Treatment Responsiveness of Replicated Psychopathy Profiles

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Abstract

Theory and accumulating data suggest systematic heterogeneity among offenders with psychopathic traits. Several empirical investigations converge on the nature of subtypes, but little is known about differences in treatment responsivity. We have used the 4-facet model of the Psychopathy Checklist–Revised (PCL-R) to provide a framework for detecting subtypes. The present study used the full range of PCL-R scores in a sample of male violent offenders (N = 190) to replicate subtypes found in a partly overlapping sample by Neumann, Vitacco, and Mokros (2016), using Latent Profile Analysis (LPA), and subsequently to examine potential differences in treatment responsivity. Four subtypes emerged. Within the prototypical psychopathic group, the distinction between intent-to-treat and completers was crucial. Prototypical psychopathic offenders were significantly more likely to drop out, but completers appeared to proceed through the different phases of treatment in much the same way as the other groups. Clearly, more research is needed to elucidate treatment interfering mechanisms and their associated patient characteristics, particularly for the prototypical psychopathic group. Developing therapeutic strategies to improve treatment compliance is a necessary step in the development of specialized treatment programs for these difficult patients.

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