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http://cjb.sagepub.com/content/38/10/965The online version of this article can be foundat:
DOI: 10.1177/0093854811418048
2011 38: 965Criminal Justice and BehaviorDaliah L. Bauer, Lindsay A. Whitman and David S. Kosson
Among Incarcerated Adolescent GirlsReliability and Construct Validity of Psychopathy Checklist: Youth Version Scores
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965
CRIMINAL JUSTICE AND BEHAVIOR, Vol. 38 No. 10, October 2011 965-987
DOI: 10.1177/0093854811418048
2011 International Association for Correctional and Forensic Psychology
AUTHORS NOTE:The data for this study were collected by Daliah L. Bauer in 1998 and 1999 in partial
fulfillment of the doctoral degree requirements of the Finch University of Health Sciences/Chicago Medical
School (Rosalind Franklin University) and was supported in part by Grants MH49111 and MH57714 from the
National Institute of Mental Health to David S. Kosson. The study was approved by the institutional review
board. We thank Glenda Blakemore and the Illinois Youth Center in Warrenville, Illinois, for their support of
this research. We also thank Diane Goldstein, Seoni Llanes, and Jasmin Vassileva for conducting interviews.
David S. Kosson is one of the coauthors of the Psychopathy Checklist: Youth Version: Technical Manual and
earns a small amount of money annually from sales of the manual. However, his work on the manual had no
influence on the research questions asked or interpretations of the research findings. Correspondence should
be addressed to David S. Kosson, Department of Psychology, Rosalind Franklin University of Medicine andScience, 3333 Green Bay Rd., North Chicago, IL 60064; e-mail: [email protected].
RELIABILITY AND CONSTRUCT VALIDITY OF
PSYCHOPATHY CHECKLIST: YOUTH VERSION
SCORES AMONG INCARCERATEDADOLESCENT GIRLS
DALIAH L. BAUERJefferson Parish Human Services Authority
LINDSAY A. WHITMANNew York University
DAVID S. KOSSONRosalind Franklin University of Medicine and Science
Although recent studies have demonstrated the utility of assessing psychopathic traits in adolescent males, there is
substantially less evidence on the utility of assessing psychopathic traits in adolescent females. This study investigated the
reliability and construct validity of the Psychopathy Checklist: Youth Version (PLC:YV) among a sample of 80 incarcerated
adolescent females. Reliability analyses indicated high interrater agreement and internal consistency for PCL:YV scores.
Consistent with research on adults and adolescent male offenders, psychopathic traits were associated with a greater number
of conduct disorder and alcohol dependence symptoms, earlier onset of criminal behavior, a propensity toward institutional
violence, and interpersonal behaviors associated with psychopathy. Consistent with some prior studies of youth, there were
no negative relationships between PCL:YV scores and internalizing disorder diagnoses and some positive associations
between psychopathy ratings and negative affectivity. Results suggest that assessing psychopathic traits in adolescent females
provides meaningful information regarding criminal behavior, patterns, and personality traits in youth.
Keywords: adolescent psychopathy; female inmates; adolescent psychopathology; construct validity
Although the bulk of the research establishing the importance of psychopathy has beenconducted on adult samples, there is now substantial evidence that the psychopathyconstruct is applicable to adolescents (Rutter, 2005; Vasey, Kotov, Frick, & Loney, 2005).
Psychopathy has many of the same correlates in adolescents as in adults (Kosson, Cyterski,
Steuerwald, Neumann, & Walker-Matthews, 2002; Salekin, Leistico, Trobst, Schrum, &
Lochman, 2005; Vitale, Newman, Bates, Goodnight, Dodge, & Pettit, 2005). Among
adolescents, psychopathic traits predict violence and recidivism (Falkenbach, Poythress, &
Heide, 2003; Salekin, 2008) and psychopathic traits in adulthood (Lynam, Caspi, Moffitt,
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966 CRIMINAL JUSTICE AND BEHAVIOR
Loeber, & Stouthamer-Loeber, 2007). In addition, there is preliminary evidence for
effective treatment of youth with psychopathic traits (Caldwell, McCormick, Umstead, &
Van Rybroek, 2007).
Because most research on adolescent samples has focused primarily on males, there is
relatively little evidence on the utility of assessing psychopathic traits in adolescent
females. This issue is relevant given that growth rates for criminal offenses among
adolescent females are higher than among adolescent males (Puzzanchera, Stahl, Finnegan,
Tierney, & Snyder, 2003), and adolescent females represent a growing proportion of forensic
populations (Porter, 2000). Consequently, the issue of whether indices of psychopathy are
valid and reliable among females is a crucial question in the context of forensic evaluations.
In fact, some theories suggest that psychopathy may be expressed differently in females
than in males. For these reasons, it is important to address the construct validity of
psychopathy instruments in an exclusively female sample. The current study is designed to
address this issue by examining the reliability and validity of psychopathy in adolescentfemales as measured by the Psychopathy Checklist: Youth Version (PCL:YV; Forth,
Kosson, & Hare, 2003). The PCL:YV is an expert rater measure of psychopathic traits
based on the widely validated Psychopathy Checklist Revised (PCL-R; Hare, 2003) but
adapted for use with adolescents.
BACKGROUND
PSYCHOPATHIC TRAITS IN FEMALES
Some researchers have raised the possibility that gender role socialization or biological
sex differences may lead to differences in the expression of psychopathic features in
females versus males (see Cale & Lilienfeld, 2002; Forouzan & Cooke, 2005). Several
studies have identified adult female offenders with psychopathic traits (Salekin, Rogers,
Ustad, & Sewell, 1998; Vitale, Smith, Brinkley, & Newman, 2002; Warren et al., 2003).
Investigations have found PCL-R scores to be reliable and valid in samples of female
methadone patients (Rutherford, Cacciola, Alterman, & McKay, 1996) and female inmates
(Vitale et al., 2002; see also Widom, 1978). As in male substance abusers, PCL-R and
Psychopathy Checklist: Screening Version scores predict poor treatment response among
incarcerated female substance abusers (Richards, Casey, & Lucente, 2003). However,Salekin, Rogers, and Sewell (1997) reported that PCL-R scores were less predictive of staff
ratings related to violence among females than was expected on the basis of prior studies
of male offenders.
