Psychopathic Personality
Psychopathic Personality
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精神病态人格
DOI：
--
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发表时间：
2011
影响因子：
25.4
通讯作者：
S. Lilienfeld
中科院分区：
文献类型：
--
作者：
Jennifer L Skeem;D. Polaschek;C. Patrick;S. Lilienfeld
很少有心理学概念能像精神病人格或精神病一样同时引起如此多的迷恋和误解。通常，精神病患者被误解为与人类其他部分根本不同，并且是不可改变的危险。流行的对“精神变态者”的描述是多种多样且相互矛盾的，从异常冲动和暴力的罪犯到冷酷而巧妙地操纵自己通往社会阶梯最高阶梯的企业人物。尽管观点多样，但近年来，一种行之有效的精神病测量方法——精神病检查表修订版（PCL-R; Hare, 1991; 2003）已经主导了临床和法律实践。PCL-R的项目涵盖了两个基本内容领域——人际情感领域，包括冷酷无情和操纵性等核心特征；反社会领域，包括去抑制和慢性反社会行为。在大多数西方国家，PCL-R及其衍生品通常应用于刑事罪犯的法律决定，这些决定取决于危险和可治疗性问题。事实上，在很多情况下，临床医生选择PCL-R，而不是其他专门设计的风险评估工具，以告知他们对罪犯应该受到什么样的判决，他们是否应该作为“危险罪犯”或“性暴力侵犯者”无限期监禁，或者他们是否应该从少年法庭转到成人法庭。在过去的三十年里，PCL-R在研究和实践中发挥了非凡的生成作用，以至于人们开始担心，在许多人的脑海中，这种测量方法已经等同于精神病构建本身（Skeem & Cooke 2010a）。将测量等同于概念可能会阻碍科学进步，因为它忽视了基本原则，即测量总是不能完美地操作概念，我们对概念的理解是不断发展的（Cronbach & Meehl, 1955）。实际上，在任何领域中，构造验证过程都是一个渐进的过程，在澄清假设实体的性质和边界的过程中，需要在概念化和测量的连续点上进行转换。尽管近年来PCL-R测量模型占主导地位，但关于什么是精神病和什么不是精神病的激烈科学辩论仍在继续。适应性、积极调节特征（一方面）和犯罪和反社会行为（另一方面）是否应被视为该结构的基本特征？那些被PCL-R和其他测试确定为精神病患者的焦虑和情绪反应的人真的是精神病患者吗？更根本的是，精神病是一个单一的实体（即，一个具有离散的潜在原因的整体综合征），还是它是几个可区分但交叉的特征维度的配置？虽然这些和其他争议仍未解决，但关于PCL-R和替代测量的理论和研究已经开始澄清精神病结构的范围和边界。在当前的综合综述中，我们提供了一个综合的描述框架——三分结构模型——以帮助读者理解不同的概念。该模型的精髓在于，对精神病的不同观点在不同程度上强调了三种不同的可观察到的（表型）特征：大胆（或无所畏惧的支配）、卑鄙和去抑制。三重结构框架有助于澄清和协调看似不同的历史概念、现代操作方法和当代精神病研究项目。我们的综述讨论了什么是精神病，是否存在变异或亚型（即原发性和继发性，不成功和成功），导致精神病的各种因果影响，如何在发展早期有效地识别精神病，以及精神病如何与未来的犯罪行为和治疗结果相关。尽管这些主题都存在争议和固有的细微差别，但科学知识的现状对公共政策有着明确的影响。政策领域包括精神病患者是否应该为他们的犯罪行为负责，以及雇主是否应该筛选求职者是否有精神病倾向。在许多情况下，我们回顾的研究结果汇集在一起，挑战了支撑现代精神病测量应用的普遍假设，并呼吁在使用这些假设时要谨慎。例如，包括PCL-R在内的当代精神病测量方法，似乎表明在预测暴力或其他犯罪方面没有特殊的能力。相反，它们的预测性与专门设计的暴力风险评估工具差不多，也许是因为它们评估的许多风险因素与那些宽带工具相同。具体而言，PCL-R和其他精神病测量方法的预测效用主要来自反社会和去抑制倾向的“因子2”评估；这些测量的“因素1”部分，反映了更具体的精神病态的人际和情感特征，最多只能起到很小的预测作用。同样，目前对精神病的测量似乎也不能缓和治疗对暴力和其他犯罪行为的影响。也就是说，越来越多的研究表明，精神病患者并不是唯一的应该被取消治疗资格的“无望”病例，而是一般的“高风险”病例，需要针对这些病例进行强化治疗，以最大限度地提高公共安全。专业人士对在PCL-R等测试中获得高分的个人的犯罪倾向和可治疗性一直存在误解，他们以刻板的方式解释这些高分，而不考虑细微差别或异质性问题。我们回顾的一个关键信息是，经典精神病，无论是用PCL-R还是其他方法来衡量，都不是单一的；相反，它代表了多种特征的集合，这些特征可能在不同程度上包括大胆、吝啬和去抑制的表型域。诸如PCL-R之类的测试不能直接评估低焦虑、无所畏惧或大胆的特征，更广泛地倾向于将个体的异质亚群识别为精神病患者。因此，对精神病患者实行一刀切的公共政策的努力可能注定要失败。总的来说，这些结论可能有助于阐明什么是精神病，什么不是精神病，并指导政策干预，以改善公共卫生和公共安全。语言:在
Few psychological concepts evoke simultaneously as much fascination and misunderstanding as psychopathic personality, or psychopathy. Typically, individuals with psychopathy are misconceived as fundamentally different from the rest of humanity and as inalterably dangerous. Popular portrayals of "psychopaths" are diverse and conflicting, ranging from uncommonly impulsive and violent criminal offenders to corporate figures who callously and skillfully manuever their way to the highest rungs of the social ladder. Despite this diversity of perspectives, a single well- validated measure of psychopathy, the Psychopathy Checklist-Revised (PCL-R; Hare, 1991; 2003), has come to dominate clinical and legal practice over recent years. The items of the PCL-R cover two basic content domains--an interpersonal-affective domain that encompasses core traits such as callousness and manipulativeness and an antisocial domain that entails disinhibition and