Running head: DIAGNOSIS OF PSYCHOPATHY 1

Diagnosis of Psychopathy

Whitney Farrand

Alfred State College

DIAGNOSIS OF PSYCHOPATHY 2

Abstract

This research aims to use a 20 question shortened assessment to diagnose psychopathy in

adolescents aged 13-18. The hope is to find a shortened assessment that can be used in place of

the 173 question Elemental Psychopathy Assessment (EPA). Participants were taken from the

Susquehanna Valley area. The inclusion criteria for this group include being an adolescent male,

from a middle class home and have no criminal background. Each participant was taken through

the shortened assessment. The length of time to administer the assessment was monitored as well

as the time to read the results. It was concluded that this exam was reliable for the diagnosis of

psychopathy. Therefore, the question was, is this a faster exam to administer. It was found that

the EPA took 2 hours to administer versus the shortened assessed which was 42 minutes. The

average time to read the results for the EPA was 1 hour and the shortened assessment was 45

minutes.
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Diagnosis of Psychopathy

Psychopathy is a mental disorder diagnosed and characterized by eccentricity, cognitive/

perceptual dysregulation, unusual beliefs or unusual experiences (American Psychiatric

Association, 2012). Eccentricity is defined as odd or unusual behaviors that are disruptive to

society or inappropriate. Cognitive or perceptual dysregulation is a thought process that is vague

or odd patterns that are inconsistent with society. Finally, unusual beliefs or experiences in

psychopathic persons tend to be outside of what is considered normal or possible.

Approximately 1% of the population is thought to be psychopathic (Collison, Miller,

Gaughan, Widiger & Lynam, 2016). Historical psychopathy has been thought to be a dangerous

disorder that leads to criminal, delinquent and antisocial activity. The tendencies towards certain

personality traits, to be discussed later in this section, have long been thought to increase

likelihood of committing violent crime as well as make psychopaths more likely to be victimized

(Hare and Neumann, 2009). Psychopathy has been diagnosed with many different criteria over

the years with the current method of diagnosis being the Elemental Psychopathy Assessment

(EPA). This exam is an exam that is over 170 questions, requires expert to administer and is

fairly costly to administer (Hare & Neumman, 2009).

Personality traits have long been linked to different forms of mental illness or well-being.

The Triarchic model of personality is a tool used by psychologist to study personality. This

assessment focuses on three areas of personality, impulse control, social dominance and

emotional resiliency (Miller, Lynan, Patrick & Drislane, 2015). It is generally accepted that those

with psychopathy will exhibit the following designations for each category, impulse control will

be demonstrated as disinhibition, social dominance will be displayed as over boldness and

DIAGNOSIS OF PSYCHOPATHY 4

emotional resiliency can be interrupted as meanness (Miller et al., 2015). These key personality Commented [BYT1]:

expressions (disinhibition, boldness and meanness) are known as the Triarchic Model of

Psychopathy (TriPM) (Weidacker, O’Farrell, Gray, Johnston & Snowden, 2017).

In 2016 a group of psychologists set out to find a more efficient way of diagnosis and

evaluate those who have psychopathy. It was determined that there are characteristic personality

traits that can be predicted in those with psychopathy (Mullin-Sweatt, Glover, Derekinko, Miller

& Widiger 2010). The traits that were hypothesized high recurrence in those with psychopathy

include callousness, dishonesty, exploitative, and remorseless, but low in irresponsibility and

impulsivity. To assess this idea, psychologists were asked to answer 15 questions about the

personalities of psychopaths. All 15 questions were about how much or little the specific person

being assessed exhibited a personality trait. The participant was assessed on a 0-5 scale, with 0

being meaning the participant does not and 5 being the participant does show that trait. The study

showed that psychopaths were highly dishonest, showed low remorse, minimized self-blame,

showed arrogance and shallowness. As predicted the participants showed low rates of carefree

life style (irresponsibility) and impulsivity, along with low rates of criminal activity in childhood

(Mullin-Sweatt et al. 2010). By helping to identify common traits exhibited and not exhibited by

a psychopath, this group may have helped develop shorter testing methods for the diagnosis of

mental illness.