PSYCHOPATHIC TRAITS AND AGGRESSION IN JUVENILE POPULATIONS
Several studies have reported that relationships between psychopathic traits and aggression
and delinquency were generally similar for girls and boys (Marsee, Silverthorn, & Frick, 2005;
Penney & Moretti, 2007; Salekin, 2008). In contrast, both Vincent, Odgers, McCormick,and Corrado (2008) and Odgers, Repucci, and Moretti (2005) reported different relationships
between psychopathy and aggression in girls than is typically reported in boys (Falkenbach
et al., 2003). Furthermore, Marsee et al. (2005) noted that the association between
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psychopathic features and relational aggression was stronger in girls than in boys. These
findings suggest that the relationship between psychopathy and aggression might be more
complex in girls than in boys.
ASSESSING PSYCHOPATHIC FEATURES IN CHILDREN AND ADOLESCENTS
Several measures have been developed for assessing psychopathic features in younger
populations. The PCL:YV (Forth et al., 2003) is an expert-rater measure of psychopathic
traits based on the best-validated measure of psychopathic traits in adults, the PCL-R (Hare,
2003). Other validated measures, such as the Antisocial Processes Screening Device (Frick
& Hare, 2001) and the Childhood Psychopathy Scale (Lynam, 1997) differ from the PCL:YV
in that they rely solely on information provided by parents or staff. Assessments of the
psychopathy construct in youth using these measures have generated a nomological net quite
similar to that surrounding the psychopathy construct in adults (Salekin et al., 2005).
Nevertheless, the study of psychopathic traits in youth has led to some controversies.
Several researchers have expressed concern that some of the traits associated with
psychopathy are relatively common in adolescence and may not reflect the severe pathology
that they indicate in adults or that, in youth, such traits are not stable across time. In
addition, researchers have recommended caution about the use of youth psychopathy
measures in court proceedings, given the potentially grave consequences of labeling an
adolescent psychopathic (Edens, Skeem, Cruise, & Cauffman, 2001; Seagrave & Grisso,
2002). In addition, there are questions about the specificity and sensitivity of specific
measures of psychopathy. Nevertheless, extant studies suggest that ratings of psychopathy
are relatively stable (Frick, Kimonis, Dandreaux, & Farell, 2003) and reliable across raters.Moreover, evidence suggests that individual differences in psychopathic traits are not
attributable to base rates of psychopathic traits during adolescence (Kosson, 2008) and that
scores on measures based on downward extensions of the adult psychopathy construct
converge with scores based on other approaches (Lynam, Derefinko, Caspi, Loeber, &
Stouthamer-Loeber, 2007).
Because the current investigation employed the PCL:YV to assess psychopathic traits,
we briefly review current knowledge regarding the reliability and validity of PCL:YV
ratings.1Studies indicate that PCL:YV scores are comparable in internal consistency and
interrater agreement to PCL-R scores (e.g., Edens et al., 2001; Forth et al., 2003). Skeem
and Cauffman (2003) reported that the PCL:YV possesses adequate 1-month testretest
reliability. Total scores on the PCL:YV correlate moderately with scores on other measures
of psychopathy and related syndromes, including the Interpersonal Measure of Psychopathy
(IM-P; Kosson, Steuerwald, Forth, & Kirkhart, 1997) and the Antisocial Processes
Screening Device (McBride, 1998; Murrie & Cornell, 2002) and with total scores on self-
report measures as well as with number of conduct disorder symptoms (Forth et al., 2003)
in adolescent male samples.2 In addition, PCL:YV scores correlate with violent and
nonviolent criminal behavior, instrumental violence, institutional violence, and recidivism
(Corrado, Vincent, Hart, & Cohen, 2004; Flight & Forth, 2007; Gretton, Hare, & Catchpole,
2004; Murrie, Cornell, Kaplan, McConville, & Levy-Elkon, 2004). Moreover, PCL:YVscores evidence unique correlations with antisocial behavior criteria after controlling for
other disruptive behavior disorder symptoms (Salekin, Neumann, Leistico, DiCicco, &
Duros, 2004). Although findings are less consistent than in adult samples, psychopathic
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968 CRIMINAL JUSTICE AND BEHAVIOR
features in male adolescents are reportedly associated with several other forms of
psychopathology, including alcohol and drug use (Epstein, Douglas, Poythress, Spain, &
Falkenbach, 2002), attention-deficit/hyperactivity disorder (ADHD; Colledge & Blair,
2001; Kaplan & Cornell, 2004; Kosson et al., 2002), and externalizing behaviors in general
(Schmidt, McKinnon, Chattha, & Brownlee, 2006).
In contrast, differences between adults and youth with psychopathic traits have been
reported with respect to indices of internalizing psychopathology. Whereas psychopathy
scores in adult samples have correlated negatively with indices of depression and anxiety
disorders (Lovelace & Gannon, 1999; Stalenheim & von Knorring, 1996), PCL:YV scores
have been reported to be uncorrelated with diagnoses and self-reports of depression
(Epstein et al., 2002; ONeill, 2001). Moreover, relations between PCL:YV scores and self-
reported anxiety have been discrepant across samples, ranging from positively correlated
(Kosson et al., 2002) to uncorrelated (Epstein et al., 2002; ONeill, 2001) to negatively
correlated (Dolan & Rennie, 2007; Murrie & Cornell, 2000). A recent community studyreported that PCL:YV scores were positively correlated with ratings of internalizing
behavior problems (Schmidt et al., 2006). However, these relationships have not previously
been investigated in female youth.
