• Presentations
 
 

Presentations

2013

 

Cooke, D.J. (2013) Invited workshop on the Comprehensive Assessment of Psychopathic Personality. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Hoff, H., Rypdal, K., Hart, S.D., COOKE, D.J., & Mykletun, A., (2013) Domains of psychopathic symptoms: A card sort test of the CAPP Model. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Cooke, D.J.,  Michie, C., Hart, S.D., Logan, C., & Johnstone, L. (2013) The Comprehensive Assessment of Psychopathic Personality – Institutional Rating Scale: Validation of a Measure. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Cooke, D.J., Hart, S.D., & Logan, C.  (2013) The Development of the Comprehensive Assessment of Psychopathic Personality Model. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Edens, J., Kristiansson, M., Sörman, K., Svensson, O., Howner, K., Caman, S., Fischer, H., & Smith, S. T. CAPP Prototype Ratings and their Correlates among Forensic Mental Health Professionals in Sweden. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Hoff, H., Rypdal, K., Cooke, D. J., & Anrstein M. The Validation of the CAPP by Card Sort in Norway. . Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Pedersen, L. Examining the applicability of the CAPP-IRS in a Danish forensic psychiatric sample. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Heinzen, H., Kreis, M. F., Tikalsky, I., Stoll, E., Fittkau, K., Hahn, C., Wulff, V., & Huchzermeier, C. Validation of CAPP in Germany. Presented at the 13th International Congress on the Disorders of Personality, Copenhagen, Denmark, September 15th -19th, 2013.


Cook, A. N., Viljoen, S., Hart, S. D., Layden, B. K., Murray, A. A., McGinnis, C. R. (2013, March). Validity of the PPI:SF and the TriPM using the CAPP as a concept map. Paper presented at the annual meeting of the American Psychology-Law Society (AP-LS), Portland, OR.


Cook, A. N., Hart, S. D., Van Dongen, S., van Marle, H. J. C., & Viljoen, S. (2013, June). Evaluation of the TriPM and PPI using the CAPP as a concept map in Canadian and Dutch samples.‌ In S. Van Dongen (Chair), New Conceptualizations of Psychopathy. Symposium presented at the annual meeting of the International Association of Forensic Mental Health Services (IAFMHS), Maastricht, the Netherlands.


Cooke, D. J., Michie, C., Hart, S. D., Logan, C., & Johnstone, L. (2013, September). Clinical assessment using the Comprehensive Assessment of Psychopathic Personality: Results from a multi-site UK study. In C. Logan (Chair), Comprehensive Assessment of Psychopathic Personality: International Perspectives. Symposium presented at the annual meeting of the European Association of Psychology and Law (EAPL), Coventry, United Kingdom.


Delannoy, D., Saloppé, X., & Pham, T. H. (2013, June). Convergent validity of the Comprehensive Assessment of Psychopathic Personality-Institutional Rating Scale, Interpersonal Measure Psychopathy and Psychopathy Checklist-Revised among Belgian forensic inpatients. Poster presented at the annual meeting of the International Association of Forensic Mental Health Services (IAFMHS), Maastricht, the Netherlands.


Hart, S. D., Cooke, D. J., & Logan, C. (2013, September). Explicating the construct of psychopathy: the Comprehensive Assessment of Psychopathic Personality as conceptual map. In C. Logan (Chair), Comprehensive Assessment of Psychopathic Personality: International Perspectives. Symposium presented at the annual meeting of the European Association of Psychology and Law (EAPL), Coventry, United Kingdom.


Hoff, H. A., Rypdal, K., Cooke, D. J., & Mykletun, A. (2013, September). The validation of the CAPP by card sort in Norway. In C. Logan (Chair), Comprehensive Assessment of Psychopathic Personality: International Perspectives. Symposium presented at the annual meeting of the European Association of Psychology and Law (EAPL), Coventry, United Kingdom.


Heinzen, H., Stoll, E., Tikalsky, I., Wulff, V., Hahn, C., Fittkau, K., & Huchzermeier, C. (2013, September). An evaluation of the German version of the Comprehensive Assessment of Psychopathic Personality. In C. Logan (Chair), Comprehensive Assessment of Psychopathic Personality: International Perspectives. Symposium presented at the annual meeting of the European Association of Psychology and Law (EAPL), Coventry, United Kingdom.


Murray, A. A., Layden, B. K., Cook, A. N., Viljoen, S., McGinnis, C. R., & Hart, S. D. (2013, March). A psychometric evaluation of the Comprehensive Assessment of Psychopathic Personality (CAPP) model: Validating CAPP symptoms as lexical markers of psychopathy. Paper presented at the annual meeting of the American Psychology-Law Society, Portland, OR.


Van Dongen, J., Cook, A., Hart, S. D., Bogaerts, S., & van Marle, H. (2013, June). Construct validity of the TriPM and CAPP: Relations to conceptual relevant constructs in a community and forensic sample. In S. Van Dongen (Chair), New Conceptualizations of Psychopathy. Symposium presented at the annual meeting of the International Association of Forensic Mental Health Services (IAFMHS), Maastricht, the Netherlands.


Viljoen, S., Cook, A. N., Layden, B. L., Murray, A. A., McGinnis, C. R., & Hart, S. D. (2013, March). Psychopathy and gender:Examining validity of the PPI: SF and TriPM. Paper presented at the annual meeting of the American Psychology-Law Society (AP-LS), Portland, OR.


Viljoen, S., Cook, A. N., Layden, B. K., Murray, A. A., McGinnis, C. R., & Hart, S. D. (2013, June). Psychopathy and gender: Examining validity of the PPI:SF and TriPM. In S. Van Dongen (Chair), New Conceptualizations of Psychopathy. Symposium presented at the annual meeting of the International Association of Forensic Mental Health Services (IAFMHS), Maastricht, the Netherlands.


 

2012


Clercx, M., Johnstone, L., Cooke, D.J., & de Ruiter, C. (2012, March). The concept of psychopathy before adulthood: a study on the content validity of the CAPP in adolescents. Poster presented at the 3rd European Association for Forensic Child & Adolescent Psychiatry, Psychology & other involved professions (EFCAP) Congress, Berlin, Germany.


Cook, A. N., Layden, B. K., Murray, A. A., Viljoen, S., McGinnis, C. R., & Hart, S. D. (2012, August). Comparison of Comprehensive Models of Psychopathic (CAPP) & Borderline Personality Disorder (CABP).Paper presented at the American Psychological Association (APA) Annual Convention, Orlando, FL, USA.


Sandvik, A.M., Hansen, A.L., Johnsen, B.H., Hart, S.D., Thornton, D.M., Logan, C., & Cooke, D.J. (2012, April). Autonomic reactivity, executive functions, and psychopathy. Paper presented at the 12th International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Miami, FL, USA.


2011


Cooke, D. J. (2011, November). Psychopathy: Capturing an elusive concept. Paper presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract

Before we can treat psychopathy we must first evaluate it. Two key and distinct steps are required. First, the conceptual domain – ‘What is Psychopathy?’ – must be specified. Second, measures of that domain must be developed. Current measures of the conceptual domain are limited. Four limitations stand out; current measures confuse domains of discourse, personality trait being conflated with antisocial and/or criminal behaviour; they are not comprehensive in their coverage of traits; they are static and thereby cannot capture change – change through intervention or maturation – finally, they are not clinically informed.

