Assessing the relevance of self-reported ADHD symptoms and cognitive functioning for psychopathy using the PCL-R and the TriPM

Abstract

Psychopathy and ADHD are highly comorbid disorders, possibly linked to the underlying trait of impulsivity. It is therefore likely that ADHD symptoms are also of importance when studying cognitive functioning linked to psychopathy. Few studies of psychopathy and cognitive functioning have taken ADHD symptoms into account. In this cross-sectional study, male offenders (n = 201 of whom 105 were neuropsychologically tested) were recruited from all high security correctional facilities in Sweden. The aim of the study was to investigate if self-reported ADHD symptoms and cognitive functioning could predict specific subcomponents of psychopathy in offenders. Results showed that self-rated ADHD symptoms (ASRS) and psychopathy were highly correlated. Furthermore, the associations of ASRS and PCL-R Facet 3, as well as TriPM Disinhibition, were remarkably high. As expected, ASRS was not related to either Facet 1 or 2 of the PCL-R, or to TriPM Boldness. Cognitive functioning did not contribute in predicting psychopathy beyond the effect of ASRS. The high overlap in reported symptoms highlights the importance of thorough clinical assessments to be able to distinguish psychopathic personality traits from ADHD and lessen the risk of misdiagnosis. Further, it points to the need of finding discriminative measures possibly linked to etiological underpinnings.

Do Triarchic Psychopathy Components of New Zealand High-Risk Parolees Predict Probation Officer Relationship Quality, Quality of Life on Parole, and Recidivism?

“…Previous research with correctional and forensic samples has reported a wide range of scores on the TriPM subscales. Our scores appear to be high relative to most previous samples (e.g., Dargis et al, 2022; Pauli et al, 2019; Wall et al, 2015; Weidacker et al, 2017), especially for Disinhibition where they are about twice the level reported for several samples, but similar to the Salcido et al (2019) community re-entry sample. High levels of PCL-psychopathy are a feature of high-risk prisoner samples, a finding that is to be expected given that the PCL-R is widely used to predict criminal risk (Douglas et al, 2018).…”

Investigating the Validity Evidence of the Swedish TriPM in High Security Prisoners Using the PCL-R and NEO-FFI

“…However, other disorders characterized by reduced impulse control, such as attentiondeficit hyperactivity disorder (ADHD), are also linked to delinquent behavior and criminality (36). In a previous report from the current sample we found that primarily TriPM Disinhibition, but also Meanness, were independently associated to self-reported ADHD symptoms (37). Nonetheless, as the overlap was quite salient, we concluded that the Disinhibition scale in particular was not adequately distinguishable from selfreported ADHD symptoms in offenders.…”

“…The latter is a feature not paired with psychopathy in general, but which is often discussed in terms of secondary psychopathy [e.g., (57)]. A potential explanation may stem from the overlap between TriPM Disinhibition and ADHD symptoms, which has previously been discussed in regards to the current sample of prison inmates (37). A previous study by Retz et al (58) found that ADHD and psychopathy assessed with PCL:SV among offenders were clearly separable constructs, though they intersect in regards to the items that measure impulsive behavior in their respective diagnostic instruments.…”

“…The participants were male offenders recruited from all seven high security prisons in Sweden, as previously described in Pauli et al (37). As the subjects were also part of a genetic study, all participants were of Swedish ethnicity.…”

Triarchic traits as risk versus protective factors for ADHD symptomatology: A prospective longitudinal investigation

“…The present study is the first to evaluate contributions of all three triarchic neurobehavioral traits (boldness, meanness, and disinhibition) to the persistence and severity of ADHD symptoms. Prior studies examining the triarchic traits in relation to ADHD have focused on disinhibition and meanness (or callousunemotionality), finding disinhibition to be associated with general proneness to externalizing problems (Dotterer et al, 2017;Yancey et al, 2013) including ADHD (Palumbo et al, 2021;Pauli et al, 2019;Perkins et al, 2022;Young et al, 2000Young et al, , 2009, and meanness to be related robustly to antisocial expressions of externalizing but less or negligibly to ADHD (Palumbo et al, 2021;Perkins et al, 2022;Sica et al, 2020). Preliminary evidence for a significant but weak association of boldness with fewer ADHDrelated problems was reported in two prior cross-sectional studies of children and adolescents (Palumbo et al, 2021;Sica et al, 2020).…”