FACTOR STRUCTURE OF THE PCL:YV
Preliminary evidence suggests that the factor structure of the PCL:YV is similar to that
reported for the PCL-R. Adult samples have demonstrated good fit for both a three-factor
model comprising interpersonal, affective, and impulsive and irresponsible lifestyle
dimensions and a four-factor model that also includes unusual and prodigious antisocialbehavior (Cooke & Michie, 2001; Neumann, Hare, & Newman, 2007; Vitacco, Rogers,
Neumann, Harrison, & Vincent, 2005). Recent studies of adolescents have indicated that
both the three- and four-factor models provide good fit in large samples of incarcerated
adolescent males assessed with the PCL:YV (Neumann, Kosson, Forth, & Hare, 2006).
Jones, Cauffman, Miller, and Mulvey (2006) also suggested that, with slight modifications,
the three- and four-factor models provided equally good fit in both girls and boys. Although
Sevecke, Pukrop, Kosson, and Krischer (2009) reported that neither model provided
consistently good fit in a sample of female German adolescents, Kosson et al. (2011)
reported acceptable fit for both the three- and four-factor models in a large sample of
adolescent females.
THE CURRENT STUDY
The current study was designed to assess the reliability and validity of psychopathy as
assessed by the PCL:YV in a sample of incarcerated female adolescent offenders. The study
had several goals. First, the reliability of the instrument was examined. Specifically, the
internal consistency and interrater reliability of PCL:YV scores were calculated. Second,
the construct validity of PCL:YV scores was assessed by examining relationships between
psychopathic features and external criteria in several domains. We examined correlationsbetween PCL:YV ratings and scores on the IM-P and number of conduct disorder (CD)
symptoms. We examined correlations between PCL:YV scores and several measures of
antisocial behavior: criminal activity, violence proneness, age of onset of criminal behavior,
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and institutional misconduct. On the basis of prior research with adolescent males, we
expected PCL:YV scores to be positively associated with IM-P scores, number of CD
symptoms, and violent and nonviolent criminal activity but negatively correlated with age
of onset of criminal behavior.
Construct validity was also addressed by examining relations between PCL:YV scores
and symptoms of other forms of psychopathology and pathological personality traits. We
predicted that PCL:YV scores would correlate positively with number of ADHD symptoms
and alcohol and substance use disorder symptoms but would be uncorrelated or negatively
correlated with scores on measures of depression (Hare, 1991; Hare, Hart, & Harpur, 1991;
Harpur, Hare, & Hakstian, 1989; Hart, Forth, & Hare, 1990; Schmitt & Newman, 1999).
We predicted positive correlations between PCL:YV scores and scores on measures of
narcissism (Harpur et al., 1989; Shine & Hobson, 1997). We also examined fearlessness
(Levenson, Kiehl, & Fitzpatrick, 1995; Lykken, 1995). Although two studies with
adults suggested that fearlessness scores should correlate negatively with psychopathictraits (Levenson et al., 1995;Verona, Patrick, & Joiner, 2001), not all studies have replicated
this association (Schmitt & Newman, 1999). As noted above, prior studies of adolescent
males have reported a wide variety of findings with measures of anxiety and fear. Thus, no
predictions were made with regard to relationships between PCL:YV scores and anxiety or
fearlessness scores.
The third goal of the study was to examine whether the associations between psychopathic
traits and the aforementioned criteria could be attributed to overlap between psychopathic
traits and disruptive behavior disorder symptoms. Consequently, we examined whether these
relationships were evident even after controlling for symptoms of ADHD and CD. If the
relationships between psychopathic traits and antisocial behavior and psychopathology
are as robust among females as among males, then PCL:YV scores should be uniquely
predictive of the pattern of antisocial behavior and psychopathology. Finally, given that
prior studies have yielded generally good fit for the three-factor model in independent
samples of adolescent females, we also reported correlations between these PCL:YV factor
scores and external criteria in supplementary analyses.
METHOD
PARTICIPANTS
Participants were 80 females incarcerated at an Illinois correctional facility for youth
offenders. Participants ranged in age from 14 to 19. Fifty-two of the girls (65%) were
European American, 20 (25%) were African American, 6 (7.5%) were Latina, and 2 (2.5%)
were classified as Other. Socioeconomic status information was unavailable at the time of
assessment. The mean age of the participants was 16.2. (See Table 1 for demographic data.)
MATERIALS
The PCL:YV.The PCL:YV (Forth et al., 2003)was used to assess psychopathic traits.
The PCL:YV differs from the PCL-R in that item content and scoring procedures were
modified to reflect the contexts in which adolescents function and the differences in the
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970 CRIMINAL JUSTICE AND BEHAVIOR
expression of relevant dispositions at different ages and to direct raters to compare each
participants behaviors with norms for her or his age or peer group. Like the PCL-R, the
PCL:YV was designed to assess the behavioral, interpersonal, and affective components ofthe psychopathy construct on the basis of a semistructured interview and collateral
information from institutional files. Each item is scored on a 3-point scale (0 to 2), where
2 indicates that the disposition or trait generally applies to the participant, 1 indicates that
the disposition applies to some extent, and 0 indicates that the disposition does not apply.
Item scores are summed to yield total scores ranging from 0 to 40. Prior studies have
indicated good internal consistency and interrater agreement for PCL:YV total (and factor)
scores (Forth et al., 2003). Raters for this measure included several graduate students given
intensive PCL:YV training by one of the authors (DSK). Where interrater agreement was
computed, it was based on independent observation of the same interview and an independent
review of the participants file information.
The Kiddie Schizophrenia and Affective Disorders ScaleEpidemiological Version
(K-SADS-E).The K-SADS-E (Kaufman, Birmaher, Brent, Rao, & Ryan, 1994) is the child
and adolescent version of the Schizophrenia and Affective Disorders Scale (Endicott &
Spitzer, 1978), a measure of major psychiatric illness. The K-SADS-E interview was
modified to be compatible with diagnostic criteria listed in the Diagnostic and Statistical
Manual of Mental Disorders(3rd ed., rev.;DSM-III-R; American Psychiatric Association,
1987), which was the latest DSM version published at the beginning of this study. The
interview assesses the following disorders: ADHD, anxiety disorders, CD, oppositionaldefiant disorder (ODD), major depressive disorder, dysthymia, eating disorders, and
substance use disorders. Prior studies have reported high interrater agreement for diagnoses
based on the K-SADS-E (Ambrosini, 2000).