I will discuss the development of a new conceptual model of psychopathy – The Comprehensive Assessment of Psychopathic Personality (CAPP). I will outline its conceptual basis describing the terrain of personality pathology that we are concerned with. I will present preliminary evidence in support of the conceptual model from both prototypicality studies and translation work. Different maps of the terrain have been developed; preliminary evidence of the utility of different measurement approaches, in different samples, will be discussed. The application of the CAPP in clinical formulation will be outlined. 

Hart, S. D. (2011, November). Conceptualising psychopathy using CAPP: Formulation over numbers. Paper presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Hausam, J. & Köhler, D. (2011). The factor structure of the CAPP model and its relationship to the five factor model of personality. Paper presented at the 14th meeting of the Section Psychology and Law of the German Association of Psychology, Münster, Gemany.


Heinzen, H., Fittkau, K., Kreis, M. K. F., & Huchzermeier, C. (2011, November). Content validation of the German version of the CAPPPoster presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract
The Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, 2004) is a recently developed conceptual model and instrument for the assessment of psychopathic personality traits. It covers six domains, described by 33 symptoms, which are thought to coherently and comprehensively describe the concept of psychopathy. The CAPP has been translated from English into a number of languages. The model of the CAPP has been developed using a lexical approach, which assumes that a clinical concept can be coherently described using natural language. The current study sought to assess the content validity of the German version of the CAPP using prototypical analysis. A sample of 74 lay people and 68 experts rated the prototypicality of the CAPP symptoms. Across samples, CAPP symptoms were rated as significantly more prototypical of psychopathy than foil items, with high to moderate prototypicality ratings depending on the respective CAPP domain: prototypicality was rated high for the domains Self, Attachment, Dominance and Emotional, and moderate for the Cognitive domain. Significant differences in prototypicality ratings were found between the lay sample and the expert sample. Results of the study will be outlined and discussed in relation to previous findings and clinical implications.


Hoff, H. A. (2011, November). What do we think about when we think about psychopathy? Paper presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract
The CAPP defines symptoms using the lexical approach to personality. This approach is founded on the assumption that individual differences are richly encoded in natural language, generally, but not exclusively in the form of trait-descriptive adjectives. This might especially be the case for antisocial traits which typically are marked by a divergence from social norms and expectations. As such the CAPP is suitable for content validation by lay samples as well as by forensic experts. The current paper will present prototypicality ratings of the CAPP symptoms in different languages (Norwegian, English and German), and in different samples with different levels of formal knowledge of psychopathy. This approach will test both the content validity of the CAPP model, and the lexical hypothesis as such.

 


Hoff, H. A. & Rypdal, K. (2011, November). Card sort validation of the CAPP model. Poster presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract
Early CFA analysis on available CAPP data indicates that it is possible to achieve unidimensional measurement of each of the six CAPP domains after removal of a few symptoms. The aim of the current study was to evaluate the CAPP model by employing card sort methodology. Card sort is a user-friendly approach to examine how people understand and organize information into meaningful categories. If mental health professionals and lay people would sort the 33 CAPP symptoms into the domains suggested by the CAPP authors, this would add weight to the validity of the model as homogeneous dimensions are vital in improving clarity of clinical description.

Overall the card sort indicated good symptom-to-domain fit, with some noteworthy exceptions. Some symptoms from the Dominance domain and Cognitive domain may be difficult to differentiate from symptoms reflecting behaviour (i.e., Inflexible, Antagonistic, Deceitful, Garrulous, Insincere). The single most “mistaken” symptom was Unempathic, perceived to be part of the Emotional domain, and not the Attachment domain as proposed. As it is widely recognized that empathy has a strong emotional component, this is perhaps not surprising.


Hoff, H. A. & Rypdal, K. (2011, June). Card sort validation of the CAPP model. Poster presented at the 11th annual International Association of Forensic Mental Health Services (IAFMHS) conference, Barcelona, Spain.


Kreis, M. K. F. & Cooke, D. J. (2011, November). The expression of psychopathic traits in women: implications for clinical practice. Poster presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract
Despite growing empirical interest in the construct of psychopathy in women, knowledge about the nature and manifestation of psychopathic traits in females is still limited. This is partly due to the lack of clinical case examples of psychopathic women in the literature, and the limitation of many psychopathy measures to adequately capture the construct in females. This paper reports on a study that explored the expression of psychopathic traits in a sample of women offenders, using the newly developed Comprehensive Assessment of Psychopathic Personality - Institutional Rating Scale (CAPP-IRS; Cooke, Hart, Logan, & Michie, 2004) and the Psychopathy Checklist Screening Version (PCL:SV; Hart, Cox, & Hare, 1995). The study was the first to utilize the CAPP-IRS with women as part of its ongoing construct validation. The expression of psychopathy traits in women is discussed using case examples. The results suggest that there are key gender differences in the typical expression of psychopathic traits, and that the CAPP-IRS is more sensitive than the PCL:SV to both within and between gender differences in psychopathy. The clinical implications of this are discussed.


Pedersen, L. & Rasmussen, K. (2011, November). Evaluating the applicability of a clinical measure of psychopathy (CAPP) in a sample of mentally disordered offenders. Poster presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract
Background: In forensic clinical practice the Psychopathy Checklists (PCL) are generally the number one measures of psychopathy. Still, the construct of psychopathy is abundantly debated, and it has been argued that the PCL scales have several limitations, for example in relation to the conceptualisation of the disorder and in relation to clinical utility. Recently, a new model of psychopathy has been developed; the Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, 2004). The CAPP model aims at encompassing the full domain of the psychopathic symptomatology as well as providing a measure that is sensitive towards capturing change in personality traits.

Aims: This study examines the CAPP model in a sample of mentally disordered offenders in Denmark. Especially, the comprehensiveness of the CAPP model is evaluated in relation to clinical utility.

Method: Ninety-six patients discharged from a forensic mental health centre during the years 2001 and 2002 were retrospectively assessed for psychopathy using the CAPP and the PCL:SV (PCL Screening Version). Data on outcome measures (criminal recidivism, imprisonment and re-hospitalisations) were subsequently obtained from national registers after a 5.7 years follow-up period.

Results and conclusions: The CAPP showed to have high internal consistency and acceptable interrater reliability and validity (convergent/PCL:SV and predictive/criminal recidivism). In comparison to the PCL:SV the CAPP ratings showed to be more comprehensive and diversified. Clinical implications of applying a more comprehensive assessment of psychopathy will be addressed.


Sandvik, A. M., Hansen, A. L., Johnsen, B. H., Hart, S. D., Thornton, D., Logan, C., & Cooke, D. J. (2011, November). Psychopathy assessment and its relation to autonomic reactivity. Poster presented at the 2nd Bergen Conference on the Treatment of Psychopathy (BCTP), Bergen, Norway.

