As measured with the Psychopathy Checklist-Revised (PCL-R), psychopathy is a dimensional construct underpinned by 4 correlated factors: Interpersonal, Affective, Lifestyle, and Antisocial. Theorists and clinicians (e.g., Karpman and Arieti) have posited 2 variants of "primary" or "true" psychopathy, both distinct from so-called "secondary" or "pseudopsychopathy." We used latent profile analysis to determine if homogeneous classes exist within a sample of 1,451 male offenders with high PCL-R scores (≥ 27). The 4 PCL-R factors were the dependent variables for clustering. A solution with 3 latent classes showed a better fit to the data than did a unitary model without latent classes. Tentative labels for the latent classes are Manipulative (Latent Class 1 [LC1]), Aggressive (Latent Class 2 [LC2]), and Sociopathic (Latent Class 3 [LC3]). The latter class represented an antisocial group that lacked the emotional detachment observed in the other 2 groups. We propose that LC1 and LC2 reflect phenotypic variations on a theme of the traditional construct of psychopathy, and that LC3 is consistent with conceptions of antisocial personality disorder and sociopathy. Replication and external classification with an independent data set of 497 adult male offenders again yielded clearly separable clusters, as well as meaningful differences or trends among latent classes on education, intelligence, symptoms of antisocial personality disorder, and self-reported psychopathic traits and negative affect. The conceptualization of psychopathy in terms of manipulative and aggressive variants is consistent with clinical theory and is empirically grounded.

The aim of this study was to contribute to the characterization of the entactogen (ecstasy) substance group. The psychopathological, neuroendocrine and autonomic effects of common recreational doses of the entactogen 3,4-methylenedioxyethylamphetamine (MDE), the hallucinogen psilocybin, the stimulant d-methamphetamine and placebo were investigated in a double-blind study with healthy volunteers (n = 32). Psychological effects of the drugs were assessed by means of standardized rating scales, self assessment inventories and free descriptions. The most characteristic effects of MDE were pleasant emotional experiences of relaxation, peacefulness, content and closeness to others. However, significant stimulant and hallucinogen-like effects were also present, although the latter were weaker than the effects of psilocybin. MDE elicited the strongest endocrine and autonomic effects among the three drugs, including robust rises of serum cortisol and prolactin, elevations of blood pressure and heart rate, and a moderate, but significant rise of body temperature. The apparent contrast between psychological and autonomic effects (subjective relaxation versus physical activation) was a unique feature of the MDE state. Our findings are in line with both users' reports and results from previous experimental studies, and support the view that entactogens constitute a distinct psychoactive substance class taking an intermediate position between hallucinogens and stimulants.

The conflicting reports and diagnoses presented by forensic psychiatrists at the trial of Anders Breivik did not address the threat posed by him prior to his crimes, that is, the warning behaviors that were evident that may have indicated accelerating patterns of risk during the period prior to his attacks on July 22, 2011. In this case study, the authors analyze his activities and mental state through the lens of 8 warning behaviors that may indicate proximal and dynamic patterns of risk for targeted violence: pathway, fixation, identification, novel aggression, energy burst, leakage, last resort, and directly communicated threats. Breivik was positive for 6 of these warning behaviors. Although such superordinate patterns have yet to be shown to predict targeted violence, and may be very difficult "signals" to detect amid the "noise" of other cases, they may prove more useful in the threat assessment of such targeted or intended violence toward others than the accuracy of psychiatric diagnosis, whether a personality disorder or a mental illness; the latter is most germane to the threat management of the case. Such warning behaviors, although etiologically nonspecific, are discussed in the context of current attempts to validate these dynamic patterns of concern to threat assessors.

Previous studies associated psychopathy in adults with deficits in empathy but these studies did not directly compare cognitive and emotional facets of empathy. The present study sought to establish whether psychopathy is associated with impairments in emotional empathy among adult offenders. Participants were 90 male offenders scoring low (n = 29), medium (n = 33) or high (n = 28) on the Psychopathy Checklist-Revised (PCL-R) and n = 28 male noncriminal controls. Empathy functioning was assessed through self-report and computerized decision tasks, differentiating between perspective-taking (cognitive empathy) and compassion (emotional empathy). Against expectations, level of psychopathy among the offenders was not associated with either emotional or cognitive empathy. Offenders however had lower scores for both cognitive and emotional components of empathy functioning than controls. Both facets of empathy showed small but significant positive correlations with education level and social desirability. The methods employed to assess differences in empathy functioning may not be sensitive enough to assess differences in forensic samples.