Beck Depression Inventory (BDI).The BDI (Beck & Ward, 1972) is a widely used self-
report instrument designed to assess symptoms of depression, and BDI scores are internally
consistent (coefficient alpha of .86 for psychiatric patients and .81 for nonpsychiatric
patients) and correlate highly with diagnoses of depression in various samples (Subramaniam,
Harrell, Huntley, & Tracy, 2009). It has been reported to be valid for use in adolescent
samples (Krefetz, Steer, Gulab, & Beck, 2002) and appears to perform better at screeningdepressive symptoms than some other self-report measures (Atlas & DiScipio, 1992).
Harm Avoidance Scale (HAS). The HAS (Tellegen, 1982) is a self-report fearfulness
subscale from the Multidimensional Personality Questionnaire (Tellegen, 1982). It was
TABLE 1: Sample Characteristics
Measure n M SD
PCL:YV total score 80 25.18 5.88
Number of charges for any offense 79 6.23 3.39
Number of charges, violent offenses 79 1.67 1.65
Age of first charge, any offense (years) 79 13.34 1.55
Age of first charge, violent offense (years) 57 12.53 4.06
Number of institutional infractions 79 9.92 21.27
Number of violent institutional infractions 79 1.10 2.80
Note. PCL:YV =Psychopathy Checklist: Youth Version (Forth, Kosson, & Hare, 2003).
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designed to assess fearfulness, as opposed to neuroticism, and is related to a lack of risk
taking. HAS scores correlate highly with indices of fear proneness and behavioral inhibition
but are independent of trait anxiety (Watson & Clark, 1984; White & Depue, 1999). Levenson
et al. (1995) reported high internal consistency of HAS scores (alpha coefficient = .87)
among college students.
Welsh Anxiety Scale (WAS). The WAS of the Minnesota Multiphasic Personality
Inventory (Welsh, 1956) is a self-report scale that has been widely used to measure
anxiety in studies of adult psychopathy. Although originally interpreted as a measure of
trait anxiety, it is typically considered a measure of neuroticism or negative affectivity
(Watson & Clark, 1984). The measure assesses five dimensions of anxiety-related symptoms,
including poor mental efficiency, negative affect, pessimism and anhedonia, interpersonal
oversensitivity, and schizoid mentation (Welsh, 1956). Split-half reliability coefficient
of the assessment was .88 (Welsh, 1956).
Anxiety Sensitivity Index (ASI). The ASI (Reiss, Peterson, Gursky, & McNally, 1986) is
a self-report scale designed to measure the tendency to react negatively to the experience
of anxiety symptoms. ASI scores exhibit good psychometric properties (Reiss et al., 1986).
Although no prior studies have examined relationships between psychopathy and ASI
scores in youth, Hale, Goldstein, Abramowitz, Calamari, and Kosson (2004) reported that
PCL-R and ASI scores are not correlated in adults. High internal consistency and acceptable
test-retest reliability across 2-week (Reiss et al., 1986) and 3-year intervals (Maller &
Reiss, 1992) has been reported. The internal consistency of the ASI for the present sample
was high (=.86).
Intellectual functioning. The Wechsler Intelligence Scales for ChildrenThird Edition
(Wechsler, 1991) and the Wechsler Adult Intelligence ScaleRevised (WAIS-R; Wechsler,
1981) are well-established measures of intelligence used to assess cognitive functioning in
children ages 6 to 16 and ages 16 and older, respectively. The current study used only the
Vocabulary and Block Design subtests. Previous investigations have used WAIS-R subtest
standard scores to estimate intelligence in adult offenders (e.g., Weizman-Henelius,
Viemero, & Eronen, 2004).
The Peabody Picture Vocabulary TestRevised (PPVT-R).The PPVT-R (Dunn & Dunn,
1981) is a 10- to 15-min measure of receptive vocabulary skills for standard English and
screens for verbal ability in persons ages 2.5 to 40. The PPVT-R requires no reading or
writing. The PPVT-R has been used in previous investigations with adjudicated youth (e.g.,
Linz, Hooper, Hynd, Isaac, & Gibson, 1990). Although there appear to be no prior studies
of the relation between PPVT-R scores and psychopathic traits, PPVT-R scores are
correlated with measures of achievement (Naglieri & Pfeiffer, 1983; Smith, Smith, &
Dobbs, 1991).
Narcissistic Personality Inventory (NPI).The NPI (Raskin & Hall, 1981) is a widelyused self-report measure of narcissism. It has been reported to exhibit adequate reliability
and moderate correlations with other self-report and interview measures of narcissistic
personality disorder (Emmons, 1987; Raskin & Terry, 1988). It is a 40-item forced-choice
measure. Scores on the NPI are internally consistent (=.87).
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972 CRIMINAL JUSTICE AND BEHAVIOR
CD symptoms. Symptoms of CD, according to DSM-IVcriteria (American Psychiatric
Association, 1994), were assessed via semistructured interview as well as a comprehensive
review of each participants institutional file.
Violence proneness and criminal activity.Interviews and institutional file reviews wereused to code three aspects of violence proneness: number of charges for violent offenses,
age at first charge for a violent offense, and number of violent institutional infractions.
Consistent with prior studies, robbery, assault, murder, sexual assault, and kidnapping
were classified as violent offenses (Hare & McPherson, 1984; Kosson et al., 2002). Drug
offenses, burglary or theft, fraud, escape, arson, obstruction of justice, and miscellaneous
minor offenses were classified as nonviolent offenses. With respect to institutional
infractions, threats and assaults were considered violent; the remainder of infractions
consisted of rule violations, insubordination, theft, and lying to officials. The age at which
participants were first officially charged with any criminal act was also coded frominstitutional files.