Abstract
Background: The study aims to explore the relationship between the two psychopathy assessment instruments the Psychopathy Checklist (PCL-R; Hare, 1991) and the Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, manuscript under preparation) and autonomic reactivity measured through heart rate variability.
Psychopathy, following Cleckley’s (1976), tradition, is a personality disorder characterized by affective, interpersonal and behavioral symptoms. The PCL-R, developed by Hare, has long been regarded as the most valid and reliable instrument for assessing psychopathic personality. However, the instrument has been criticized for its emphasis on antisocial behavior and criminal history (Skeem & Cook, 2010). The PCL-R with its reliance on the person’s behavioral history is not well suited to detect changes in personality, if such changes are indeed possible. Recently, a new assessment instrument aiming to overcome this restriction has been developed by Cooke et al. (manuscript under preparation). The CAPP aims at encompassing the full domain of psychopathic personality disorder and is developed with the aim of detecting changes in personality over time.
Studies have consistently shown that adults with antisocial personality disorder and youth with conduct disorders have autonomic disturbances characterized by lower resting heart rate (HR) compared to controls (Lorber, 2004; Ortiz & Raine, 2004; Raine, 1997). One emerging methodology for the study of individual differences in autonomic activity pattern is heart rate variability (HRV; Porges, 1992). Heart rate is determined by the continuous interplay between sympathetic nerves and parasympathetic (vagus) nerves at the sino-atrial node of the heart. HRV is the sequence of time interval between heart beats (beat-to-beat) (Thayer, Hansen, & Johnsen, 2010). The beat-to-beat interval is used to calculate the variability in the timing of the heartbeat. Patterns of organized variability are observed as a response to changing environmental demands, and have been associated with individual differences in regulation of behavior and emotion (Appelhans & Luecken, 2006).

Our study: We will present some preliminary results from our study of 100 inmates in Bergen prison and 40 “non-criminal” controls. We will look at the relation between these two psychopathic assessment instruments (PCL-R and CAPP) and the autonomic reactivity measured through HRV during cognitive stress experienced during executive function tests. For PCL-R, we look at differences in autonomic reactivity patterns for the 4 facets (the interpersonal facet, the affective facet, the impulsive lifestyle facet, and the antisocial facet) of psychopathy described by Bolt, Hare, Vitale, and Newman (2004). Equally for CAPP, we look at the 6 domains (the attachment domain, the behavioral domain, the cognitive domain, the dominance domain, the emotional domain and the self domain).

Implications: With the parallel use of the two psychopathic assessment instruments, we can look at differences and similarities between the instruments, and cross-validate the psychopathy measures. The use of psychological measures in combination with biological measures canexpand ourunderstanding of underlying mechanisms for psychopathic personality disorder.


2010


Psychopathy: Found in translation? International perspectives on the Comprehensive Assessment of Psychopathic Personality – Session 1. Symposium conducted at the 20th European Association of Psychology and Law (EAPL) annual conference, Gothenburg, Sweden, June 2010.
Chair: David J. Cooke

Paper one

David J. Cooke

The Comprehensive Assessment of Psychopathic Personality Disorder: translations as tests of validity.

Abstract
The CAPP is a clinical measure of psychopathy: the CAPP model is founded on the lexical approach to personality evaluation. The lexical approach posits that the most salient aspects of human personality are widely represented in the lexicon of a language. Within the CAPP model the symptoms of psychopathy are expressed in natural language terms; the meaning of each of the 33 symptoms is clarified and refined through triangulation using sets of three trait descriptive adjectives. The translation of the CAPP model is not only facilitated through the use of these natural language terms, but also, the evaluation of translations serves to test both the content validity of the CAPP model and the limits of its generalisability. This paper will set the scene for the symposia by introducing the CAPP model, by examining the benefits of the lexical approach, and by discussing the contributions, both practical and theoretical, that can be made by translations of the CAPP across languages, and language groups.

Paper two

Hanna Heinzen, Eva Stoll, Denis Köhler, Christian Huchzermeier, Ina Tikalsky, Daniela Herbst

Validation of the Comprehensive Assessment of Psychopathic Personality (CAPP) German version – preliminary results.

Abstract
The Comprehensive Assessment of Psychopathic Personality (CAPP) is a new instrument to assess psychopathic personality disorder. The current version of the CAPP is the CAPP-Institutional Rating Scale (CAPP-IRS) which was designed for the use in secure treatment facilities. The present study examines the validity of the German version of the CAPP-IRS in a German sample of adult male forensic psychiatric patients and adult male prisoners of a high security state prison. To examine construct validity of the CAPP-IRS the following instruments are used: PCL:SV, HCR-20, STAI-T, NEO-FFI, a drug screening questionnaire, SCID-II questionnaire and the APD interview of the SCID-II. Furthermore, sociodemographic, clinical and criminal variables are assessed. On the basis of a mulit-trait-multi-method-analysis it is expected that there will be positive correlations between CAPP-IRS total scores, PCL:SV, Extraversion and HCR-20 scores. Negative correlations are expected for CAPP-IRS total scores and STAI-T scores, Neuroticism, Conscientiousness and Agreeableness. Data collection and calculation will be finished in spring 2010. The preliminary results of the study will be discussed in light of the construct validity of psychopathy. In particular, the CAPP model of psychopathy will be embedded into the nomological network of psychopathy by use of the MTMMA. Finally, initial experiences in the application of the CAPP-IRS in institutional settings (forensic psychiatry and prison) and practical aspects of the translation process will be discussed critically.

Paper three

Rui Abrunhosa Conçalves, Maria Francisca Rebocho

The Portuguese version of the CAPP: an exploratory study with a sample of offenders

Abstract
Despite the universal character of the concept of psychopathy, there are in fact many cultural nuances evident in the existing research. Such nuances pertain mainly to aspects such as the expression of emotions, the culturally accepted gender roles, and even linguistic specificities, reflecting broader social and cultural differences. Given that languages evolve primarily from needs of expression, and reflect symbolic meanings, it is interesting to find such contrasts in conveying what are indeed universal features of this disorder. These contrasts, evident especially when comparing different European countries (Northern, Central and Southern), must be addressed and explored in order to achieve a greater standardization in the assessment procedure. In this sense, a preliminary version of the Portuguese CAPP is tested on a sample of incarcerated male offenders, serving time in both central and local correctional facilities. Age, schooling, criminal record and type of index crime are also factors in the analysis of the obtained scores.

Paper four

Helge Andreas Hoff, Knut Rypdal

Prototype validation of the CAPP model in a Norwegian context.

Abstract
Ideally, a measure should be able to capture all clinically relevant aspects of a construct, but at the same time be purged of construct irrelevant content. One way to approach this aspect of validity is by prototype analysis. A prototype can be regarded at the best example or best marker of a category or a construct. Prototype analysis evaluates the level of match or similarity between a case and this paradigmatic marker. The approach has been found especially useful when a concept lacks necessary or sufficient criteria, and thus has unclear boundaries or criterion overlap, as is the case with personality disorder diagnosis.
This paper will present findings from a Norwegian prototype study where forensic staff and clinicians as well as a community sample evaluated the typicality of the CAPP symptoms for psychopathy, as well as their level of typicality for non-psychopaths. Together these two levels of analysis provide a stringent test of the prototypicality of the symptoms currently comprised in the CAPP model.
Any differences between experts’ and lay peoples’ perception of psychopathy will be highlighted, as well as possible differences across background variables as gender, age , education or experience as victim of harmful acts by a alleged psychopath. Challenges in relation to translating a personality measure like the CAPP will also be addressed.


Psychopathy: Found in translation? International perspectives on the Comprehensive Assessment of Psychopathic Personality – Session 2. Symposium conducted at the 20th European Association of Psychology and Law (EAPL) annual conference, Gothenburg, Sweden, June 2010.
Chair: Caroline Logan

Paper one

Elena Dozortseva, Ksenia Syrokvashina

The CAPP approach in the context of Russian clinical and psychological traditions.

