Psychopathic personality disorder (PPD) has important clinical and forensic implications. But much more effort has been devoted to assessing or diagnosing PPD than to explicating or defining it. In the first part of this paper, we describe the development of a conceptual model or "concept map" of PPD. Based on a systematic review of descriptions of PPD in the clinical and research literature, as well as consultation with subject matter experts, we identified key features of the disorder and translated them into 33 symptoms, presented as natural language (i.e., non-technical) trait descriptive adjectives or adjectival phrases. Each symptom in turn was defined by three synonymous adjectives or adjectival phrases. The 33 symptoms were grouped rationally to reflect six domains of personality functioning. In the second part of the paper, we discuss research completed and in progress intended to validate the CAPP conceptual model.

The Comprehensive Assessment of Psychopathic Personality (CAPP; Cooke, Hart, Logan, & Michie, 2004) is a new personality-based model and clinical assessment of psychopathy. This study was the first to examine the content validity of the English-language CAPP. Content validation is a crucial part of the development and refinement of any new instrument. Prototypical analysis was used to evaluate the representativeness of CAPP symptoms to the psychopathy construct in adults. Symptoms were rated by international mental health professionals (N = 132). Findings support good content validity of the CAPP, with most symptoms rated as highly representative of psychopathy. Domains relating to interpersonal style were particularly prototypical. Confirmatory factor analyses further suggested that CAPP domains are highly unidimensional. However, some CAPP symptoms may be weaker items in the model and further refinement is needed.

Work is increasingly complex, specialized, and interdependent, requiring coordination across roles, disciplines, organizations, and sectors to achieve desired outcomes. Relational coordination theory proposes that relationships of shared goals, shared knowledge, and mutual respect help to support frequent, timely, accurate, problem-solving communication, and vice versa, enabling stakeholders to effectively coordinate their work across boundaries. While the theory contends that cross-cutting structures can strengthen relational coordination, and that relational coordination promotes desired outcomes for multiple stakeholders, the empirical evidence supporting the theory has not previously been synthesized. In this article, we systematically review all empirical studies assessing the predictors and outcomes of relational coordination published from 1991 to 2019. We find evidence supporting the existing theory and discuss how that evidence supports expanding the theory from a linear structure–process–outcomes model to a dynamic model of change. An agenda for researchers and practitioners is proposed.

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Two studies examined the higher-order factor structure of DSM-IV personality disorders using the International Personality Disorder Examination in male forensic psychiatric patients. In Study 1 (N = 168), exploratory factor analysis at the level of individual personality disorder criteria indicated nine primary factors. Exploratory and confirmatory factor analyses of these first-order factors supported a hierarchical structure in which two of three second-order factors covaried to yield a third-order factor. The two resulting superordinate factors were labelled Anxious-Inhibited and Acting Out. In Study 2 (N = 160), we used exploratory and confirmatory factor analyses to test hypotheses of common dimensions underlying these superordinate factors of personality disorder and superordinate factors of the five-factor model of personality, dimensions of the interpersonal circle, and psychopathy. Of three common factors, one combined Anxious-Inhibited disorders, "neurotic introversion," and hostile-submission. The other two factors of Acting Out/ psychopathy and antagonism/hostile-dominance covaried to yield a superordinate factor. Possible substrates underlying two superordinate dimensions common to normal and abnormal personality were identified in the theoretical literature.

Even when patient-staff interactions are relatively brief, as in outpatient settings, high levels of relational coordination among interdependent workgroups contribute to positive outcomes for both staff and patients, and low levels tend to have the opposite effect. Clinical leaders can increase the expectation of positive outcomes for both staff and their patients by implementing interventions to strengthen relational coordination.