PROCEDURES
Eligible females were invited to meet with the experimenter (DLB) to learn about the
study. Females taking psychotropic medication were not eligible to participate in the study,
given concern about the effects of medications on results of neuropsychological tasks
unrelated to the current study. Following an explanation of the protocol by the first author,
each individual was presented with the opportunity to assent to participation. Participation
was voluntary and confidential. If an adolescent agreed, consent from her parent or legal
guardian was requested by telephone, followed by request for written consent through the
mail. Oral consent was witnessed and documented in writing. These procedures were
approved by the institutional review board of Finch University of Health Sciences (now
Rosalind Franklin University of Medicine and Science). Individuals were paid a total of
$10 to $15 for their participation.
During the morning, participants completed a series of neuropsychological tests and an
emotional processing task (see Bauer, 1999, for additional details). The interview and
all questionnaires were administered during the afternoon session. Each participants
institutional file was reviewed after testing was completed to obtain collateral informationabout her criminal history and behavioral history at the institution as well as to assess the
consistency of interview and file material. Fifteen percent of interviews were observed by
the third author or one of three other graduate students trained by the third author.
Statistical procedures.To reduce the number of analyses, the sample prevalence of
each disorder assessed with the K-SADS-E was evaluated prior to conducting analyses.
Relationships between psychopathic features and presence of specific psychiatric
disorders were examined only for disorders with base rates of 10% or higher (Tabachnick
& Fidell, 2001). In addition, relationships between psychopathic features and total
number of psychiatric diagnoses were examined. Because 85% of participants metcriteria for CD, CD was excluded from analyses addressing the total number of psychiatric
illnesses.
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RESULTS
DESCRIPTIVE INFORMATION AND RELIABILITY OF PCL:YV SCORES
The mean PCL:YV total score for the sample was 25.18 (SD=5.88). Neither skewnessnor kurtosis appeared to be evident (skewness =.05; kurtosis =.88). Interrater reliability
for PCL:YV total scores was assessed for 15% of the cases by computing intraclass
correlation coefficients (ICCs) using the one-way random effects model to obtain an
average intraclass r as a measure of absolute agreement between raters. The ICC for
prorated PCL:YV total scores was .95, suggesting good interrater agreement. This value is
slightly higher than that reported in prior PCL-R and PCL:YV studies (Forth et al., 2003;
Hare, 1991). Coefficient alpha for PCL:YV scores was .82, similar to that previously
reported for the PCL-R and PCL:YV (Edens et al., 2001; Hare, 1991; Kosson, Smith, &
Newman, 1990). Corrected item-to-total correlations for each PCL:YV item also suggested
adequate internal consistency: All of these exceeded .20 except that for Item 19, which was.19. All items were retained for further analyses.
CONSTRUCT VALIDITY
To ensure that correlations with external criteria were not inflated by direct overlap
between PCL:YV scores and criterion measures, scores on PCL:YV items likely to overlap
with criterion measures were subtracted before calculating validity correlations. Following
Kosson et al. (2002), scores on PCL:YV Items 12 and 18 (early behavior problems and
serious criminal behavior) were deleted before calculating correlations between PCL:YV
scores and number of CD symptoms and age of onset of criminal and violent behavior.
Analyses of criminal activity and institutional misconduct corrected PCL:YV scores for
Items 10, 18, and 20 (poor anger control, serious criminal behavior, and criminal versatility).
Where observers were present, averages of interviewer and observer PCL:YV scores were
used in calculating correlations between PCL:YV scores and criterion variables.
Psychopathy and related constructs.As expected, PCL:YV scores correlated highly
with IM-P scores, r=.53,p
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974 CRIMINAL JUSTICE AND BEHAVIOR
the number of violent infractions, r=.38,p=.001, and with the total number of behavioral
infractions, r=.43,p
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the sum total), no relationship between PCL:YV scores and number of diagnoses emerged
(r=.06, ns; see Table 3).
PERSONALITY TRAITS
Total PCL:YV scores and NPI scores were correlated although not significantly, r=.21,
p=. 07 (see Table 2). No relationship between PCL:YV and HAS scores was found (see
Table 2).
INTELLIGENCE AND RECEPTIVE VOCABULARY
Psychopathic traits were unrelated to measures of intelligence. Neither the correlation
with scaled scores for the Vocabulary subtest or that for the Block Design subtest
approached significance, both rs
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976 CRIMINAL JUSTICE AND BEHAVIOR
institutional infractions, r=.35,p
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TABLE 4: Correlations Between PCL:YV Factor Scores and Measures of Concurrent, Convergent, and
Discriminative Validity
Variable Interpersonal Affective Lifestyle za
Measures commonly associated with psychopathic features
IM-P .51*** .37** .33**
Total number of CD symptoms .38*** .39*** .50***
Number of violent charges .21 .32**a .082 2.20
Total number of charges .22* .22* .23*
Age at first violent charges .03 .23 .14
Age at first charges .23* .30** .18
Number of violent infractions .38***a .32** .11b 2.17
Total number of infractions .39***a .36***a .08b 2.48, 2.58
ADHD .29**a .10a .52***b 2.00, 4.02
ODD .01 .06a .27*b 2.81
Alcohol dependence .15 .03a .32**b 2.641
Drug dependence .17 .02
a
.24*
b
1.99 NPI .20 .20 .12
Measures considered independent of or inversely
associated with psychopathic features
Major depression .12a .06a .33**b 3.49, 3.52
Dysthymic disorder .02 .02 .16
PTSD .14 .03 .06
Psychotic symptoms .10 .00 .20
Beck Depression Inventory .07a .00a .41***b 3.78, 3.77
Harm avoidance .12 .02 .03
Anxiety Sensitivity Index .02 .03 .17
Welsh Anxiety Scale .10a .06a .49***b 3.19, 4.03
Total psychiatr ic disordersb
.12b
.01a
.53***b
3.24, 4.80 PPVT-R .14 .34**a .05b 2.62
BDS .07 .11 .05
VOCS .06 .13 .04
Note. PCL:YV = Psychopathy Checklist: Youth Version (Forth, Kosson, & Hare, 2003); IM-P = InterpersonalMeasure of Psychopathy (Kosson, Steuerwald, Forth, & Kirkhart, 1997); CD = Conduct disorder; ADHD =attention-deficit/hyperactivity disorder; ODD = oppositional defiant disorder; NPI = Narcissistic PersonalityInventory (Raskin & Hall, 1981); PTSD =posttraumatic stress disorder; PPVT-R =Peabody Picture VocabularyTestRevised (Dunn & Dunn, 1981); BDS =Block Design scaled score; VOCS =Vocabulary scaled score (seetext for additional detail).a. Columns with different superscripts denote significant differences between the magnitude of correlations fordifferent PCL:YV factors. Z scores are significant values for the z test for dependent correlations, p
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978 CRIMINAL JUSTICE AND BEHAVIOR
Douglas, Poythress, & Epstein, 2004) as well as similar to that reported by Odgers et al.