Abstract
The translation and validation of the CAPP in Russia require taking into consideration cultural customs of the land with respect not only to behavioural patterns and norms of its population, but also to scientific and professional traditions in the field of psychology and mental health. It would help to avoid terminological confusion and to find new ideas and fruitful theoretical parallels. The CAPP presents a new psychological approach to the concept and the assessment of psychopathic personality disorder. In Russian psychiatry the term “psychopathic personality” traditionally encompassed all the range of personality disorders. Since the adoption of ICD-10 at the end of the 20th century, the term has been not in use, but has retained its original meanings. Russian psychology developed its own basic theories in two main psychological schools. In one of them personality is considered as an integrative system including various structures with the predominance of character expressing the person’s main attitudes. The other school conceptualizes personality as a hierarchical system of motives and senses regulating social behaviour on the basis of the person’s free choice. Predispositions to stereotyped behaviours as individual characteristics constitute a lower level of personality. Concepts of clinical personal abnormalities are derived from the basic personality theories. Similarities and differences in the CAPP approach and those of the Russian concepts will be discussed in the presentation.

Paper two

Rita Zukauskiene, Gitana Kamanduliene, Alfredas Laurinavièius

CAPP and PCL-R in a Lithuanian context: preliminary findings on reliability and validity

Abstract
The measurement of psychopathy is the most important development in the field of criminal forensic psychiatry and psychology over the past three decades and has become a critical area of assessment in personality disorder. In both clinical practice and in research, psychopathy has traditionally been measured by The Psychopathy Checklist (e.g. PCL-R, Hare, 2003; PCL:SV, Hart, Cox, & Hare, 1995). However, the PCL has been criticized for over-reliance on potentially tautological characteristics such as criminal behaviour to assess its validity, as well as the absence of conceptually related characteristics such as a lack of anxiety. Recent research suggests that additional dimensions of psychopathic traits, previously unrecognized in measurements of psychopathy, need to be explored in order for psychopathy to be more useful in predicting violent crime. The Comprehensive Assessment of Psychopathic Personality Disorder: Institutional Rating Scale (CAPP-IRS; Cooke, Hart, Logan, & Michie, 2004) is an instrument created to assess psychopathic traits in institutionalized populations. This study analyzes reliability of the CAPP in new cultural context, e.g., in Lithuania, also as the internal validity (e.g. face validity, criterion related and concurrent validity) of the CAPP and PCL-R with a sample of 108 incarcerated offenders. Moderator variables for CAPP and PCL-R (age and current violent offence) were compared. Several factors that could affect the results are discussed.

Paper three

Caroline Logan

Psychopathy: clinical interviewing skills for risk formulation using the CAPP

Abstract
Papers in this symposium and in the linked symposium that has preceded today have examined the use of the Comprehensive Assessment of Psychopathic Personality (the CAPP), a semi-structured clinical interview, to measure a wide range of symptoms and traits of this disorder across six domains of functioning. The objective of the present paper is to discuss the clinical interviewing skills required to conduct a competent and useful assessment of psychopathy using the CAPP as an exploratory framework. The paper begins with a brief overview of the core clinical interviewing skills, derived from a variety of practitioner training courses. The need for additional interviewing skills in the assessment of those with personality pathology in general and psychopathy specifically is then justified. The paper concludes with a description of a number of practice guidelines for interviewing people with psychopathic personality traits as defined in the CAPP. These “top tips” on interviewing are intended to assist practitioners (clinicians, investigators, and researchers) in gathering the maximum amount of information from a client who may be motivated to minimise or deny critical aspects of their functioning, in order to undertake a competent assessment of psychopathy relevant to an evaluation of their future risk of harm.


Logan, C., Cooke, D. J., Hart, S. D., & Michie, C. (2010, May). The Comprehensive Assessment of Psychopathic Personality: Progress on a new development. Symposium conducted at the 10th International Association of Forensic Mental Health (IAFMHS) annual conference, Vancouver, BC, Canada.

Abstract
Psychopathy is a complex disorder that can be construed as a higher order construct underpinned by distinct symptom domains. In 2002, a programme of work was commenced to develop a comprehensive theoretical model of psychopathy. The Comprehensive Assessment of Psychopathic Personality (CAPP) is the model developed and it entails six symptom domains – namely, attachment, behavioural, cognitive, dominance, emotion, self – within which 33 symptoms have been conceptually ordered. The CAPP is operationalised in research and clinical practice by two assessment tools designed for use with clients in institutional settings, namely a semi-structured interview and a staff rating scale. Research is ongoing internationally to test the model.

This symposium will address four key issues relating to the development of this new model of psychopathy. First, in a paper entitled ‘The Comprehensive Assessment of Psychopathic Disorder: The challenge of developing a new model, Professor Stephen Hart will introduce the CAPP. In addition, he will describe the reason for commencing this work examining the concept of psychopathy from a novel and different viewpoint and discuss the range of issues raised by developing a new model.

Second, in a paper entitled ‘Dimensions of Psychopathy: The homogeneity of CAPP domains’, Professor David Cooke will argue that in order to validate the model, it is necessary to determine the unidimensionality – or homogeneity – of the individual domains prior to considering the nature of the higher order composite, that is, psychopathy. The theoretical assumption that the domains are unidimensional requires to be tested empirically. Confirmatory Factor Analysis (CFA) provides the best procedure for determining the unidimensionality of domains. Indicators of the domain being tested are specified to correlate with the domain of interest and not to correlate with other domains, and the extent to which that specification is consistent with data is evaluated using model fit indices.

So far, the homogeneity of CAPP domains has been examined using three distinct types of data: interview data, prototypicality data, and data derived from an internet survey. Triangulation of data sources provides a robust test of dimensionality. Several domains demonstrate clear and consistent evidence of homogeneity; other domains demonstrate that modifications are necessary to achieve this goal. The theoretical and clinical implications of the findings will be discussed by Professor Cooke in the light of recent arguments that progress in the study of personality disorders will be best served through the study of unidimensional, homogenous constructs.

Third, in a paper entitled ‘Formulation and the CAPP’, Dr Caroline Logan will examine the use of the CAPP in clinical practice to aid the development of formulations, especially those relevant to risk. A model of risk formulation will be proposed, based on the key principles of clinical case formulation. The usefulness of the CAPP in informing this process will be illustrated with a case example, where information gathered from clinical interview and staff ratings of psychopathic traits are utilised.


2009


Cooke, D. J., Logan, C., Kreis, M. K. F., & Hoff, H. A. (2009, September). New Developments and New Findings with the Comprehensive Assessment of Psychopathic Personality. Symposium conducted at the 19th European Association of Psychology and Law (EAPL) Conference, Sorrento, Italy.

Abstract

The Comprehensive Assessment of Psychopathic Personality (CAPP) is a new clinically derived measure of psychopathic personality disorder designed to provide a detail description of this forensically important construct. The model underlying the CAPP delineates six key domains of pathology; attachment, behaviour, cognitive, dominance, emotions and self. In this symposium we describe new ways of assessing these domains and new ways of using this information in violence risk formulation. We present evidence of the content validity of the model and describe its use with a sample of female offenders.

Paper one

David J. Cooke

Risk formulation and the Comprehensive Assessment of Psychopathic Personality Disorder (CAPP).