chronic antisocial behavior. In most Western countries, the PCL-R and its derivatives are routinely applied to inform legal decisions about criminal offenders that hinge upon issues of dangerousness and treatability. In fact, clinicians in many cases choose the PCL-R over other, purpose-built risk-assessment tools to inform their opinions about what sentence offenders should receive, whether they should be indefinitely incarcerated as a "dangerous offender" or "sexually violent predator," or whether they should be transferred from juvenile to adult court. The PCL-R has played an extraordinarily generative role in research and practice over the past three decades--so much so, that concerns have been raised that the measure has become equated in many minds with the psychopathy construct itself (Skeem & Cooke 2010a). Equating a measure with a construct may impede scientific progress because it disregards the basic principle that measures always imperfectly operationalize constructs and that our understanding of a construct is ever-evolving (Cronbach & Meehl, 1955). In virtually any domain, the construct-validation process is an incremental one that entails shifts in conceptualization and measurement at successive points in the process of clarifying the nature and boundaries of a hypothetical entity. Despite the predominance of the PCL-R measurement model in recent years, vigorous scientific debates have continued regarding what psychopathy is and what it is not. Should adaptive, positive-adjustment features (on one hand) and criminal and antisocial behaviors (on the other) be considered essential features of the construct? Are anxious and emotionally reactive people that are identified as psychopaths by the PCL-R and other measures truly psychopathic? More fundamentally, is psychopathy a unitary entity (i.e., a global syndrome with a discrete underlying cause), or is it rather a configuration of several distinguishable, but intersecting trait dimensions? Although these and other controversies remain unresolved, theory and research on the PCL-R and alternative measures have begun to clarify the scope and boundaries of the psychopathy construct. In the current comprehensive review, we provide an integrative descriptive framework--the triarchic model--to help the reader make sense of differing conceptualizations. The essence of this model is that alternative perspectives on psychopathy emphasize, to varying degrees, three distinct observable (phenotypic) characteristics: boldness (or fearless dominance), meanness, and disinhibition. The triarchic framework is helpful for clarifying and reconciling seemingly disparate historical conceptions, modern operationalizations, and contemporary research programs on psychopathy. Our review addresses what psychopathy is, whether variants or subtypes exist (i.e., primary and secondary, unsuccessful and successful), the sorts of causal influences that contribute to psychopathy, how early in development psychopathy can validly be identified, and how psychopathy relates to future criminal behavior and treatment outcomes. Despite controversies and nuances inherent in each of these