PCL-R psychopathy and its relation to DSM-IV Axis I and II disorders in a sample of male forensic psychiatric patients in The Netherlands.

Psychopathy was the first personality disorder to be recognized in psychiatry. According to Schneider (1923), a German psychiatrist, the term psychopathy referred to a variety of personality disorders (psychopathic personalities [PDs]) as extreme variants of normal personality. It has been given many different labels (Hare, 1991) such as psychopathic inferiority, character deficiency, moral insanity, and manipulative personality. The current interest in the disorder is (at least partly) attributable to the development of the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991; Hare et al., 1990) and the abundance of empirical research it has generated over the past two decades. PCL-R items are personality traits and behaviors, which are scored on a 3-point scale (2 = the item definitely applies to the participant, 1 = the item applies to a certain extent, 0 = the item does not apply to the participant), yielding a maximum total of 40. A score of 30 or more is recommended by Hare (1991) to identify the prototypical psychopath. PCL-R items define two correlated oblique factors, Factor 1 (callous and remorseless style of relating to other people), primarily at high levels of the construct, and Factor 2 (unstable, socially deviant lifestyle) at low levels of the construct (Cooke & Michie, 1997). Recently, however, Cooke and Michie (2001), using confirmatory factor analysis, identified distinct interpersonal, affective, and behavioral factors of which the measurement is uncontaminated by items reflecting antisocial behavior. Evidence gathered in the last decade demonstrates that the PCL-R scale is highly reliable when used with trained and experienced raters. Studies in a variety of countries have typically obtained intraclass correlations (ICCs) >.80 for a single rater. Internal consistency (alpha coefficients >.80; mean interitem