Abstract:

There is a growing awareness that statistical models cannot be used with any confidence to predict future violent behaviour. It is not generally recognised that factor models (e.g., 3-factor model of the PCL-R) describe differences amongst people but provide little information about the psychological processes that operate at the individual case. Bridging the gap between nomothetic and idiographic information is one of the key challenges facing forensic practitioners. Clinical formulation is one approach towards understanding the key processes that have relevance to future risk in the individual case. More systematic approaches for developing and validating risk formulations are required. Psychopathic personality disorder is a key risk factor for future violence. The CAPP has been developed to map six clinically relevant domains of psychopathy; Attachment, Behavioural, Cognitive, Dominance, Emotional, and Self. In this paper the relevance of these domains to future risk and, critically, to future risk management, is examined from several theoretical perspectives. It is argued that there is an urgent need for the development of a taxonomy of risk processes.

Paper two

Caroline Logan

A new assessment instrument for psychopathy: The CAPP semi-structured interview.

Abstract:

In 2002, a programme of work began in earnest to develop a new model of psychopathy. Once the model was ready, encompassing six domains of functioning and a total of 33 dynamic traits, work commenced to develop the means by which these traits could be assessed in clients believed to be psychopathic. The resulting instrument – the Comprehensive Assessment of Psychopathic Personality – has evolved over four distinct developmental phases. First, the range of self-report and semi-structured instruments already available to assess personality constructs related to psychopathy was identified and examined in order to determine key topics for consideration and optimal assessment formats. Second, using the information extracted from the first phase, work commenced to outline the form of a semi-structured interview and a staff rating form. An initial programme of work was carried out to test the interview and staff rating form and research projects commenced using the interview as the means of collecting data on men and women with psychopathy. In addition, translations of the model and the semi-structured interview into other languages provided invaluable feedback opportunities. Third, the semi-structured interview and staff rating forms were revised on the basis of all the feedback received from researchers and translators. These revised assessments were then subject to evaluation by focus groups and further requests for feedback from researchers, translators and more recently, clinicians testing the interview in practice. Finally, the interview and staff rating forms were revised once again. This paper will describe each of these developmental phases in some detail and highlight their key findings and observations. A programme for future work to improve the CAPP assessment suite further will be outlined.

Paper three

Mette K. F. Kreis & David J. Cooke

Comprehensive Assessment of Psychopathic Personality – Institutional Rating Scale (CAPP-IRS): Preliminary construct validity with women offenders.

Abstract:

Little is known about psychopathy in women and no conceptualization of female psychopathy exists. Current psychopathy measures are inadequate for use with women, which impedes significant progress in this area. This study was the first to explore the utility of a new psychopathy measure and model – the Comprehensive Assessment of Psychopathic Personality - Institutional Rating Scale (CAPP-IRS; Cooke, Hart, Logan, & Michie, 2004) – for assessing psychopathy in women. The study was part of the ongoing construct validation process of the CAPP-IRS. An exploratory multi-method design was used to broadly assess the psychopathic and general personality pathology in 20 women offenders, including Canadian forensic psychiatric patients and British prison inmates. This paper will discuss the tentative associations between the CAPP-IRS and the Psychopathy Checklist: Screening Version (PCL:SV), the Dimensional Assessment of Personality Pathology - Basic Questionnaire (DAPP-BQ), and the NEO-Five Factor Inventory-Revised (NEO-FFI-R).

Paper four

Helge A. Hoff

CAPP in a Norwegian context: Preliminary findings on content validity.

Abstract:

Maximising content validity is the first step in the production of a valid measure, as good content validity is an essential building block for the establishing of all other forms of validity. Ideally, a measure should be able to capture all clinically relevant aspects of the construct, but at the same time be purged of construct irrelevant content. This can be achieved by using prototypical analysis. A prototype can be regarded as the best example or best marker of a category or a construct. Prototypical analysis was developed as a way of determining the core of a construct, but also for mapping the boundaries of a construct. The approach has been shown particularly useful when diagnostic criteria have unclear boundaries or when there is a large degree of criterion overlap, as is the case with regard to personality disorders. This paper will present preliminary results from prototypicality analysis of the CAPP items in different samples of forensic experts and lay people in Norway, and compare these findings with results from international prototypicality analyses. The paper will thus provide a measure of the content validity of the CAPP model within a Norwegian setting, highlighting any indication of cross-cultural differences in the perception of psychopathy as measured by the CAPP model.


Cooke, D. J., Hart, S. D., Logan, C., & Kreis, M. K. F. (2009, June). Recent Developments in the Use of the Comprehensive Assessment of Psychopathic Personality (CAPP). Symposium conducted at the Ninth International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Edinburgh, Scotland.

Paper one

David J. Cooke

Risk formulation and the Comprehensive Assessment of Psychopathic Personality Disorder (CAPP).

Paper two

Caroline Logan

Developing a new assessment of psychopathy: The CAPP semi-structured interview.

Paper three

Mette K. F. Kreis & David J. Cooke

Constructing validity: Multi-method examination of psychopathic personality in women offenders using the CAPP-IRS.

Paper four

Nikolova, N. & Douglas, K. (2009, June). Is the Comprehensive Assessment of Psychopathic Personality-Institutional Rating Scale suitable for use at correctional facilities? Poster presented at the Ninth International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Edinburgh, Scotland.


2008


Cooke, D. J., Hart, S. D., Logan, C., & Michie, C. (2008, July). Towards a Clinically Relevant Measure of Psychopathy: Some Initial Findings on the Comprehensive Assessment of Psychopathic Personality Disorder (CAPP). Paper presented at the 18th European Association of Psychology and Law Conference, Maastricht, the Netherlands.

Abstract

Traditional measures of psychopathy are not suitable for the purpose of evaluating stability and change: They are not dynamic. There is a growing awareness that personality disorders in general are not as stable as previously considered. We have developed a new measure of psychopathy which is designed to be potentially dynamic. There were three initial steps in the process. First, we reviewed the extant literature on psychopathy. Second, we interviewed an international panel of experts about the core features of the disorder. Third, we applied a lexical approach to identify and define distinct symptoms. These processes resulted in the specification of 33 symptoms that were grouped rationally into six domains of functioning (Interpersonal-Attachment, Behavioural, Cognitive, Interpersonal-Dominance, Emotional, and Self). In this paper we describe preliminary analysis using Confirmatory Factor Analysis designed to determine the extent to which the conceptual model can be shown to fit the conceptual model.


Hart, S. D., Kreis, M. K. F., Logan, C., Hoff, H. A., & Pham, T. (2008, July). The Comprehensive Assessment of Psychopathic Personality (CAPP): Construct validation and clinical application of a new measure of psychopathy. Symposium conducted at the Eight International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Vienna, Austria.

Abstract

The Comprehensive Assessment of Psychopathic Personality (CAPP) is a new measure of psychopathy that assesses the full domain of psychopathic symptomatology and the possible change of these symptoms over time. The CAPP is still under development and validation but has already received much international interest with several translations underway. This symposium reviews pilot research assessing different aspects of the construct validity of the CAPP. The clinical application of the instrument and issues of its translation will also be discussed.


In the first paper Stephen Hart introduces the measure and examines the findings of the first study using the CAPP with a British male forensic sample. The ability of the measure to adequately capture the psychopathy construct in this population is discussed.

The second paper, presented by Mette K. F. Kreis, will discuss the findings of the first study of the CAPP with women, carried out with a British and Canadian female forensic sample. The assessment of psychopathy in women is controversial and much debated. This paper will examine the utility of the CAPP in capturing the disorder in females.

In the third paper Helge A. Hoff presents the initial findings of an ongoing study of the content validity of the CAPP carried out in Norway.