(2005) for a sample of incarcerated adolescent females (M=24.7, SD=5.2, vs. current
M=25.18, SD=5.88).Consistent with prior studies using the PCL:YV,reliability statistics
indicate that it is possible for trained raters to obtain very high interrater agreement for
PCL:YV total scores in an adolescent female sample.
CONSTRUCT VALIDITY
Regarding convergent validity, PCL:YV scores correlated highly with IM-P scores,
suggesting a link between PCL:YV scores and interpersonal manifestations of psychopathy
analogous to that previously reported in adult males using the PCL-R and in adolescent
males using the PCL:YV. Although more than 80% of the current sample met diagnostic
criteria for CD, PCL:YV scores were highly correlated with number of CD symptoms,
suggesting that female youth with more psychopathic traits demonstrate more severe
conduct problems than do peers with fewer psychopathic traits. Whether psychopathic
traits moderate the persistence of antisocial behavior into adulthood among girls with CD
symptoms is an important question for future studies.
ANTISOCIAL BEHAVIOR AND VIOLENCE
Consistent with evidence suggesting that adults with psychopathic traits begin committing
crimes at earlier ages and commit more crimes than other offenders (Forth et al., 2003),
current findings indicate that among adolescent females, psychopathic traits were associated
with an earlier age of onset of criminal charges and with the total number of charges.Although the zero-order correlation between PCL:YV scores and age of onset of violent
charges was not significant (after correcting for item scores likely to overlap substantially
with measures of violent crime), the corresponding partial correlation was significant after
controlling for disruptive behavior disorder scores. This pattern of findings is largely
consistent with prior findings on adolescent males (Forth et al., 2003; Salekin, 2008).
Interestingly, though, the correlation between psychopathy and number of violent
charges was not significant (after controlling for predictor-criterion overlap) in this sample.
As this result is inconsistent with previous research, it is important to consider possible
reasons for this pattern of results. One possibility is that the significant correlation reported
in some prior studies reflects a failure to correct for predictor-criterion overlap whenexamining relations between psychopathic features and violence proneness. For example,
Penney and Moretti (2007) reported significant correlations between psychopathic features
and self-reported aggressive behavior in both males and females, but they did not correct
PCL:YV scores for overlap with aggression. However, Corrado et al. (2004) did correct for
predictor-criterion overlap and nevertheless reported significant relationships between
psychopathic traits and violent recidivism in a mixed youth sample composed of 79%
males. In contrast, Odgers et al. (2005) found that corrected PCL:YV scores predicted
concurrent but not future aggression; moreover, the relationship for concurrent aggression
was no longer significant after controlling for victimization experiences. Thus, it could beargued that the relationship between psychopathic traits and violent charges is robust in
males but not in females. Alternatively, it could be argued that the absence of a relationship
between PCL:YV scores and number of violent charges in the current sample may reflect
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a lower base rate of violent charges in this sample compared to other samples. Unfortunately,
given the variation in the operationalization of violent acts in different studies (e.g., violent
convictions from file review vs. self-reported violent charges), it is not possible to compare
the base rates of violent acts in prior investigations with those in the current sample. That
said, the base rate for violent infractions in our study was lower than the base rate for
violent charges, and violent infractions were significantly correlated with PCL:YV scores.
Psychopathic features were associated with greater numbers of violent and total
institutional infractions, suggesting that females with psychopathic features continue to
violate rules and expectations, despite the extreme structure and regulation associated with
incarceration. This finding is consistent with prior research on adults with psychopathic
features in prisons (e.g., Edens, Buffington-Volum, Colwell, Johnson, & Johnson, 2002)
and hospitals (Hildebrand, de Rutter, & Nijman, 2004) as well as with some prior findings
with adolescent males (Stafford & Cornell, 2003). This suggests the possibility that such
youth may be less responsive than other adolescent inmates to the interventions anddisciplinary methods employed in correctional settings. However, a recent report that
incarcerated adolescent males with psychopathic traits exhibited poorer behavior during
treatment but benefited from an intervention program suggests the possibility that
proneness to institutional infractions does not necessarily presage poor prognosis (Caldwell
et al., 2007). Nevertheless, it must be noted that prior findings with adolescents have been
inconsistent(Edens & Campbell, 2007), suggesting that there may be more variability to
this relationship in youth than in adult samples.
PSYCHOPATHOLOGY AND INTERNALIZING SYMPTOMS
The relatively high proportion of psychiatric disorders in our sample is consistent with
the high prevalence rates for psychiatric disorders reported previously for incarcerated
adult female samples (Abram, Teplin, McClelland, & Dulcan, 2003; Teplin, Abram, &
McClelland, 1996) as well as for incarcerated adolescents (Odgers, Burnette, Chauhan,
Moretti, & Reppucci, 2005). Considering more specific relationships, PCL:YV scores
were moderately associated with ADHD diagnosis and modestly associated with alcohol
dependency diagnosis. These findings substantiate the commonly reported finding that
psychopathic traits are correlated with externalizing psychopathology in male and mixed-
gender adolescent samples (e.g., Kaplan & Cornell, 2004; Kosson et al., 2002; Schmidt
et al., 2006). The comorbidity of psychopathic traits with psychiatric disorders, such asalcohol dependence and ADHD, may contribute to some of the problems in adjustment to
incarceration associated with psychopathic features.