Some studies have used personality research to make shorter and better assessments to be

used in the diagnosis of psychopathy. The Hare Psychopathy Checklist-Revised (PCL-R), the

Hare Psychopathy Checklist-Youth Version (PCL-YV) and the Hare Psychopathy Checklist-

Screening Version (PCL-SV) are three tools that are used by different groups of people to predict

Psychopathy (Hare & Neumann, 2009). The PCL-R is a tool that was developed to aid in the
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forensic and criminal diagnosis of psychopathy. This scale is a 20 item assessment used by

forensic teams, if a participant scores a 30 or higher on the exam it is accepted to mean that the

participant is a psychopath (Hare & Neumman, 2009). Hare and Neumann sought to use the

PCL-YV and PCL-SV as adapted forms of the PCL-R for the general public. The PCL-SV is a

version use on the general public of adults. This assessment was paired down to a less extensive

12 item assessment. The score of 18 on the PCL-SV was indicative of psychopathy in the general

public. The PCL-YV is an adapted version of the PCL-R that is more appropriate for youth

(adolescents). Due to the complexity adolescences, the test was again 20 items like its PCL-R

counterpart. Research found this tool very reliable for diagnosing psychopathy in adolescents.

Many ethical concerns were raised however about the use of an assessment to label a “child” and

a psychopath. It was thought to be inappropriate to evaluate, diagnose, treat and possibly label a

“child” with the term psychopath (Hare and Neumann, 2009).

Much of the literature supports a super-short form of assessment used to diagnose

psychopathy. This however, needs to be backed up by more scientific data. All of the above

mentioned studies are repeatable and have clear ability to be recreated. The fact is, that main of

these studies have not been retested and therefore, there is a lack of consistency about which

assessment to use for psychopathy and how to implement them. Further study needs to be done

into the implications of studying, diagnosing and treating adolescents with psychopathy. There
also needs to be further study into the assessment of accuracy and reliability of psychopathy
Commented [BYT2]: Good observation, this would be a good
direction for your proposal. You could design a study that use an
adolescent population perhaps. Or, you could run a study where
you compare adults and adolescents to see if the assessment is just
as accurate in diagnosing adolescents as it is for adults.

assessments like the PCL-SV and TriPM.

For the purposes of this research, several different forms of shortened assessments were

studied in hopes of identifying a more clear and precise way of diagnosing psychopathy than the

traditional EPA. It was hypothesized that the Elemental Psychopathy Assessments (EPA) can be
DIAGNOSIS OF PSYCHOPATHY 6

shortened to 20 questions for adolescents used to identify psychopathy with equal accuracy to the

full length EPA.

Methods

Participants

In order to eliminate possible unknown variables, participants in this study will all come

from a uniform background. It is generally accepted that adolescents are between the ages of 13

and 18. This is the age group that will be used for the purposes of this study. Participants with

any other previously diagnosed mental illnesses will be not eligible to participate in this study.

Middle class, males with no prior history of mental illness and no prior history of arrest will be

used in this study. Both the participant and parent/guardian will be given informed consent and

give written permission to participate in the study. All participants will be taken from the

Susquehanna Valley area of Pennsylvania. Participants will be randomly selected and chosen

from the adolescents living in this area.

Instruments

The goal of each study was to prove the accuracy of using personality traits and a

shortened examination in the diagnosis of psychopathy. A simple 20 question exam based on

objective and subjective questioning about an adolescent’s behavior and personality traits will be

developed. Similar to that of the PCL-YV, this assessment will consider a score of 18 to be

indicative of psychopathy.

Procedure
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Each participant will be first given information about the study and given a chance to ask

questions. After each participant and their guardian has given consent to the study, an interview

process will begin. This interview process will be to ensure that each participant meets the

inclusion criteria for this study.

After all participants have agreed to this study, testing will begin. Each participant will be

taken through the 20 item assessment. After each person has been taken through the assessment,

all of the data will be evaluated. Due to the relatively low rate of psychopathy in the general

population, the number of participants needs to be high in order to statically have significance.

For this reason, the study is looking to examine approximately 1,000 adolescent males.

It is important to report that participants will be given an initial debrief after being given

the assessment or being studied. They will be allowed to ask questions and gather information.

Every participant should have equal access to the results of this experiment.

Ethical Issues

Both Alfred State and the researcher of this paper have no bias or conflicts of interest in

this research. This research is conducted using adolescences, therefore special protection will be

made. Precautions will be made to make sure that their identities are protected and the results are

kept private. Along with this all participants will be offered counseling or help if there are any

negative effects of this exam. All other studies had been carried out ethically and in accordance

with the IRB checklist.