In the fourth paper Thierry H. Pham discusses some of the issues involved in translating the CAPP into French and its interest within the context of the Belgian Social Defense Law for forensic patients.

In the fifth paper Caroline Logan discusses using the CAPP as a formulation aid in clinical practice.


Köhler, D. & Heinzen, H. (2008, June). New models of psychopathy: Current status and future directions. Paper presented at the Research in Forensic Psychiatry Conference , Regensburg, Germany.

Abstract

Since Cleckley’s definition of the criminal psychopath and Hare’s (2003) conceptualization research of the psychopathy construct used to be based on PCL-R. Originally, Hare (1991) postulated two distinct but correlated factors representing an affective and an interpersonal component. Many studies seemed to confirm this factor structure. However, Cooke and Michie (2001) questioned the adequacy of a two-factor model. They refined the construct of psychopathy and developed a new hierarchical three-factor model. In the 2nd edition of the PCL-R Hare reacted to this critique by conceptualizing a hierarchical four-factor structure of psychopathy. Recently, several models of psychopathy assuming distinctive underlying theoretical structures have been proposed. The current paper gives an overview about current models of psychopathy with respect to taxonomic studies and dimensional approach of personality.
Furthermore, a new model of psychopathy, the Comprehensive Assessment of Psychopathic Personality by Cooke and colleagues, will be presented (CAPP; German Version by Köhler & Heinzen, in prep). The CAPP includes aspects of the lexical approach of personality and consists of the facets: self, attachment, behavioural, cognitive, dominance and emotional domains. The instrument will be discussed with respect to its methodological, empirical and theoretical features and its implications for future research.


Kreis, M. K. F.& Cooke, D. J. (2008, June). Exploring the symptomatology of psychopathy in women with a new psychopathy assessment measure. Paper presented at the British Psychological Society Division of Forensic Psychology Annual Conference, Edinburgh, Scotland.

This paper aims to explore the symptomatology of psychopathy in women using a new measure of psychopathy - the Comprehensive Assessment of Psychopathic Personality (CAPP) - and examine its utility for assessing psychopathy in a female forensic population.

An exploratory design was used because little is known about psychopathy in women and existing psychopathy measures are limited in their ability to adequately capture the construct in females.

Twenty female offenders were broadly assessed with the CAPP and several other personality measures through a multi-method procedure. The data was explored using descriptive and correlational analyses. Preliminary results suggest the CAPP is useful for assessing psychopathy in women. The paper concludes by noting how the CAPP may be better able to adequately capture psychopathy in women than other existing measures. More accurate assessments and knowledge about the disorder in women will help improve the risk assessment and management of women with psychopathy.


McCormick, A., Corrado, R., & Hart, S. D. (2008, July). Interrater reliability and internal consistency reliability of the Comprehensive Assessment of Psychopathic Personality Disorder among incarcerated young offenders. Paper presented at the Eight International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Vienna, Austria.


Pedersen, L., Elsass, P., Pedersen, C., & Rasmussen, K. (2008, July). Psychopathy as a risk factor for violent recidivism – comparing a standardised scale and a new measure of psychopathy. Paper presented at the Eight International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Vienna, Austria.

Abstract

Psychopathy is a central clinical construct in forensic practice. In both clinical practice and in research, psychopathy has traditionally been measured by The Psychopathy Checklist (e.g. PCL-R, Hare, 2003; PCL:SV, Hart, Cox, & Hare, 1995). However, even though high PCL-R scores have proven to be a very strong risk factor in relation to future disruptive and criminal behaviour, it is considered less suitable for measuring treatment advances or changes. The recent development of The Comprehensive Assessment of Psychopathic Personality (CAPP, Cooke, Hart, & Logan, 2006) as a clinical tool sensitive to change, opens up for the possibility of actually measuring the stability of the construct of psychopathic personality over time and hence measuring potential changes over time.

The results from a retrospective study including all patients discharged from a forensic unit at Sct. Hans Hospital in Denmark during 2001 and 2002 (n=148) will be presented. All patients were retrospectively assessed for risk of future violence and psychopathy by using the HCR-20, the PCL:SV and the CAPP. Information from files allowed for scoring both the PCL:SV and the CAPP for a total of 96 patients. Data on crime and imprisonment have been obtained from The Danish National Crime Register and data on re-hospitalisation have been obtained from The Danish Psychiatric Central Research Register.

Preliminary analyses suggest that both instruments could be scored with adequate reliability and both instruments were related to future general and violent recidivism. Further data on both the PCL:SV and the CAPP in relation to future criminal behaviour will be presented. Implications for clinical use will be discussed.


Strub, D., Kreis, M.K.F, & Hart, S.D. (2008, July). A new approach to the assessment of psychopathy: Discriminant and convergent validity of the CAPP across clusters of personality disorders. Poster presented at the Eight International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Vienna, Austria.

Abstract

Both the construct of psychopathy and its assessment have become the source of much debate. In order to address these qualitative and quantitative issues, the field of psychology needed a new way of conceptualizing and appraising this psychopathology. Consequently, Cooke, Hart, Logan and Michie developed the Comprehensive Assessment of Psychopathic Personality Disorder (CAPP; Cooke, Hart, Logan, & Michie, 2004), a new model and measure of psychopathy. The present study is part of the ongoing construct validation of this measure.

This study aims to evaluate the CAPP symptoms in relation to different clusters of personality disorders in order to assess the discriminant and convergent validity of the measure. The CAPP symptoms are expected to be rated as more severe in patients with Cluster B personality disorders than in patients with cluster A, C or no personality disorder.

Mental health professionals experienced with personality disorders are being sampled internationally through various mental health organizations. The participants are asked to select two of their clients (based on their personality profile) and rate them on 42 symptoms consisting of the CAPP symptoms plus several other personality symptoms irrelevant to the construct of psychopathy.

This paper will discuss the preliminary results of the study, including the ability of the CAPP to discriminate between psychopathy and clusters of other personality disorders.


2007


Cooke, D. J., Hart, S. D., Logan, C., & Michie, C. (2007, September). CAPP: Towards a measure of change
of psychopathic personality disorder. In A. Fossati (Chair), When personality disorders meet the court: Forensic implications of the severe disorders of personality. Symposiumconducted at the meeting of the Xth International Congress of the International Society for theStudy of Personality Disorders (ISSPD), The Hague, the Netherlands.

Abstract

Traditional measures of psychopathy are not suitable for this purpose of evaluating stability and change: They are not dynamic. The Psychopathy Checklist-Revised (PCL-R), for example, is inherently static being based on a life-time perspective; once an individual achieves a score it is difficult for that score to diminish.

The processes required to build a new measure to ensure that the measure reflects the clinical construct of concern will be described. The first step in development of the CAPP was a systematic review of clinical and theoretical literatures on psychopathy and personality disorder. We reviewed historical and contemporary writings by experts in clinical psychiatry, clinical psychology, and experimental psychopathology to identify symptoms and associated features.

The second step involved interviews with expert clinicians and important theorists in Europe and North America. We used a semi-structured protocol to conduct face-to-face or telephonic interviews. The interviews asked respondents to identify primary symptoms or features, as well as any other symptoms of features that they believed were potentially useful in describing psychopathy and differentiating it from other disorders.