Interestingly, findings with respect to internalizing psychopathology and personality
traits were less consistent with prior adult findings but consistent with several prior studies
of adolescents. Specifically, whereas adult studies suggest negative correlations between
psychopathic features and diagnoses of depressive and anxiety disorders, there were no
significant relationships between PCL:YV total scores and diagnoses for internalizing
disorders. Similarly, PCL:YV scores were not significantly correlated with BDI, ASI, or
HAS scores. However, PCL:YV scores correlated positively with WAS scores, and anonsignificant correlation with BDI scores was positive (r = .16), corroborating the
possibility reported in some other studies of adolescent males that the relation between
psychopathic traits and internalizing psychopathology may be different in adolescents
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980 CRIMINAL JUSTICE AND BEHAVIOR
compared to adults (Kosson et al., 2002; Schmidt et al., 2006). In contrast, a recent
investigation of adolescent male offenders with CD (Dolan & Rennie, 2007) indicated a
negative correlation between trait anxiety and affective component scores. Although the
inconsistencies in the literature in this field may reflect a lack of consistency with regard
to anxiety measures and/or heterogeneity of samples investigated, the current results
corroborate that additional research with youth samples is necessary to determine the
nature of the relationship between psychopathic traits and negative affectivity in juveniles.
Indeed, it is possible that youth characterized by a greater proportion of psychopathic traits
may experience more distress in general and during their incarceration than their adult
counterparts with more long-standing legal histories. Alternatively, given that several
studies of adults have identified subtypes among offenders described as primary psychopaths
and secondary psychopaths (Hicks, Markon, Patrick, Krueger, & Newman, 2004; Vassileva,
Kosson, Abramowitz, & Conrod, 2005), it is possible that the apparent discrepancies in
findings reflect differences across samples with regard to proportions of youth characterizedby primary psychopathy versus secondary psychopathy syndromes.
Overall, the pattern of relationships between PCL:YV scores and indices of antisocial
behavior was similar before and after controlling for disruptive behavior disorder symptoms.
Similar correlations were observed for IM-P scores, for CD symptoms, for violent and
nonviolent infractions, and for age of onset of criminal behaviors. Findings were somewhat
weaker for relationships between psychopathic traits and indices of externalizing and
internalizing psychopathology, suggesting that the comorbidity between psychopathic traits
and other externalizing disorders may account for some of the relationships between
PCL:YV scores and symptoms of substance use disorders and negative affectivity.
However, unique relationships between psychopathic features and narcissism scores and
age of first violent offense were significant, whereas the zero-order correlations with these
criteria had fallen short of significance.
SUPPLEMENTARY ANALYSES OF FACTOR SCORE CORRELATIONS
The correlations between factor scores and external criteria were also largely consistent
with prior findings on both adolescent and adult males. First, correlations between factor
and criterion scores suggest that both interpersonal and affective dimensions contribute to
the utility of the psychopathy construct. Scores on both dimensions were significant (cross-
sectional) predictors of antisocial behavior and comorbid psychopathology. Consistent with
previous research with males (e.g., Corrado et al., 2004), scores on these two dimensions
predicted scores on different violence indices. Whereas affective dimension scores were
especially associated with the number of charges for violent crimes, consistent with Penney
and Moretti (2007), only interpersonal dimension scores were associated with the number
of violent institutional infractions. Nevertheless, the pattern of correlations was moderately
similar for the affective and interpersonal components of psychopathy, as scores on both
dimensions appear to be related to antisocial behavior. Most of the differences observed in
relationships with specific forms of psychopathology were between the correlation for the
affective or interpersonal factor scores (or both) and the correlation for lifestyle dimensionscores.
For both externalizing and internalizing forms of psychopathology, correlations were
generally stronger for lifestyle dimension scores than for interpersonal and affective
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dimension scores. With respect to externalizing psychopathology, lifestyle scores were
stronger predictors of ADHD, ODD, and alcohol and other drug dependence diagnoses.
Regarding internalizing psychopathology, lifestyle scores were better predictors of major
depression diagnoses, of BDI scores, and of negative affectivity (WAS) scores. These
findings suggest that at least in this sample, lifestyle scores are generally predictive of
psychopathology.
Relevant to the current results, Rutherford, Alterman, Cacciola, and McKay (1998)
reported gender differences in relationships between factor scores and criterion variables in
adult offenders. They noted that the relationship between Factor 1 and a history of CD was
less consistent for women than for men. In contrast, in this sample, relationships between
number of CD symptoms and scores on the interpersonal and affective factors were as
strong as the relationship between CD symptoms and lifestyle scores.
COMMENT ON PREDICTIVE VALIDITY
As noted earlier, Odgers et al. (2005) reported that PCL:YV scores in a female adolescent
sample were not predictive of future violent criminal activity. Similarly, Schmidt et al.
(2006) and Vincent et al. (2008) reported that PCL:YV scores were less predictive of
violent recidivism among female than among male adolescents. Unfortunately, because
prospective data were not available in the current study, this relationship could not be tested
with this sample. However, because the current study is one of only a few investigations to
date that focus exclusively on adolescent female offenders, replication of current findings
in independent samples and extensions to examinations of predictive validity are critical.
Although several recent studies with adolescents included female youth (Andershed,Hodgins, & Tengstrom, 2007; Penney & Moretti, 2007; Salekin et al., 2004), most prior
studies included only males (Corrado et al., 2004; Kosson et al., 2002; Murrie & Cornell,
2002; Spain et al., 2004) or examined mixed samples without addressing gender differences
(e.g., Falkenbach et al., 2003).
LIMITATIONS OF THE CURRENT STUDY
One of the chief limitations of the current study is the relatively small sample size.