Results
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The research was conducted between January and December of 2017. The experimental

design was evaluated for speed, reliability and accuracy. In this study 250 males were identified

in the Susquehanna Valley area as being appropriate for participation. The control group was

analyzed using the EPA. In this group, ten males dropped out of the study. Five did not wish to

participate once the exam was started and were permitted to leave. Another five were not

included in the results as they admitted they were not answering the questions honestly. The

experimental group contained 125 males at the beginning with 8 males leaving the study. One

adolescent did not show up to the appointment, one had a family emergency and six others

admitted to answering the questions dishonestly.

These adolescences scores, times and the validity of the exams were calculated. The

control group reported a rate of psychopathy in the population of the expected 1%. The arrange

time of completing the exam was 120 minutes. In a post-exit interview students reported losing

focus and interest after the first 45 minutes. When asked to rate their focus and answers to the

questions on a 0-5 scale (0- none focus 5-extremely focused), the mean for participants was 3.2.

The experimental group also reported the expected rate of 1%. The mean time spent

administering the exam was 42 minutes. The post exit interview revealed a self-evaluation of

focus as a mean rating of 4.4. Participants reported no loss of interest.

The EPA scores on a different basis than that of the shortened exam. The shortened exam

uses a score of 18 to reflect psychopathy in adolescents. The EPA by contrast uses a more

complex scoring system. The average score of the shortened exam was 6.5 for the experimental

group.
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The interruption process yielded interesting results. The standard EPA took

approximately one hour to evaluate and score. Professionals at administering this exam were able

to swiftly and accurately read this examination to produce a result. The shortened exam took 45

minutes to examine and score. The difference between the scoring process online being 15

minutes.

Discussion

In the beginning it was hypothesized that the Elemental Psychopathy Assessments (EPA)

can be shortened to 20 questions for adolescents used to identify psychopathy with equal

accuracy to the full length EPA. The results seem to support this hypothesis. The shortened time

supports the notion that a 20 question exam can be used to eliminate the time constraint that

prevents more people from being evaluated. This is important due to the before mentioned fact

that some research has linked early identification and treatment of psychopathy to better

outcomes for that person’s role in society. It is also of note that the EPA and shortened exam

identified an equal rate of psychopathy within the given population. This supports the part of the

hypothesis that predicted equal accuracy of the exam.

It was thought the review process of the exams would have significantly shortened

assessment times. However, there was only 15 minutes separating the EPA and shortened

assessment. Several factors could have influenced this data. Firstly, the process of analyzing and

understanding the EPA has been perfected. This is a tool that evaluators are used to and therefore

have a degree practice that effects the results. The new exam was a learning curve for the

professionals. Being unfamiliar with the system meant that extra caution had to be exercised with

the grading process. If this caution had not been exercised, it could have led to false results.
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There are some areas that can be improved upon in this study. Firstly, this study can only

be applied to middle-class, male-adolescents with no criminal back ground. Possible areas of

future study include females, adolescences with criminal records and those adolescences with

another known mental illness. Including the study area of other mental illness, learning disability

or social disorder will be a tricky study. Further study will need to be done into the personality

traits of each different type of mental illness and learning disability. These personality traits

could overlap with psychopathy traits and therefore cause false positive results in those taking

the exam. Additional questions and variable control may be needed for these studies. In

conclusion, this preliminary study seems to support the idea that the EPA can be shortened and

used for the diagnosis of adolescences with psychopathy. Further study is required to apply these

results to a wider demographic.

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References

Collison K., Miller J., Gaughan E., Widiger T., &Lynam D. (2016). Development and validation

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Hare, R. & Neumann, C. (2009). Psychopathy: assessment and forensic implications. Canadian

Journal of Psychiatry, 54(12), 791-802.

Miller, J., Lynam, D., Patrick, C., & Drislane, L. (2015). Triarchic psychopathy measure: origins,

operationalizations, and observed linkages with personality and general psychopathology.

Journal of Personality, 31(6), 627. Doi:10.1111/jopy.12119

Mullin-Sweatt, S., Glover, N., Derekinko, K., Miller, J., Widiger, T. (2010). The search for the

successful psychopath. Journal of Research in Personality, 44(4).

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Personality and general psychopathology. Journal of Personality, 83(6), 627

643.doi:10.1111/jopy.12119

Weidacker, K., O’Farrell, K., Gray, N., Johnston, S., & Snowden, R. (2017). Psychopahy and

impulsivity: The relationship of the triarchic model of psychopathy to different forms of

impulsivity in offenders and community participants. Personality & Individual

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