The third step involved the rational identification and definition of symptoms using a lexical approach. We started by compiling all the symptoms and features identified from the literature review and expert interviews. Next, consistent with the lexical approach that has been used in personality psychology for many years, we reduced this list to set of trait-descriptive adjectives. We attempted to balance the competing needs for comprehensiveness and brevity by combining adjectives that were synonymous, but retaining adjectives whose association with psychopathy might be considered uncertain, unclear, or controversial. After numerous iterations, the result was a list of 33 symptoms that were grouped rationally into six domains of functioning (Interpersonal-Attachment, Behavioral, Cognitive, Interpersonal-Dominance, Emotional, and Self).


Corrado, R. R., Watkinson, A. M., Hart, S. D., Lussier. P., & Cohen, I. M. (2007, July). The interrater reliability of the Comprehensive Assessment of Psychopathic Personality Disorder. Paper presented at the Third International Congress of Psychology and Law, Adelaide, Australia.


Hart, S. D. (2007, July). Developing a new model of psychopathy: The Comprehensive Assessment of Psychopathic Personality (CAPP). Paper presented at the Third International Congress of Psychology and Law, Adelaide, Australia.


Hart, S. D. (2007, October). The development of a comprehensive, change-sensitive measure of psychopathy: Searching for the Holy Grail. Department of Mental Health, Law, and Policy, University of South Florida, Tampa, Florida.


Kreis, M. K. F., Logan, C., Cooke, D. J., & Hoff, H. A. (2007, June). Prototypical analysis of Psychopathic personality disorder: A focus on gender. Paper presented at the Seventh International Association ofForensic Mental Health Services (IAFMHS) Annual Conference, Montreal, Canada.

Abstract

The construct of psychopathy has been greatly studied in men but much less so in women. Consequently our knowledge about the nature and manifestation of psychopathy in women is still very limited (see Nicholls & Petrila, 2005). Researchers have been urged to go ‘back to basics’ by starting to map the domain of symptoms of psychopathy in women (Forouzan & Cooke, 2005). This study was an attempt to do this through the use of prototypical analysis. The study also investigated the content validity of a new measure of psychopathy, the Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, 2004).

Mental health professionals (N = 100), experienced with psychopathic clients, were asked to rate 42 symptoms according to their degree of prototypicality of psychopathy in men and women. Participants were sampled internationally through different forensic mental health organisations and institutions (e.g., the IAFMHS). The 42 symptoms consisted of the CAPP symptoms plus several other personality disorder symptoms expected to be irrelevant to psychopathy. Preliminary results suggest good content validity of the CAPP; they also suggest that the psychopathy construct differs to some extent across gender.

This presentation will discuss the results of the study in detail, including the utility of the CAPP in capturing the symptoms of psychopathy in both men and women.


Kreis, M. K. F., Logan, C., Cooke, D. J., & Hoff, H. A. (2007, September). Prototypical analysis of Psychopathic personality disorder: A focus on gender. In A. Fossati (Chair), When personalitydisorders meet the court: Forensic implications of the severe disorders of personality. Symposium conducted at the meeting of the Xth International Congress of the International Society for the Study of Personality Disorders (ISSPD), The Hague, the Netherlands.

Abstract

Psychopathy has been studied much less in women than men. Consequently little is known about the nature and manifestation of psychopathy in women although it is suggested that gender differences may exist in the disorder (see Nicholls & Petrila, 2005). Researchers have been urged to go ‘back to basics’ and start to map the domain of symptoms of psychopathy in women as was initially done with men (Forouzan & Cooke, 2005). This study was an attempt to do this through the use of prototypical analysis. The study also investigated the content validity of a new measure of psychopathy, the Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, 2004).

One hundred international mental health professionals with experienced of psychopathy rated 42 symptoms according to their prototypicality of psychopathy across gender. The 42 symptoms consisted of the CAPP symptoms plus other personality disorder symptoms expected to be irrelevant to psychopathy. Preliminary results suggest good content validity of the CAPP and that some gender differences exist in the psychopathy construct.


Watkinson, A., Corrado, R. R., Lussier, P., Hart, S. D., & Cohen, I. M. (2007, June). Comprehensive Assessment of Psychopathic Personality Disorder and the Psychopathy Checklist: Youth Version. Paper presented at the Seventh International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Montreal, Canada.

Abstract

Previous research demonstrates that certain psychopathy dimensions are more predictive of both general and violent recidivism than others. Recent research suggests that additional dimensions of psychopathic traits, previously unrecognized in measurements of psychopathy, need to be explored in order for psychopathy to be more useful in predicting violent crime. In addition, once validated, these new dimensions could direct further treatment interventions and possibly reduce risk for reoffending.

The Comprehensive Assessment of Psychopathic Personality Disorder: Institutional Rating Scale (CAPP-IRS) is an instrument created by Cooke, Hart, and Logan (unpublished manuscript) to assess psychopathic traits in institutionalized populations. Cooke et al. describe the psychopathic personality as an overarching construct composed of distinct symptomatology involving six domains of dysfunction, each characterized by multiple symptoms.

The current study employed the CAPP-IRS and the Psychopathy Checklist: Youth Version (PCL: YV) with 30 serious and violent young offenders incarcerated in a youth detention facility in Western Canada. Semi-structured interviews were conducted shortly after the youth were admitted to the institution. The initial interviews collected information pertaining to demographics, education, family, criminal history, current offence(s), and current and historical mental health profiles. During a second semi-structured interview, participants were asked a series of questions relating to their personality. Questions were devised according to the six main domains of the CAPP-IRS: self; behavioural; cognitive; dominance; attachment; and emotional. This presentation will provide a descriptive overview of the new instrument and the extent to which it correlates with and improves upon the three-factor model of the PCL:YV.


2006


Cooke, D., Hart, S., & Logan, C. (June, 2006). Towards a Comprehensive and Clinically Informed Measure of Psychopathy: The Comprehensive Assessment of Psychopathic Personality Pathology (CAPP). Symposium conducted at the Sixth International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Amsterdam, the Netherlands.

Abstract

Psychopathic personality disorder is a central construct in forensic practice. The Dangerous and Severe Personality Disorder (DSPD) project within England and Wales requires a measure that can be used to assess stability and change in psychopathic personality disorder. The symposium will contain three papers describing the development of a clinical model of psychopathy, the Comprehensive Assessment of Psychopathic Personality Pathology (CAPP), and a rating scale based on the CAPP model intended for use in institutional settings that is potentially sensitive to change over time (the CAPP-IRS).

The first paper outlines the limitations of existing models and measures of psychopathy.

The second paper described on the development of a new, comprehensive clinical model of psychopathy, the CAPP.

The third paper discusses the development of adjectival and behavioral rating scales based on the CAPP.

Symposium papers

Towards a Dynamic Measure of Psychopathy: Conceptual Basis

David J Cooke, Stephen Hart, Caroline Logan, Christine Michie, Tammy Walker & Fiona Campbell

Longitudinal studies are beginning to qualify assumptions about the stability of personality disorders. Attempts to intervene clinically with those suffering from psychopathic personality disorder require evaluation of stability and change. The Dangerous and Severe Personality Disorder (DSPD) project within England and Wales has provided the opportunity to revisit the construct of psychopathy and consider how stability and change in this disorder can be evaluated.

Traditional measures of psychopathy are not suitable for this purpose of evaluating stability and change. First, they are not comprehensive. None of the existing measures of psychopathy includes the full range of symptomatology discussed by major clinicians and theorists. Second, they are not dynamic. Few of these measures are constructed in a way that would permit them to be used to systematically evaluate changes over time in the severity of symptoms. For these reasons, new models and measures of psychopathy are required. This paper sets out the requirements for theoretical new measures of psychopathy that are both comprehensive and potentially sensitive to change.

