In this review, we focus on two major influences on current conceptualizations of psychopathy: one clinical, with its origins largely in the early case studies of Cleckley, and the other empirical, the result of widespread use of the Hare Psychopathy Checklist-Revised (PCL-R) for assessment purposes. Some investigators assert that the PCL-R, ostensibly based on Cleckley's work, has "drifted" from the construct described in his Clinical Profile. We evaluate this profile, note its basis in an unrepresentative sample of patients, and suggest that its literal and uncritical acceptance by the research community has become problematical. We also argue that the idea of construct "drift" is irrelevant to current conceptualizations of psychopathy, which are better informed by the extensive empirical research on the integration of structural, genetic, developmental, personality, and neurobiological research findings than by rigid adherence to early clinical formulations. We offer some suggestions for future research on psychopathy.

There is a very large literature on the important role of psychopathy in the criminal justice system. We know much less about corporate psychopathy and its implications, in large part because of the difficulty in obtaining the active cooperation of business organizations. This has left us with only a few small-sample studies, anecdotes, and speculation. In this study, we had a unique opportunity to examine psychopathy and its correlates in a sample of 203 corporate professionals selected by their companies to participate in management development programs. The correlates included demographic and status variables, as well as in-house 360 degrees assessments and performance ratings. The prevalence of psychopathic traits-as measured by the Psychopathy Checklist-Revised (PCL-R) and a Psychopathy Checklist: Screening Version (PCL: SV) "equivalent"-was higher than that found in community samples. The results of confirmatory factor analysis (CFA) and structural equation modeling (SEM) indicated that the underlying latent structure of psychopathy in our corporate sample was consistent with that model found in community and offender studies. Psychopathy was positively associated with in-house ratings of charisma/presentation style (creativity, good strategic thinking and communication skills) but negatively associated with ratings of responsibility/performance (being a team player, management skills, and overall accomplishments).

Although a 2-factor model has advanced research on the psychopathy construct, a 3-factor model was recently developed that emphasized pathological personality and eliminated antisocial behavior. However, dropping antisocial behavior from the psychopathy construct may not be advantageous. Using a large sample of psychiatric patients from the MacArthur Risk Assessment Study (J. Monahan & H. J. Steadman, 1994), the authors used confirmatory factor analysis to test a 4-factor model of psychopathy, which included interpersonal, affective, and behavioral impulsivity dimensions and an antisocial behavior dimension. Model fit was good for this 4-factor model, even when ethnicity, gender, and intelligence variables were included in the model. Structural equation modeling was used to compare the 3- and 4-factor models in predicting proximal (violence) and distal (intelligence) correlates of psychopathy.

Numerous studies conducted with offender or forensic psychiatric samples have revealed that individuals with psychopathic traits are at risk for violence and other externalizing psychopathology. These traits appear to be continuously distributed in these samples, leading investigators to speculate on the presence of such traits in the general population. Nonetheless, few studies of psychopathy have been conducted with large random samples of individuals from the community. The community sample from the MacArthur Violence Risk Assessment Study provides an opportunity to examine the prevalence and structural nature of psychopathic traits, as well as their association with external correlates in an urban community. The community data (N = 514) represent a stratified random sample of persons between the ages of 18 and 40 who were assessed on the Psychopathy Checklist: Screening Version (PCL: SV) and also for violent behavior, alcohol use, and intellectual functioning. Structural equation model analyses revealed that a 4-factor model found in offender and forensic psychiatric samples fit the community data well and was invariant across sex and ethnicity. Also, a superordinate factor comprehensively accounted for the 4 psychopathy first-order factors and significantly predicted the external correlates. The findings offer insight into the dimensional nature of the psychopathy construct.

Current knowledge about the validity of the psychopathy syndrome in youth is limited largely to studies relying on parent-teacher rating scales or slight modifications of adult measures. Recently, the Psychopathy Checklist: Youth Version (PCL:YV) was designed for use with adolescents. However, most studies that have used this measure examined incarcerated males and addressed only validity criteria related to antisocial behavior. We investigated the generality and construct validity of the psychopathy syndrome in an adolescent sample by assessing 115 adolescent males on probation with the PCL:YV. Reliability of measurement was high. PCL:YV ratings predicted not only antisocial behaviour but also other indices of childhood psychopathology, interpersonal behaviors associated with adult psychopathy, and a lack of attachment to parents. These findings suggest that the PCL:YV identifies a syndrome in adolescence consistent with theory and research on adult males.

Psychopathy, while perhaps the earliest and most recognized personality disorder, is the subject of intense debate about its nature and measurement. The most recent proposal on its structural nature suggests that it is a multifaceted construct, made up of at least four dimensions reflecting Interpersonal, Affective, Lifestyle, and Antisocial anomalies (Hare & Neumann, 2005, 2006). These dimensions are significantly interrelated, suggesting that they are indicators for a super-ordinate factor. The nature of this higher-order factor may reflect the unifying feature which comprehensively defines the disorder. To examine this super-factor, the current study used several very large data sets of male (N = 4865) and female (N = 1099) offenders, and forensic psychiatric patients (N = 965), who were assessed with the Psychopathy Checklist-Revised (PCL-R; Hare, 2003). Structural equation modeling results indicated that the four first-order factor dimensions could be explained by a single second-order cohesive super-factor.

Psychopathy traditionally is defined by a cluster of inferred personality traits and socially deviant behaviors. The accepted standard for the reliable and valid assessment of psychopathy is the Psychopathy Checklist-Revised (PCL-R). Because of its importance in basic and applied research, and in the mental health and criminal justice systems, the PCL-R has been subjected to intense scrutiny by researchers and clinicians. In this article we discuss issues surrounding its structural properties and those of its derivatives. Using factor analysis, item response theory, and multidimensional scaling, we propose that the PCL-R and its derivatives are underpinned by at least four correlated factors: Interpersonal, Affective, Lifestyle, and Antisocial. We argue that attempts to characterize antisocial behaviors as merely "downstream" manifestations of more central traits are inconsistent with the structural properties of the PCL-R and with evidence that the development of traits and actions are interactive and reciprocal. We also report new evidence that psychopathy and its factors are dimensional in nature, perhaps extreme variants of normal personality traits and behaviors.

J. Skeem and D. J. Cooke (2010) asserted that Hare and Neumann consider criminality to be an essential component of the psychopathy construct. The assertion, presented in the guise of a debate on the nature of psychopathy, is neither accurate nor consistent with the clinical and empirical literature on psychopathy to which Hare and Neumann have contributed. Broadly defined antisociality, not criminality per se, is considered to be part of the psychopathy construct. Skeem and Cooke also expressed concerns that the popularity of the Psychopathy Checklist-Revised (R. D. Hare, 2003) inhibits the development and use of other instruments, that it has become the construct it measures, that it deviates from its clinical roots, and that it conflates criminality with personality. These and related issues are addressed, and it is suggested that the arguments proffered by Skeem and Cooke are not convincing, nor do they provide clear directions for theory and research.