The PCL-R is used for indicating a dimensional score, or a categorical diagnosis, of psychopathy for clinical, legal or research purposes. It is rated by a mental health professional (such as a psychologist or other professional trained in the field of mental health, psychology, or psychiatry), using 20 items. Each of the items in the PCL-R is scored on a three-point scale according to specific criteria through file information and asemi-structured interview.
The scores are used to predict risk for criminal re-offense and probability of rehabilitation.
The current edition of the PCL-R officially lists three factors (1.a, 1.b, and 2.a), which summarize the 20 assessed areas via factor analysis. The previous edition of the PCL-R listed two factors. Factor 1 is labelled “selfish, callous and remorseless use of others”. Factor 2 is labelled as “chronically unstable, antisocial and socially deviant lifestyle”. There is a high risk of recidivism and mostly small likelihood of rehabilitation for those who are labelled as having “psychopathy” on the basis of the PCL-R ratings in the manual for the test, although treatment research is ongoing.
PCL-R Factors 1a and 1b are correlated with narcissistic personality disorder. They are associated with extraversion and positive affect. Factor 1, the so-called core personality traits of psychopathy, may even be beneficial for the psychopath (in terms of nondeviant social functioning).
PCL-R Factors 2a and 2b are particularly strongly correlated to antisocial personality disorder and borderline personality disorder and are associated with reactive anger, criminality, and impulsive violence. The target group for the PCL-R in prisons in some countries is criminals convicted of delict and/or felony. The quality of ratings may depend on how much background information is available and whether the person rated is honest and forthright.
Each of the 20 items in the PCL-R is scored on a three-point scale, with a rating of 0 if it does not apply at all, 1 if there is a partial match or mixed information, and 2 if there is a reasonably good match to the offender. This is said to be ideally done through a face-to-face interview together with supporting information on lifetime behavior (e.g. from case files), but is also done based only on file information. It can take up to three hours to collect and review the information.
Out of a maximum score of 40, the cut-off for the label of psychopathy is 30 in the United States and 25 in the United Kingdom. A cut-off score of 25 is also sometimes used for research purposes.
High PCL-R scores are positively associated with measures of impulsivity and aggression, Machiavellianism, persistent criminal behavior, and negatively associated with measures of empathy and affiliation.
|Factor 1||Factor 2||Other items|
|Facet 1: Interpersonal
Facet 2: Affective
|Facet 3: Lifestyle
Facet 4: Antisocial
Early factor analysis of the PCL-R indicated it consisted of two factors. Factor 1 captures traits dealing with the interpersonal and affective deficits of psychopathy (e.g., shallow affect, superficial charm, manipulativeness, lack of empathy) whereas factor 2 dealt with symptoms relating to antisocial behavior: (e.g., criminal versatility, impulsiveness, irresponsibility, poor behavior controls, juvenile delinquency).
The two factors have been found by those following this theory to display different correlates. Factor 1 has been correlated with narcissistic personality disorder, low anxiety, low empathy, low stress reaction and low suicide risk but high scores on scales of achievement and social potency. In addition, the use of item response theory analysis of female offender PCL-R scores indicates factor 1 items are more important in measuring and generalizing the construct of psychopathy in women than factor-2 items.
In contrast, factor 2 was found to be related to antisocial personality disorder, social deviance, sensation seeking, low socioeconomic status and high risk of suicide. The two factors are nonetheless highly correlated and there are strong indications they do result from a single underlying disorder. Research, however, has failed to replicate the two-factor model in female samples.
Researchers Cooke and Michie suggested, using statistical analysis involving confirmatory factor analysis, that a three-factor structure may provide a better model, with those items from factor 2 strictly relating to antisocial behavior (criminal versatility, juvenile delinquency, revocation of conditional release, early behavioral problems and poor behavioral controls) removed. The remaining items would be divided into three factors: arrogant and deceitful interpersonal style, deficient affective experience and impulsive and irresponsible behavioral style. Hare and colleagues have published detailed critiques of the three-factor model and argue that there are statistical and conceptual problems.
In the most recent edition of the PCL-R, Hare adds a fourth antisocial behavior factor, consisting of those factor-2 items excluded in the previous model. Again, these models are presumed to be hierarchical with a single, unified psychopathy disorder underlying the distinct but correlated factors.
The Cooke & Michie hierarchical three-factor model has severe statistical problems—i.e., it actually contains ten factors and results in impossible parameters (negative variances)—as well as conceptual problems. Hare and colleagues have published detailed critiques of the Cooke & Michie model. New evidence, across a range of samples and diverse measures, now supports a four-factor model of the psychopathy construct, which represents the interpersonal, affective, lifestyle, and overt antisocial features of the personality disorder.