First, the evidence for stability and change in personality and personality disorder will be reviewed briefly.

Second, consideration will be given to the processes required to build a new measure to ensure that the measure reflects the clinical construct of concern. It will be argued that the measure should focus on the domain of personality pathology and not specific behavioural acts such as criminal behaviour. The process of building a new measure requires an iterative process between data collection and data analysis in order that the complex facet structure of the disorder can be articulated and the association between the measure and the latent structure can be specified. Once key symptoms of an individual facet of the disorder have been identified by theory it is necessary to use analytic techniques, including item response models and confirmatory factor analytic models, to demonstrate the extent to which observed structures of the measure adhere to the theoretical structure of the construct. These approaches can be applied to enhance the likelihood that change is detected by ensuring maximal precision of measurement at the high end of the trait.

Third, the problematic nature of measuring change in clinical variables will be considered. It is argued that the nature of the measures used to assess change has the potential to mislead evaluations of the efficacy of clinical change. It is argued that traditional approaches to evaluating change are inappropriate and that novel statistical approaches will be considered.

Developing a New Model of Psychopathy: The Comprehensive Assessment of Psychopathic Personality (CAPP)

Stephen D Hart, Caroline Logan, David J Cooke, Christine Michie

The second paper in this symposium describes the development of the new clinical model of psychopathy, which we call the Comprehensive Assessment of Psychopathic Personality Pathology (CAPP).

The first step in development of the CAPP was a systematic review of clinical and theoretical literatures on psychopathy and personality disorder. We reviewed historical and contemporary writings by experts in clinical psychiatry, clinical psychology, and experimental psychopathology to identify symptoms and associated features.
The second step involved interviews with expert clinicians and important theorists in Europe and North America. We used a semi-structured protocol to conduct face-to-face or telephonic interviews. The interviews asked respondents to identify primary symptoms or features, as well as any other symptoms of features that they believed were potentially useful in describing psychopathy and differentiating it from other disorders.

The third step involved the rational identification and definition of symptoms using a lexical approach. We started by compiling all the symptoms and features identified from the literature review and expert interviews. Next, consistent with the lexical approach that has been used in personality psychology for many years, we reduced this list to set of trait-descriptive adjectives. We attempted to balance the competing needs for comprehensiveness and brevity by combining adjectives that were synonymous, but retaining adjectives whose association with psychopathy might be considered uncertain, unclear, or controversial. After numerous iterations, the result was a list of 33 symptoms that were grouped rationally into six domains of functioning (Interpersonal-Attachment, Behavioral, Cognitive, Interpersonal-Dominance, Emotional, and Self).

The paper ends with a discussion of validation research planned or in progress concerning the CAPP. One particularly important type of research, given the lexical approach on which the CAPP is based, is translation of the CAPP from English into other languages. Another is the development if new assessment procedures.

Developing New Measures of Psychopathy: An Institutional Rating Scale Version of the Comprehensive Assessment of Psychopathic Personality Pathology (CAPP-IRS)

Caroline Logan, Fiona Campbell, Tammy Walker, David J Cooke, Stephen Hart, & Christine Michie

The final paper in this symposium describes the development of an Institutional Rating Scale version of the Comprehensive Assessment of Psychopathic Personality Pathology (CAPP). The CAPP-IRS was developed to assess change over time in psychopathic personality disorder symptomatology in institutionalized populations.

The CAPP-IRS is an expert observer rating scale scored on the basis of a semi-structured interview with the target and a review of institutional records. The interview is designed to be personally interesting to the client as well as to allow the interviewer to explore with the client key areas of his personality functioning relevant to the construct of psychopathy underlying the measure. The interview focuses on recent functioning only - ratings are made of symptoms present in the six months prior to assessment. Anchor dates (e.g., birthdays) and events (e.g., the World Cup) are established with the client at the beginning of the assessment to ensure that its focus is maintained on recent functioning and not functioning across the lifetime or prior to incarceration. File information is also reviewed. Final ratings of key symptoms are concluded on the basis of all the information collected.

In this paper, the processes by which ratings on the key symptoms are derived will be described. Examples will be given of some of the different symptoms and how they are assessed. Techniques for maintaining the client’s focus on recent as opposed to lifetime functioning will be demonstrated. Also, the format of the behavioural rating scale for use by staff will also be reviewed.

The CAPP-IRS is currently being piloted at two sites. Fiona Campbell, who is a co-author on this paper, is piloting the CAPP at the Westgate Unit, which is the DSPD facility at HMP Frankland, a high secure prison in the north-east of England. Tammy Walker, who is also a co-author on this paper, is piloting the CAPP at the Peaks Unit, which is the DSPD facility at Rampton Hospital, one of England’s three high secure forensic psychiatric hospitals. Fiona and Tammy will conclude this paper with some examples of the use of the CAPP-IRS in their respective settings.


Corrado, R., Watkinson, A., Hart, S., & Cohen, I. (2006, June). Comprehensive Assessment of Psychopathic Personality Disorder: Initial findings with incarcerated serious and violent youth. Paper presented at the Sixth International Association of Forensic Mental Health Services (IAFMHS) Annual Conference, Amsterdam, the Netherlands.

Abstract

The Comprehensive Assessment of Psychopathic Personality Disorder is a new measure of psychopathy developed for use within adolescent and adult institutionalized populations. This presentation will explain the purpose and methods of the instrument, describe its inaugural use within a sample of British Columbia incarcerated young offenders, and will discuss some initial results of the ongoing study.

Psychopathy is a personality disorder that is characterized by traits such as remorselessness, callousness, impulsivity, egocentricity, and superficiality. Psychopathy is diagnosable in adult populations, however, the ability to successfully treat the disorder at this time remains unproven. Research has begun to focus on children and adolescents in an attempt to identify psychopathic traits at a time when these traits are still developing and stabilizing, which should make them more malleable to treatment efforts. Because previous research among adolescent and adult populations demonstrates that psychopathy is predictive of both general and violent recidivism (e.g., Corrado, Vincent, Hart, & Cohen, 2004), there is a need for assessment measures that can validly identify psychopathic traits in adolescent delinquent populations in order to better assess treatment needs and subsequent risk for reoffending.

The Comprehensive Assessment of Psychopathic Personality Disorder: Institutional Rating Scale (CAPP-IRS) is a new instrument created by Cooke, Hart, and Logan (unpublished manuscript) to assess psychopathic personality symptoms in adolescent and adult institutionalized populations. Cooke, Hart, and Logan identify the psychopathic personality as an overarching construct that is composed of distinct symptomatology. This instrument assesses the disorder by identifying six domains of dysfunction that are each characterized by multiple symptoms.

The current study employed the CAPP-IRS with a sample of serious and violent young offenders who were incarcerated in one of three British Columbian youth detention facilities. Two sets of semi-structured interviews were conducted with this population of youth shortly after being admitted to the detention centre. The initial interviews collected information pertaining to demographics, education, family, and criminal history, the offender’s current offence(s), and their current and historical mental health profiles. During the second interview, which consisted entirely of the CAPP-IRS, participants were asked a series of questions related to their personality. Questions were built around a series of domains of the CAPP-IRS: self; behavioural; cognitive; dominance; attachment; and emotional. This presentation will describe the purpose and methods of the instrument, its use in an incarcerated young offender population, and the initial results of this pilot measure.