The relationships of psychopathy, therapeutic change, and violent recidivism were examined in a sample of 152 high-risk violent offenders treated in a high-intensity violence reduction program at the Regional Psychiatric Centre (RPC) in Saskatoon, SK. The Violence Risk Scale (VRS; Wong & Gordon, 1999-2003) and Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003) were rated on the sample. As an extension on a prior psychometric study of the VRS (Lewis, Olver, & Wong, 2012), the associations of therapeutic change scores, obtained from pre- and posttreatment ratings of VRS dynamic items, and violent recidivism were examined among high-risk psychopathic offenders (mean PCL-R >25) over approximately 5 years' follow-up. Positive therapeutic change correlated negatively with the PCL-R, particularly Factor 1 and the Affective facet, and was significantly associated with reductions in violent recidivism after controlling for psychopathy. The association of change to violent outcome decreased, however, when controlling for the Affective facet. Taken together, the present results suggest that risk-related treatment changes demonstrated by high-risk psychopathic offenders can be predictive of reductions in violent recidivism, and that reliable measurements of therapeutic change may be informative about treatment outcome in a high-risk violent offender group.

Psychopathy, a personality disorder, is characterized by dysfunctional and externalizing affective and interpersonal traits that can be manifested as violent and antisocial behaviors. Psychopathic individuals are often referred for treatment in criminal justice or forensic mental health settings to reduce the harm they may inflict on themselves and others. While the 'what works' treatment approaches to reduce recidivism and violence have enjoyed widespread support, therapeutic nihilism for psychopathy abounds. A two-component model is proposed to provide a conceptual framework for the treatment of psychopathy. Three studies on the treatment of psychopathic offenders to reduce violence and offending behaviors are reviewed and show positive treatment outcomes. The study results support the efficacy for the treatment of psychopathic individuals and for the proposed model.

The Violence Risk Scale (VRS) uses ratings of static and dynamic risk predictors to assess violence risk, identify targets for treatment, and assess changes in risk following treatment. The VRS was rated pre- and posttreatment on a sample of 150 males, mostly high-risk violent offenders many with psychopathic personality traits. These individuals attended a high-intensity institution-based cognitive-behavioral-oriented violence reduction treatment program in Canada and were then followed up for approximately 5 years postrelease to determine court adjudicated community violent recidivism. VRS scores significantly predicted violent recidivism. Measurements of risk reduction using dynamic VRS predictors were significantly correlated with reduction of violent recidivism after controlling for various potential confounds. The results suggest that, in a high-risk group of offenders with significant psychopathic traits, the VRS demonstrated predictive validity and the dynamic predictors can be used to assess treatment progress, which is linked to a specific criterion variable, thus, fulfilling the criteria for causal dynamic predictors set forth by Kraemer et al.

The present study is a cluster analytic examination and validation of psychopathic offender subtypes from 4 combined samples of Canadian federally incarcerated offenders, most of whom were serving sentences for violent offenses. The men were rated on the Hare Psychopathy Checklist-Revised (PCL-R; Hare, 1991, 2003) on the basis of comprehensive file information and 314 cases were extracted using a PCL-R total cut score of 25. Cluster analysis of the 4 PCL-R facets converged at a 2-cluster solution: a primary subtype characterized by prominent interpersonal and affective features of psychopathy and a secondary subtype characterized by comparatively few interpersonal features and high scores on the remaining facets. Validation analyses found that the vast majority of primary psychopathic offenders (74.1%) were White or of non-Aboriginal descent in contrast to the secondary subtype (47.6%). Secondary psychopathic offenders tended to be actuarially higher risk, have greater criminogenic needs, and to make greater amounts of treatment change on criminogenic targets; however, contrary to expectations, within-treatment changes from a violence reduction program were significantly associated with reductions in violent recidivism for primary, but not secondary, variants. There were few differences in rates of recidivism between the groups overall; secondary variants had higher rates of sexual violence which was largely accounted for by individual differences in baseline static risk. Implications for risk assessment, treatment planning, and the classification and etiology of primary and secondary psychopathy are discussed.

The present study examined the psychometric properties of Hare Psychopathy Checklist-Revised (PCL-R; Hare, 2003) scores in a multisite sample of 1,163 federally incarcerated Canadian indigenous and non-indigenous offenders from the Prairie Region of the Correctional Service of Canada. The research occurred against the backdrop of the Ewert v. Canada (2015) matter, in which the PCL-R was originally impugned in Federal Court for use with indigenous persons (later overturned in Canada v. Ewert, 2016). Indigenous men scored higher than non-indigenous men on most components of the PCL-R and had higher rates of recidivism, irrespective of follow-up. Discrimination analyses, however, supported the predictive efficacy of PCL-R total, factor, and facet scores for violent and general recidivism across both ancestral groups, with most group differences in area under the curve (AUC) magnitudes being small and nonsignificant. Calibration analyses demonstrated that higher PCL-R scores were associated with higher rates of general and violent recidivism for both ancestral groups, although higher recidivism rates were observed and estimated for indigenous men at specific PCL-R score thresholds. Confirmatory factor analyses supported the 4-factor model of psychopathy and hence, structural invariance, of PCL-R scores across ancestral groups. Structural equation modeling affirmed the predictive efficacy of the 4-factor model for recidivism. We discuss these findings in terms of clinical applications of the PCL-R and the psychopathy construct in general, with male offenders of indigenous ancestry. (PsycINFO Database Record