statute to measure psychopathy; almost all use this test. It is not surprising that prosecutors find the PCL-R particularly attractive: Evidence of high psychopathy has a powerfully prejudicial impact on jurors deciding whether a capital case defendant or a convicted sex offender is at high risk for bad conduct in the future.

But a current effort by the instrument's author, Robert Hare, to suppress publication of a critical article in a leading scientific journal may paradoxically reduce the credibility of the construct of psychopathy in forensic contexts.

That's the opinion of two psychology-law leaders, psychologist Norman Poythress and attorney John Petrila of the University of South Florida (two authors of a leading forensic psychology text, Psychological Evaluations for the Courts), in a critical analysis of Dr. Hare's threat to sue the journal Psychological Assessment. The contested article, "Is Criminal Behavior a Central Component of Psychopathy? Conceptual Directions for Resolving the Debate," is authored by prominent scholars Jennifer Skeem of UC Irvine and David Cooke of Glasgow University. The study remains unpublished.

"[T]he threat of litigation constitutes a serious threat to academic freedom and potentially to scientific progress," write Poythress and Petrila in the current issue of the International Journal of Forensic Mental Health. "Academic freedom rests on the premise that advances in science can only occur if scholars are permitted to pursue free competition among ideas. This assumes that scholars have the liberty to do their work free from limitations imposed by political or religious pressure or by economic reprisals."

According to Poythress and Petrila, after the critical article passed the peer-review process and was accepted for publication, Dr. Hare's lawyer sent a letter to the authors and the journal stating that Dr. Hare and his company would "have no choice but to seek financial damages from your publication and from the authors of the article, as well as a public retraction of the article" if it was published. The letter claimed that Skeem and Cooke's paper was "fraught with misrepresentations and other problems and a completely inaccurate summary of what amounts to [Hare's] life's work" and "deliberately fabricated or altered quotes of Dr. Hare, and substantially altered the sense of what Dr. Hare said in his previous publications."

In general, defamation claims must prove that a defendant made a false and defamatory statement that harmed the plaintiff's reputation. Truth is an absolute defense. Critical opinions are also protected from defamation actions, as are "fair comments" on matters of public interest.

In this case, the contents of Skeem and Cooke's contested article have not been made public. However, it is hard to see how critical analysis of a construct that is enjoying such unprecedented popularity and real-world impact would NOT be of public interest.

Poythress and Petrila express concern that defamation claims against opposing researchers, while traditionally rare, may be becoming more common, leading to a potentially chilling effect on both individual researchers and the broader scientific community. Like so-called SLAPPS -- Strategic Lawsuits Against Public Participation -- used by corporations and other special interest groups to impede public participation, even meritless defamation lawsuits extract heavy penalties in terms of lost time and money and emotional distress.

Judges have been critical of pretextual deployment of defamation lawsuits, Poythress and Petrila report; a judge in one case warned that "plaintiffs cannot, simply by filing suit and crying 'character assassination!,' silence those who hold divergent views, no matter how adverse those views may be to plaintiffs' interests. Scientific controversies must be settled by the methods of science rather than by the methods of litigation."

Potential negative effects of defamation threats against scientific researchers include:

1. Researchers avoid conducting critical research out of fear of lawsuits.
2. Academics decline to serve as volunteer peer reviewers for academic journals due to loss of anonymity in defamation suits.
3. Journal editors self-censor on controversial topics.

As Poythress and Petrila conclude:

Because publication of the article by Professors Skeem and Cooke has effectively been long delayed, if not ultimately suppressed, one clear impact of this threat to sue is that researchers who may have been willing to investigate alternative models of psychopathy that might have been derived from the Skeem and Cooke article are not able to do so, simply because the article is unavailable. Because science progresses, in part, both by confirming viable models and disconfirming nonviable ones, the suppression of information relevant to constructing candidate models for empirical evaluation can be viewed as impeding the progress of science….

[I]t seems clear from our review that such threats strike at the heart of the peer review process, may have a chilling effect on the values at the core of academic freedom, and may potentially impede the scientific testing of various theories, models and products. In our view it is far better to debate such matters in peer review journals rather than cut off debate through threats of litigation.

In court, meanwhile, the effects of Dr. Hare's threat may prove paradoxical. Attorneys whose clients could be prejudiced by introduction of the Psychopathy Checklist may be able to discredit the instrument by pointing to the suppression of critical literature about the underlying construct of psychopathy.

