Understanding the affective and cognitive components of psychopathy: Developing a new assessment

Abstract

This PhD aimed to understand the construct of psychopathy from an expert perspective and gain consensus on the fundamental components of the disorder. To assist with this, the research aimed to develop, refine and evaluate a new self-report measure of psychopathy that was in agreement with experts and captured the core aspects of the disorder relating to cognitive and affective functioning. The research also aimed to explore the role of implicit and explicit cognitive and affective processing in psychopathy, investigating how these processes present in the consensus definition and psychopathy defined through clinical measures. In doing so, the research aimed to further the understanding of implicit processing in psychopathy and current, more explicit, approaches to measurement.

Study one comprised a review of the relevant literature and an expert Delphi survey. Thirty-two experts participated in the Delphi survey and this was completed over three rounds. Experts agreed that psychopathy could be understood through interpersonal factors, behavioural characteristics, deficits in cognition and affect, and developmental factors. As predicted, experts gravitated towards the Psychopathy Checklist-Revised (PCL-R) definition of psychopathy and rated items relating to this as most important. It was also predicted that experts would capture the affective components of psychopathy in their understanding of the construct, but not cognition. Partial support was found for this. Nine items examining cognition and affect were included in a new self-report measure, the Psychopathic Processing and Personality Assessment (PAPA). This allowed for a theoretical understanding of the construct that extended to assessment.

Study two recruited 431 participants [310 university students (154 men and 156 women) and 121 male prisoners] to evaluate the new self-report measure of psychopathy and to determine its value when assessing psychopathic cognition and affect. It was predicted that the PAPA would be positively associated with an existing self-report measure of psychopathy (i.e. the Levenson Self-Report Psychopathy Scale; LSRP), negative cognitive schema, positive cognitive schema, and negative affect. This was supported. The LSRP also positively correlated with positive and negative cognitive schema, and negative affect, thus providing further support for predictions stating that psychopathy would correlate with these variables. Exploratory factor analysis extracted two components from the PAPA, which were underpinned by ‘dissocial tendencies’ and ‘negative views towards others’.

Study three involved an in-depth interview with 50 students and 41 psychiatric patients to allow for further exploration of cognitive and affective processing in psychopathy. All participants were men. As expected, analyses indicated that psychopathy defined by experts and clinical measures were predicted by explicit and implicit cognition and affect assessed via the Affect, Cognitive and Lifestyle Assessment (ACL). Implicit processing was also found to be influenced by levels of psychopathy, with those scoring high on the disorder demonstrating more deficits. Contrary to expectation, implicit and explicit affect appeared to perform differently across samples. Results suggest that psychopathy assessment would benefit from the inclusion of implicit measures to assess for psychopathic processing. Self-report, observation, collateral review and items that explore lifestyle were also deemed important when assessing for the disorder. An evaluation of the PAPA found it to have acceptable levels of reliability and validity.

The current research indicates that explicit and implicit cognitive and affective processing are integral aspects of psychopathy and need to be considered when assessing for the disorder. The research also points towards a change in the assessment of psychopathy, with the inclusion of different methods, such as implicit testing, interview, collateral review, self-report and observation to capture cognition and affect, and reduce the possibility of response bias.