topics, the current state of scientific knowledge bears clear implications for public policy. Policy domains range from whether psychopathic individuals should be held responsible for their criminal actions to whether employers should screen job candidates for tendencies toward psychopathy. In many cases, the findings we review converge to challenge common assumptions that underpin modern applications of psychopathy measures and to call for cautions in their use. For example, contemporary measures of psychopathy, including the PCL-R, appear to evidence no special powers in predicting violence or other crime. Instead, they are about as predictive as purpose-built violence-risk-assessment tools, perhaps because they assess many of the same risk factors as those broader-band tools. Specifically, the PCL-R and other psychopathy measures derive most of their predictive utility from their "Factor 2" assessment of antisocial and disinhibitory tendencies; the "Factor 1" component of such measures, reflecting interpersonal and affective features more specific to psychopathy, play at best a small predictive role. Similarly, current measures of psychopathy do not appear to moderate the effects of treatment on violent and other criminal behavior. That is, an increasing number of studies suggest that psychopathic individuals are not uniquely "hopeless" cases who should be disqualified from treatment, but instead are general "high-risk" cases who need to be targeted for intensive treatment to maximize public safety. Misunderstandings about the criminal propensities and treatability of individuals achieving high scores on measures like the PCL-R have been perpetuated by professionals who interpret such high scores in a stereotypic manner, without considering nuances or issues of heterogeneity. A key message of our review is that classical psychopathy, whether measured by the PCL-R or other measures, is not monolithic; instead, it represents a constellation of multiple traits that may include, in varying degrees, the phenotypic domains of boldness, meanness, and disinhibition. Measures such as the PCL-R that do not directly assess features of low anxiety, fearlessness, or boldness more broadly tend to identify heterogeneous subgroups of individuals as psychopathic. As a consequence, efforts to apply one-size-fits-all public policies to psychopathic individuals may be doomed to failure. In aggregrate, these conclusions may help to shed light on what psychopathy is, and what it is not, and to guide policy interventions directed toward improved public health and public safety. Language: en
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影响因子：
2.7
作者：
D. Schneider;S. Madon;James A. Stoeckel;R. Sparks
通讯作者：
D. Schneider;S. Madon;James A. Stoeckel;R. Sparks
自然的选择性关注：定向和情感。
影响因子：
3.7
作者：
Bradley MM
通讯作者：
Bradley MM
犯罪精神病患者的情绪：惊吓反射调制。
影响因子：
4.6
作者：
Patrick,CJ;Bradley,MM;Lang,PJ
通讯作者：
Lang,PJ
提高结构有效性：Cronbach、Meehl 和 Neurath 的船。
DOI：
10.1037/1040-3590.17.4.409
发表时间：
2005
期刊：
Psychological assessment.
影响因子：
--
作者：
Westen,Drew;Rosenthal,Robert
通讯作者：
Rosenthal,Robert
注意力集中条件下的精神病和双重任务表现。
影响因子：
4.6
作者：
Kosson,DS
通讯作者：
Kosson,DS