POSTSCRIPT: Just hours after I posted this, alert readers advised me that: (1) Dr. Skeem discusses the as-yet-unpublished article in her 2009 book, Psychological Science in the Courtroom: Consensus and Controversy, co-authored by Kevin Douglas and Scott O. Lilienfeld (page 179 in the Google book view is HERE), and (2) according to Dr. Hare's website, he has a response in press (which, ironically, cites the Skeem and Cooke article as being published last year).

The full article is: "PCL-R Psychopathy: Threats to Sue, Peer Review, and Potential Implications for Science and Law. A Commentary," by Norman Poythress and John P. Petrila, in the current issue of the International Journal of Forensic Mental Health. The abstract if available HERE; the full article requires a subscription.

Dr. Hare's response is: "The role of antisociality in the psychopathy construct: Comment on Skeem & Cooke (2009)." Hare, R. D., & Neumann, C. S. (in press). Psychological Assessment.

Of related interest:

• "The Dark Side of Peer Review," by Stephen D. Hart, also in the current issue of the International Journal of Forensic Mental Health (abstract HERE)

• "Does interrater (dis)agreement on Psychopathy Checklist scores in Sexually Violent Predator trials suggest partisan allegiance in forensic evaluations?" by Murrie, D.C., Boccaccini, M.T., Johnson, J.T., & Janke, C. (2008). Law & Human Behavior, 32, 352-362 (abstract HERE)

Jury rejects Samenow’s lone insanity opinion

During one of my stints as a prison clinician, I had the unfortunate experience of being supervised by a psychologist who believed that prisoners were monsters bent on manipulation, and who thus tried to thwart my attempts to provide treatment. That psychologist's favorite book: Stanton Samenow's Inside the Criminal Mind.

"Criminals think differently" is the basic premise of the well-worn treatise. Samenow rejects out-of-hand most mainstream sociological, environmental, traumatogenic, developmental, biological, and psychological theories of crime, labeling them as absurd, simplistic, or even plain "kooky":

[C]riminals are not mentally ill or hapless victims of oppressive social conditions…. Despite a multitude of differences in their backgrounds and crime patterns, criminals are all alike in one way: how they think…. [A]ll regard the world as a chessboard over which they have total control, and they perceive people as pawns to be pushed around at will…. Some of their most altruistic acts have sinister motives.

Samenow promotes this popular rhetoric on national TV and radio shows such as Good Morning America and the Larry King show. In court, the well-known psychologist has testified for many decades in insanity cases, being called exclusively by the prosecution to attack defendants' claims of insanity. Over time, this one-sidedness started working to defense attorneys' advantage; they were able to rebut his testimony simply by telling juries that Samenow always testified against insanity. (Here is a recent example.)

This month, however, Samenow broke with tradition and for the first time opined in court that a defendant met the legal standard for insanity. He picked a rather unusual case. Unlike most defendants who plead insanity, Evan D. Gargiulo, being prosecuted in Virginia for the shooting death of a cab driver, had no history of psychiatric disorder. The competitive swimmer and former college swim team coach was an engineer for Lockheed Martin and a lieutenant in the National Guard when he shot Mazhar Nazir in the back of the head with his 9 mm pistol.

Gargiulo testified that he shot Nazir in self defense when the Pakistani-born cabbie tried to grab him. He said that after getting a taxi ride home from a nightclub, he realized he had lost his wallet. He went into his apartment, retrieved his gun and car keys, and had Nazir drive him to his car. Once there, he realized he had also lost a roll of cash so could not pay his $130 fare. It was at that point, he claimed, that Nazir became angry and reached over the seat to grab him, making him fear for his safety. The hapless driver died from a single gunshot to the back of his head.

Samenow testified that Gargiulo had led such a sheltered life, and had developed such an exaggerated paranoia, that he could not distinguish right from wrong at the time of the crime. As Tom Jackman of the Washington Post reported it:

Samenow said Gargiulo's dismay at being robbed and his "enormous fear" of Nazir caused him to shoot without thinking of the consequences. "I haven't encountered somebody with this level of fear," Samenow said. He said there is no formal definition of Gargiulo's mental condition in the Diagnostic and Statistical Manual of Mental Disorders, the accepted reference book for courts trying to parse mental illness and criminal culpability.