Although 80 participants appear ample for examining correlations, this sample is smaller
than some samples examined among male adolescents (e.g., Corrado et al., 2004; Murrie
et al., 2004). In spite of the small sample, the pattern of significant relationships was quite
similar to that previously reported in adolescent males.
A related weakness was that to avoid reducing statistical power, we did not correct for
the number of correlations calculated. As a result, it is possible that some of the relationships
noted here reflect alpha inflation. We believe it is important to seek a balance between
statistical power and conservatism. In this context, we note that had we used a more
conservative alpha level of .01, almost all the correlations reported here would have
remained statistically significant. However, the exceptionsrelationships between PCL:YV
scores and WAS scores and alcohol dependencyreflect relatively small effects andshould be viewed as tentative pending replication in other female samples. Even so, it is
noteworthy that similar correlations with alcohol use (Mailloux, Forth, & Kroner, 1997)
and with negative affectivity scores (e.g., Kosson et al., 2002; Sevecke, Kosson, Lehmkuhl,
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982 CRIMINAL JUSTICE AND BEHAVIOR
& Krischer, 2009; cf. Schmidt et al., 2006) have been reported in prior studies of adolescent
males and females. In fact, because our sample was modest in size, it is possible that some
correlations that were not statistically significant in our sample would have been significant
had we been able to test a larger number of participants. For this reason, further examination
of these relationships appears warranted.
Another salient weakness of this study is its limited generalizability. All participants were
females incarcerated in a medium-security facility. Inclusion of a community sample
(e.g., Forth & Burke, 1998) would have allowed for comparisons between delinquents and
nonadjudicated adolescents. It is crucial that such comparisons be made as well as that
larger, more diverse samples are studied. Moreover, adolescents receiving psychotropic
medications were excluded from analyses. Frequently, youth with frequent irritable mood
states and violent and aggressive tendencies receive medication in the community and in
correctional settings. Excluding youth receiving medication could result in a skewed sample
with fewer of the violent juvenile offenders who may exhibit psychopathic traits in additionto aggressive behaviors and other mental health problems. To assess the generalizability of
these results, future research should examine the construct of psychopathy in samples that
include more mentally ill adolescent offenders.
CONCLUSIONS
Overall, the results of the current study suggest that the construct of psychopathy is
meaningful in the current sample of adolescent female offenders. It is significant that many
of the findings regarding both reliability and construct validity of PCL:YV scores parallel
findings in studies of adult psychopathy and adolescent male offenders. Consistent with
data on adolescent and adult males (Epstein et al., 2002; Hare, 2003; Kosson et al., 1990;
Schmidt et al., 2006), psychopathic traits in the current adolescent female sample were
associated with a pervasive pattern of criminal behavior, interpersonal anomalies associated
with psychopathy, and externalizing psychiatric disorders. Although psychopathic features
were not linked to symptoms of certain psychiatric disorders, such as depression, in the
current sample, psychopathic features were associated with anxiety features, ADHD, CD,
and having more than one psychiatric disorder (after excluding CD). In sum,these data
suggest that the PCL:YV is useful in evaluating adolescent female offenders. Just as malepsychopathic offenders have demonstrated a more pervasive pattern of persistent and
violent criminal behaviors, female participants in the current study demonstrated a similar
pattern of early-onset criminal behaviors and more persistent difficulties adjusting to the
demands of incarceration. From a clinical perspective, these data are relevant in suggesting
that treatment programs informed by psychopathic traits among inmates may well be as
useful for young girls as they are for young boys. The links to early antisocial behavior and
externalizing disorders suggest the possibility that interventions with these youth should
begin at an early age and should target conduct and interpersonal problems. At the same
time, given the concerns that have been raised about the pejorative nature of the label
psychopathy, we believe caution is warranted in generalizing from the results of this studyuntil these findings are replicated in independent samples.
However, additional analyses of the factor structure underlying PCL:YV scores in larger
samples appear warranted (cf. Kosson et al., 2011). In addition, where current findings
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appear inconsistent with those of prior studies (e.g., the absence of correlations between
PCL:YV scores and violent offenses), analyses in independent samples are necessary to
examine the robustness of the findings reported here.
NOTES
1. Several studies have also been conducted in which adolescents were rated on the Psychopathy ChecklistRevised
(PCL-R) or slight modifications of the PCL-R. However, to avoid confusion, we have restricted our literature review to
studies employing measures designed for use with adolescents. Nevertheless, findings from studies with the modified PCL-R
appear consistent with the suggestion that psychopathic features can be assessed in adolescents (e.g., Forth, Hart, & Hare,
1990; Roussy & Toupin, 2000).
2. Self-report measures of psychopathic traits have also yielded findings similar to those for the Psychopathy Checklist:
Youth Version (PCL:YV) in several studies; however, some studies have reported discrepancies between the correlates of
PCL:YV ratings versus scores on self-report measures (Lee, Vincent, Hart, & Corrado, 2003; Spain, Douglas, Poythress, &
Epstein, 2004; Vitacco, Rogers, & Neumann, 2003). It is noteworthy that PCL:YV total and factor scores correlate
significantly with scores on self-report measure, but analogous factor score correlations are generally not very high (e.g.,
Cauffman, Kimonis, Demetrieva, & Monahan, 2009; Spain et al., 2004).
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Daliah Bauer,PhD, is the director of forensic services at Jefferson Parish Human Services Authority in Louisiana. She is
also an adjunct faculty member at the University of New Orleans and Tulane University. Her work focuses on personality
development in adolescence and application of evidence based treatments in community settings.
Lindsay Allen Whitman, PhD, is a neuropsychology postdoctoral fellow at the Comprehensive Epilepsy Center at New York
University. She conducts comprehensive neuropsychological evaluations with children and adults with a variety of neurological
and psychiatric disorders. Her graduate research focused on the cognitive correlates of psychopathy in adolescents.
David S. Kosson, PhD, is a professor of psychology at Rosalind Franklin University of Medicine and Science. He studies
psychopathy and other personality disorders with primary foci on cognitive, affective, physiological, and developmental
mechanisms underlying psychopathy.