Abstract
Objective
The study aimed to examine the distribution of psychopathic traits in a representative household population to identify whether a transition point is reached on a continuum of psychopathy to indicate a ‘disease’ or categorical entity.
Method
Mixture Poisson distribution and epidemiological procedures were used to examine the distribution of the Psychopathy Checklist Screening Version (PCL:SV) score in a sample of 638 adults in households in Great Britain. Analysis aimed to identify a cut-off within the population using the distribution of continuous scores (mean and ½ SD) and validate a ‘probable’ psychopathy category using a scale of social and behavioural problems as an external validator.
Results
The distribution of psychopathy within the population was quasicontinuous, represented by a mixture of three-Poisson distributions with differing demography and comorbid Axis I and II psychopathology. Independent calculation indicated a cut-score at 11.8 on the PCL:SV. There was an exponential rise of associated social and behavioural problems at a transition point of 11.3. The prevalence of ‘probable’ psychopathy was 3.6% (95% CI = 2.3–5.5%) above this level.
Conclusions
The findings suggest a transition from a non-clinical to clinical state of psychopathy which can be defined categorically using a cut-off on the PCL:SV. The cut-off approximates to that previously recommended for identification of a case using the instrument. Above this critical level, individuals are at exceptional risk of compulsory care or incarceration due to multiple social and behavioural problems. Psychopathy should be considered for future inclusion in DSM-V and successfully combines both categorical and dimensional approaches to diagnosis.
Similar content being viewed by others
References
Alterman AI, Cacciola JS, Rutherford MJ (1993) Reliability of the revised psychopathy checklist in substance abuse patients. Psychol Assess 5:442–448
Babor TF, de la Fuente JR, Saunders J, Grant M (1992) AUDIT: the alcohol use disorders identification test: guidelines for use in primary healthcare. World Health Organisation, Geneva
Bebbington P, Nayani T (1994) The psychosis screening questionnaire. Int J Methods Psychiatr Res 5:11–19
Bolt D, Hare RD, Neumann CS (2007) Score metric equivalence of the PCL-R scores across North American and UK criminal offenders: a critique of Cook et al. (2005) and new analysis. Assessment 14(1):44–56
Chen F, Yang SQ (1997) Mixed Poisson distribution and it’s applications. Chin Health Stat 5:11–19
Cleckley H (1941) The mask of Sanity. Mosby, St Louis
Coid J, Yang M, Roberts A, Ullrich S, Moran P, Bebbington P et al. Prevalence and correlates of psychopathic traits in Great Britain. Int J Law Psychiatry (in press)
Coid J, Yang M, Tyrer P, Roberts A, Ullrich S (2006) Prevalence and correlates of personality disorder in Great Britain. Br J Psychiatry 188:423–431
Cooke DJ, Michie C (1999) Psychopathy across cultures: Scotland and North America compared. J Abnorm Psychol 108:58–68
Cooke DJ, Michie C, Hart SD, Hare RD (1999) Evaluating the screening version of the hare psychopathy checklist—revised (PCL:SV): an item response theory analysis. Psychol Assess 11:3–13
First MB, Gibbon M, Spitzer RL, William JBW, Benjamin L (1997) Structured clinical interviews for DSM-IV Axis-II personality disorders. American Psychiatric Press, WA
Hare RD (1985) Comparison of procedures for the assessment of psychopathy. J Consult Clin Psychol 53:7–16
Hare RD (1991) The hare psychopathy checklist—revised. Multi-Health Systems, Toronto
Hare RD (2003) The psychopathy checklist—revised technical manual. 2nd edn. Multi-Health Systems, Toronto
Harris GT, Rice ME, Quinsey VL (1994) Psychopathy as a taxon: evidence that psychopaths are a discrete class. J Consult Clin Psychol 62(2):387–397
Hart SD, Cox DN, Hare RD (1995) The hare psychopathy checklist: screening version. Multi-Health Systems Inc, New York
Hasselblad V (1966) Estimation of parameters for a mixture of normal distributions. Technometrics 8:431–444
Kendell RE, Brockington IF (1980) The identification of disease entities and the relationship between schizophrenia and affective psychoses. Br J Psychiatry 137:324–331
Kish L (1965) Survey sampling. Wiley, London
Lewis G, Pelosi AJ (1990) Manual of the revised clinical interview schedule (CIS-R). Institute of Psychiatry, London
Marcus DK, John SL, Edens JF (2004) A taxometric analysis of psychopathic personality. J Abnorm Psychol 113(4):626–635
Meehl PE (1995) Boostraps taxometrics: solving the classification problem in psychopathology. Am Psychol 50:266–275
Meehl PE, Golden R (1982) Taxometric methods. In: Kendall P, Butcher J (eds) Handbook of research methods in clinical psychology. Wiley, New York, pp 127–181
Meehl PE, Yonce LJ (1994) Taxometric analysis: I. Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure). Psychol Rep 74:1059–1274
Meehl PE, Yonce LJ (1996) Taxometric analysis: II. Detecting taxonicity using covariance of two quantitative indicators in successive intervals of a third indicator (MAXCOV procedure). Psychol Rep 78:1091–1227
van Os J, Verdoux H (2003) Diagnosis and classification of schizophrenia: Categories versus dimensions, distributions versus disease. In: Murray RM, Jones AB, Sussex E, van Os J, Cannon M (eds) The epidemiology of schizophrenia. Cambridge University Press, Cambridge, pp 364–410
Singleton N, Bumpstead R, O’Brien M, Lee A, Meltzer H (2001) Psychiatric morbidity among adults living in private households, 2000. The Stationery Office, London
Skilling TA, Harris GT, Rice ME, Quinsey VL (2002) Identifying persistently antisocial offenders using the hare psychopathy checklist and DSM antisocial personality disorder criteria. Psychol Assess 14:27–38
Stefanis NC, Hanssen M, Smivnis NK et al (2002) Evidence that three dimensions of psychosis have a distribution in the general population. Psychol Med 32:347–358
Stockwell T, Murphy D, Hodgson R (1983) The severity of alcohol dependence questionnaire: its use, reliability and validity. Br J Addict 78:145–155
Strube M (1989) Evidence for the Type in Type A behaviour. A taxometric analysis. J Pers Soc Psychol 56(6):972–987
Tanner JM (1989) Foetus into man. Castlemead Publications, Ware
WHO (1999) SCAN schedules for clinical assessment in neuropsychiatry, Version 2.1. In: Health DoM (ed) World Health Organisation, Geneva
Waller NG, Meehl PE (1998) Multivariate taxometric procedures: distinguishing types from continua. Sage, Newbury Park
Wing JK, Babor TF, Brugha T, Burke J, Cooper JE, Giel R et al (1990) SCAN: schedules for clinical assessment in neuropsychiatry. Arch Gen Psychiatry 47(6):586–593
Yang M (1983) A method of dissecting mixed samples for estimating the normal values of medicine. Chin J Prev Med 17:275
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Coid, J., Yang, M. The distribution of psychopathy among a household population: categorical or dimensional?. Soc Psychiat Epidemiol 43, 773–781 (2008). https://doi.org/10.1007/s00127-008-0363-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00127-008-0363-8