Sexual offender treatment outcomes among psychopathy subtypes
| Pages | 161-173 |
| Published date | 17 September 2018 |
| Date | 17 September 2018 |
| DOI | https://doi.org/10.1108/JCRPP-11-2017-0035 |
| Author | Lindsay A. Sewall,Mark E. Olver |
| Subject Matter | Health & social care,Criminology & forensic psychology |
Sexual offender treatment outcomes
among psychopathy subtypes
Lindsay A. Sewall and Mark E. Olver
Abstract
Purpose –The purpose of this paper is to examine sexual offender treatment responses as a function of
psychopathy subtype.
Design/methodology/approach –Measures of sexual violence risk, treatment change and outcome
variables were coded ret rospectively on a sample of 86 high Psychopathy Check list-Revised (PCL-R)
scoring sexual offenders. Psychopathy subtypes were identified through cluster analysis of PCL-R
facet scores.
Findings –Two subtypes were identified labeled classic and aggressive. They were comparable in their
level of risk and need and did not differ in rates of treatment completion or change. The aggressive subtype
had higher rates of violent and general recidivism and higher frequencies of major mental disorder and
cognitive disability. Results of Cox regression survival analysis demonstrated that treatment-related
changes in risk were associat ed with reductions in violent r ecidivism for the aggressi ve, but not classic,
psychopathy variant .
Practical implications –Psychopathy is a heterogeneous syndrome. Moreover, psychopathic offenders
can demonstrate risk relevant treatment changes. PCL-R facet profiles have important responsivity
implications. However, not all psychopathic offenders fare poorly in treatment.
Originality/value –This is one of very few studies to examine treatment response and links to outcome
among psychopathic offenders, particularly as this relates to subtype.
Keywords Psychopathy, Treatment, Offenders, Risk, Crime prevention and reduction, PCL-R
Paper type Research paper
Psychopathy is a serious personality disorder characterized by a constellation of interpersonal,
affective and behavioral features (Hare, 2003). Interpersonally, psychopathic individuals are
superficial and charming, arrogant and grandiose, and pathologically deceitful and manipulative.
Affectively, psychopathic persons lack guilt and remorse, they are callous and lack empathy,
having only an intellectual appreciation for the anguish and suffering of others, and have deficits in
their capacity to form attachments and in their depth and range of emotional experience.
Behaviorally, psychopathic individuals exhibit a chronic antisocial lifestyle pattern, characterized
by impulsive, irresponsible and often criminal, behavior, beginning at an early age and
progressing throughout the lifespan. High scores on the assessment tool most frequently
used to assess psychopathy, the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991,
2003), are associated with a miscellany of troubling correlates including higher rates of
recidivism, including violence (Leistico et al., 2008), failure on conditional release (Hart et al.,
1988) and lengthier criminal careers (Olver and Wong, 2015).
Therapeutic pessimism also abounds in efforts to rehabilitate psychopathic offenders
(Salekin et al., 2010), with high ps ychopathy men tend ing to display less mot ivation for
treatment (Ogloff et al., 1990), fewer therapeutic gains (Olver et al., 2013), higher rates of
program attrition (Olver et al., 2011) and weaker working alliances, particularly in the emotional
bond with their th erapists (DeSorcy et al., 2017). The treatability of psychopathy remains a
contentious matt er, and a possible considerat ion may be in the heterogeneit y of this syndrome.
In short, there may b e multiple ways in which people can be psy chopathic, and this can have
implications for treatment.
Received 5 November 2017
Revised 27 March 2018
Accepted 9 July 2018
Lindsay A. Sewall is based at
Shift Psychological,
Calgary, Canada.
Mark E. Olver is Professor at
the Department of Psychology,
University of Saskatchewan
College of Arts and Science,
Saskatoon, Canada.
DOI 10.1108/JCRPP-11-2017-0035 VOL. 4 NO. 3 2018, pp.161-173, © Emerald Publishing Limited, ISSN 2056-3841
j
JOURNAL OF CRIMINOLOGICAL RESEARCH, POLICY AND PRACTICE
j
PAGE161
To continue reading
Request your trial