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Objectives: Psychopathy is a distinct personality organization and differs from antisocial personality disorders in many aspects. Its diagnosis is challenging but also critical to predict criminality. In this context, Psychopathy Checklist Revised (PCL-R) is a useful tool in the diagnosis of psychopathy. Its reliability and validity was shown in various populations but has not been studied in a Turkish population. Our aim was to demonstrate the reliability and validity of PCL-R in a sample from Turkey. Methods: 425 male subjects with antisocial personality disorder and 125 controls without any psychiatric diagnoses were included in the study. DSM-5 diagnostic criteria were used and PCL-R was administered to all participants. The reliability of the Turkish version of PCL-R was determined by test-retest and internal consistency methods. In the ROC analysis performed with PCL-R, DSM-5 criteria were taken as a gold standard, the sensitivity; specificity and cutoff values of PCL-R were estimated. To evaluate the adequacy of the scale construct validity, Exploratory Factor Analysis and Kaiser-Meyer-Olkin (KMO) and Barlett tests were applied. Reproducibility of the test was evaluated by Pearson correlation coefficient. Re-testing was performed with 171 subjects two weeks after the first test. Results: In reliability analysis, the Cronbach's alpha internal consistency coefficient was calculated to be α=0.977. Pearson correlation coefficient of test-retest was r=0.94 (p<.001). Item-total correlations ranged from 0.18 to 0.94. Its sensitivity and specificity was 98.3% and 100.0%, respectively, with a cutoff point of 20. In principal component analysis, two factors had Eigen values greater than 1. These two factors accounted for 76.54% of the variance in PCL-R scores. Conclusions: Turkish PCL-R is a valid and reliable measure of psychopathy to detect psychopathic traits. However, more studies on psychopathy need to be conducted in different Turkish sample groups.

As ACC plays an important role in decision-making and emotional information processing, we postulate that the lower NAA/Cr ratio, suggesting impaired neural integrity, may increase the severity of interpersonal/affective problems of the psychopathy factor in male subjects exhibiting APD, high psychopathy overall scores and violent crimes.

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