Samenow said later that his first appearance for the defense in an insanity case in 40 years showed that he has an open mind after decades of examining mentally ill defendants and finding them criminally responsible. He testified that he was paid $25,000 by the defense, which rested with Samenow as its only witness.

The jury didn't buy either the self defense or insanity defenses. After six hours of deliberations, it convicted Gargiulo of second-degree murder and sentenced him to 15 years in prison. To the disappointment of the victim's family, that was 25 years less than the maximum the jury could have imposed.

Gargiulo photo courtesy Fairfax County (Virginia) Police Department

Forensic psychiatrist: Courts fostering "POLITICAL DIAGNOSIS"

After sex offenders, who will be next?

More leading experts are starting to notice and voice alarm over the pretextual use of psychiatric diagnoses in SVP civil commitment cases. In an editorial this week, a prominent forensic psychiatrist quotes the late Michael Crichton, calling it "bad science 'tricked out' for public policy ends."

Writing in the Psychiatric Times, James Knoll, psychiatry professor at SUNY-Syracuse and director of a forensic fellowship program, critiques both the questionable diagnoses and the shaky risk assessment techniques being used to civilly commit Sexually Violent Predators:

A variety of instruments have been developed (PCL-R, Static-99, Phallometry, Minnesota Sex Offender Screening Tool, etc.); however, these tests are often challenged in courts as not meeting legal standards for expert evidence and testimony. So while the research database has grown, the question remains: is it reliable enough to be proffered as expert testimony? Experts in the field continue to have serious reservations, and express caution about the (mis)use of these instruments for expert testimony.

Turning to the questionable diagnoses being used in SVP cases, Knoll puts the onus squarely on the U.S. Supreme Court for creating a tautological and "politico-legal" definition of "mental disorder or abnormality" for use in these civil commitment proceedings:

[T]he courts may use our diagnoses when they choose to, and they may ignore them and/or devise their own if it suits public policy…. Since it is forensic mental health professionals who are tasked with SVP evaluations, they have attempted to give this term meaning within the confines of their science. Have these attempts reached a consensus? It would appear that they have not. There continues to be substantial disagreement….

When psychiatric science becomes co-opted by a political agenda, an unhealthy alliance may be created. It is science that will always be the host organism, to be taken over by political viruses…. [P]sychiatry may come to resemble a new organism entirely -- one that serves the ends of the criminal justice system.

If we want to know where all this is headed if someone doesn't slam on the brakes, Knoll points us across the Atlantic to the United Kingdom, where offenders are indefinitely committed on the basis of a nebulous "Dangerous and Severe Personality Disorder" (DSPD):

Given the similarities between our SVP laws and the UK’s DSPD laws, is it too outrageous to speculate that a psychopathy (or DSPD-equivalent) commitment law might be on the U.S. horizon? Remember, the driving force behind such initiatives is usually only one highly publicized, egregious case away.

Related resource:

For an empirical study on the scientific problems with determining future violence under the UK's "Dangerous and Severe Personality Disorder" law, see: Ullrich, S., Yang, M., & Coid, J. (2009), "Dangerous and severe personality disorder: An investigation of the construct," International Journal of Law & Psychiatry (in press). The ultimate conclusions are strikingly similar to the issues posed by Knoll.

The study found a high rate of false positives -- that is, people categorized as DSPD and at high risk of serious reoffending when they actually did not reoffend when tracked in the community: 26 DSPD offenders would need to be civilly committed to prevent one major violent act.

When tracking sex crimes, which are of particular public concern, the researchers found that most new sex offenses were committed by offenders who were NOT categorized as DSPD, undermining the UK Home Office and Department of Health assumption that offenders at the highest risk for future sex offending would be categorized as DSPD.

After critiquing the accuracy of actuarial techniques, the article concludes:

"Bearing in mind the inaccuracy of DSPD criteria in identifying high risk individuals ... the construction of medico-legal terms, as in the case of DSPD, appears highly questionable.... [M]any determinants of violence are circumstantial and situational, and will invariably change over time, rather than related to some inherent characteristics of the perpetrator.... [F]ar more research is necessary ... before attempting to integrate a psychiatric condition into a legal system."

Heed these warnings, folks. The way things are headed in the U.S. criminal justice system, I expect to hear expansion of civil commitment to other groups -- violent offenders, juveniles, and others -- being proposed any minute now.

Photo credit: SUNY Office of Public Affairs